Association between health literacy and Framingham risk score.

High health literacy (HL) plays a critical role in preventing or delaying the onset of cardiovascular diseases (CVDs) and can improve disease management and control. The present study aims to determine the association between HL and non-laboratory-based (office-based) Framingham 10-year risk score of CVD. This cross-sectional study was conducted on 648 people aged 30-65 in the health centers of Jahrom. The Health Literacy Instrument for Adults (HELIA) was used to assess HL. The non-laboratory-based Framingham risk score (FRS) was utilized to determine the 10-year risk of CVDs. Risk factors such as age, gender, diabetes, current smoking status, systolic blood pressure (SBP), hypertension (HTN) treatment, and body mass index (BMI) were applied in the non-laboratory-based model. The average age of the subjects was 44.7 ± 10.5 years, among which 49.2% were males. The prevalence of diabetes, HTN, and smoking equaled 8.5%, 15.7%, and 10%, respectively. In addition, the average BMI was 26.1 ± 3.6 kg/m2. Based on the non-laboratory-based Framingham 10-year risk score of CVD, 72.5%, 13.9%, and 13.6% of the subjects were in the low, moderate, and high risk groups, respectively. Based on the HL grouping, the levels of insufficient, borderline, sufficient, and excellent HL were 19.3%, 26.4%, 34.6%, and 19.7%, respectively. A significant association was observed between 10-year CVD risk and HL grouping. In addition, a negative correlation was reported at the individual level between HL and non-laboratory-based FRS among the whole population (r = - 0.39, p < 0.001), men (r = - 0.32, p < 0.001), and women (r = - 0.42, p < 0.001). A higher HL score is associated with a lower risk of CVD. In addition, the adjusted logistic regression analysis showed that there was a strong association between elevated CVD risk (≥ 10%) and HL (OR 6.1, 95% CI 2.9-12.6) among inadequate HL participants compared with excellent HL individuals. Thus, designing and implementing training programs to increase HL, especially among those who are at risk of CVDs, should be regarded as an important issue for the prevention of such diseases.

Framingham risk scores for determination the 10-year risk of cardiovascular disease in participants with and without the metabolic syndrome: results of the Fasa Persian cohort study.

BACKGROUND: Metabolic syndrome (MetS) is a cluster of risk factors and the Framingham risk score (FRS) is a useful metric for measuring the 10-year cardiovascular disease (CVD) risk of the population. The present study aimed to determine the 10-year risk of cardiovascular disease using the Framingham risk score in people with and without MetS in a large Iranian cohort study. METHODS: This cross-sectional study was done using the Fasa cohort. Participants aged ≥ 35 years old were recruited to the study from 2015 to 2016. The FRS was calculated using age, sex, current smoking, diabetes, systolic blood pressure (SBP), total cholesterol, and high-density lipoprotein (HDL) cholesterol. MetS was defined as the presence of three or more of the MetS risk factors including triglyceride (TG) level ≥ 150 mg dl- 1, HDL level < 40 mg dl- 1 in men and < 50 mg dl- 1 in women, systolic/diastolic blood pressure ≥ 130/≥85 mmHg or using medicine for hypertension, fasting blood sugar (FBS) level ≥ 100 mg dl- 1 or using diabetes medication and abdominal obesity considered as waist circumference (WC) ≥ 88 cm for women and ≥ 102 cm for men. Multiple logistic regressions were applied to estimate the 10- year CVD risk among people with and without MetS. RESULTS: Of 8949 participants, 1928 people (21.6%) had MetS. The mean age of the participants with and without Mets was 50.4 ± 9.2 years and 46.9 ± 9.1 years respectively. In total 15.3% of participants with MetS and 8.0% of participants without MetS were in the high-risk category of 10-year CVD risk. Among participants with MetS gender, TG, SBP, FBS and in people without MetS gender, TG, SBP, FBS, and HDL showed strong associations with the predicted 10-year CVD risk. CONCLUSION: Male sex and increased SBP, TG, and FBS parameters were strongly associated with increased 10-year risk of CVD in people with and without MetS. In people without MetS, reduced HDL-cholestrol was strongly associated with increased 10-year risk of CVD. The recognition of participant's TG, blood pressure (BP), FBS and planning appropriate lifestyle interventions related to these characteristics is an important step towards prevention of CVD.

