bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vitro Characterization of Polyethyleneimine–Oleic Acid Cationic Micelle as a Novel Protein Carrier
Authors: Sabzehei Faezeh , Taromchi Amir Hossein , Danafar Hossein , Rashidzadeh Hamid , Ramazani Ali 
Published: October 2023

Background:
Nanotechnology has introduced valuable carriers for vaccine delivery. The success of vaccination depends on many factors, such as the intact and safe presentation of vaccine candidates to immune cells. We have conjugated branched PEI-2k and oleic acid (OL) as the building block of the cationic micelle. We aimed to introduce a novel carrier for vaccine candidates.

Materials and Methods:
We conjugated polyethyleneimine and OL (POA) to synthesize the building blocks of cationic micelles. The critical micelle concentration (CMC), size and zeta potential of micelles, and their stability in 60 days were determined. Loading, encapsulation efficiency, and in vitro release study were assessed using bovine serum albumin (BSA) as a protein model. Furthermore, the cytotoxicity and hemocompatibility of developed nanosized micelles were evaluated to ascertain the biocompatibility of fabricated micelles. Cell uptake of cationic micelles in the macrophage cell line was also followed up.

Results:
The conjugation of two polymer parts was confirmed by Fourier transform infrared spectroscopy and 1H nuclear magnetic resonance techniques. The CMC of the developed micelles was around 5.62 × 10 − 8 mg/ml, whereas the loading and encapsulation efficiencies were 16.5% and 70%, respectively. The size and zeta potential of the cationic micelles were 96.53 ± 18.53 nm and 68.3 mV, respectively. The release of BSA from POA micelles after 8 and 72 hours was 8.5% and 82%, respectively. Finally, fluorescence microscopy showed that the prepared micelles were successfully and effectively taken up by RAW264.7 cells.

Conclusion:
These results may provide a cutting-edge vaccine delivery solution and open up a new avenue for future vaccine research.
Comparative Study of the Effect of Vaginal Use of Primrose Oil with Misoprostol on Cervical Preparation of Prim Gravid Women: A Double-Blind Clinical Trial
Authors: Danesh Shahraki Azar , Mirhoseini Sara , Movahedi Minoo , Hajihashemy Maryam , Haghollahi Fedyeh 
Published: October 2023

Background:
This study compares the effect of vaginal administration of evening primrose oil with misoprostol on cervical preparation in prim gravid women at ≥40 weeks gestation.

Materials and Methods:
This was a double-blind randomized clinical trial conducted in Isfahan, Iran during 2019-2020 on 110 prim gravid pregnant women with a gestational age of 40 weeks and more and cephalic presentation of the fetus with the obstetrical indication for pregnancy termination. After obstetric examinations to rule out cephalo pelvic disproportion and calculation of the Bishop score by the researcher, patients were randomized to receive 25 μg misoprostol tablets (n = 55) or 1000 mg evening primrose oil Pearls (n = 55) administrated vaginally by a midwife. We compared Bishop's score before and after the intervention, time of cervical ripening, a dose of intervention for cervical ripening, need to induce labor, the interval between cervical preparation and induction of labor, duration of oxytocin use, need for cesarean section, and its cause, Apgar score at 5 and 10 minutes, neonatal birth weight.

Results:
Mean baseline Bishop Score was not significant between the groups (P = 0.45); after the intervention, it was significantly higher in the primrose oil group (P < .001). Significantly fewer patients required cesarean sections in the primrose oil group (P = 0.03). The other outcomes were. not significant between the groups (P > 0.05).

Conclusion:
Misoprostol and primrose oil administration appear to positively affect cervical readiness. Primrose oil resulted in significantly better Bishop Scores and fewer cesarean sections compared to misoprostol in pregnancy 40 weeks and more.
Comparing the effectiveness of cognitive behavioral group therapy and mindfulness and acceptance group therapy for adults who stutter: A randomized clinical trial
Authors: Khoshnam Soroush , Gharraee Banafsheh , Ashouri Ahmad 
Published: October 2023

Background:
Considering the importance of psychological interventions for adults who stutter (AWS), the present study compared the effectiveness of Cognitive Behavioral Group Therapy (CBGT) and Mindfulness and Acceptance Group Therapy (MAGT), in combination with Speech Therapy (ST) in AWS.

Materials and Methods:
A randomized clinical trial was conducted with 36 AWS in Tehran and Alborz provinces in Iran from September-2019 to September-2020. Participants were assigned to CBGT + ST and MAGT + ST groups. Outcomes variables, the fear of negative evaluation scale (FNE) and the social avoidance and distress scale (SAD), were measured at four stages: (1) pretest, (2) after MAGT/CBGT, (3) after ST, and (4) at 6-month follow-up.

