Non-cannulated versus cannulated cancellous screws for the internal fixation of femoral neck fractures in osteoporotic patients: A single-blind randomized clinical trial.

Background: The incidence of femoral neck fractures in osteoporotic patients is rising worldwide and is associated with significant increases in healthcare and social costs, as well as dependency. Improving minimally invasive treatment strategies, including internal fixation with screws, can result in favorable clinical outcomes and lesser incidence of complications, while preserving the hip. This study compared the outcomes of using non-cannulated cancellous screws (NCS) and cannulated cancellous screws (CS) in the internal fixation of undisplaced intracapsular femoral neck fractures (UIFNF) of osteoporotic patients of Iranian descent. Methods: This randomized clinical trial was conducted on the patients referring to an institutional tertiary hospital in northwestern Iran between March 2020 and June 2021. The patients' preoperative, perioperative, and postoperative characteristics were evaluated for at least two years. Primary endpoints were defined as the incidence of hip-related complications, while secondary endpoints were assessed based on the patients' hip function using Harris Hip Score (HHS). Results: Fifty-seven patients with osteoporosis and UIFNF were included in the final analysis, with 27 patients in the NCS group and 30 patients in the CS group. The surgical duration, the amount of intraoperative blood loss, and the frequency of C-arm were considerably lower in the CS group (p < 0.05). The incidence of implant failure was higher in the NCS group (p = 0.04). Screw migration occurred more frequently in the CS group (p = 0.03). The HHS values were significantly higher for the NCS group than those of the CS group at both the 1-year and 2-years of follow-up assessments (1 year, p = 0.007; 2 years, p = 0.001). Conclusion: Fixation using CS was accompanied by enhanced perioperative outcomes and lower implant failure rates compared to the NCS group. However, patients in the NCS group posed a reduced risk of complications, including screw migration, and experienced a long-term improvement in HHS scores.

Identifying drivers affecting air quality in metropolitan areas of developing countries: evidence from Tehran metropolitan area.

Environmental issues and the significant reduction of air quality in the metropolitan areas of developing countries have become chronic challenges. While the impacts of many reasons such as the rapid trend of urbanization, lacking sustainable thinking in urban planning approaches, and urban sprawl have been explored in previous literature, the role of political economy, especially the structure based on the rentier economy, in the change of air quality as an environmental challenge in the metropolitan areas of developing countries has received little attention. To fill this gap, this study focuses on the role of the rentier economy and identifies the drivers based on it that have a tremendous impact on the air quality in Tehran metropolitan area, Iran. To this end, using the Grounded Theory (GT) foundation database and two-round Delphi survey, the opinions of 19 experts were used to identify and explain major drivers that impact air quality in Tehran. Our findings revealed that nine major drivers have an increasing impact on the air quality in the metropolitan area of Tehran. These drivers considering the dominance of the rentier economy are interpreted as the lack of powerful local governance, the rental economy, centralized structure of government, unsustainable economic development, institutional conflicts, a faulty planning system, financial unsustainability of municipalities, unfair distribution of power, and inefficient urban development policies. Among the drivers, the impacts of institutional conflicts and lack of powerful local governance on air quality are more considerable. This study highlights the role of the rentier economy as a major obstacle to resilient responses and constructive actions against chronic environmental challenges such as drastic changes in air quality in metropolitan areas of developing countries.

Impacts of the COVID-19 pandemic on the social sphere and lessons for crisis management: a literature review.

The COVID-19 pandemic is the most difficult challenge that has affected humanity in recent decades. It has disrupted many features of development with domino effects in the social sphere. This study reviews the literature on the social effects of the COVID-19 pandemic and identifies the affected social areas that have undergone dramatic changes during the pandemic. We use inductive content analysis and thematic analysis to review the literature. The results show that there are seven major areas that have been negatively affected by the COVID-19 pandemic: health, social vulnerability, education, social capital, social relationships, social mobility, and social welfare. The literature has reported dramatic psychological and emotional effects, exacerbation of segregation and poverty, disruption in educational systems and formation of an information gap, as well as a declining trends of social capital among communities. We highlight some lessons that can be learned from the pandemic to enhance social resilience in future. Among others, to effectively respond to the pandemic and other potential future adverse events, governments should adopt fair policies, identify the required changes in the socially affected contexts and take necessary responsive actions, and adopt collaboratively designed approaches to increase social resilience.