Trend Analysis of Lung Cancer Mortality and Years of Life Lost (YLL) in South of Iran, 2004-2019.

Background: We aimed to determine the mortality rate and Years of Life Lost (YLL) due to lung cancer in Fars, Iran, during the period from 2004 to 2019. Methods: All deaths due to lung cancer in Fars Province, Iran from the electronic population-based death registration system (EDRS) were obtained. Crude mortality rate, age-standardized mortality rate, YLL and YLL rate data were calculated and trends examined. Results: During 2004-2019, 3346 deaths occurred due to lung cancer in Fars Province, which was 10.8% (3346/30936) of the total cancer deaths in this period. Crude mortality rate of lung cancer had increased 70% and 53% in male and female respectively from 2004 to 2019. The total YLL of lung cancer during the 16-year study period was 28,094 (0.9 per 1000) in men, 14,174 (0.5 per 1000) in women, and 42,268 (0.8 per 1000) in both sexes (sex ratio male/female=2). According to the join point regression, the 16- year trend of YLL rate due to premature mortality was increasing: APC was 2.5% (95% CI 0.9 to 4.2, P=0.005) for males, 1.4% (95% CI 0.3 to 2.6, P=0.017) for females. Conclusion: The mortality rate and YLL due to lung cancer in Fars Province is increasing, although the standardized mortality has a constant trend. Tobacco control is the most effective and least expensive way to reduce the number of lung cancer patients worldwide. National and local media can also play an important role in informing people about the risk factors.

An Analysis of Scientific Research Trends in Oral Implantology Between 2016 - 2022.

The present study aims to evaluate the trends of oral implant-related research in design and topics between the range of 2016 to the end of 2022. The electronic search was conducted in MEDLINE via Pubmed. Papers published in Clinical Oral Implant Research, Clinical Implant Dentistry and Related Research, International Journal of Oral Implantology and previously, European Journal of Oral Implantology, International Journal of Oral and Maxillofacial Implants, and Journal of Oral Implantology, Between January 1, 2016, to December 30, 2022, were retrieved. Articles were classified according to their study design and major subjects. The Joinpoint regression model was used to determine changes in the trends of study designs and topics. Statistical significance was defined as a p-value < 0.05. A total of 3,382 articles were analyzed in this study. In the specified period, in vivo, prospective cohort, retrospective case-control, randomized clinical studies, in the design; and prosthetic complications, peri-implant hard tissue studies, in the topic, experienced a significant decreasing pattern in the number of published articles as well as the total number of articles. Case reports and series, retrospective cohort, non-randomized clinical studies, in the design; and outcomes of implant-related treatment plans, immediate implant placement, peri- implantitis, in the topic, experienced a significant decreasing pattern followed by a significant increasing pattern with a turning point between 2017 to 2020. Considering the limitations of this scientific topical trends analysis, it can be concluded that the recent pandemic affected the research path in oral implantology in many ways.

Engineered dendritic cells-derived exosomes harboring HIV-1 Nefmut-Tat fusion protein and heat shock protein 70: A promising HIV-1 safe vaccine candidate.