Results:
The results of repetitive measure-analysis on variance showed that CBGT + ST and MAGT + ST were significantly effective (P = 0.001 and P = 0.003) on SAD. The same analysis showed that CBGT + ST was significantly effective (P = 0.001) on FNE. The results of Analysis of Covariance showed that there was no significant difference between CBGT + ST and MAGT + ST on SAD but CBGT + ST was more effective than MAGT + ST at stage 3 (P < 0.05) on FNE.

Conclusion:
Data indicated that CBGT + ST and MAGT + ST were both effective for SAD of AWS. Regarding FNE, unlike MAGT + ST, CBGT was effective either alone or in combination with ST for AWS. Further studies are needed to confirm the results of this study.
Evaluating Daily Cell-Phone Use in Elderly and Its Effect on Lifestyle, Isfahan Comprehensive Health Care Centers
Authors: Amini Pozveh Zahra , Shariat Ashkan , Tavakoli Moghadam Neda 
Published: October 2023

Background:
The seniors' lifestyle is an important public-health issue. Hence, assessing the association of cell phone use as a rapidly spreading technology on older adults' lifestyle can be useful for planning prevention and health-promotion policies.

Materials and Methods:
This cross-sectional study was conducted from March 2020 to March 2021 in Isfahan Comprehensive Health Care Centers to investigate the impact of cell phone use on the lifestyle of the elderly. The Cell-Phone Over-Use Scale and the lifestyle checklist were the assessment tools employed for this purpose.

Results:
Of the 300 participants with a mean age of 67.93 ± 5.14 years, 46% were male and 54% female. The average value of cell phone usage score was 47.88 ± 26.56, which was categorized into low 36%, moderate 41%, and overuse 23%. A positive and significant correlation was reported between the level of cell phone use in males (β =10.711, [0.95 confidence interval {CI} =4.262–17.160]) and people who have used a substance or opium in the past year (β =10.819, [0.95 CI = 3.677–17.961]). The present results found no significant association between cell phone use patterns and age, level of education, body mass index, television time, sports time, smoking in the past year, marital relationship, and living alone.

Conclusion:
In this study, we demonstrated a correlation between cell phone use and some demographic and lifestyle variables, namely sex and drug abuse.
Early Vitrectomy: An Effective Treatment for Acute Postcataract Surgery Endophthalmitis
Authors: Fazel Najafabadi Farhad , Salehi Ali , Vaezi Mohammad Hadi , Ghanbari Heshmatollah , Fazel Najafabadi Mohamadreza , Koosha Nima , Jafarzadeh Zahra 
Published: October 2023

Background:
Endophthalmitis is a rare but a high morbid complication after cataract surgery, and a gold standard treatment is not recommended yet. In this study, we aim to evaluate the effect of early vitrectomy on the visual acuity of patients with postcataract endophthalmitis.

Materials and Methods:
This study was a single-arm clinical trial on 27 patients with postcataract surgery endophthalmitis. Early vitrectomy was the intervention. Visual acuity as the primary outcome was evaluated and compared at baseline, at discharge, and 1 and 3 months after the intervention.

Results:
From 27 patients who included in our study, six patients gain favorable visual acuity of 5/10 and above (success rate = 22%), and four of them have no improvement in their visual acuity. Retinal detachment was reported as a complication in just one case. Negative culture was a predictor for success in terms of visual acuity after the surgery. All patients who gain favorable results, presented in the first 15 days after the cataract surgery.

Conclusion:
The result of our study showed that, considering complete, early vitrectomy for the treatment of postcataract surgery endophthalmitis, especially for those who presented in the first 15 days of cataract surgery and for those who have negative culture is promising.
The Efficacy of Ropivacaine 0.5% in Transversus Abdominis Plane Block to Relieve the Postoperative Pain of Female Laparoscopic Surgery Grade II
Authors: Rouholamin Safoura , Ghahiri Ataollah , Dehghan Khalili Banafsheh 
Published: October 2023

Background:
The aim of this study was determination of the effect of the transversus abdominis plane block (TAP block) with ropivacaine 0.5% in relieving postoperative pain after laparoscopic gynecologic surgery.

