Intraocular Pressure Before and After Corneal Refractive Surgery: A Prospective Comparison of Corvis ST and Ocular Response Analyzer

PRECIS

The study showed that Corvis ST's bIOP and ORA's IOPcc do not agree well, before or after PRK, and may not be used interchangeably. bIOP remained unchanged after PRK.

PURPOSE

To evaluate the agreement between the biomechanically-corrected intraocular pressure (bIOP) measured by the Corvis-ST and the cornea-compensated IOP (IOPcc) measured by the Ocular Response Analyzer (ORA) before and after photorefractive keratectomy (PRK).

METHODS

In this prospective interventional study, a total of 53 patients (53 eyes) were included. Measurements were acquired using both the Corvis-ST and ORA devices before and 3 months post- PRK. The agreement between the two devices was evaluated using limits of agreement (LoA) and Bland-Altman plots.

RESULTS

The participants had a mean age of 29.6±5.21 years (range: 21 to 40), with 41 (77.4%) of them being female. Following the surgery, the average change in IOP was 0.3±1.7 mmHg for bIOP and -1.6±4.0 mmHg for IOPcc. The corresponding 95% LoA were -3.5 to 4.2 mmHg and -9.5 to 6.3 mmHg, respectively. The 95% LoA between bIOP and IOPcc after PRK was -2.3 to 8.5 mmHg. Notably, the bIOP values were higher for IOPs <20 mmHg and lower for IOPs >20 mmHg compared to IOPcc.

CONCLUSIONS

The findings indicate a weak agreement between the Corvis ST-bIOP and the ORA- IOPcc both before and after PRK. These devices may not be used interchangeably for IOP measurement. bIOP exhibited less variation compared to the IOPcc, suggesting that the bIOP is a superior option for IOP reading following PRK.

Does collagen cross linking have any effect on retinal circulation in patients with keratoconus? An optical coherence tomography angiography (OCTA) study

BACKGROUND

We aimed to employ Optical Coherence Tomography Angiography (OCTA) to comprehensively assess changes in the optic nerve head (ONH) and macular perfusion before and after the Corneal Collagen Cross-Linking (CCL) procedure in patients with keratoconus.

METHODS

A total of 22 keratoconus patient's candidate for CCL procedures were included based on specific criteria, with meticulous exclusion criteria in place to minimize potential confounders. Participants underwent OCTA assessments of the ONH and macula using the Spectralis OCT (Heidelberg) before CCL, as well as at 1- and 3-months post-CCL. MATLAB software was utilized for image analysis.

RESULTS

The mean age of the participants was 20.09 ± 6.11, including 59% male, and the mean intraocular pressure (IOP) before the surgery was 13.59 ± 2.85 mmHg. Peripapillary Retinal nerve fiber layer (ppRNFL) thickness and overall retinal thickness remained stable post-CCL. However, significant alterations were observed in macular vessel density, emphasizing regional variations in vascular response. For macular large vessel density (LVD), both superficial and deep vascular complex (SVC and DVC) demonstrated significant differences between before surgery and the 3 months post-surgery follow-up (p < 0.001 and p = 0.002, respectively). Optic nerve head markers demonstrated relative stability, except for changes in avascular complex density, which was 49.2 ± 2.2% before the surgery and decrease to 47.6 ± 1.7% three months after the operation (P-value = 0.005).

CONCLUSION

While CCL appears to maintain the integrity of certain ocular structures, alterations in macular perfusion post-CCL suggest potential effects on retinal blood supply. Long-term monitoring is crucial to understand the implications of these changes, particularly in the context of conditions such as diabetes.

QSAR models for the ozonation of diverse volatile organic compounds at different temperatures

In order to assess the fate and persistence of volatile organic compounds (VOCs) in the atmosphere, it is necessary to determine their oxidation rate constants for their reaction with ozone (kO3). However, given that experimental values of kO3 are only available for a few hundred compounds and their determination is expensive and time-consuming, developing predictive models for kO3 is of great importance. Thus, this study aimed to develop reliable quantitative structure-activity relationship (QSAR) models for 302 values of 149 VOCs across a broad temperature range (178-409 K). The model was constructed based on the combination of a simplified molecular-input line-entry system (SMILES) and temperature as an experimental condition, namely quasi-SMILES. In this study, temperature was incorporated in the models as an independent feature. The hybrid optimal descriptor generated from the combination of quasi-SMILES and HFG (hydrogen-filled graph) was used to develop reliable, accurate, and predictive QSAR models employing the CORAL software. The balance between the correlation method and four different target functions (target function without considering IIC or CII, target function using each IIC or CII, and target function based on the combination of IIC and CII) was used to improve the predictability of the QSAR models. The performance of the developed models based on different target functions was compared. The correlation intensity index (CII) significantly enhanced the predictability of the model. The best model was selected based on the numerical value of Rm2 of the calibration set (split #1, Rtrain2 = 0.9834, Rcalibration2 = 0.9276, Rvalidation2 = 0.9136, and calibration = 0.8770). The promoters of increase/decrease for log kO3 were also computed based on the best model. The presence of a double bond (BOND10000000 and $10 000 000 000), absence of halogen (HALO00000000), and the nearest neighbor codes for carbon equal to 321 (NNC-C⋯321) are some significant promoters of endpoint increase.

Co-Occurrence Analysis of COVID-19 Publications with an Emphasis on the Global Health Governance (GHG)

Background

Analyzing co-occurrence is an effective way to monitor the overview of topic spreading. The present study aimed to conduct a co-occurrence analysis of scientific publications related to COVID-19, emphasizing Global Health Governance (GHG).

Materials and Methods

This applied research with an analytical approach was carried out on all the scientific publications related to COVID-19, emphasizing GHG (51056 records), extracted from PubMed Central on 26/01/2022. The research population consisted of all the scientific publications related to COVID-19, emphasizing GHG (51056 records), extracted from PubMed Central on 26/01/2022. The data were analyzed using BibExcel, UCINET, Excel, and SPSS software, and Spearman's test was used to confirm correlations.

Results

The co-word network of the thematic area of COVID-19 includes 226 nodes and 7292 edges. COVID-19 and the pandemic formed the most co-word pairs with 2224 connections. The COVID-19* mental health and COVID-19* anxiety, with 1019 and 925 connections, are ranked next, respectively. The term COVID-19 is ranked first with a centrality index of 225. The keywords of pandemic and public health are ranked second and third with the centrality index of 217 and 206, respectively.

Conclusion

The global approach of studies related to COVID-19 is more inclined to the epidemiological and public health fields. Assuming the GHG, detailed and comprehensive planning should be performed to strengthen these studies and pave the way for international cooperation, determining research requisites, and developing applied research studies.

