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This project has studied the effects of metformin on cognition impairment, depression, hyperalgesia, stress oxidative and neuroinflammation in a rodent Alzheimer's disease (AD) model created via LPS (lipopolysaccharide). For defining possible mechanisms, the NO/cGMP/K_ATP pathway roleplay was considered.  Mice model was created via LPS treatment. Open field forced swimming and hot plate tests were done. Shuttle-box test and Y-maze test were used to assay Learning-memory. Biochemical assay compromised malondialdehyde (MDA) and TNF-alpha concentration and superoxide dismutase (SOD) activity measurement in hippocampus samples. NO-cGMP-KATP pathway contribution was assessed by its agonists/antagonist pre-treatment, 15 min before metformin (150, 200, 250 mg/kg). Initial latency (IL) was increased by LPS injection while it was reduced by metformin (250 mg), in shuttle-box test. Pretreatment with methylene blue, L-NAME and glibenclamide before metformin augmented IL, although it was diminished by L- arginine and sildenafil pretreatment. Also, metformin increased the LPS induced step through latency (STL) reduction. L-NAME, methylene blue and glibenclamide decreased the STL, but it was increased by L-arginine and sildenafil. In Y-maze test, metformin increased the LPS-induced spontaneous alternation reduction. L-NAME, methylene blue and glibenclamide decreased it. LPS added immobility time in forced swimming trial, whereas it was reduced thru metformin. L-NAME, methylene blue and glibenclamide increased the anti-depressive effect of metformin while it was attenuated via L-arginine, sildenafil and diazoxide. LPS treatment diminished the threshold of pain perception in hot-plate test, while metformin didn’t have any significant effect. Metformin reduced the LPS-induced lipid peroxidation (MDA level). But, L-NAME, methylene blue and glibenclamide worsen the lipid peroxidation, whereas it was improved by L-arginine and sildenafil. Metformin improved LPS-induced reduction in SOD activity. SOD activity was reduced by L-NAME, methylene blue and glibenclamide pre-treatment. LPS enhanced TNF-alpha amount that decreased by metformin. Pre-injection with methylene blue, L-NAME and glibenclamide increased TNF-alpha concentrations while L-arginine, sildenafil and diazoxide reduced it. Conclusions: Metformin can improve learning-memory loss, depression, hyperalgesia, neuroinflammation and oxidative stress produced by LPS and NO/cGMP/K_ATP pathway maybe has a roleplay. 

Gastroenteritis is associated with high rates of morbidity and mortality in the general population, especially in children. To investigate the predictive role of interleukins (IL-1β and IL-7) in children with viral gastroenteritis as potential diagnostic biomarkers. This cross-sectional study included children who were diagnosed with gastroenteritis at private clinics and Al-Batoul Teaching Hospital for Maternity and Childhood, Diyala, Iraq. The present study was conducted from May 2023 to May 2024. Ninety blood samples were collected from children with gastroenteritis, and 50 blood samples were taken from healthy children and those in the control group. Additionally, 90 samples of the stool were collected. The ELIZA technique was used for exploring IL-1β and IL-7 in blood samples and for detecting viral antigens (Norovirus, Adenovirus and Astrovirus) in stool samples. The data were analyzed statistically via SPSS v. 24 and Prism v. 10. There was a statistically significant increase in the incidence of infectious gastroenteritis in thin children aged 1-3 years who were living in rural areas. As indicated in this study, the most common symptoms were diarrhoea, vomiting and fever, and the differences were significant. Compared with those in the control group, there were significant differences in the levels of IL-1β and IL-7 among the children infected with gastroenteritis. ROC analysis of IL-1β and IL-7 interleukins revealed moderate sensitivity (79% and 88%, respectively) and low specificity (64% and 69%, respectively) at cut-off values of 8.52 and 7.01. The occurrence of norovirus occurred in 30% of the total samples, followed by Adenovirus in 20% and Astrovirus in 11%. The serum levels of IL-1β and IL-7 were high among children infected with gastroenteritis. Nevertheless, these parameters cannot be considered reliable vital indicators that are sufficient for diagnosing infections caused by gastroenteritis.

Recurrent implantation failure (RIF) remains a significant challenge in assisted reproductive technology (ART), affecting a substantial proportion of patients undergoing treatment. While advancements in ART have improved outcomes, the multifactorial nature of RIF complicates its management. This study aims to evaluate the factors influencing RIF and identify potential predictors of ART success in affected patients. A retrospective analysis was conducted on 123 women with at least two failed implantation attempts. Demographic, clinical, and laboratory data were collected, including age, body mass index (BMI), uterine abnormalities, sperm quality, and embryo formation. Statistical analyses were performed to evaluate the relationships between these variables and ART outcomes. Most participants (62.6%) were under 35 years of age, and BMI was significantly associated with the number of embryos formed (P=0.037). Among the participants, 69.91% had bilaterally patent fallopian tubes, while uterine abnormalities were linked to reduced implantation success. Sperm motility showed a significant correlation with embryo formation (P<0.05), whereas sperm count, and morphology were not statistically significant predictors. Despite comprehensive evaluations, only 1.6% of patients achieved live births, underscoring the complexity of RIF. This study highlights the critical roles of maternal age, BMI, uterine health, and sperm motility in influencing ART outcomes. Addressing modifiable factors such as BMI and uterine abnormalities and optimizing sperm quality may enhance the likelihood of successful implantation. Further research is needed to explore additional predictors and develop personalized treatment strategies for patients with RIF.