Materials and Methods:
The population of the double-blinded clinical trial study included 200 women candidates for elective laparoscopic gynecologic surgery who referred to Al-Zahra and Beheshti hospitals in Isfahan during 2016–2018. In the TAP block group in addition to standard general anesthesia, an anesthetic drug Ropivacaine (Naropin, 0.5%) was injected at a dose of 0.5 mg/kg between transverse abdominal muscle and internal oblique muscle facia. And in control group just received standard general anesthesia. Hence, the severity of pain and nausea and vomiting is recorded at the time of recovery, at 30 min, 2, 4, 6, 12, and 48 h after the surgery.

Results:
The results of this study showed that in all periods of time (30 min, 2, 4, 6, 12, 24, 36, and 48 h after the surgery), mean pain score in TAP block group was lower than control group (P < 0.001). Hence that, in the 48 h after the surgery, the pain score in the TAP block group with a mean of 0.46 ± 0.50 was significantly lower than the control group with a mean of 1.06 ± 0.68 (P < 0.001). Nausea and vomiting between the two groups were no significant differences. There was no decrease in narcotic use or length of stay among those who received the TAP block.

Conclusions:
TAP block with ropivacaine 0.5% had a significant role in reducing postoperative pain of laparoscopic surgery.
The Effect of COVID-19 Pandemic on the Characteristics of Pediatric Supracondylar Fracture
Authors: Sabaghzadeh Amir , Bonakdar Sona , Ebrahimpour Adel , Khoshkholghsima Maryam , Gorji Mona , Soufiabadi Kamand , Gholipour Morteza 
Published: October 2023

Background:
Environmental factors play a key role in the occurrence of pediatric supracondylar humerus (SH) fracture which has been widely affected by the COVID-19 pandemic and the measures taken to curb its spread. In this study, we aim to investigate the ultimate impact coronavirus pandemic has had on SH fractures in children.

Materials and Methods:
This retrospective cohort study compares SH fractures which occurred during the pandemic with their prepandemic counterpart in a pediatric trauma public hospital. Patient's data, submitted from February to July 2020 and 2019, were collected and divided into two groups based on fractures’ time of occurrence, i.e., during or before the pandemic.

Results:
There was no significant difference in terms of gender, type of fracture, injury location, and time of admission during a day between the aforementioned groups. However, in the pandemic group, patients were transferred to the operating room significantly quicker (odds ratio; 2.13 vs. 0.607, P = 0.01) and the surgery duration was shorter (40.17 ± 12.28 min vs. 49.11 ± 15.48 min, P = 0.011). It was found that the location of injury (home, school, etc.) varied between the two groups (P = 0.01) and the proportion of domestic injuries during the pandemic grew significantly (53.6% vs. 19.8%).

Conclusion:
Although the incidence of pediatric SH fractures has decreased due to the closure of schools and sports clubs during the pandemic, domestic occurrence of the same fracture type has grown disproportionately. To prevent this trend, pediatric centers should educate parents on child safety measures and fracture risks during the lockdown.
The Impact of Maternal Predisposing Factors on Level of Maternal Serum Pregnancy-Associated Plasma Protein A and Free Subunit Human Chorionic Gonadotropin and Nuchal Translucency
Authors: Mirsafaie Maryam , Kheirollahi Majid , Moghaddam-Banaem Lida 
Published: October 2023

Background:
This study aimed to investigate the relationship between maternal predisposing factors with the level of maternal serum pregnancy-associated plasma protein A and free subunit human chorionic gonadotropin and nuchal translucency.

Materials and Methods:
We performed a cross-sectional-analytical study on 762 pregnant women who referred to the Gene Azma Medical Genetics Laboratory in Isfahan for amniocentesis. All pregnant women at high risk of screening in the first trimester of pregnancy for trisomy 21 and other aneuploidy were referred to a gynecologist for amniotic fluid sampling (amniocentesis). Multiple of the means (MoM) of PAPPA ≤0.5, 0.5 ≥ MoM free β-hCG >2.5, and NT ≥3.5 mm were considered abnormal. We used Chi-square method and Mann–Whitney U-test to compare data qualitative and quantitative, respectively.

Results:
In individuals with less pregnancies and deliveries, the value of abnormal NT was higher (P < 0.01, P < 0.001, respectively). On the other hand, the highest abnormal rate of NT was observed in pregnant women under 35 years (21, 84%, P < 0.012). In addition, abnormal levels of free β-hCG are more common in women < 35 years of age (186, 66.9%, P < 0.02) and female fetuses (171, 58.8%) (P < 0.006).

