The effect of pregabalin on postoperative pain after anterior cruciate ligament reconstruction: A systematic review of randomized clinical trials.

Background: Despite the enormous success of anterior cruciate ligament (ACL) reconstruction, acute neuropathic pain can develop postoperatively and is both distressing and difficult to treat once established. Pregabalin, an anticonvulsant agent that selectively affects the nociceptive process, has been used as a pain relief agent. The purpose of this systematic review of randomized controlled trials (RCTs) was to evaluate the pain control effect of pregabalin versus placebo after ACL reconstruction. Method: A search of the literature was performed from inception to June 2022, using PubMed, Scopus, Google Scholar, Web of Science, Cochrane and EBSCO. Studies considered for inclusion were RCTs that reported relevant outcomes (postoperative pain scores, cumulative opioid consumption, adverse events) following administration of pregabalin in patients undergoing ACL reconstruction. Result: Five placebo-controlled RCTs involving 272 participants met the inclusion criteria. 75 mg and 150 mg oral pregabalin was used in included trials. Two studies used a single dose of pregabalin one hour before anesthesia induction. Two studies used pregabalin 1 hour before anesthesia induction and 12 hours after. One study used daily pregabalin 7 days before and 7 days after surgery. Out of five papers, three papers found significantly lower pain intensity and cumulative opioid consumption in pregabalin group compared with placebo group. However, a decrease in pain scores was found in all trials. Pregabalin administration was associated with dizziness and nausea. Conclusion: The use of pregabalin may be a valuable asset in pain management after ACL reconstruction. However, future studies with larger sample size and longer follow-up period are required.

Applying the Delphi and fuzzy DEMATEL methods for identification and prioritization of the variables affecting Iranian citrus exports to Russia.

Foreign trade is one of the important components in economic development and a source of foreign exchange earnings. In Iran, the government desires to develop foreign trade with a focus on non-oil exports. One of the substantial non-oil products is agricultural products. Iran is one of the top ten countries in the world in terms of producing agricultural products, especially citrus, but it does not have suitable conditions in terms of exports. Mazandaran province is a considerable source of citrus production in Iran, and the main produced citrus in the province is exported to Russia. Worth bearing in mind that although the production rate of citrus in the province is very well, the amount of export is not very appropriate. Therefore, the government struggles to adopt an appropriate approach to improve the conditions and taking the right approach is not possible without identifying the variables affecting exports. In this regard, in this study, first, the variables affecting citrus exports regarding the case are determined using literature review and the most related those to the case study are selected using the Delphi method. Then, the identified variables are ranked using the fuzzy DEMATEL method. Focusing on the results, it can be observed that "exchange rate fluctuation" and "marketing" have the most and the least impact on the development of citrus exports from the province to Russia, respectively. Moreover, to better analyze the gained results, the determined variables are divided into two main categories based on stages of trade, and each category's variables are discussed in detail.

Recovery solutions for ecotourism centers during the Covid-19 pandemic: Utilizing Fuzzy DEMATEL and Fuzzy VIKOR methods.

Obviously, the Covid-19 pandemic has huge impact on most businesses and has caused serious and countless problems for them. Therefore, providing solutions for affected businesses to recover and improve their activities during pandemic times is inevitable. In this regard, ecotourism centers are one of the businesses that went through this problem and have faced significant dilemmas in their activities. Also, reportedly, there is no related research focusing on the recovery approaches to address these obstacles relating to these kinds of businesses during the pandemic. Therefore, all of these exhorted us to do the current research. In this paper, some practical and useful action plans for ecotourism centers are firstly developed to help these businesses. To obtain the action plans, some brainstorming sessions were held consisting of tourism experts, university professors, managers, owners, and some personnel of eco-tourism centers. In order to prioritize the defined action plans, four criteria are considered. Firstly, we compute the weights of the considered criteria by the Fuzzy DEMATEL and then they are prioritized using the Fuzzy VIKOR. The findings of the current study divulge that the AP2 "Standardization of the centers" and AP3 "Estimating demand number and increasing the capacity" and AP7 "Identifying other natural tourist attractions of the region" have the highest and lowest priority to be implemented.

Ecotourism supply chain during the COVID-19 pandemic: A real case study.

The coronavirus (COVID-19) disease has caused serious and irreversible damage to the ecotourism industry, posing serious challenges to all parts of the ecotourism supply chain. The ecotourism supply chain is made up of various components, the most important of which are ecotourism centers. During these pandemic times, the primary concerns of these centers are to improve their deplorable economic conditions and retain customers for the post-coronavirus era. As a result, an investigation should be conducted to address these concerns and provide appropriate solutions to help them overcome the challenges that have emerged. To achieve the research goal, a bi-objective mathematical model for the ecotourism supply chain in an uncertain environment is developed, accounting for the effects of COVID-19. The first objective function minimizes the total cost of the supply chain, while the second maximizes customer satisfaction. The proposed mathematical model is solved using a fuzzy goal programming (FGP) method. A sensitivity analysis study is also carried out to examine the performance of some basic parameters. Furthermore, the model is tested in a real case study to determine its efficacy. Finally, some effective managerial insights are proposed to improve the situation of the centers during the pandemic.

