Showing papers by "Tehran University of Medical Sciences published in 2023"

Features and effects of computer-based games on cognitive impairments in children with autism spectrum disorder: an evidence-based systematic literature review

Abstract: Children with Autism Spectrum Disorder (ASD) have different cognitive and intelligence profiles than typical developing individuals. Some of these children need cognitive rehabilitation. This study's main purpose is to provide a systematic review about applying computerized cognitive games for autistic children and to determine the effectiveness of such interventions.A thorough search of the ISI Web of Science, Medline (through PubMed), Scopus, IEEE Xplore, and APA PsycInfo databases was performed for articles published from inception to May 17, 2022.Of 1746 papers, 28 studies were found to be eligible in this systematic review. Fifteen studies (53.57%) compared a Control Group (CG) with Experimental Groups (EGs), while 13 papers (46.42%) evaluated only the impact of the applied intervention in an experimental group. Major domains of cognitive functions are divided into five main categories: 1. Executive functions, 2. Social cognition/emotions, 3. Attention/concentration, 4. Learning and memory, and 5. Language. In 42.85% (12 studies) of the screened papers, social cognition and emotions were assessed after cognitive rehabilitation. The highest rate of effects reported by studies were related to social cognition enhancement. Of the total number of included studies, 17 studies reported a positive effect at all scales, of which nine were quasi-experimental, and seven were fully experimental.Using suitable computerized game-based solutions could enhance cognition indexes in autistic children. Hence, further investigation is needed to determine the real effectiveness of these novel technologies.

Silver Nanoparticles and Their Therapeutic Applications in Endodontics: A Narrative Review

Abstract: The efficient elimination of microorganisms and their byproducts from infected root canals is compromised by the limitations in conventional root canal disinfection strategies and antimicrobials. Silver nanoparticles (AgNPs) are advantageous for root canal disinfection, mainly due to their wide-spectrum anti-microbial activity. Compared to other commonly used nanoparticulate antibacterials, AgNPs have acceptable antibacterial properties and relatively low cytotoxicity. Owing to their nano-scale, AgNPs penetrate deeper into the complexities of the root canal systems and dentinal tubules, as well as enhancing the antibacterial properties of endodontic irrigants and sealers. AgNPs gradually increase the dentin hardness in endodontically treated teeth and promote antibacterial properties when used as a carrier for intracanal medication. The unique properties of AgNPs make them an ideal additive for different endodontic biomaterials. However, the possible side effects of AgNPs, such as cytotoxicity and tooth discoloration potential, merits further research.

Selling by clicks or leasing by bricks? A dynamic game for pricing durable products in a dual-channel supply chain

Abstract: <p style='text-indent:20px;'>In this paper, we discuss if and which pricing policies by a manufacturer who sells its products online motivate a retailer as an independent part to enter the market to provide selling and leasing options through a brick store. Moreover, the impact of online shopping preferences and brand image on end-user behavior is examined, and different consumption patterns are considered. For this purpose, a dynamic game is applied to model a supply chain consisting of one manufacturer and one retailer. The model aims to specify the optimal pricing policies in the second-hand market and according to physical utility associated with depreciation, brand image, and online shopping preferences for different end-users in an infinite time horizon. Markov perfect equilibria are considered as the solution concept to predict the behavior of end-users in the long term. The results revealed that enriching brand image always benefits the manufacturer and the retailer, while it does not mean there is the same optimal brand image level for both manufacturer and retailer. Besides, the improvement of physical utility makes more demand for leasing products and motivates the retailer to be active in the market. Notably, online shopping preferences play a prominent role in market segmentation and retailer decision as a result. Also, growing production costs have a significant reverse effect on the profitability of both manufacturer and retailer. Therefore, the manufacturer must focus on economic production.</p>

A Novel Nanocomposite Scaffold based on Polyurethane [PU] Containing Cobalt Nanoparticles [CoNPs] for Bone Tissue Engineering Applications

Abstract: Bone tissue engineering, as a relatively new approach, has focused on combining biodegradable scaffolds, cells, and biologically active molecules for the recovery of different damaged tissues, such as bone defects. Polyurethane (PU), as a synthetic polymer, benefits from a porous structure which impersonates bone's natural environment. However, PU lacks osteoinduction activities. Cobalt nanoparticles (CoNPs) stimulate angiogenesis and biomineralization, which greatly favors osteogenesis.Here, we designed a novel scaffold based on PU and combined it with CoNPs for bone regeneration applications. The composition and structure of PU-CoNPs nanocomposite were characterized using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and differential scanning calorimetry (DSC). MTT and AO data showed biocompatibility and enhanced viability and proliferation of fibroblasts on PU-CoNPs scaffold. Ascorbic acid-2-phosphate, β-glycerophosphate, and dexamethasone-induced osteogenesis for 14 days.The alkaline phosphatase test asserts the increased mineralization of hADSCs cultured on PU-CoNPs compared to pure PU scaffold. Further, the results disclosed an elevated osteogenic differentiation at the level of genes and proteins using immunocytochemical analysis (ICC) and quantitative real-time PCR (qPCR).These findings provide an evidence that PU-CoNPs nanocomposite might be a promising candidate for bone repair applications.

