Explore the vast range of titles available.

In the Coronavirus 2019 (COVID-19) global pandemic, various studies on the target communities of this virus were widely started and rapidly progressed. Smokers and opioid consumers are one of the virus targets since they have a vulnerable respiratory system. Due to the contradictory results in previous studies and the lack of similar investigations in this area, we aimed to perform this study to investigate the effect of smoking and opioid consumption on the consequences of the COVID-19 disease.In this retrospective study, the required information was collected and analyzed from the archives of Razi Hospital, Rasht, Iran. Study variables included age, sex, the need for intubation, hospital length of stay, history of current smoking or opioid consumption, and intensive care unit (ICU) admission, ICU length of stay, admission oxygen saturation, disease severity, and the outcome of death or recovery. Data were collected and divided into the case (including current cigarette smokers, opioid consumers, and cigarette-opioid consumers) and control (non-smokers and non-opioid-consumers) groups. Out of 986 patients, 489 patients met the criteria for inclusion and subsequent analysis. The average age was 69.79 ± 16.06, and 294 (60.1%) patients were male. The median age of the case group (65.15 ± 42.41) was older than the control group (57.45 ± 15.71, P = 0.001). The case group consisted of more male patients than the control group (P = 0.001).The adjusted regression models demonstrated that current cigarette smoking, opioid, and cigarette-opioid consumption did not significantly predict hospital and ICU length of stay, ICU admission, disease severity, and mortality outcomes (P > 0.05). Current cigarette smoking and opioid consumption could not be an independent predictor for the consequences of ICU admission, hospital and ICU length of stay, the need for intubation, disease severity, and mortality in COVID-19 patients.

Background/Objectives: Physical inactivity and unhealthy nutritional behaviors are recognized as the key factors in the cause and management of metabolic syndrome (MetS). The effectiveness of interactive web-based interventions on dietary intakes, physical activity and health-related quality of life (HRQOL) among people with MetS is currently unknown. Methods: The two-arm randomized-controlled trial was conducted for patients with MetS from June through December 2012 in Tehran, Iran. Participants ( n= 160) were recruited through online registration on the study website. After free clinical assessments of eligible participants for MetS, they were randomly assigned to intervention and control groups ( n= 80). All participants received general information about cardiovascular diseases and MetS risk factors via the website. The intervention group logged in to interactive part including My Healthy Heart Profile, received tailored calorie-restricted diet and used all parts of the interactive prevention program. Anthropometric measures, glycemic status, lipid profile, physical activity and food intake were evaluated at the beginning and after 6-month follow-up. HRQOL was assessed at beginning, 3- and 6-month follow-up. Results: There were no significant differences between the intervention and control groups on age, gender, education and MetS factors. In comparison with control group, the intervention group showed significant changes in moderate physical activity 260.3±473.6 vs 101.6±213.1 MET-min/week, walking 505.2±505.3 vs 321±884 MET-min per week, cholesterol intake −88.4±158.7 vs −8.3±6 mg per day, total calories −430.2±957.5 vs −392.9±34.7 kcal per day and sodium 1336.9±2467 vs 1342±3200.4 mmol per day. With regard to HRQOL, the intervention group showed greater improvement in general health and vitality ( P< 0.05 for all). Conclusion: These results indicate the positive impact of a lifestyle intervention by a web-based program on physical activity, dietary intake and several dimension of QoL. The use of web-based approaches is a great interest to manage patients at high cardiovascular risk, especially where the prevalence of obesity, MetS and diabetes is increasing.

Purpose To determine the proper time for traumatic cataract surgery after open globe injuries. Setting Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Design Randomized clinical trial. Patients and methods In a randomized clinical trial, 30 eyes with traumatic cataract after open globe injury with IOL implantation underwent early (in the first week after the trauma) and 30 eyes underwent late cataract surgery (from the first to second month after the trauma). We excluded patients who were under 12-year-old. All patients were visited at 1 week, 4 weeks, 12 weeks, and 6 months after surgery. In each visit, patients were examined regarding visual acuity, intraocular pressure (IOP), anterior chamber inflammation, IOL position, and posterior synechiae. In addition, posterior segment evaluation and fundoscopy were performed. Intraoperative complication including posterior capsular rupture, anterior vitrectomy, and zonulysis as well as the site of IOL implantation were documented and post-operative complications including raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were listed. Results Best-corrected visual acuity 6 months after surgery was not different between the two groups. Also in early cataract surgery group, the rate of posterior capsular rupture was not significantly higher than the late surgery group ( P =0.069). On the other hand, zonulysis was significantly higher in the late procedure group ( P =0.039). Other complications including anterior vitrectomy, raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were not different in the two groups. Conclusions Early and late traumatic cataract surgery and IOL implantation after open globe injuries, have no significant difference regarding the post-surgical BCVA and prominent intraoperative and post-operative complications.