Effect of chitosan-whey protein isolated coatings incorporated with tarragon Artemisia dracunculus essential oil on the quality of Scomberoides commersonnianus fillets at refrigerated condition.

The purpose of present work was to assess the effects of chitosan (CH) coating in combination with whey protein isolated (WPI) and tarragon essential oil (TEO) on the bacterial (total mesophilic (TMC) bacteria and psychrotrophic (PTC) bacteria), physicochemical (total volatile bases- nitrogen (TVB-N), pH, thiobarbituric acid reactive substances (TBARS), free fatty acid (FFA)) and sensory properties of Scomberoides commersonnianus muscle during storage at refrigerator (4 ± 1 °C). The fillet were randomly divided into seven lots and subjected to the following treatments by immersion: chitosan (CH), whey protein isolate (WPI), whey protein isolate- TEO (WPI-TEO), chitosan-TEO (CH-TEO), chitosan-whey protein isolated (CH-WPI), chitosan/whey protwin isolated+ TEO (CH/WPI + TEO) and controls, then stored at 4 °C. Results indicated that incorporation of WPI and TEO into the material coating developed active coatings with good antimicrobial agent growth inhibition activity against TMC and PTC bacteria. The coated samples also retarded the increase in the contents of TVB-N, pH, TBARS and FFA during storage. The score less than critical score of 3 was made at day 8 and 12 for fillet coated with control and coated samples except of fillets coated with chitosan, respectively. These results confirmed that the incorporation of essential oils or other biopolymers into edible coatings may improve the deterioration of chilled seafood.

The shelf life extension of refrigerated Nemipterus japonicus fillets by chitosan coating incorporated with propolis extract.

In this study, chitosan coatings incorporated with propolis extract (PE) were utilized to extend the shelf-life of refrigerated Nemipterus japonicus fillets. Microbiological (total mesophilic bacteria (TMB) and total psychrotrophic count (TPC)), physicochemical (pH, total volatile bases nitrogen (TVB-N), 2-thiobarbituric acid reactive substances (TBARS), free fatty acid (FFA)) and sensory (color, odor and preference) characteristics of coated fillets were evaluated during 12days. The results showed that incorporating PE into chitosan solution could significantly (P<0.05) improve the quality of fish fillets. The results showed that the chitosan+PE samples reduced the extent of lipid oxidation, as judged by TBARS and FFA, suggesting that there is a synergistic effect between chitosan coating and propolis. Moreover, the application of chitosan coatings with PE improved the TVB-N and pH values of the Nemipterus japonicus samples significantly compared to untreated sample, thus extending the shelf life of Nemipterus japonicus fillet approximately >10days. All wrapped fillets in treatment samples incorporated with PE had lower bacterial counts compared to control (P<0.05). However, the bacterial counts of chitosan coating combined with PE were lower than those treated by chitosan or PE alone during the storage. The fillets treated with chitosan and PE had the best sensory properties. The increase (>10days) in the shelf-life was attributed to the antioxidant and antimicrobial characteristics of chitosan and PE. These results confirmed that chitosan coating enriched with PE can be an improving method to reducing deterioration of refrigerated Nemipterus japonicus fillets.

Vitamin D status of 6- to 7-year-old children living in Isfahan, Iran.

INTRODUCTION: Vitamin D is essential for the maintenance of good health, and vitamin D deficiency has been reported from many countries, including those with a lot of sunshine. This study was conducted to evaluate the vitamin D status in healthy 6- to 7-year-old children in Isfahan, Iran. MATERIAL AND METHODS: Five hundred and thirteen healthy children were enrolled. Serum PTH and 25-hydroxyvitamin D (25-OHD) were measured. Dietary vitamin D intake, duration of daily sunlight exposure, and percentage of exposed body surface area were determined. 25-OHD levels < 20 ng/mL and < 10 ng/mL were defined as mild and severe vitamin D deficiency, respectively. The ROC curve was utilized to obtain a local cut-off point of vitamin D deficiency. RESULTS: 25-OHD was < 20 ng/mL in 3% and < 33 ng/mL (local cut-off point of vitamin D deficiency) in 26% of subjects. Duration of sunlight exposure and daily intake of vitamin D had significant effects on serum level of vitamin D. CONCLUSIONS: A high prevalence of vitamin D deficiency in Isfahan children was observed in this study. Improvements in duration of sunlight exposure and daily intake of vitamin D can prevent vitamin D deficiency in these children.