Unmet needs and health-related quality of life of breast cancer survivors: survey from Gaza Strip, Palestine

Abstract: Cancer, especially breast cancer, remains a public health problem because of its negative consequences, which require long-term programs to alleviate its devastating effects. This study aimed to examine unmet supportive care needs and health-related quality of life of females with breast cancer.A cross-sectional study with a mixed-method design was employed. A simple, randomly selected sample of 352 females attending Al-Rantisi and Al-Amal hospitals was included in this study. A validated Arabic version of the Supportive Care Needs Survey (34 items) and The European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C15-PAL) were used. Moreover, twenty-five semi-structured interviews were performed (13 females, eight husbands, and four healthcare workers). Quantitative data were analysed using descriptive and inferential analysis, whereas thematic analysis was used for qualitative data to highlight main themes.The highest unmet need reported by females with breast cancer was psychological needs (63%), followed by health-related systems and information (62%) and physical and daily life (61%). Pain and fatigue were the most reported symptoms (65.8% and 62.5%, respectively), followed by emotional distress, physical function, and physical symptoms; 55.8%, 54.3%, and 51.5%, respectively. These unmet needs and health-related quality of life-related dimensions were highlighted and elicited by qualitative data analysis. Unmet needs are high among married females, on conservative treatments, young females (< 40 years old), and females in the first year of diagnosis. The presence of chronic diseases did not increase needs. However, health-related quality of life was affected. Six themes are subtracted: availability of anticancer therapy, affordability of healthcare, family and social support, psychological support, health education, and self-image & intimate relationship.Many needs are unmet. Caring for females with breast cancer should be comprehensive to fill gaps, including psychological care, health information and education, physical care and support, and medical care.

Effect of charcoal-based dentifrices on surface roughness of an aged resin composite

Abstract: Recently, the use of whitening dentifrice has increased among patients. However, these products might increase the surface roughness of composite restorations and make them more susceptible to discoloration and plaque accumulation. This study aimed to compare the effects of two charcoal-based dentifrices and other whitening dentifrices with different mechanisms of action on the surface roughness of an aged resin composite.Forty-five composite specimens were made (2 × 7mm) and their initial surface roughness was obtained using a Profilometer. The specimens were subjected to the Accelerated Artificial Aging (AAA) process for 300 hours. Then, the surface roughness of the specimens was reevaluated using the Profilometer. The specimens were randomly divided into 5 groups (N.=9), namely Control (Gc), Bencer (Gb; Sormeh Company, Tehran, Iran), Perfect White Black (Gp), Colgate Total Whitening (Gt), and Colgate Optic White (Go) (Colgate-Palmolive Company, New York, NY, USA). The specimens were brushed for 14 minutes with respective dentifrices. In the Gc group, the specimens were only brushed with distilled water. The surface roughness of the specimens was measured again. The data were analyzed using repeated measure ANOVA at a significance level of 0.05.There was no significant difference in surface roughness parameters (Ra, Rq, Rz) between the groups, but in each group, the roughness parameters decreased after the aging procedure and increased after brushing significantly except for Rz parameter in Gb group which increased after aging and decreased after brushing.None of the whitening dentifrices used in the present study had an adverse effect on the surface roughness of an aged composite resin.

Population attributable fraction estimates of cardiovascular diseases in different blood pressure levels in a large-scale cross-sectional study: a focus on prevention strategies and treatment coverage