Slab-column connections in reinforced concrete structures are prone to brittle punching shear failure when subjected to lateral or seismic loads. This vulnerability was due to limited capacity of shear transfer and poor confinement at the slab column interface. To cover this aspect, the current research focuses on the structural behavior of composite slab-column joints with different steel column types. This paper reports an experimental investigation to study the seismic behavior of slab-column connections with various configurations of steel columns under the influence of coupled gravity load and lateral cyclic displacement. Four 1:2.5-scale specimens were tested, consisting of one conventional reinforced concrete (RC) connection and three composite systems comprising RC slabs connected to either wide-flange (W) steel, hollow structural steel (HSS), or concrete-filled HSS columns. All specimens were preloaded with a constant axial load equal to 75 kN and then subjected to lateral cyclic loading according to the lateral displacement protocol outlined in ACI 374. Experimental results showed that connections using steel columns significantly increase lateral load-carrying capacity, stiffness, ductility, and energy dissipation compared to the traditional RC specimen. It was also found that the specimen with the concrete-filled HSS column showed the most increase in stiffness (60.6%), while that with a W-shaped steel column reached the highest lateral load gain (up to 67%). While composite columns reduced the displacement capacity by about 29%, they delayed punching shear failure significantly leading to increased overall seismic resilience. These results help to understand the effectiveness of the steel-concrete composite connections concerning improving the seismic response of slab-column systems and provide design recommendations for practical applications in seismic design.

Reinforced concrete (RC) slab-column connections are significant components of flat slab systems and participate in the transfer of loads or forces from stabilized structures to the foundation under both gravity loads as well as combined gravity and lateral cyclic loads including those induced during earthquakes. This study analyzes the effect of multiple gravity load ratios on the response of such connections. The experimental program included four (1:2.5) scale of slab-column specimens were tested to simulate seismic effects. The first specimen (SC-G) represents the reference one, which was only subjected to monotonic gravity load to get its ultimate vertical capacity. The other three specimens were subjected to combined gravity loads and lateral cyclic displacements according to the ACI-374 protocol. The applied gravity loads were defined to 40%, 60%, and 80% of the ultimate capacity from SC-G for the specimens SC-1, SC-2, and SC-3 respectively. The findings showed that elevated gravity load ratio applied from 40% to 80%, improved lateral force resisting ability about 32% in percentage, predominately driven by enhanced stress concentration. However, increased gravity loading also leads to faster stiffness degradation at cyclic displacements and results in lower ductility. All samples reached failure via a punching shear failure mechanism (failure angles varied between 15.6° and 18.4°), indicating differences in the propagation of the shear crack.

There is a need for higly accurate non-invasive methods for assessing organ iron content in thalassaemia patients. This study evaluated the relation between serum ferritin level, liver enzyme levels and hepatitis C antibody and liver and heart iron deposition assessed by MRI T2*. Data were obtained from the medical records of 156 thalassemia major patients in Tehran. There was a moderate negative correlation between serum ferritin and liver MRI T2* relaxation time (r = -0.535) and a weak negative correlation between serum ferritin and heart MRI T2* relaxation time (r = -0.361). Hepatitis C infection and liver enzyme levels did not confound or modify the relation between ferritin and liver or heart MRI T2*. Liver and heart MRI T2* readings were poorly correlated (r = 0.281). Routine evaluation of liver and heart iron content using MRI T2* is suggested to better evaluate the haemosiderosis status in thalassemia patients.

The aim of this study was to determine the association between smoking and breast cancer after adjusting for smoking misclassification bias and confounders. In this case-control study, 1000 women with breast cancer and 1000 healthy controls were selected. Using a probabilistic bias analysis method, the association between smoking and breast cancer was adjusted for the bias resulting from misclassification of smoking secondary to self-reporting as well as a minimally sufficient adjustment set of confounders derived from a causal directed acyclic graph (cDAG). Population attributable fraction (PAF) for smoking was calculated using Miettinen's formula. While the odds ratio (OR) from the conventional logistic regression model between smoking and breast cancer was 0.64 (95% CI: 0.36-1.13), the adjusted ORs from the probabilistic bias analysis were in the ranges of 2.63-2.69 and 1.73-2.83 for non-differential and differential misclassification, respectively. PAF ranges obtained were 1.36-1.72% and 0.62-2.01% using the non-differential bias analysis and differential bias analysis, respectively. After misclassification correction for smoking, the non-significant negative-adjusted association between smoking and breast cancer changed to a significant positive-adjusted association.