Conclusion:
According to the results of this study, it can be said that considering the underlying factors of pregnant mothers in performing tests related to screening in the first trimester of pregnancy can lead to a reduction in false positive rates.
Clinical Symptoms of COVID-19 and Their Association with Disease Outcome
Authors: Tavakolifard Negah , Moeini Mina , Haddadpoor Asefeh , Heidari Kamal , Rezaee Mostafa , Amini Zahra 
Published: October 2023

Background:
COVID-19 pandemic placed immense pressure on health systems. The current study aimed to evaluate the symptoms of COVID-19 in Isfahan province and their association with disease outcome.

Materials and Methods:
In this cross-sectional study, which was conducted on patients with a definite diagnosis of COVID-19, as a part of the investigations performed by the Deputy for Public Health of the Isfahan University of Medical Sciences, the frequency of underlying diseases, and general, respiratory, gastrointestinal, neurological, renal, cardiac, dermal, hearing symptoms are assessed using a checklist. The participants were followed up 1 month after definitive diagnosis, and the outcome of the disease (recovery or death) was recorded.

Results:
Of 300 patients, 143 (47.4%) were male and 157 (52.6%) were female. The mean age of patients was 43 ± 17.84 years. Muscle pain and fatigue were the most common early symptoms (63% and 60.3%, respectively). Age, sex, level of education, and occupation of patients and general, respiratory, and gastrointestinal symptoms and underlying diseases of respiratory disease showed a statistically significant association with the disease outcome (P < 0.05).

Conclusion:
General, respiratory, and gastrointestinal symptoms were associated with an increased risk of death due to COVID-19. General, visual, and hearing symptoms, and diabetes, cardiovascular diseases, and respiratory disease had a statistically significant association with the hospitalization of patients.
The Association between Exposure to Air Pollution and Type 1 Diabetes Mellitus
Authors: Mozafarian Nafiseh , Hashemipour Mahin , Yazdi Maryam , Hani Tabaei Zavareh Mohsen , Hovsepian Silva , Heidarpour Maryam , Taheri Ensiyeh 
Published: October 2023

Background:
This systematic review and meta-analysis aimed to overview the observational studies on the association of exposure to air pollution and type 1 diabetes mellitus (T1DM).

Materials and Methods:
Based on PRISMA guidelines, we systematically reviewed the databases of PubMed, Scopus, Embase, and Web of Science databases to determine the association of air pollution exposure and T1DM. Quality assessment of the papers was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies. The odds ratios (OR) and their 95% confidence intervals (CI) were calculated to assess the strength of the associations between air pollutants (gases and particulate matter air pollutants including PM10, PM2.5, NO2, volatile organic compound, SO4, SO2, O3) and T1DM.

Results:
Out of 385 initially identified papers, 6 studies were used for this meta-analysis. Fixed effects meta-analysis showed a significant association between per 10 μg/m3 increase in O3 and PM2.5 exposures with the increased risk of T1DM (3 studies, OR = 1.51, 95% CI: 1.26, 1.80, I
2 = 83.5% for O3 and two studies, OR = 1.03, 95% CI: 1.01, 1.05, I
2 = 76.3% for PM2.5). There was no evidence of association between increased risk of T1DM and exposure to PM10 (OR = 1.02, 95% CI: 0.99–1.06, I
2 = 59.4%), SO4 (OR = 1.16, 95% CI: 0.91–1.49, I
2 = 93.8%), SO2 (OR = 0.94, 95% CI: 0.83–1.06, I
2 = 85.0%), and NO2 (OR = 0.995,95% CI: 1.05–1.04, I
2 = 24.7%).

Conclusion:
Recent publications indicated that exposure to ozone and PM2.5 may be a risk factor for T1DM. However, due to limited available studies, more prospective cohort studies are needed to clarify the role of air pollutants in T1DM occurrence.
Comparison of the Effectiveness of Two Management Strategies in the Pandemic COVID-19 Period in Patient Visits (Face-to-Face Visits vs. a Smartphone) in follow-up the Range of Motion of the Knee in Patients with Anterior Cruciate Ligament Reconstruction
Authors: Aslani Hamidreza , Bonakdar Sona , Gorji Mona , Gholipour Morteza 
Published: October 2023

Background:
As the prevalence of the coronavirus increases, there is now more emphasis on reducing “face-to-face” patient visits. Therefore, the use of smartphones and their special medical applications can play an important role in following up patients. The aim of this study was to evaluate the use of smartphone in evaluating clinical outcomes and range of motion (ROM) of patients after anterior cruciate ligament reconstruction (ACLR).

Materials and Methods:
From January to December 2020, 112 patients between 20 and 50 years old were randomly selected at our orthopedic sports center. All patients were visited online through smartphone by a knee fellowship surgeon in the morning (case group) and again all of them were visited online through smartphone in the evening by another knee fellowship surgeon (control group). Both visits were done at regular intervals in the 2nd, 6th, and 12th week after surgery. Patients were evaluated for function outcomes and joint ROM.