Non-invasive diagnosis of early cutaneous squamous cell carcinoma

Early cutaneous squamous cell carcinoma (cSCC) can be challenging to diagnose using clinical criteria as it could present similar to actinic keratosis (AK) or Bowen's disease (BD), precursors of cSCC. Currently, histopathological assessment of an invasive biopsy is the gold standard for diagnosis. A non-invasive diagnostic approach would reduce patient and health system burden. Therefore, this study used non-invasive sampling by tape-stripping coupled with data-independent acquisition mass spectrometry (DIA-MS) proteomics to profile the proteome of histopathologically diagnosed AK, BD and cSCC, as well as matched normal samples. Proteomic data were analysed to identify proteins and biological functions that are significantly different between lesions. Additionally, a support vector machine (SVM) machine learning algorithm was used to assess the usefulness of proteomic data for the early diagnosis of cSCC. A total of 696 proteins were identified across the samples studied. A machine learning model constructed using the proteomic data classified premalignant (AK + BD) and malignant (cSCC) lesions at 77.5% accuracy. Differential abundance analysis identified 144 and 21 protein groups that were significantly changed in the cSCC, and BD samples compared to the normal skin, respectively (adj. p < 0.05). Changes in pivotal carcinogenic pathways such as LXR/RXR activation, production of reactive oxygen species, and Hippo signalling were observed that may explain the progression of cSCC from premalignant lesions. In summary, this study demonstrates that DIA-MS analysis of tape-stripped samples can identify non-invasive protein biomarkers with the potential to be developed into a complementary diagnostic tool for early cSCC.

Molecular Classifiers in Skin Cancers: Challenges and Promises

Skin cancers are common and heterogenous malignancies affecting up to two in three Australians before age 70. Despite recent developments in diagnosis and therapeutic strategies, the mortality rate and costs associated with managing patients with skin cancers remain high. The lack of well-defined clinical and histopathological features makes their diagnosis and classification difficult in some cases and the prognostication difficult in most skin cancers. Recent advancements in large-scale "omics" studies, including genomics, transcriptomics, proteomics, metabolomics and imaging-omics, have provided invaluable information about the molecular and visual landscape of skin cancers. On many occasions, it has refined tumor classification and has improved prognostication and therapeutic stratification, leading to improved patient outcomes. Therefore, this paper reviews the recent advancements in omics approaches and appraises their limitations and potential for better classification and stratification of skin cancers.

Combined phacoviscocanalostomy versus phacoemulsification alone in patients with coexisting cataract and mild-to-moderate open-angle glaucoma; a randomized-controlled trial

BACKGROUND/OBJECTIVE

Management of concomitant cataract and glaucoma depends on the stage of glaucoma and the patient's situation. There are different surgical options for handling visually significant cataract and mild-to-moderate open-angle glaucoma (OAG). We aimed to compare the one-year results of phacoemulsification alone versus phacoviscocanalostomy in these patients.

SUBJECTS/METHODS

This was a parallel-arm, single-masked, randomized-controlled trial, conducted at Farabi Eye Hospital, Tehran, Iran between January 2016 and January 2018. We enrolled 89 eyes from 89 patients with mild-to-moderate primary OAG or pseudoexfoliative glaucoma (PEXG) with visually significant age-related cataract. They randomly underwent phacoemulsification alone (n = 44) or combined phaco-viscocanalostomy (n = 45). All patients had a 12-month follow-up period, and the mean intraocular pressure (IOP), the number of antiglaucoma medications, and complete and qualified success rates were compared.

RESULTS

After the 1st and 3rd months, the mean IOP showed significantly decreased in the phaco-visco group compared to the phaco group (P < 0001 and P = 0.004, respectively), but it was not statistically significant at 6th and 12th months (P = 0.540 and P = 0.530). The need for antiglaucoma medication and the complete and qualified success rates were significantly in favour of the phaco-visco group in all postoperative visits (P < 0.05).

CONCLUSIONS

Although both phacoemulsification alone and phacoviscocanalostomy procedures can be considered for patients with mild-to-moderate OAG, we found better success rates using phacoviscocanalostomy. Therefore, if the surgeon is an expert in performing this technique, this non-penetrating procedure can be applied in patients with visually significant cataract and earlier stages of OAG, especially in patients with PEXG.

Proteomic profiling of cutaneous melanoma explains the aggressiveness of distant organ metastasis

Despite recent developments in managing metastatic melanomas, patients' overall survival remains low. Therefore, the current study aims to understand better the proteome-wide changes associated with melanoma metastasis that will assist with identifying targeted therapies. The latest development in mass spectrometry-based proteomics, together with extensive bioinformatics analysis, was used to investigate the molecular changes in 60 formalin-fixed and paraffin-embedded samples of primary and lymph nodes (LN) and distant organ metastatic melanomas. A total of 4631 proteins were identified, of which 72 and 453 were significantly changed between the LN and distant organ metastatic melanomas compared to the primary lesions (adj. p-value <0.05). An increase in proteins such as SLC9A3R1, CD20 and GRB2 and a decrease in CST6, SERPINB5 and ARG1 were associated with regional LN metastasis. By contrast, increased metastatic activities in distant organ metastatic melanomas were related to higher levels of CEACAM1, MC1R, AKT1 and MMP3-9 and decreased levels of CDKN2A, SDC1 and SDC4 proteins. Furthermore, machine learning analysis classified the lesions with up to 92% accuracy based on their metastatic status. The findings from this study provide up to date proteome-level information about the progression of melanomas to regional LN and distant organs, leading to the identification of protein signatures with potential for clinical translation.

Small and Large Extracellular Vesicles Derived from Pleural Mesothelioma Cell Lines Offer Biomarker Potential

Pleural mesothelioma, previously known as malignant pleural mesothelioma, is an aggressive and fatal cancer of the pleura, with one of the poorest survival rates. Pleural mesothelioma is in urgent clinical need for biomarkers to aid early diagnosis, improve prognostication, and stratify patients for treatment. Extracellular vesicles (EVs) have great potential as biomarkers; however, there are limited studies to date on their role in pleural mesothelioma. We conducted a comprehensive proteomic analysis on different EV populations derived from five pleural mesothelioma cell lines and an immortalized control cell line. We characterized three subtypes of EVs (10 K, 18 K, and 100 K), and identified a total of 4054 unique proteins. Major differences were found in the cargo between the three EV subtypes. We show that 10 K EVs were enriched in mitochondrial components and metabolic processes, while 18 K and 100 K EVs were enriched in endoplasmic reticulum stress. We found 46 new cancer-associated proteins for pleural mesothelioma, and the presence of mesothelin and PD-L1/PD-L2 enriched in 100 K and 10 K EV, respectively. We demonstrate that different EV populations derived from pleural mesothelioma cells have unique cancer-specific proteomes and carry oncogenic cargo, which could offer a novel means to extract biomarkers of interest for pleural mesothelioma from liquid biopsies.

Multi-Objective Optimization of Copper Bioleaching: Comparative Study of Pure and Co-Cultured Cultivation

Background

Bioleaching is a practical method to recover metals from low-grade mineral sulfides. The most frequent bacteria involved in the bioleaching of metals from ores are Acidithiobacillus ferrooxidans and Acidithiobacillus thiooxidans. Experimental design is a method through which the optimum activity condition will be obtained, avoiding numerous trials and errors.

Objectives

This study aimed to optimize the bioleaching condition of two indigenous iron- and sulfur-oxidizing bacteria from the Meydouk mine, Iran, and evaluate their function in a semi-pilot operation in pure and mixed cultures.

Material and Methods

After treatment with sulfuric acid, the bacterial DNA was extracted, and further 16S rRNA was sequenced to characterize the bacterial species. The cultivation condition of these bacteria was optimized using Design-expert (6.1.1 version) software. The copper recovery rate and the differentiation in the ORP rate in the percolation columns were also investigated. These strains were isolated from the Meydouk mine for the first time.