Antigen presenting cells (APCs)-derived exosomes are nano-vesicles that can induce antigen-specific T cell responses, and possess therapeutic effects in clinical settings. Moreover, dendritic cells (DCs)-based vaccines have been developed to combat human immunodeficiency virus-1 (HIV-1) infection in preclinical and clinical trials. We investigated the immunostimulatory effects (B- and T-cells activities) of DCs- and exosomes-based vaccine constructs harboring HIV-1 Nefmut-Tat fusion protein as an antigen candidate and heat shock protein 70 (Hsp70) as an adjuvant in mice. The modified DCs and engineered exosomes harboring Nefmut-Tat protein or Hsp70 were prepared using lentiviral vectors compared to electroporation, characterized and evaluated by in vitro and in vivo immunological tests. Our data indicated that the engineered exosomes induced high levels of total IgG, IgG2a, IFN-γ, TNF-α and Granzyme B. Moreover, co-injection of exosomes harboring Hsp70 could significantly increase the secretion of antibodies, cytokines and Granzyme B. The highest levels of IFN-γ and TNF-α were observed in exosomes harboring Nefmut-Tat combined with exosomes harboring Hsp70 (Exo-Nefmut-Tat + Exo-Hsp70) regimen after single-cycle replicable (SCR) HIV-1 exposure. Generally, Exo-Nefmut-Tat + Exo-Hsp70 regimen can be considered as a promising safe vaccine candidate due to high T-cells (Th1 and CTL) activity and its maintenance against SCR HIV-1 exposure.

Non-coding RNA transcripts, incredible modulators of cisplatin chemo-resistance in bladder cancer through operating a broad spectrum of cellular processes and signaling mechanism.

Bladder cancer (BC) is a highly frequent neoplasm in correlation with significant rate of morbidity, mortality, and cost. The onset of BC is predominantly triggered by environmental and/or occupational exposures to carcinogens, such as tobacco. There are two distinct pathways by which BC can be developed, including non-muscle-invasive papillary tumors (NMIBC) and non-papillary (or solid) muscle-invasive tumors (MIBC). The Cancer Genome Atlas project has further recognized key genetic drivers of MIBC along with its subtypes with particular properties and therapeutic responses; nonetheless, NMIBC is the predominant BC presentation among the suffering individuals. Radical cystoprostatectomy, radiotherapy, and chemotherapy have been verified to be the common therapeutic interventions in metastatic tumors, among which chemotherapeutics are more conventionally utilized. Although multiple chemo drugs have been broadly administered for BC treatment, cisplatin is reportedly the most effective chemo drug against the corresponding malignancy. Notwithstanding, tumor recurrence is usually occurred following the consumption of cisplatin regimens, particularly due to the progression of chemo-resistant trait. In this framework, non-coding RNAs (ncRNAs), as abundant RNA transcripts arise from the human genome, are introduced to serve as crucial contributors to tumor expansion and cisplatin chemo-resistance in bladder neoplasm. In the current review, we first investigated the best-known ncRNAs, i.e. microRNAs (miRNAs), long ncRNAs (lncRNAs), and circular RNAs (circRNAs), correlated with cisplatin chemo-resistance in BC cells and tissues. We noticed that these ncRNAs could mediate the BC-related cisplatin-resistant phenotype through diverse cellular processes and signaling mechanisms, reviewed here. Eventually, diagnostic and prognostic potential of ncRNAs, as well as their therapeutic capabilities were highlighted in regard to BC management.

Jewelry rock discrimination as interpretable data using laser-induced breakdown spectroscopy and a convolutional LSTM deep learning algorithm.

In this study, the deep learning algorithm of Convolutional Neural Network long short-term memory (CNN-LSTM) is used to classify various jewelry rocks such as agate, turquoise, calcites, and azure from various historical periods and styles related to Shahr-e Sokhteh. Here, the CNN-LSTM architecture includes utilizing CNN layers for the extraction of features from input data mixed with LSTMs for supporting sequence forecasting. It should be mentioned that interpretable deep learning-assisted laser induced breakdown spectroscopy helped achieve excellent performance. For the first time, this paper interprets the Convolutional LSTM effectiveness layer by layer in self-adaptively obtaining LIBS features and the quantitative data of major chemical elements in jewelry rocks. Moreover, Lasso method is applied on data as a factor for investigation of interoperability. The results demonstrated that LIBS can be essentially combined with a deep learning algorithm for the classification of different jewelry songs. The proposed methodology yielded high accuracy, confirming the effectiveness and suitability of the approach in the discrimination process.

In silico designing of novel epitope-based peptide vaccines against HIV-1.