Results:
The two groups were similar in terms of mean International Knee Documentation Committee score, Lysholm knee score, and Tegner Knee Score and did not show statistically significant difference (P < 0.05) There was no significant difference in knee ROM measurements between the two groups (face-to-face visits and online through smartphone visits) during the follow-ups (P > 0.05).

Conclusion:
Smartphone apps are highly effective in assessing postoperative condition of knee ROM after ACLR, especially in the short time. However, this ability has been reduced in evaluating the long term. Hence, evaluation is still necessary through direct examination in the presence visit.
Bacterial Superinfection and Antibiotic Management in Patients with COVID-19 Admitted to Intensive Care Medicine in Central Iran: A Follow-Up Study
Authors: Nokhodian Zary , Rostami Soodabeh , Zeraatei Parisa , Rahimkhorasani Marzieh , Abbasi Saeed , Sadeghi Somayeh 
Published: October 2023

Background:
Bacterial superinfections are one of the crucial challenges in patients with coronavirus disease 2019 (COVID-19) that are associated with a high mortality rate. The current study was designed to assess bacterial superinfections and antibiotic management in COVID-19 patients admitted to intensive care unit (ICU).

Material and Methods:
Seventy-three adult intubated patients with COVID-19 were included in a cross-sectional study. The lung aspirate samples were collected in two stages and assessed for bacterial growth by standard methods. Antimicrobial susceptibility testing was performed using the Kirby-Bauer method as recommended by the Clinical Laboratory Standard Institute guideline (2021 edition). Also, demographic and clinical data were collected. The statistical analysis was done by chisquare test and Student's t-test, and a P value <0.05 was considered significant.

Results:
Forty men and thirty-three women with a mean age of 64.78 ± 13.90 have included in our study. The mean length of hospitalization and stay in ICU were 18.77 ± 12.94 and 13.51 ± 9.83 days, respectively; 84.9% of cases died. Thirty-three patients had a bacterial superinfection mainly caused by Klebsiella spp and Acinetobacter spp; 21.2% of piperacillin/tazobactam consumers' patients survived that; the differences were significant (p = 0.034). A significant relationship was seen between superinfection and length of hospital stay until intubation (p = 0.033).

Conclusion:
Bacterial superinfection and mortality rates were relatively high in COVID-19 patients admitted to ICU. According to the results, using beta-lactam/beta-lactamase inhibitors antibiotics in hospitalized patients in ICU can effectively control superinfection.
Predictive Value of Middle Cerebral Artery to Umbilical Artery Pulsatility Index Ratio for Neonatal Outcomes in Hypertensive Disorders of Pregnancy
Authors: Zarean Elahe , Azami Nahal , Shahshahan Zahra 
Published: October 2023

Background:
Hypertension may lead to notifying adverse perinatal events that should be diagnosed and managed precisely. This study aims to investigate the values of cerebroplacental ration for the prediction of adverse perinatal events in hypertensive disorders of pregnancy.

Materials and Methods:
The current descriptive-comparative study has been conducted on 100 singleton pregnant women with the diagnosis of preeclampsia or pregnancy-induced hypertension. The Cerebroplacental ratio (CPR) was measured for the included population and divided into normal and abnormal ranges of >1 and ≤1. The adverse perinatal outcomes, including abnormal 5 min APGAR, low birth weight, perinatal death, neonatal intensive care unit (NICU) admission, academia, seizure, emergency cesarean delivery, and Tchirikov index as the general manifestation of adverse perinatal outcomes were compared between the groups. The specificity, sensitivity, positive predictive value, negative predictive value (NPV), and accuracy were measured for the adverse perinatal outcomes.

Results:
The two groups were remarkably different in terms of 5 min APGAR, low birth weight, cesarean section delivery, and Tchirikov index (P < 0.05). The specificity of CPR for prediction of small-for-gestational age, poor APGAR, requirement of assisted respiration, academia, Tchirikov score and NICU admission was 93.1%, 93.1%, 67.1%, 91.8%, 71.2%, and 63%, and its sensitivity was 26%, 14.8%, 51.8%, 14.8%, 51.8%, and 37%, respectively.

Conclusion:
CPR seems to be an appropriate means for the prediction of adverse perinatal outcomes with diversity in the prediction values of different determinants of adverse perinatal outcomes; however, in general, it had sensitivity, specificity, PP, NPV, and accuracy of 51.8%, 71.2%, 40%, 80%, and 66%, respectively.