Results

16S rRNA analysis revealed that both bacteria belong to the Acidithiobacillus genus. The factors with the most significant impact on Acidithiobacillus ferrooxidans with their optimum level were temperature=35 °C, pH=2.5, and initial FeSO₄ concentration=25 g.L^-1. Also, initial sulfur concentration had the most significant impact on Acidithiobacillus thiooxidans with the optimum level of 35 g.L^-1. Moreover, the mixed culture determined higher bioleaching efficiency compared with the case of employing the pure cultures.

Conclusions

Utilizing a mixture of both bacteria, Acidithiobacillus ferrooxidans and Acidithiobacillus thiooxidans elevated the Cu recovery rate due to the synergetic function of the strains. Also, introducing an initial dosage of sulfur and pre-acidification could elevate metal recovery efficiency.

Ab-interno Trabeculotomy Procedures: A Review

Purpose

To discuss the safety and efficacy of various forms of ab-interno trabeculotomy procedures.

Methods

A comprehensive search in PubMed and Google Scholar was done using the keywords "glaucoma", "microinvasive glaucoma surgery", "complications", "goniotomy", and "trabeculotomy". Publications discussing ab-interno trabeculotomy procedures were selected; furthermore, the relevant references in these articles were gathered and the search was updated during the article preparation. Since gonioscopy-assisted transluminal trabeculotomy was first introduced in 2014, we had no time restriction.

Results

Ab-interno trabeculotomy procedures, as a type of minimally invasive glaucoma surgeries, facilitate the natural trabecular outflow and lower the intraocular pressure (IOP) while preserving the conjunctiva for possible future glaucoma surgeries. It can be done alone or in combination with cataract surgery and effectively lowers the IOP and the number of antiglaucoma medications in various forms of glaucoma.

Conclusion

By appropriate patient selection, ab-interno trabeculotomy could be selected as a safe and effective procedure in the management of various forms of glaucoma either as an isolated procedure or in combination with cataract extraction.

Tape stripped stratum corneum samples are suitable for diagnosis and comprehensive proteomic investigation in mycosis fungoides

BACKGROUND

Mycosis Fungoides (MF) is a common cutaneous T-cell lymphoma. It can sometimes be challenging to diagnose MF using current clinico-histopathological criteria. Non-invasive molecular profiling analysis has the potential to aid the diagnosis and understanding of MF.

METHOD

Lesional and body site matched normal stratum corneum samples were obtained from the same MF patients (n = 28) using adhesive discs, followed by proteomic analyses using data-independent acquisition mass spectrometry (DIA-MS). Differential abundance analyses and bioinformatic analyses were performed to identify differentially abundant proteins and altered biofunctions between the MF and normal stratum corneum samples.

RESULTS

In total, 1303 proteins were identified, of which 290 proteins were significantly changed in the MF cohort compared to the normal stratum corneum. Ingenuity pathway analysis (IPA) predicted the significant inhibition of cell death of cancer cells and significant activation of immune-related activities and viral infection in the MF lesions. MF lesions were also associated with upstream regulators relating to immuno-oncologic dysfunctions. The top-250 variating proteins efficiently separated normal stratum corneum from matched MF samples.

CONCLUSION

Non-invasive proteomic analysis could transform the diagnosis of MF by reducing the need for invasive biopsy. The identification of altered biological functions may serve as useful biomarkers to predict MF progression.

Adaptation of a cervical bilateral contusive spinal cord injury for study of skilled forelimb function

We present an updated, clinically relevant model of moderately severe bilateral cervical level 6 contusive spinal cord injury (SCI) in the rat. This model is more clinically relevant than previous models due it its severity, yet animals readily survive the lesion. The C6 bilateral lesion is administered to Fischer 344 rats using the Infinite Horizons impactor adjusted to a 200 kdyne force with a 3.5 mm impactor head. The lesion results in loss of 60 ± 10% of the spinal cord area, including virtually the entire dorsal half of the spinal cord and complete interruption of the main corticospinal tract. Skilled forelimb performance declines by 60 ± 10% compared to the pre-operative baseline and deficits are sustained over time. This model is a substantial step closer to mimicking the most common level (cervical) and more severe form of SCI in humans and should provide a superior tool for assessing the likelihood that experimental interventions may promote motor recovery after SCI in humans.

Genomic and proteomic findings in early melanoma and opportunities for early diagnosis

Overdiagnosis of early melanoma is a significant problem. Due to subtle unique and overlapping clinical and histological criteria between pigmented lesions and the risk of mortality from melanoma, some benign pigmented lesions are diagnosed as melanoma. Although histopathology is the gold standard to diagnose melanoma, there is a demand to find alternatives that are more accurate and cost-effective. In the current "omics" era, there is gaining interest in biomarkers to help diagnose melanoma early and to further understand the mechanisms driving tumor progression. Genomic investigations have attempted to differentiate malignant melanoma from benign pigmented lesions. However, genetic biomarkers of early melanoma diagnosis have not yet proven their value in the clinical setting. Protein biomarkers may be more promising since they directly influence tissue phenotype, a result of by-products of genomic mutations, posttranslational modifications and environmental factors. Uncovering relevant protein biomarkers could increase confidence in their use as diagnostic signatures. Currently, proteomic investigations of melanoma progression from pigmented lesions are limited. Studies have previously characterised the melanoma proteome from cultured cell lines and clinical samples such as serum and tissue. This has been useful in understanding how melanoma progresses into metastasis and development of resistance to adjuvant therapies. Currently, most studies focus on metastatic melanoma to find potential drug therapy targets, prognostic factors and markers of resistance. This paper reviews recent advancements in the genomics and proteomic fields and reports potential avenues, which could help identify and differentiate melanoma from benign pigmented lesions and prevent the progression of melanoma.

Epidemiological and Clinical Features of Pediatric Open Globe Injuries: A Report from Southern Iran

Purpose

To evaluate the epidemiological features of open globe injury (OGI) in a tertiary ophthalmic center in the south of Iran.

Methods

The medical files of pediatric patients diagnosed with OGI between March 2014 and March 2019 were reviewed retrospectively. Demographic data, laterality, time of injury, cause of trauma, location and mechanisms, complications, and the involved tissues, visual acuity, type of operation, and antibiotic therapy were all analyzed. Data were processed using the SPSS.

Results

In total, 110 eyes of 108 patients were included. Ages < 7 years comprised 49.1%, 7-12 years 26.4%, and 13-18 years 24.5% of cases. Of the 108 patients, 76 (70.3%) were males. No significant difference between right versus left eyes was seen. The incidence of OGI was lowest in winter and highest in spring, and it had more prevalence on the weekends. Sharp objects were the most common cause of OGI in ages < 7 years, while blunt objects, accidents and falls, and guns and fireworks were more prevalent in older children. Home was the most common place of injury overall. The most common type of injury was penetrating trauma. Upon arrival, most of the children had a visual acuity < 0.1 decimal. Primary wound closure was the most prevalent type of surgery done predominantly within 24 hr from admission time.

Conclusion

Ages < 7 years and male gender were the most common age and sex of pediatric OGI, respectively, and sharp objects were the predominant etiology. Early management and primary repair are essential for prevention of complications such as endophthalmitis and amblyopia.