The HIV-1 virus has been regarded as a catastrophe for human well-being. The global incidence of HIV-1-infected individuals is increasing. Hence, development of effective immunostimulatory molecules has recently attracted an increasing attention in the field of vaccine design against HIV-1 infection. In this study, we explored the impacts of CD40L and IFN-γ as immunostimulatory adjuvants for our candidate HIV-1 Nef vaccine in human and mouse using immunoinformatics analyses. Overall, 18 IFN-γ-based vaccine constructs (9 constructs in human and 9 constructs in mouse), and 18 CD40L-based vaccine constructs (9 constructs in human and 9 constructs in mouse) were designed. To find immunogenic epitopes, important characteristics of each component (e.g., MHC-I and MHC-II binding, and peptide-MHC-I/MHC-II molecular docking) were determined. Then, the selected epitopes were applied to create multiepitope constructs. Finally, the physicochemical properties, linear and discontinuous B cell epitopes, and molecular interaction between the 3D structure of each construct and CD40, IFN-γ receptor or toll-like receptors (TLRs) were predicted. Our data showed that the full-length CD40L and IFN-γ linked to the N-terminal region of Nef were capable of inducing more effective immune response than multiepitope vaccine constructs. Moreover, molecular docking of the non-allergenic full-length- and epitope-based CD40L and IFN-γ constructs to their cognate receptors, CD40 and IFN-γ receptors, and TLRs 4 and 5 in mouse were more potent than in human. Generally, these findings suggest that the full forms of these adjuvants could be more efficient for improvement of HIV-1 Nef vaccine candidate compared to the designed multiepitope-based constructs.

Are behavioral economics interventions effective in increasing colorectal cancer screening uptake: A systematic review of evidence and meta-analysis?

Various interventions have been investigated to improve the uptake of colorectal cancer screening. In this paper, the authors have attempted to provide a pooled estimate of the effect size of the BE interventions running a systematic review based meta-analysis. In this study, all the published literatures between 2000 and 2022 have been reviewed. Searches were performed in PubMed, Scopus and Cochrane databases. The main outcome was the demanding the one of the colorectal cancer screening tests. The quality assessment was done by two people so that each person evaluated the studies separately and independently based on the individual participant data the modified Jadad scale. Pooled effect size (odds ratio) was estimated using random effects model at 95% confidence interval. Galbraith, Forrest and Funnel plots were used in data analysis. Publication bias was also investigated through Egger's test. All the analysis was done in STATA 15. From the initial 1966 records, 38 were included in the final analysis in which 72612 cases and 71493 controls have been studied. About 72% have been conducted in the USA. The heterogeneity of the studies was high based on the variation in OR (I2 = 94.6%, heterogeneity X2 = 670.01 (d.f. = 36), p < 0.01). The random effect pooled odds ratio (POR) of behavioral economics (BE) interventions was calculated as 1.26 (95% CI: 1.26 to 1.43). The bias coefficient is noteworthy (3.15) and statistically significant (p< 0.01). According to the results of this meta-analysis, health policy and decision makers can improve the efficiency and cost effectiveness of policies to control this type of cancer by using various behavioral economics interventions. It's noteworthy that due to the impossibility of categorizing behavioral economics interventions; we could not perform by group analysis.

Development of novel HPV therapeutic vaccine constructs based on engineered exosomes and tumor cell lysates.