Abstract: Hypertension is one of the major modifiable risk factors in developing cardiovascular diseases (CVD). Hence, we aimed to ascertain age- and sex-specific population attributable fraction (PAF) for CVD in different blood pressure levels to implement efficient preventive strategies at the population level.Participants' data were obtained from the Iranian stepwise approach for surveillance of noncommunicable disease risk factors (STEPs) survey to calculate PAF in four subsequent phases. In phase 0, PAF was measured, irrespective of the diagnosis status. In phase 1, the theoretical minimum range of 115 ≤SBP less than 130 mmHg was considered as the low-risk and measurements equal to or higher than 130 mmHg as the high-risk group. Across phase 2, patients were divided into normal and hypertensive groups based on the American College of Cardiology/American Heart Association guideline. In phase 3, patients were divided into two categories based on treatment coverage.A total number of 27 165 participants aged ≥25 years had valid blood pressure measurements and were enrolled. Phase 0: PAF generally had an upward trend with age advancing. Phase 1: participants with BP ≥130 mmHg comprised the largest PAF, extending from 0.31 (0.25-0.37) in older male individuals to 0.85 (0.79-0.91) in younger females. Phase 2: higher values were found in younger ages for hypertension. Phase 3 represented that attributable fractions among hypertensive patients who received treatment were much lower than drug-naïve hypertensive participants.Our study enlightens the necessity for implementing effective screening strategies for the younger generation and providing adequate access to antihypertensive medications for the low-risk population.

Evaluation of Nrf2/ARE Signaling Pathway in the Presence of Pentoxifylline as a Cryoprotectant in Mouse Spermatogonial Stem Cells

Abstract: The process of spermatogonial stem cell cryopreservation (SSCs) in young male cancer survivors is associated with increased reactive oxygen species (ROS), DNA fragmentation, apoptosis, decreased cell activity, and finally reduced fertility of SSCs. Therefore, it is necessary to add cryoprotectants to the freezing medium to minimize the injuries associated with cryopreservation. In addition, the Nrf2/ARE pathway is a main cellular pathway that regulates the antioxidant defense system. The purpose of this study was to evaluate the cryoprotective effect of pentoxifylline (PTX) on SSCs after freezing–thawing through the Nrf2/ARE pathway. SSCs extracted from neonatal mice testes were isolated and their purity was measured by flow cytometry with GDNF family receptor alpha-1 (GFRα1) and inhibitor of differentiation 4 (ID4). After culturing, the cells were frozen in different groups for 1 month. After freezing–thawing, cell viability, colonization rate, and intracellular ROS, malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) were evaluated. Quantitative real-time polymerase chain reaction and western blotting were done to assess the expression levels of Nrf2, Keap-1, PI3K, and AKT genes and proteins. The survival and colonization rates of SSCs, SOD, and CAT levels, and Nrf2, PI3K, and AKT expression levels were significantly higher in the PTX group compared with the other cryopreservation groups. The Keap-1 expression level and the ROS and MDA production levels also decreased significantly in the PTX group (p-value <0.05). According to our findings, PTX can activate the antioxidant defense through the Nrf2/ARE signaling pathway; therefore, it could be a suitable cryoprotectant candidate for freezing and long-term storage of SSCs in the clinical setting.

Investigating the Expression Pattern of the SETMAR Gene Transcript Variants in Childhood Acute Leukemia: Revisiting an Old Gene

Abstract: Background: The chimeric enzyme SETMAR (or Metnase) has been associated with several DNA processes, including DNA damage repair through the non-homologous joining pathway and suppression of chromosomal translocation in mouse fibroblasts. SETMAR overexpression has been reported in certain cancers suggesting that it might contribute to the establishment or progression of these cancers. In leukemia, the SETMAR gene transcript variants have not been widely studied. Therefore, this study aimed to quantify 3 predominant SETMAR variants in 2 types of childhood acute leukemia, acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Methods: In this study, using reverse transcription-quantitative polymerase chain reaction (RT-qPCR), the relative expression of 3 SETMAR transcript variants (Var 1, Var 2, and Var A) were evaluated in the bone marrow samples collected from 30 newly diagnosed patients with AML, 65 newly diagnosed patients with ALL, and 15 healthy individuals. Results: The expression of SETMAR variants 1 and A were significantly higher in AML patients compared with controls (P=0.02, and P=0.009, respectively). Variant A expression was significantly higher in ALL compared with controls (P=0.003). When comparing the expression in translocation-positive and negative subgroups, the expression of variant 1 was significantly higher in translocation-positive ALL patients (P=0.03). The variants’ distribution patterns differed concerning translocation status (P=0.041), as variants 1 and A were dominant in the translocation-positive ALL group, and variant 2 was more prevalent in translocation-negative ones. Conclusions: According to the results, SETMAR showed increased expression in pediatric acute leukemia’s bone marrow samples, indicating a role for this molecule in leukemia pathogenesis. As this is the first report of SETMAR expression in pediatric leukemias, further studies are needed to investigate the causality of this association.