Physiologic function of mediastinum space

The mediastinum forms the central part of the thoracic cavity that is surrounded by pleural space on the two sides, thoracic vertebrae at the posterior, thoracic inlet on the top, and diaphragm at the bottom. It encompasses cardiopulmonary organs and organ systems. Pathological dysfunction or deformity in any part of the mediastinum can have adverse cardiovascular and respqiratory effects. Pectus excavatum and pectus carinatum are the most common congenital chest deformities that are characterized by sternal depression and protuberance of the sternum, respectively. Together, these account for 90% of chest wall deformities. Patients are known to be represented with respiratory distress and cardiovascular dysfunction. The aim of the review article is to present the anatomical and physiological role of the mediastinum in association with important parts of the thoracic cavity and pathological dysfunction of the mediastinum (cardiopulmonary system) due to pectus excavatum and pectus carinatum.

•

Mediastinum forms the central part of thoracic cavity that is surrounded by pleural space.

•

PC and PE are structural chest deformities.

•

Chest deformation by pressing on the chin causes coughing, stridor, dyspnea and exacerbation.

•

Clinical symptoms along with inflammation that requires urgent medical treatment.

Does Gadolinium Deposition Lead to Metabolite Alteration in the Dentate Nucleus? An MRS Study in Patients with MS

BACKGROUND AND PURPOSE

Repeat contrast-enhanced MR imaging exposes patients with relapsing-remitting MS to frequent administration of gadolinium-based contrast agents. We aimed to investigate the potential metabolite and neurochemical alterations of visible gadolinium deposition on unenhanced T1WI in the dentate nucleus using MRS.

MATERIALS AND METHODS

This prospective study was conducted in a referral university hospital from January 2020 to July 2021. The inclusion criteria for case and control groups were as follows: 1) case: patients with relapsing-remitting MS, visible gadolinium deposition in the dentate nucleus (ribbon sign), >5 contrast-enhanced MR images obtained; 2) control 1: patients with relapsing-remitting MS without visible gadolinium deposition in the dentate nucleus, >5 contrast-enhanced MR images obtained; 3) control 2: patients with relapsing-remitting MS without visible gadolinium deposition in the dentate nucleus, <5 contrast-enhanced-MR images obtained; and 4) control 3: adult healthy individuals, with no contrast-enhanced MR imaging. Dentate nucleus and pontine single-voxel 12 × 12 × 12 MRS were analyzed using short TEs.

RESULTS

Forty participants (10 per group; 27 [67.5%] female; mean age, 35.6 [SD, 9.6] years) were enrolled. We did not detect any significant alteration in the levels of NAA and choline between the studied groups. The mean concentrations of mIns were 2.7 (SD, 0.73) (case), 1.5 (SD, 0.8) (control 1), 2.4 (SD, 1.2) (control 2), and 1.7 (SD, 1.2) (control 3) (P = .04). The mean concentration of Cr and mIns (P = .04) and the relative metabolic concentration (dentate nucleus/pons) of lipid 1.3/Cr (P = .04) were significantly higher in the case-group than in healthy individuals (controls 1-3). Further analyses compared the case group with cumulative control 1 and 2 groups and showed a significant increase in lactate (P = .02), lactate/Cr (P = .04), and Cr (dentate nucleus/pons) (P = .03) in the case group.

CONCLUSIONS

Although elevated concentrations of Cr, lactate, mIns, and lipid in the dentate nucleus of the case group indicate a metabolic disturbance, NAA and choline levels were normal, implying no definite neuronal damage.

The thickness of the outer retina in the macula and circumpapillary area in patients with unilateral advanced glaucoma

PURPOSE

To compare outer macular and retinal thickness in the circumpapillary area in unilateral advanced glaucomatous eyes to the normal or mild glaucomatous fellow eyes.

METHODS

Seventy-eight eyes of 39 patients with unilateral advanced glaucoma (mean deviation (MD) worse than -12.00 dB based on visual field 24-2) were included in this cross-sectional study as the cases. The healthy or mild glaucomatous fellow eyes were enrolled as the control group. All eyes underwent optical coherence tomography of the macula and circumpapillary retina by Topcon DRI Triton (Topcon, Tokyo, Japan). Ganglion cell layer 2+ was considered as the inner retina. Total retinal thickness minus the thickness of the inner retina was considered as the outer retina. Comparison between groups was done by paired-sample sign test. The correlation between structural and functional parameters was evaluated by a partial correlation coefficient.

RESULTS

Seventeen (43.6%), 15 (38.5%), and 7 (17.9%) patients had pseudoexfoliation, primary angle-closure, and primary open-angle glaucoma, respectively. The mean age was 62.69 ± 12.00 years. Thirty-three (84.6%) patients were male. The outer retinal thickness in the circumpapillary area was higher in temporal, superior, and inferior quadrants (p < 0.05). The outer macula in different parafoveal and perifoveal quadrants was also thicker (p < 0.05). Average outer parafoveal thickness in the case group had a significant negative correlation with MD (r = -0.339; p = 0.035).

CONCLUSION

Advanced glaucomatous eyes had a thicker outer retina in the macula and circumpapillary area. There was a significant negative correlation between outer perifoveal thickness and MD.

A CoviReader Architecture Based on IOTA Tangle for Outbreak Control in Smart Cities during COVID-19 Pandemic

Background: Reportedly, many of the data collected for detecting infected people are being used for other than healthcare purposes. On the other hand, fabricated digital COVID-19 test results will pose a danger to vulnerable people and to public health. This paper presents a CoviReader architecture designed for a smart city health information management system to manage outbreak of COVID-19 pandemic while protecting citizens' privacy and tamper-proofing their health status data. Methods: We used IOTA as an infrastructure for data management. We introduced two plans: "Transaction Plan", handling daily interactions of citizens in a smart city and "Big Data Plan", providing the COVID-19 crisis headquarters with the aggregated data for curbing the pandemic. Results: Through the proposed CoviReader architecture people's using IOTA tangle, people's health status data are readily available to the crisis headquarters and verification of the validity of the final file against data manipulation will also be possible by comparing the hash of the consolidated received file with the original hash of the file registered in the IOTA Tangle. Reported plans were capable of handling tamper proofed data delivery. Conclusion: The proposed CoviReader architecture ensures the availability and at the same time constrains manipulation of data. The provided solution aids healthcare providers to control pandemic and at the same time to preserve commuting people's data for any unintended or illegal identity disclosure.

Radical extrapleural pneumonectomy with bronchial fistula by pulmonary function test evaluation technique

Introduction

and importance: Pulmonary Function Tests (PFTS) is an important tool in the assessment of pulmonary pathologies and preoperative evaluation. Case presentation: A 54-year-old man with history of massive pleurisy in the left thorax, treated by placing chest tube and drainage of bloody effusion, was readmitted for epithelioid mesothelioma. He was then presented with pneumothorax due by a refractory bronchial fistula while having a plural catheter. Based on the consultation, the whole-body bone scan was conducted, and findings demonstrated epithelioid mesothelioma (stage 1) with the refractory fistula for which the patient was candidate for thoracic surgery. Decreased lung capacity was seen by Pulmonary Function Testing - PFTS.

Clinical discussion

The novel PFTS Evaluation Technique was designed to measure the true pulmonary capacities in order to evaluate the pulmonary post-operative tolerance. In this technique the chest tube was placed for 4 weeks until the patient reaches mediastinal fixation then the measurements by PFTS were carried out in two steps. First, using an open chest tube and second, using a clamped chest tube. In both steps, the pulmonary capacities were measured and provided to the pulmonologist for consultation.