AIMS: Human papillomavirus (HPV) infections are highly prevalent globally. While preventive HPV vaccines exist, therapeutic vaccines are needed to treat existing HPV lesions and malignancies. This study evaluated the immunostimulatory and anti-tumor effects of three therapeutic vaccine candidates based on the recombinant protein, tumor cell lysate (TCL), and engineered exosome (Exo) harboring the heat shock protein 27 (Hsp27)-E7 fusion construct in mouse model. MAIN METHODS: At first, the recombinant Hsp27-E7 protein was generated in E. coli expression system. Then, tumor cell lysates-based and engineered exosomes-based vaccine constructs harboring green fluorescent protein (GFP) and Hsp27-E7 were produced using lentiviral system. Finally, their immunological and antitumor effects were investigated in both prophylactic and therapeutic experiments. KEY FINDINGS: Our data showed that the recombinant Hsp27-E7 protein, TCL-Hsp27-E7 and Exo-Hsp27-E7 regimens can induce the highest level of IFN-γ, TNF-α and Granzyme B, respectively. The percentage of tumor-free mice was identical for three vaccine strategies (survival rate: 75 %) in both prophylactic and therapeutic experiments. Generally, the TCL-Hsp27-E7, Exo-Hsp27-E7 and recombinant Hsp27-E7 protein regimens induced effective immune responses toward Th1 and CTL activity, and subsequently antitumor effects in mouse model. SIGNIFICANCE: Regarding to higher Granzyme B secretion, lower tumor growth and more safety, the Exo-Hsp27-E7 regimen can be considered as the most promising HPV vaccination strategy.

Transcriptional alteration of NF-κB-associated long noncoding RNAs in the stomach of Helicobacter pylori-infected and non-infected patients.

INTRODUCTION: Helicobacter pylori could colonize the gastric mucosa and cause gastritis, ulcers and cancer. Numerous virulence factors have been identified in this bacterium that play important roles in promoting gastric disorders. Although the interaction of long noncoding RNAs (lncRNAs) with transcription, processing, and translation of genes associated with different diseases are described, their interaction with the inflammatory genes and H. pylori infection in the gastric tissue is not well known. This study compared changes in common NF-κB-regulatory lncRNAs in the gastric tissue of H. pylori-infected and non-infected patients with gastritis. Moreover, a link between the virulence entity of the strains and the transcriptional changes was analyzed. METHODOLOGY: Two groups of infected and non-infected patients with chronic gastritis were included in the study. Genotyping of the H. pylori strains was done by PCR and relative changes in the expression of NF-κB and regulatory lncRNAs, lincRNA-p21, MALAT1, NKILA, were measured by relative quantitative real time-PCR. RESULTS: Transcriptional levels of MALAT1, lincRNA-p21, and NKILA genes decreased in the infected patients compared with the non-infected patients, which was significantly linked with increased NF-κB gene expression. Our results showed that a hypervirulent strain of H. pylori with oipA"on"/HP-NAP+/iceA1+/iceA2+/vacA s1m1/s1m2+/cagA+ genotype can promote a higher level of NF-κB transcription in the inflamed tissue. CONCLUSIONS: H. pylori infection could promote down-regulation of lincRNA-p21, MALAT1 and NKILA in the infected gastric tissue in correlation with NF-κB upregulation. More detailed studies are needed to show a link between the virulence genes and their impact on the regulation of lncRNAs in the stomach.

Captopril supported on magnetic graphene nitride, a sustainable and green catalyst for one-pot multicomponent synthesis of 2-amino-4H-chromene and 1,2,3,6-tetrahydropyrimidine.

Captopril (CAP) is a safe, cost-effective, and environmentally organic compound that can be used as an effective organo-catalyst. Functional groups of captopril make it capable to attach to solid support and acting as promoters in organic transformations. In this work, captopril was attached to the surface of magnetic graphene nitride by employing a linker agent. The synthesized composite efficiently catalyzed two multicomponent reactions including the synthesis of 1,2,3,6-tetrahydropyrimidine and 2-amino-4H-chromene derivatives. A large library of functional targeted products was synthesized in mild reaction conditions. More importantly, this catalyst was stable and magnetically recycled and reused for at least five runs without losing catalytic activity.

Mortality Rate and Years of Life Lost Due to Road Traffic Accidents in Fars Province, 2004-2019.