The Sensitivity of Tau Tracers for the Discrimination of Alzheimer's Disease Patients and Healthy Controls by PET.

Hyperphosphorylated tau aggregates, also known as neurofibrillary tangles, are a hallmark neuropathological feature of Alzheimer's disease (AD). Molecular imaging of tau by positron emission tomography (PET) began with the development of [18F]FDDNP, an amyloid ß tracer with off-target binding to tau, which obtained regional specificity through the differing distributions of amyloid ß and tau in AD brains. A concerted search for more selective and affine tau PET tracers yielded compounds belonging to at least eight structural categories; 18F-flortaucipir, known variously as [18F]-T807, AV-1451, and Tauvid®, emerged as the first tau tracer approved by the American Food and Drug Administration. The various tau tracers differ concerning their selectivity over amyloid ß, off-target binding at sites such as monoamine oxidase and neuromelanin, and degree of uptake in white matter. While there have been many reviews of molecular imaging of tau in AD and other conditions, there has been no systematic comparison of the fitness of the various tracers for discriminating between AD patient and healthy control (HC) groups. In this narrative review, we endeavored to compare the binding properties of the various tau tracers in vitro and the effect size (Cohen's d) for the contrast by PET between AD patients and age-matched HC groups. The available tracers all gave good discrimination, with Cohen's d generally in the range of two-three in culprit brain regions. Overall, Cohen's d was higher for AD patient groups with more severe illness. Second-generation tracers, while superior concerning off-target binding, do not have conspicuously higher sensitivity for the discrimination of AD and HC groups. We suppose that available pharmacophores may have converged on a maximal affinity for tau fibrils, which may limit the specific signal imparted in PET studies.

The neural effects of oxytocin administration in autism spectrum disorders studied by fMRI: A systematic review.

PURPOSE: Oxytocin (OXT) is a hypothalamic neuropeptide that is released from the posterior pituitary gland and at specific targets in the central nervous system (CNS). The prosocial effects of OXT acting in the CNS present it as a potential therapeutic agent for the treatment of aspects of autism spectrum disorder (ASD). In this article, we systematically review the functional MRI (fMRI) literature that reports task-state and resting-state fMRI (rsfMRI) studies of the neural effects of single or multiple dose intranasal OXT (IN-OXT) administration in individuals with ASD. METHOD: We searched four databases for relevant documents (PubMed, Web of Science, Scopus, and Google Scholar) using the keywords "autism spectrum disorder", "Asperger Syndrome", "oxytocin", and "fMRI". Moreover, we made a manual search to assess the quality of our automatic search. The search was confined to English language articles published in the interval February 2013 until March 2021. RESULTS: The search yielded 12 fMRI studies with OXT intervention, including 288 individuals with ASD (age 8-55 years) enrolled in randomized, double-blind, placebo-controlled, parallel designs, within-subject-crossover experimental OXT trials. Studies reporting activation task and rsfMRI were summarized with region of interest (ROI) or whole-brain voxel wise analysis. The systematic review of the 12 studies supported the proposition that IN-OXT administration alters brain activation in individuals with ASD. The effects of IN-OXT interacted with the type of the task and the overall results did not indicate restoration of normal brain activation in ASD signature regions albeit the lack of statistical evidence. CONCLUSION: A large body of evidence consistently indicates that OXT alters activation to fMRI in brain networks of individuals with ASD, but with uncertain implications for alleviation of their social deficits.

Analysis of the state of social resilience among different socio-demographic groups during the COVID- 19 pandemic.