Conclusion

In this case, after acquiring the approval of the specialist depended on PFTS after PFTS Evaluation Technique, the radical extra pleural pneumonectomy surgery was conducted, and the patient was discharged with a good general appearance and treated fistula.

Late-onset neuromyelitis optica spectrum disorder: A case series from Iran

INTRODUCTION

Neuromyelitis optica spectrum disorder (NMOSD) is a disabling autoimmune disease of the central nervous system that can start at ages of 50 or more, when it is called late-onset NMOSD (LO-NMOSD). Data on this disorder are sparse. In this cross-sectional study, patient characteristics of the disease were studied. LO-NMOSD patients of a tertiary center in Tehran were studied from 2016 to 2020.

CASE REPORTS

Eight patients were identified, half of whom were men. The diagnostic delay was from no time-lapse to three years (mean: 0.62, SD: 1.06), which was significantly shorter than in early-onset patients. Seven patients (87.5%) tested positive for AQP4-IgG which was significantly higher compared to early-onset patients (p-value=0.01). Four patients (50%) had both transverse myelitis and optic neuritis as presenting symptoms, while three (38%) had just myelitis and only one (12%) had optic neuritis.

CONCLUSION

There is discrepancy regarding different aspects of LO-NMOSD. Further studies are needed to clarify the subject in order to enhance diagnosis and treatment.

The Relation between Media Literacy and COVID-19 Vaccination

Background: Media literacy refers to a set of skills designed specially to help people make better health decisions while dealing with media tasks. The present study was conducted to investigate the relationship between media literacy and willingness to be vaccinated among medical students.

Methods: This is a descriptive cross-sectional study. The statistical population consisted of all students at Iran University of Medical Sciences, among whom, 389 samples were recruited. Two questionnaires were used: (1) Media Literacy and (2) Willingness to be Vaccinated. The validity of these questionnaires was confirmed by the content validity method and consultation with experts. Data were analyzed using Pearson correlation, t test, and one-way analysis of variance using SPSS v. 20 (SPSS Inc).

Results: The willingness to be vaccinated was higher in men (23.04 ± 5.59) than in women (21.07 ± 3.77) and this difference was significant (P<.001). However, there was no significant difference between willingness to be vaccinated and marital status, educational level, and age. The findings showed a significant relationship between media literacy and willingness to be vaccinated.

Conclusion The effect of media literacy on retrieving and recognizing accurate information is one of the crucial results of the present study. This skill affects an individual’s willingness to make the right decision on timely COVID-19 vaccination.

The Role of Trace Elements in Pseudoexfoliation Syndrome: A Cross-sectional Study

Purpose

Pseudoexfoliation syndrome (PXF) is an age-related condition, characterized by deposition of whitish flake-shaped materials in the anterior segment of the eye. Although it occurs all over the world, a considerable racial variation exists. According to the high frequency of PXF in Iran and the importance of prevention and early treatment, we evaluated the plasma level of iron, zinc, copper, and magnesium in patients with PXF.

Methods

In this study, 83 individuals were enrolled; 40 patients with cataract and PXF as the case group and 43 age- and sex-matched individuals with cataract but without PXF as the control group. The serum levels of the mentioned microelements were compared in two groups.

Results

In the case group, 25 (62.5%) male and 15 (37.5%) female subjects participated. In the control group, the corresponding figures were 22 (51.2%) and 21 (48.8%), respectively. The mean age of the case group was 66.07 ± 9.46 and that for the control group was 66.88 ± 8.04 years. Regarding the case group, the serum levels of iron, zinc, copper, and magnesium were 60.58 ± 21.04, 84.7 ± 14.37, 120.23 ± 14.43, and 2.11 ± 0.23, respectively. These serum levels in the control group were 89.07 ± 26.06, 97.51 ± 17.42, 123.33 ± 19.01, and 2.14 ± 0.16. The serum levels of iron and zinc were significantly lower in the case group than the control group (P< 0.0001); however, such a difference was not observed in terms of copper and magnesium serum levels.

Conclusion

Our study demonstrated that the serum iron and zinc levels were lower in PXF patients. Nutritional deficiency may be a cause of zonular weakness in these patients. Heme is a cofactor for the enzyme which contributes to the biosynthesis of fibrillin, the major protein in zonular fibers. Therefore, iron can play a substantial role in the biosynthesis of the fibrils and also in the zonular stability.

Mass spectrometry-based proteomic analysis of the effect of storage temperature on non-invasively collected samples of human stratum corneum

PURPOSE

The collection of human stratum corneum (SC) samples by tape-stripping promises to deliver a non-invasive method for biomarker analysis of skin diseases. The current study examines the effect of storage temperature and SC layer depth on the proteome profile of SC samples.

EXPERIMENTAL DESIGN

The samples were collected from healthy volunteers (n = 5) using 10 sequential adhesive discs. Discs were pooled by five (discs 1-5, 6-10) and stored at various temperatures for 10 days before their analysis by mass spectrometry.

RESULTS

No statistically significant difference was seen in the protein yield between discs 1-5 (14.8 mg) and 6-10 (14.4 mg), or between discs stored at -80°C (14.7 mg), -20°C (15.8 mg), 4°C (14.9 mg) or room temperature (13.2 mg). Mass spectrometry analysis revealed that the storage of SC samples at higher temperatures does not affect their proteome profile considerably (< 4.7% peptide precursor loss at lower temperatures vs. -80°C). On the other hand, while 95.3% of the identified peptide precursors were shared between discs 1-5 and 6-10, the level of 17 proteins was significantly changed between these conditions.

CONCLUSIONS

The findings of this study will likely have major implications on the conduct of proteomic studies involving SC sample collection, storage, and transportation.

Comparison of endotracheal intubation, laryngeal mask airway, and I-gel in children undergoing strabismus surgery

Background

Insertion of the advanced airway during induction of general anesthesia can cause undesirable sympathetic stimulation such as increased intraocular pressure (IOP) and hemodynamic parameters. In this study, we compared insertion of three different advanced airway devices; endotracheal tube (ETT), laryngeal mask airway (LMA) and I-gel in terms of IOP, hemodynamic changes and postoperative nausea and vomiting (PONV) following induction of general anesthesia with propofol and remifentanil in children undergoing strabismus surgery.

Materials and Methods

A total of 90 children (5.68 ± 1.49 years old) were randomly assigned to one of the three groups, ETT, LMA, or I-gel insertion as advanced airway devices IOP and also hemodynamic variables were measured before (T0 and T1) and immediately after (T2) the insertion of these airway devices, although 2 min (T3) and 5 min (T4) after it. PONV was assessed about 2 h after the completion of surgery in the recovery room.

Results

The mean arterial pressure (MAP), IOP, and systolic and diastolic blood pressures were significantly different between the three groups immediately (T2), 2 min (T3), and 5 min (T4) after the insertion of airway devices. The heart rate (HR) was significantly different between the three groups in all measurement times except of T0. Within-group comparisons showed that the three groups had significant changes in MAP, IOP, HR, systolic and diastolic pressure before and after airway insertion (T1 and T2). The trend in the LMA and ETT groups was descending-ascending-descending, whereas in the I-gel group, it was quite descending. There was no significant difference among the three groups in terms of PONV.