This paper presents the results of an experimental investigation of spliced and non-spliced reinforced concrete girders strengthened with near surface mounted (NSM) CFRP bars. Six reinforced concrete girder specimens were tested, divided into two groups according to their support condition: simply supported and continuous. Each group thus contained three girders; one girder of each group was single segment without splicing, as a control for comparison purposes. The second girder was spliced in three precast segments without strengthening, and the third girder of each group was spliced in three precast segments strengthened with NSM CFRP bars at the bottom surfaces of the two splice regions. The main variables studied were support conditions, presence of the splicing technique, and strengthening with NSM CFRP bars. The strengthening of spliced girders was achieved by using two bars of 6 mm diameter CFRP in the longitudinal direction. The results for the simply supported group showed that this strengthening resulted to an increase in ultimate load of 11. 25%, as compared with that seen in the spliced girder without strengthening, and of 5.4 % when compared with the control girder. This strengthening method also reduced the maximum deflection by about 23%. The results also showed that strengthening the continuous girder resulted in an increase in ultimate load by 3.76% compared to the spliced girder without strengthening, and the maximum mid-span deflection was reduced by 8.7%. It was also found that the ultimate load of the control girder was greater than that of the strengthened girder by 2.54%. These results indicate that strengthening with NSM CFRP was more effective within the simply supported group than in the continuous group.

To study the relative contribution of major indications and geographic referral patterns for intravitreal bevacizumab injections in a tertiary hospital. In this retrospective study, hospital electronic registry was used to categorize patients who had received intravitreal injections (IVIs) during the 2014-2016 period into different groups based on indications. Relative contribution of each indication and odds of being resident of provinces other than Tehran were determined. The most prevalent indications for IVI were pathologies related to diabetes mellitus (DM) followed by choroidal neovascularization (CNV)/age-related macular degeneration (AMD) and retinal venous occlusion (RVO)-related complications. From 38,043 patients, 61.8% were residents of Tehran province. Patients in the CNV/AMD group were the oldest. Patients from Tehran province were significantly older (62.44 ±11.42 (12-99)) than patients who were referred from other provinces (59.23 ±11.39 (11-102)) (p=< 0.001). The majority of patients in all indication categories were from Tehran province, except for patients with retinopathy of prematurity (ROP). Odds of being referred from outside Tehran province for the ROP group compared to the DM-related, CNV/AMD, RVO-related and miscellaneous groups were 3.32, 4.27, 3.13 and 2.83, respectively (p<0.001). DM-related ocular complications outnumber all other indications of IVIs combined. Considering the preventable nature of these complications, efficient health policies can significantly reduce the burden of IVIs in Iran. The contribution of each indication category in overall burden of IVIs seems to vary considerably between different countries which merits further studies. The disproportionately high ratio of ROP patients who are referred from other provinces to the capital province for treatment indicates a suboptimal distribution of ROP care services throughout the country.

To evaluate the efficacy of prophylactic administration of the topical diclofenac 0.1 % on macular thickness in diabetic patients following phacoemulsification and intraocular lens implantation surgery. In a Randomized double-masked clinical trial, 108 eyes of 108 diabetic patients underwent phacoemulsification and intraocular lens implantation surgery were enrolled. Fifty four eyes received the conventional postoperative care with steroid drop, whereas the other group (54 eyes) was given a preoperative diclofenac drop four times daily in addition to steroid drop and continued 6 weeks after surgery. All patients were evaluated by optical coherence tomography (OCT) preoperatively and days 1, 30, and 90. The outcome measures including best-corrected visual acuity and OCT findings were compared in and between both groups. Mean CMT changed from 239 ± 16 and 235 ± 17 at baseline to 249 ± 15 and 254 ± 28 at 3 months in the case and control groups, respectively( p  = 0.003). Mean total volume of macula changed from 7.61 ± 0.22 and 7.56 ± 0.3 at baseline to 7.64 ± 0.22 and 7.65 ± 0.31 at 3 months in the case and control groups, respectively ( p  = 0.820). In comparison to the quadrants thicknesses and mean of them between groups did not reach the significant level. This study showed that there is a beneficial effect of topical diclofenac for prevention of macular thickness increasing following phacoemulsification in diabetic patients.