This study examines social resilience during the COVID-19 pandemic by analyzing the state of selected indicators among different Socio-Demographic Groups (SDGs) in Tehran, the capital city of Iran. Data were collected via a questionnaire survey. The survey was administered between January and April 2021 and the total number of properly completed questionnaires was 786. The findings show that, first, almost all of the Social Resilience Indicators (SRIs) have experienced negative and unfavorable changes during the pandemic in Tehran. This is remarkably the case for social coping style, social capital, social relationship, and social adaptability. Second, no significant difference in the state of SRIs was observed among different SDGs, except for the age group of 17-20, educational groups with diploma and post-diploma education, and the educational occupational group. Third, testing the impact of the state of SRIs on SDGs indicated a positive and statistically significant impact in four paths, namely SRIs with gender, SRIs with age, SRIs with Job, and SRIs with education. Our results can shed more light on SRIs that can be used to measure the state of social resilience in communities affected by the pandemic, like Tehran. They can also provide insights into actions that should be taken by planners and policy makers to enhance resilience in other communities with similar conditions.

Prognostic Impact of Monocyte to Lymphocyte Ratio in Clinical Outcome of Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-analysis.

BACKGROUND: Lymphocyte to monocyte ratio (LMR) is a surrogate marker of systemic inflammation which is shown to be related to the patient's survival in multiple malignancies. An important implication of this marker potentially is neoplasms in which there is no correlation between prognosis and histopathological staging and also has no reliable chemical markers associated with prognosis. Herein, this meta-analysis aimed to investigate the prognostic role of LMR in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: In the current systemic review and meta-analysis, we conducted a systemic search of databases and indexing sources, including PubMed, EMBASE, Cochrane, Scopus, and ProQuest up to May 2019 toinclude studies on the prognostic significance of LMR on patients with HCC. Overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS) values were extracted from the studies and analyzed. The pooled hazard ratio with a 95% confidence interval was explored to identify the prognostic value of the LMR in the survival of the patients with HCC. RESULTS: A total of 12 studies with a total sample size of 3750 cases were included. There was significant heterogeneity among the studies; therefore, subgroup analysis was also performed. Overall analysis regarding OS showed an insignificant relationship between LMR and patient's prognosis, dividing to subgroups based on LMR cut-offs did not yield any significant result, subgroup analysis for RFS founded statistically significant results and LMR was significantly related to DFS. CONCLUSION: High LMR was associated with increased DFS and RFS, in return this association was not observed for OS.

Deconstruction of the human connexin 26 hemichannel due to an applied electric field; A molecular dynamics simulation study.

Connexins are a 21-member membrane protein family constituting channels evolved in direct communication between adjacent cells by passaging cytoplasmic molecules and ions. Hexametrical assembly of connexin proteins in plasma membrane forms a wide aqueous pore known as connexin hemichannel. These hemichannels mediate cytoplasm and extracellular milieu communication both in many external tissues and in the central nervous system. In this study, a series of molecular dynamics simulations has been performed to investigate the effect of applied static and alternating electric fields on the stability and conformation of human connexin26 hemichannel. The root mean square deviations of C-alpha atoms, the dipole moment distribution, the number of inter-protein hydrogen bonds and the number of water-protein hydrogen bonds were used to assess connexin26 hemichannel stability. In the static field case, our results show that although the lowest field used in this study (0.1V/nm) does not lead to the hemichannel deconstruction, stronger fields (>0.1V/nm), however, disrupt the protein structure during the simulations time period. Furthermore, in the alternating case, compared to static field case, field effects on the connexin26 hemichannel conformation are reduced and consequently the protein maintains its native structure for longer times. Specifically, for the highest frequency used in this study (50GHz), the hemichannel keeps its structure even under the effect of the strongest field (0.4V/nm). According to our results, the protein secondary structure is preserved in the characteristic times determined for the protein deconstruction. Consequently, we suggest that the protein deconstruction is due to the tertiary and quaternary structure loss.