Conclusion

As a result, our study showed that, compared with LMA and ETT, the I-gel had less impact on undesirable stress responses and seems to be superior to LMA and ETT in children undergoing strabismus surgery.

Spatial-time analysis of cardiovascular emergency medical requests: enlightening policy and practice

Background

Response time to cardiovascular emergency medical requests is an important indicator in reducing cardiovascular disease (CVD) -related mortality. This study aimed to visualize the spatial-time distribution of response time, scene time, and call-to-hospital time of these emergency requests. We also identified patterns of clusters of CVD-related calls.

Methods

This cross-sectional study was conducted in Mashhad, north-eastern Iran, between August 2017 and December 2019. The response time to every CVD-related emergency medical request call was computed using spatial and classical statistical analyses. The Anselin Local Moran’s I was performed to identify potential clusters in the patterns of CVD-related calls, response time, call-to-hospital arrival time, and scene-to-hospital arrival time at small area level (neighborhood level) in Mashhad, Iran.

Results

There were 84,239 CVD-related emergency request calls, 61.64% of which resulted in the transport of patients to clinical centers by EMS, while 2.62% of callers (a total of 2218 persons) died before EMS arrival. The number of CVD-related emergency calls increased by almost 7% between 2017 and 2018, and by 19% between 2017 and 2019. The peak time for calls was between 9 p.m. and 1 a.m., and the lowest number of calls were recorded between 3 a.m. and 9 a.m. Saturday was the busiest day of the week in terms of call volume. There were statistically significant clusters in the pattern of CVD-related calls in the south-eastern region of Mashhad. Further, we found a large spatial variation in scene-to-hospital arrival time and call-to-hospital arrival time in the area under study.

Conclusion

The use of geographical information systems and spatial analyses in modelling and quantifying EMS response time provides a new vein of knowledge for decision makers in emergency services management. Spatial as well as temporal clustering of EMS calls were present in the study area. The reasons for clustering of unfavorable time indices for EMS response requires further exploration. This approach enables policymakers to design tailored interventions to improve response time and reduce CVD-related mortality.

Intra-hospital dissemination of clinical and environmental isolates of Stenotrophomonas maltophilia from Tehran

Stenotrophomonas maltophilia isolates are responsible for various hospital-acquired infections and are particularly increasing in the immunocompromised patients. The aim of this study was to determine the clonal relatedness between S. maltophilia isolates originating from the clinic and environment. A total of 150 S. maltophilia isolates from patients and 1108 environmental samples obtained in three hospitals from Tehran. Following molecular identification targeting 23S rRNA gene, the clonal relatedness of the environmental and clinical isolates was determined using pulsed field gel electrophoresis (PFGE). Of the 150 clinical and 18 environmental isolates identified using phenotypic tests, the speciation of 120 and 15 was confirmed by targeting the 23S rRNA gene. The 24 common pulsotypes (PTs) and 32 single PTs were identified by PFGE. Only a small cluster was shared among the clinic and environment within a hospital; therefore, the intra-hospital dissemination of certain isolates of S. maltophilia among the clinic and environment was demonstrated.

Polycyclic aromatic hydrocarbon source fingerprints in the environmental samples of Anzali-South of Caspian Sea

The major emission sources of polycyclic aromatic hydrocarbons (PAHs) in Anzali city, apportionment of these sources and transfer of PAHs through street dust and runoff to rivers and finally the Caspian Sea, were studied. PAHs in environmental samples including street dust, runoff, and river sediment samples as well as in major sources of hydrocarbons in urban area including vehicles exhaust, gasoline and diesel fuels, engine oils of automobiles and boats, asphalt, and tire debris were extracted by Soxhlet and liquid-liquid extraction in solid and liquid phase and were analyzed by GC-MS. Significance of each source in PAH emission in the area was identified by chemical fingerprinting. According to the spatial distribution of PAHs in receptor samples stations of street dust and runoff located in the center of the city with high traffic of vehicles had higher concentrations of PAHs than stations in the out bonds of the city. In the river sediment samples, the stations located in the port area had the highest concentrations of PAHs. Results of chemical fingerprinting showed that especially in street dust and runoff samples, the isometric patterns of PAHs were rather similar to those in the proposed major sources, showing that they may have been originated from them, especially from asphalt and tire. On the contrary, river sediment samples were confirmed to receive inputs from other unknown independent sources.

A Comprehensive Proteomic SWATH-MS Workflow for Profiling Blood Extracellular Vesicles: A New Avenue for Glioma Tumour Surveillance

Improving outcomes for diffuse glioma patients requires methods that can accurately and sensitively monitor tumour activity and treatment response. Extracellular vesicles (EV) are membranous nanoparticles that can traverse the blood-brain-barrier, carrying oncogenic molecules into the circulation. Measuring clinically relevant glioma biomarkers cargoed in circulating EVs could revolutionise how glioma patients are managed. Despite their suitability for biomarker discovery, the co-isolation of highly abundant complex blood proteins has hindered comprehensive proteomic studies of circulating-EVs. Plasma-EVs isolated from pre-operative glioma grade II-IV patients (n = 41) and controls (n = 11) were sequenced by Sequential window acquisition of all theoretical fragment ion spectra mass spectrometry (SWATH-MS) and data extraction was performed by aligning against a custom 8662-protein library. Overall, 4054 proteins were measured in plasma-EVs. Differentially expressed proteins and putative circulating-EV markers were identified (adj. p-value < 0.05), including those reported in previous in-vitro and ex-vivo glioma-EV studies. Principal component analysis showed that plasma-EV protein profiles clustered according to glioma histological-subtype and grade, and plasma-EVs resampled from patients with recurrent tumour progression grouped with more aggressive glioma samples. The extensive plasma-EV proteome profiles achieved here highlight the potential for SWATH-MS to define circulating-EV biomarkers for objective blood-based measurements of glioma activity that could serve as ideal surrogate endpoints to assess tumour progression and allow more dynamic, patient-centred treatment protocols.

Investigating proteome changes between primary and metastatic cutaneous squamous cell carcinoma using SWATH mass spectrometry

BACKGROUND

Cutaneous squamous cell carcinoma (cSCC) is a common malignancy worldwide and the first as the cause of death from keratinocytic carcinomas. Around 5% of primary cSCCs metastasize, leading to a 5-year survival rate of only 11 %.

OBJECTIVE

This paper aims to investigate the proteome profile of primary and metastatic cSCC lesions for the identification of potential diagnostic biomarkers and molecular alterations.

METHODS

Liquid chromatography coupled with SWATH-MS workflow was used to analyse the proteome profile of formalin-fixed and paraffin-embedded samples of primary (n = 20) and metastatic cSCC (n = 25) lesions. Statistical and bioinformatics analysis was performed to identify differentially abundant proteins and molecular alterations between the lesions.

RESULTS

A total of 5037 proteins were identified across the samples of which 19 proteins including ISG15, APOA1 and MARCKS with roles in metastasis were increased and 11 proteins including DMKN, APCS and CST6 decreased in metastatic cSCC lesions relative to the primary phenotypes (adj. p-value <0.05). The proteomic data separated the lesions based on their histopathological diagnosis. Bioinformatics analysis revealed that cell migration, cell survival and immune response are likely activated, and apoptosis is inhibited in metastatic cSCC lesions, indicating increased lesion complexity as the disease progresses from primary to the metastatic phenotype. Two samples were reclassified after PCA analysis.