Background: Traffic accidents are one of the most critical health problems and the ninth leading cause of death globally. We aimed to determine the Mortality rate and the number of Years of Life Lost (YLL) due to road traffic accidents. Methods: In this retrospective cohort study, mortality rate and YLL due to road traffic accidents were examined in Fars province, central Iran during the years 2004-2019. Mortality statistics were collected through death registration of ministry of health and medical education for Fars Province. Age Standardized mortality Rate (ASR) was calculated and join point regression analysis carried out to examine the trend of YLL rate. Data were analyzed using Excel spreadsheet version 2016 and Join point Regression Program 4.9.0.0. Results: During the 16-year study period, 25,858 deaths due to road traffic accidents occurred in the province. 79.2% (20483 cases) were in men, and 33.7% (8703 cases) were aged 15-29 years. Total YLL during the 16-year study period were 458,975 (14.6 per 1000 people) in men, 117,999 (3.8 per 1000 people) in women. According to the join point regression, the 16- year trend of YLL rate due to premature mortality was decreasing: AAPC was -4.9% (95% CI: -8.8 to -0.9; P=0.018) for male, and -3.5% (95% CI: -6.3 to-0.5; P=0.011) for female. Conclusion: Considering that the number of deaths, mortality rate and YLL has decreased in Fars province during the 16 years under study. Therefore, because the mortality rate due to road traffic accidents in Iran is higher than the global average, the need for training programs for drivers, compliance with standards and retrofitting of vehicles, road safety, driving supervision and the use of seat belts are essential.

Unintentional injuries in children in the south of Iran, 2004-2019: a trend analysis of mortality rates.

INTRODUCTION: Injury is one of the main causes of death and disability in the world. This study was designed to determine the trend of mortality rate and years of life lost (YLLs) due to unintentional injuries in children in southern Iran. METHOD: In this cross-sectional study, we extracted all death reports due to unintentional injuries based on age, gender and the year of death based on International Classification of Diseases (ICD-10)from the Electronic Death Registration System. The YLL analysis due to premature death related to unintentional injuries was executed by the 2015 YLL template from the WHO using the Excel V.2016 software. To examine the trend of crude mortality rate and YLL rates for different years, joinpoint regression was used based on the log-linear model. RESULTS: During the 16-year study period (2004-2019), 6590 deaths due to unintentional injuries in children aged 0-19 years have occurred. The total YLLs due to unintentional injuries were 138 482 in males and 53 168 in females. The three main causes of YLLs in our study were transportation injuries (67.37%), drowning (7.19%) and burns (6.70%). According to the joinpoint regression analysis, the 16-year trend of YLL rate due to premature mortality was decreasing; the annual per cent change was -5.2% (95% CI -6.5% to -3.9%, p<0.001) for males and -4.3% (95% CI -5.7% to -3.0%, p<0.001) for females. CONCLUSION: Based on the findings of this study, the trend of mortality and YLL rate has been decreasing. Road traffic injuries were the most frequent injuries and the most common cause of death. Mortality rates fell by half. To improve child survival, injuries must now be recognised as a major child health problem, and to prevent deaths from injuries in children, early and preventive measures should be taken into account.

A comparison of laboratory-based and office-based Framingham risk scores to predict 10-year risk of cardiovascular diseases: a population-based study.