The drug crisis, especially in children, is expanding as a global challenge. The purpose of this study was to compare extraction and rotation methods in exploratory factor analysis to validate the children's addiction potential questionnaire. This cross-sectional study was conducted in 2023 on 400 students from the city of Shiraz, Iran, using a multi-stage sampling method (stratified-cluster-simple random sampling). Inclusion Criteria: Participants were students residing in Shiraz and enrolled in the first or second year of high school. After designing the questions and assessing their face and content validity, as well as reliability (using Cronbach's alpha), the final questionnaire was administered to the participants. Exploratory factor analysis was performed using various extraction and rotation methods. The statistical methods used for analysis included descriptive-analytical indices, correlation coefficients, exploratory factor analysis, and Cronbach's alpha, utilizing SPSS software version 26. This research has received ethical approval under the code IR.SUMS.SCHEANUT.REC.1402.112. The mean age of participants was 15.39±1.94 years. The face and content validity (both quantitatively and qualitatively) as well as reliability (using Cronbach's alpha) were assessed and confirmed. The best extraction method was maximum likelihood, and the optimal rotation method was Varimax. The percentage of variance explained varied across different extraction methods, with the highest percentage being 39.5% for the Generalized Least Squares method and the lowest percentage being 25.8% for the Image Factoring method. The results indicate a suitable validation of the children’s addiction potential questionnaire. The careful selection of extraction and rotation methods based on the characteristics of the data and the research objectives plays a crucial role in achieving valid results. In this study, the best extraction method was found to be maximum likelihood, and the optimal rotation method was Varimax, resulting in the identification of four factors.

Teamwork is the important principle of safety in healthcare. Evaluating the teamwork manners is vital to promote the functioning of a medical teams. So this research aimed to evaluate the psychometric properties of the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®). Teamwork Perception Questionnaire (T-TPQ) among Iranian nurses. This scale may help assess teamwork in hospital settings, ultimately facilitating the improvement of care quality. This cross-sectional research was conducted in two phases from April 2019 to March 2020. The first phase involved the translation and cultural adaptation of the English version of the TeamSTEPPS questionnaire. The second phase focused on validating the Persian language version of the TeamSTEPPS questionnaire, which included assessments for face validity, content validity, construct validity, and reliability. For validation purposes, 360 native Persian nurses working in educational hospitals at Jahrom University of Medical Sciences participated in the study. The content validity index was found to be 0.92, indicating high validity of the Persian language version of the TeamSTEPPS questionnaire. The content validity ratio was deemed acceptable at 0.77. The results of the confirmatory factor analysis demonstrated that the construct validity of the Persian IR-TPQ was also acceptable (RMSEA=0.061; CFI=0.960; NFI=0.927; TLI=0.957). The factor loadings of all items fell within the range of 0.47-0.90, indicating an acceptable level of validity. The first and second questions related to the Team Structure dimension were as follows: "The skills of nurses overlap sufficiently so that work can be shared when necessary (0.472)" and "Nurses are held accountable for their actions (0.531)". The Cronbach’s α coefficient of the Persian T-TPQ was calculated to be 0.942. Based on our findings, the psychometric characteristics of the Persian version of the T-TPQ are suitable, suggesting its potential for use in future research.

The knowledge of caregivers about the ways of parenting which promote development and learning of children is often limited. The Care for Child Development (CCD) program has been proposed by the World Health Organization and UNICEF to promote caregivers’ skills in playing and communicating with their children and consequently promote child development. Providing a comprehensive program to promote the development of children and psychological support for parents of children at risk of developmental delays under three is essential. To adapt and implement " Care for Child Development" (CCD) intervention in the health system and orphanages of Iran. In this open-label randomized controlled trial, a targeted sampling method will be used in selecting the group of experts for adapting the CCD intervention. Four provinces will be selected for implementation of the present phase of study. Among obstetrics/gynecology hospitals, health centers, Child Development Centers (CDCs), and Orphanages, two health centers, two obstetrics/gynecology hospitals and two Orphanages (if exist) will be selected in each province (one center for intervention and one for control), 4 health care providers and 4 midwives from each province and 4 orphanage caregivers (48 persons in total) will receive CCD training. Using the Morgan table, 1000 children under three years old from these centers will be selected randomly and will be divided into two groups of experimental (500 people) and control (500 people). In each center, the selected care-providers and/or midwives will be trained, and they are responsible for conducting the CCD program and pre- and post-evaluation.

Reconstruction of lower limb defects can be challenging, especially when local flaps are not feasible. While free flaps are an effective option, they are time-consuming and may not be suitable for inflamed areas. Perforator-based flaps, including propeller flaps, serve as viable alternatives to free flaps. However, venous congestion remains the most common complication associated with propeller flaps, and venous supercharging is a technique that can help mitigate this issue. This report presents a case of a 28-year-old patient with a severe knee injury who was treated using a propeller flap. The great saphenous vein was included in the flap and clipped proximally. After flap dissection, the flap was propelled to the defect, with the clipped end of the saphenous vein located at the proximal of lower limb. An anastomosis was performed between the proximally clipped end of the saphenous vein and the distal end of the saphenous vein at the proximal part of the lower limb to prevent venous congestion and ensure venous drainage in a retrograde direction (from proximal to distal). Propeller-based flaps are an excellent choice for reconstructing lower limb defects. Retrograde microscopic anastomosis of the great saphenous vein can effectively prevent venous congestion.