CONCLUSION

SWATH-MS analysis identified important molecular changes between primary and metastatic cSCC samples. Exploring these findings further will allow their translation into the clinic for improved tumour diagnosis, staging and therapeutic intervention.

32-Year Scientometric analysis of the Medical Journal of the Islamic Republic of Iran

Background: Of scientometric goals are to explore scientific productivity and trend, elicit scientific collaborations and inter/intra and cross disciplinary relations within a realm of study. This is a descriptive scientometric analysis of Medical Journal of the Islamic Republic of Iran (MJIRI) from 1987 to 2018.

Methods: The data were collected from 1987 to 2018 including the MJIRI annual publication number, annual growth rate (AGR), annual citation indicators, annual degree of collaboration (DC), the most active universities, and the most co-occurred keywords being used in MJIRI articles.

Results: MJIRI has published 2166 articles in the field of health and medicine between 1987 and 2018, over a third of which have been published during the last five years (2014-2018). The highest and lowest AGR were recorded in 2014 (AGR=276.190%) and 2001(AGR=-28.75%), respectively. The journal CiteScore has increased from 0.26 in 2013 to 0.94 in 2018; the SCImago Journal Rank has promoted from 0.123 in 2013 to 0.320 in 2018. The Source Normalized Impact per Paper has enhanced from 0.398 in 2013 to 0.552 in 2018. The overall degree of collaboration of MJIRI articles was 0.89. Also, the most co-occurred keywords pertaining to the specific field of medicine were "Breast cancer", "Pregnancy", "Tuberculosis", and "Hypertension".

Conclusion: The current quantitative evaluation of MJIRI provides a holistic landscape of journal performance for 32 years.

Proteomics: An emerging approach for the diagnosis and classification of cutaneous squamous cell carcinoma and its precursors

Cutaneous squamous cell carcinoma (cSCC) and its precursors, actinic keratosis (AK) and Bowen's disease (BD), are the most common types of keratinocytic skin lesions (KSL) which account for the majority of non-melanoma skin cancer lethality. Currently, clinical and histopathological criteria are used for the diagnosis, classification and therapeutic intervention of KSLs, however discrepancies exist between the clinical presentations and histologic analyses of these lesions, making the diagnosis difficult. The identification of biomarkers as companion diagnostics for accurately stratifying KSL types is required to support the paradigm shift in current cancer care to personalised, precision medicine and ameliorate the negative impact of misdiagnoses or delayed diagnoses on patient outcome. Also, it is essential to elaborate on the poorly defined molecular modifications required for the initiation, development and progression of KSL from normal keratinocytes. By harnessing recent technological advances in molecular profiling techniques, it is anticipated that greater insight into the various combinations of proteomic events or alternative pathways underlying carcinogenesis will be gained. This review will explore recent genomic studies in KSL followed by assessing the feasibility and significance of mass spectrometry-based proteomics profiling as a promising approach to a better understanding of the oncogenic pathways underpinning the formation and progression of KSL lesions and in aiding the identification of novel biomarkers and new therapeutic targets. The development of non-invasive tools such as tape-stripping coupled with proteomic analysis alone or in conjunction with imaging and genomic technologies will complement existing clinical and histopathological parameters, leading to an improvement in patient outcomes.

Mesolimbic dopamine projections mediate cue-motivated reward seeking but not reward retrieval in rats

Efficient foraging requires an ability to coordinate discrete reward-seeking and reward-retrieval behaviors. We used pathway-specific chemogenetic inhibition to investigate how rats’ mesolimbic and mesocortical dopamine circuits contribute to the expression and modulation of reward seeking and retrieval. Inhibiting ventral tegmental area dopamine neurons disrupted the tendency for reward-paired cues to motivate reward seeking, but spared their ability to increase attempts to retrieve reward. Similar effects were produced by inhibiting dopamine inputs to nucleus accumbens, but not medial prefrontal cortex. Inhibiting dopamine neurons spared the suppressive effect of reward devaluation on reward seeking, an assay of goal-directed behavior. Attempts to retrieve reward persisted after devaluation, indicating they were habitually performed as part of a fixed action sequence. Our findings show that complete bouts of reward seeking and retrieval are behaviorally and neurally dissociable from bouts of reward seeking without retrieval. This dichotomy may prove useful for uncovering mechanisms of maladaptive behavior.

Evaluation of serum interferons in patients with age-related macular degeneration

Background:

Environmental, genetic, and immunological factors may play a role in the pathogenesis of age-related macular degeneration (AMD). In an attempt to better understand the pathogenesis of AMD, in this study, we evaluated the serum interferon (IFN) levels in patients with AMD and compared it with persons without AMD.

Materials and Methods:

In this case–control study, 42 patients with AMD and 42 healthy individuals (without AMD) were enrolled as the case and control groups, respectively. The two groups were matched regarding their age and sex. We classified the case group as dry-type and wet-type AMD. Blood samples were obtained and the serum was collected and frozen at −20°C. Alpha-, beta-, and gamma-IFN levels were measured using the sandwich ELISA method and compared between and within the groups.

Results:

The mean beta IFN levels in both case and control groups were 46.88 ± 27.25 pg/ml and 34.90 ± 18.81 pg/ml (P = 0.021), respectively. Regarding gamma and alpha IFN, the serum levels were not detectable in most of the patients and no significant difference was detected between the case and control groups.

Conclusion:

We found that serum beta IFN levels are higher in patients with AMD. This finding may have diagnostic, therapeutic, and prognostic value in AMD patients and can be a beginning for further evaluation.

Intralenticular Cilia Following Penetrating Ocular Trauma: A Case Report

Penetrating ocular trauma is one of the most important causes of vision loss, especially in men, and can be associated with intraocular foreign bodies. The incidence of intraocular cilia after trauma is very low. Here we report the case of a 24-year-old man who visited Poostchi Ophthalmology Clinic (Shiraz, Iran) due to a gradual vision loss in his left eye over the past 2 months. The probable cause was a foreign object (metal splinter) in the eye as a result of hammering metal on metal. An examination revealed the site of a 2-mm sealed corneal laceration, localized central cataract with intralenticular cilia, and moderate anterior reaction. The patient underwent foreign body removal, lensectomy, and posterior chamber intraocular lens implantation. One day after the operation, the visual acuity of the patient was 20/20. The intraocular cilia may have various clinical presentations; however, there is no report of a case with cilium embedded in the lens without any sight-threatening complications other than localized cataract and a moderate inflammatory reaction. Timely management and operation allow such patients to maintain a good vision.