BACKGROUND: Two versions of Framingham's 10-year risk score are defined for cardiovascular diseases, namely laboratory-based and office-based models. The former is mainly employed in high-income countries, but unfortunately, it is not cost-effective or practical to utilize it in countries with poor facilities. Therefore, the present study aims to identify the agreement and correlation between laboratory-based and office-based Framingham models. METHODS: Using laboratory-based and office-based Framingham models, this cross-sectional study used data from 8944 participants without a history of CVDs and stroke at baseline in the Fasa cohort study to predict the 10-year risk of CVDs. The laboratory-based model included age, sex, diabetes, smoking status, systolic blood pressure (SBP), treatment of hypertension, total cholesterol, and high-density lipoprotein (HDL); and the office-based model included age, sex, diabetes, smoking status, SBP, treatment of hypertension, and body mass index (BMI). The agreement between risk categories of laboratory-based and office-based Framingham models (low [< 10%], moderate [from 10 to < 20%], high [≥ 20%]) was assessed by kappa coefficients and percent agreement. Then, the correlation between the risk scores was estimated using correlation coefficients and illustrated using scatter plots. Finally, agreements, correlation coefficient, and scatter plots for laboratory-based and office-based Framingham models were analyzed by stratified Framingham risk score factors including sex, age, BMI categories, hypertension, smoking, and diabetes status. RESULTS: The two models showed substantial agreement at 89.40% with a kappa coefficient of 0.75. The agreement was substantial in all men (kappa = 0.73) and women (kappa = 0.72), people aged < 60 years (kappa = 0.73) and aged ≥ 60 years (kappa = 0.69), smokers (kappa = 0.70) and non-smokers (kappa = 0.75), people with hypertension (kappa = 0.73) and without hypertension (kappa = 0.75), diabetics (kappa = 0.71) and non-diabetics (kappa = 0.75), people with normal BMI (kappa = 0.75) and people with overweight and obesity (kappa = 0.76). There was also a very strong positive correlation (r ≥ 0.92) between laboratory-based and office-based models in terms of age, sex, BMI, hypertension, smoking status and diabetes status. CONCLUSIONS: The current study showed that there was a substantial agreement between the office-based and laboratory-based models, and there was a very strong positive correlation between the risk scores in the entire population as well across subgroups. Although differences were observed in some subgroups, these differences were small and not clinically relevant. Therefore, office-based models are suitable in low-middle-income countries (LMICs) with limited laboratory resources and facilities because they are more convenient and accessible. However, the validity of the office-based model must be assessed in longitudinal studies in LMICs.

Persistent suffering: Living experiences of patients with rare disease: An interpretative phenomenological study.

BACKGROUND: The low prevalence of rare diseases has caused the need for studies in this field to be neglected. Regardless of the prevalence of rare diseases, many people around the world have to live with the medical, psychological, and social consequences of their condition. Individuals with rare diseases may face challenges that are different from those experienced in more common medical conditions. The life experiences of patients with rare diseases have not been sufficiently investigated. The purpose of this study was to discover the meaning of living as a person with a rare disease. MATERIALS AND METHODS: This interpretative phenomenological study was conducted in 2021-2022 on 10 patients with one of the rare diseases (registered in the Atlas of Rare Diseases of Iran). Based on purposeful sampling, people with rare diseases living in Mazandaran, Golestan, and Tehran provinces were invited to participate in the study. Data collection was done using open and semi-structured interviews. The research question was exploring understanding the experience and meaning of life as a person with a rare disease. Van Manen's interpretive phenomenological approach was used to analyze the data, and the criteria of validity, transferability, and verifiability were used to ensure the trustworthiness of the research. RESULTS: The five main themes "permanent suffering, such as a bird in a cage, rejection, immersion in the whirlpool of thoughts, losing the feeling of life", and 10 sub-themes "nightmare, giving up, deprivation, limitation, worthlessness, being stigmatized, dark vision, confusion, continuous regret, and inferiority feeling" were extracted. CONCLUSION: The results of this study show that the suffering of the disease casts a shadow on all aspects of a patient's life with a rare disease. The effects of illness, disability, limitations, and exclusions had created a human being in a cage, whose right to live like others has been denied.

Transcriptional analysis of Helicobacter pylori cytotoxic-associated gene-pathogenicity island in response to different pH levels and proton pump inhibitor exposure.