Status of substance abuse literacy in manufacturing and production sites in Iran: Results from a nationwide survey

Background: Due to highly risk-taking behaviors such as alcohol and drug use status of health literacy at workplace is a major concern for health policy makers. Substance abuse literacy (SAL) includes the individuals' skills to obtain, understand and use substance-relevant health information. This will help to establish a healthy communication in a workplace setting and developing professional knowledge on workplace safety regulations, risky approaches and behaviours that may hurt the community workers. Since poor SAL status would inevitably cause serious harms to both community workers' health and facilities this study aimed to determine the status of SAL among manufacturing and production workers in Iran. Methods: This is a nationwide cross-sectional survey conducted on 13,600 subjects who were selected through simple randomization into 380 workplaces in 31 provinces of Iran during February 2015 to January 2016. Data were collected through an author-made structured questionnaire by some trained interviewers. The study tool was developed using the literature and then sent to some experts for approving internal validity; minor changes were applied. Internal reliability test in 30 samples yielded Cronbach's alpha of 0.82. All the questionnaires were administered at the participants' workplaces following obtaining their consent on releasing blinded information. Results: Given that the score range was from 1 to 5, the mean for SAL in substance abuse was 4.04, so that the highest and lowest means were related to East Azerbaijan (4.22±0.74) and Hormozgan (3.69±0.73) provinces, respectively. Conclusion: This study revealed that the Iranian workers SAL status was fairly high despite the reported high rate of substance abuse (30%) among Iranian workforces. This apparently contradictory finding could be resolved using Syndemics in which refers to clustering of several issues in a society that contribute to and result from socioeconomic and cultural factors and inequalities. Therefore, it is still necessary for policy makers and other researchers to take this issue into consideration in Iranian manufacturing and production plants.

Chemometrics analysis of petroleum hydrocarbons sources in the street dust, runoff and sediment of urban rivers in Anzali port - South of Caspian Sea

Major sources of petroleum hydrocarbons in the south of Caspian Sea (Anzali city) have been investigated through an approach which combines Gas Chromatography-Mass Spectrometry with Principal Component Analysis (PCA) and Multivariate Curve Resolution-Alternating Least Squares chemometric methods. Terpane, catagenetic hopane and sterane hydrocarbons were analyzed in the street dust, filtered sediments of runoff, soluble runoff water and river sediment samples as well as in automobiles exhaust, tires, asphalt, engine oil, gasoline and diesel samples, as possible sources of these hydrocarbons. PCA and MCR-ALS results showed that a large part of the analyzed hydrocarbons in street dust, runoffs and in some of the river sediment samples can be explained by the proposed known sources, while the observed variation of hydrocarbon concentrations in many of the river sediment samples was not much affected by the proposed known sources, and they were most probably receiving other pollution sources not included in our study. This study also has shown that results obtained from hydrocarbon marker molecular ratios, to identify petroleum pollution sources in the environments, are in agreement with those obtained from pollution sources resolved by MCR-ALS simultaneous analysis of all samples and variables.

Evaluation of corneal biomechanical properties in mustard gas keratopathy

Background

Degenerative biomechanical factors and immunologic processes with effect on collagen and corneal reparative process are known as the main cause of ocular surface dysfunction in mustard gas keratopathy (MGK) and may cause changes in the corneal biomechanical values. Therefore, we evaluate corneal biomechanical properties of these patients.

Methods and materials

This case-control study includes 61 chemical warfare victims with MGK. After omission according to our exclusion criteria, 88 eyes of patients with MGK were enrolled as the case group and also a group of 88 normal eyes, which were matched regarding their age and sex in the control group, were enrolled. Measurements of corneal biomechanical properties which reported by ORA and Corvis ST (CST) devices were compared. The SPSS software version 23.0 was used in the statistical analysis. For comparisons between groups, if the data had a normal distribution, were analyzed by Student’s t-test and ANOVA, and if the data didn’t have a normal distribution, Mann–Whitney U test, and Kruskal-Wallis were used. Furthermore, to identify a relationship between two groups of data Spearman's rank Correlation test was used. P value < 0.05 were considered statistically significant.

Results

In the MGK group, A1 length (A1L), A1 velocity (A1V), A2 velocity (A2V), deformation amplitude (DA) and peak distance (PD) were higher than the control group (P < 0.001). However, the corneal hysteresis (CH) (P = 0.003), corneal resistant factor (CRF), non-corrected IOP (IOPnct), corrected IOP based on corneal thickness (IOPpachy), and central corneal thickness (CCT) were lower than the control group (P < 0.001). The visual acuity according to the LogMAR scale and severity of MGK was positively associated with IOPpachy and negatively associated with CH, CRF, CCT and highest concavity radius (Radius).

Conclusion

Measurement of corneal biomechanical properties may be, have a useful role in the classification, monitoring or diagnosis of MGK.

An analytical enrichment-based review of structural genetic studies on keratoconus

Keratoconus is a progressive bilateral corneal protrusion that leads to irregular astigmatism and impairment of vision. Keratoconus is an etiologically heterogeneous corneal dystrophy and both environmental and genetic factors play a role in its etiopathogenesis. In this analytical review, we have studied all the genes that are structurally associated with keratoconus and have tried to explain the function of each gene and its association with other eye disorders in a concise way. In addition, using gene set enrichment analysis, it was attempted to find the most important impaired metabolic pathways in keratoconus. Several genetic studies have been carried out on keratoconus and several genes have been identified as risk factors involved in the etiology of the disease. In the current study, 16 studies, including nine association studies, five genome-wide association studies, one linkage study, and one meta-analysis, were reviewed and based on the 19 genes found, enrichment was performed and the most important metabolic pathways involved in the disease were identified. The enrichment results indicated that the two pathways, interleukin 1 processing and assembly of collagen fibrils, are significantly associated with the disease. Obviously, the results of this study, in addition to providing information about the genes involved in the disease, can provide an integrated insight into the gene-based etiology of keratoconus and therapeutic opportunities thereof.

Intraocular Lens Calcification: Clinico-pathological Report of Two Cases and Literature Review

Purpose:

We report the clinicopathological features and surgical outcomes of two cases of intraocular lens (IOL) calcification along with a review of the current literature.

Case Report:

The first patient was a 53-year-old woman with diabetes mellitus (type 2) who underwent phacoemulsification with posterior chamber IOL insertion (PCIOL), and pars plana vitrectomy. Significant clouding of the IOL was first noted after 1.5 years, and the IOL was replaced with an Artisan lens. The second patient was a 22-year-old woman with Vogt-Koyanagi-Harada syndrome; she underwent a lensectomy, PCIOL, and pars plana vitrectomy. IOL opacification was first noted 4.5 years after the initial surgery and the IOL was extracted.

Conclusion:

The calcification of each IOL was confirmed by a pathologist. Further studies are required to determine the primary causes and mechanisms of the calcification of biomaterials including IOLs.

In Silico Analysis Validates Proteomic Findings of Formalin-fixed Paraffin Embedded Cutaneous Squamous Cell Carcinoma Tissue

BACKGROUND

Cutaneous squamous cell carcinoma (cSCC) is a common type of skin cancer but there are no comprehensive proteomic studies on this entity.

MATERIALS AND METHODS

We employed liquid chromatography coupled with tandem mass spectrometry (MS/MS) using formalin-fixed paraffin-embedded (FFPE) cSCC material to study the tumor and normal skin tissue proteomes. Ingenuity Pathway Analysis (IPA) was used to interpret the role of altered proteins in cSCC pathophysiology. Results were validated using the Human Protein Atlas and Oncomine database in silico.

RESULTS

Of 1,310 unique proteins identified, expression of an average of 144 and 88 proteins were significantly (p<0.05) increased and decreased, respectively, in the tumor samples compared to their normal counterparts. IPA analysis revealed disruptions in proteins associated with cell proliferation, apoptosis, and migration. In silico analysis confirmed that proteins corresponding to 12 antibodies, and genes corresponding to 18 proteins were differentially expressed between the two categories, validating our proteomic measurements.

CONCLUSION

Label-free MS-based proteomics is useful for analyzing FFPE cSCC tissues.