BACKGROUND: Long-term use of proton pump inhibitors (PPIs) can increase the risk of gastric cancer in Helicobacter pylori-infected patients; nevertheless, there is no data about their impact on the pathogenicity of H. pylori. This study aimed at investigating the transcriptional alteration of key gene mediators of cytotoxin-associated gene-pathogenicity island (cag-PAI) among clinical H. pylori isolates in response to omeprazole at different pH levels. METHODS: Accordingly, H. pylori isolates with the same virulence genotypes selected from the gastric biopsies of patients and transcriptional alteration in the cag-PAI genes studied in the presence or absence of omeprazole (2 mg/mL) at pH 2.0, 4.0 and 7.0 after 30 and 90 minutes of the treatment. Relative changes in the transcriptional levels were recorded in each assay, separately. RESULTS: Of 18 H. pylori isolates, the cag-PAI empty site was detected in four strains, while the presence of cagA, cagL and cagY was characterized in 77.7%, 83.3% and 83.3% of the cag-PAI-positive strains, respectively. Transcriptional analysis of the selected strains showed up-regulation of cagA and cagL, mainly at pH 2.0 and 4.0 after 30 and 90-minute exposure. A diversity in the expression levels of cag-PAI genes was seen among the strains at the extent and time of induction. CONCLUSION: Our results showed that omeprazole could increase the expression of H. pylori cagA and cagL at acidic pH. Heterogeneity among the strains probably has an impact on the extent of their interplay with PPIs. Further studies are needed to establish this correlation.

Immunoinformatics studies of heat shock proteins 27 and 70: Development of potent therapeutic vaccine constructs against human papillomavirus-related cancers.

Heat shock proteins (HSPs) improve cross-presentation of linked tumor antigens, thus they can be exploited in therapeutic vaccine design. Herein, in silico analyses of different vaccine constructs were performed based on human papillomavirus (HPV)-16 E7 protein linked to Homo sapiens/Mus musculus Hsp27 or Hsp70 in multiepitope and whole sequence forms. Then, computational comparison between different orientations of Hsp/E7 was carried out in both forms. Finally, molecular docking was performed between the designed constructs and signaling (TLRs) or endocytic (CD14, LOX-1 and SREC-1) receptors. Our data represented the high-ranked T-cell epitopes and the potential B-cell epitopes of Homo sapiens/Mus musculus Hsp27 and Hsp70. Moreover, molecular docking showed that whole sequence of Hsp27 had better interaction with all receptors than whole sequence of Hsp70 suggesting likely stronger stimulation of innate and adaptive immunity. All designed Homo sapiens/Mus musculus Hsp27/E7 constructs had better docking scores with the endocytic receptors especially SREC-1 than all designed Homo sapiens/Mus musculus Hsp70/E7 constructs in both orientations. Generally, the multiepitope-/whole sequence-based Homo sapiens/Mus musculus Hsp27-E7 fusion constructs showed more conservancy and immunogenicity than other designed constructs. These fusion constructs were non-allergenic, non-toxic and stable suggesting them as promising vaccine candidates against HPV-related cancers.

Stability, optimum ultrasonication, and thermal and electrical conductivity estimation in low concentrations of Al12Mg17 nanofluid by dynamic light scattering and beam displacement method.

The thermal conductivity and stability of nanofluids pose challenges for their use as coolants in thermal applications. The present study investigates the heat transfer coefficient (HTC) of an Al12Mg17 nanofluid through the utilization of a novel beam displacement method. The study also examines the nanofluid's stability, particle size distribution (PSD), TEM micrograph, and electrical conductivity. From three distinct categories of surfactants, a particular surfactant (CTAB) was chosen to disperse Al12Mg17 nanoparticles in DI water, and subsequently, a two-step method was employed to generate the nanofluid. Dispersion stability is visually monitored and quantified with a zeta potential test. HTC and PSD are measured using optical setups. To evaluate the results, the HTC obtained from the beam displacement method is compared with that of the KD2 Pro apparatus, and the PSD findings are analyzed through TEM micrographs. The results show that a 0.16 vol.% CTAB is the maximum stability for 0.025 vol.% Al12Mg17 nanofluid properly. The optimum ultrasonication period is 2 h, yielding a peak PSD of 154 nm. Increasing nanoparticle concentration enhances HTC up to 40% compared to the base fluid at 0.05 vol.%. Electrical conductivity increases linearly from 155 to 188 µ[Formula: see text] with nanoparticle concentration. Optical methods for measuring HTC in nanofluids offer the advantage of early results, prior to bulk motion. Thus, the application of nanofluids in thermal systems necessitates the development of optical techniques to improve accuracy.