5-Nitro-2-furoyl chloride

Abstract: 5-Nitro-2-furoyl Chloride is a colorless crystalline derivative of nitrofurans, used as a reactant to synthesize several antibacterial agents. There are no reports on its commercial use. The 5-nitro group is responsible for the antimicrobial activity of this compound and plays a significant role in the genotoxicity of nitrofurans. It is almost impossible to conclude the toxicity of this compound, while it is only classified as a corrosive agent. More studies are also needed to investigate the 5-nitro-2-furoyl Chloride toxicology profile.

Protective effect of intensive glucose lowering therapy on all-cause mortality, adjusted for treatment switching using G-estimation method, the ACCORD trial

Abstract: Previous analysis of the action to control cardiovascular risk in diabetes showed an increased risk of mortality among patients receiving intensive glucose lowering therapy using conventional regression method with intention to treat approach. This method is biased when time-varying confounder is affected by the previous treatment. We used 15 follow-up visits of ACCORD trial to compare the effect of time-varying intensive vs. standard treatment of glucose lowering drugs on cardiovascular and mortality outcomes in diabetic patients. The treatment effect was estimated using G-estimation and compared with accelerated failure time model using two modeling strategies. The first model adjusted for baseline confounders and the second adjusted for both baseline and time-varying confounders. While the hazard ratio of all-cause mortality for intensive compared to standard therapy in AFT model adjusted for baseline confounders was 1.17 (95% CI 1.01-1.36), the result of time-dependent AFT model was compatible with both protective and risk effects. However, the hazard ratio estimated by G-estimation was 0.64 (95% CI 0.39-0.92). The results of this study revealed a protective effect of intensive therapy on all-cause mortality compared with standard therapy in ACCORD trial.

Inflammasome elements in epilepsy and seizures

Abstract: The inflammasomes refer to cytosolic multimolecular complexes within the innate immunity which drive inflammatory feedbacks. Based on structure, inflammasomes are divided into subclasses, such as NLRPs, NLRCs, and AIMs. These inflammasome components function as pattern recognition receptors (PRRs). That is, they can sense pathogen-associated molecular patterns (PAMPs), danger-associated molecular patterns (DAMPs), or homeostasis-altering molecular processes (HAMPs). Then, functional inflammasomes undergo assembly. The contribution of inflammasomes to neuroinflammation has been largely explored in the central nervous system (CNS). Neuroinflammation contributes to the pathogenesis and progression of many neuropsychiatric diseases, such as epilepsy. After CNS injury, inflammasome induction results in the release of neuroinflammatory components, such as interleukin (IL)-1β, IL-18, and high-mobility group box-1 (HMGB1), thereby resulting in epileptogenesis. Following inflammasome induction, nerve cells and glia release HMGB1 that is a ubiquitous nuclear protein as well as a target and biological marker for epilepsy; moreover, preclinical and clinical research on epilepsy therapeutics has focused on targeting inflammasomes such as NLRP1 and NLRP3. In addition to such direct evidence, inflammasomes can indirectly contribute to epileptogenesis; for instance, risk factors for epilepsy, including atherosclerosis, diabetes, hypertension, obesity, and infection are associated with the induction of inflammasomes, including NLRP3, NLRP1, NLRC4, and AIM2. In the present chapter, we discuss introductory information regarding inflammasomes, function of inflammasomes in the immunopathology and treatment of epilepsy, and insight into future translational research on epilepsy.

Differentiation of Pancreatic Beta Cells: Dual Acting of Inflammatory Factors

Abstract: In the past decades, scientists have made outstanding efforts to treat diabetes. However, diabetes treatment is still far from satisfactory due to the complex nature of the disease and the challenges encountered in resolving it. Inflammatory factors are key regulators of the immune system's response to pathological insults, organ neogenesis, rejuvenation of novel cells to replace injured cells and overwhelming disease conditions. Currently, the available treatments for type 1 diabetes include daily insulin injection, pancreatic beta cell or tissue transplantation, and gene therapy. Cell therapy, exploiting differentiation, and reprogramming various types of cells to generate pancreatic insulin-producing cells are novel approaches for the treatment of type 1 diabetes. A better understanding of the inflammatory pathways offers valuable and improved therapeutic options to provide more advanced and better treatments for diabetes. In this review, we investigated different types of inflammatory factors that participate in the pathogenesis of type 1 diabetes, their possible dual impacts on the differentiation, reprogramming, and fusion of other stem cell lines into pancreatic insulin-producing beta cells, and the possibility of applying these factors to improve the treatment of this disease.

Management of eagle syndrome

Abstract: Purpose of review Eagle syndrome is a challenging clinical presentation with important potential complications. It can be misdiagnosed due to lack of awareness; this review provides information in terms of diagnosis and management of eagle syndrome. Recent findings The importance of early diagnosis of this rare disease is preventing the delay in clinical-surgical treatment. As there is not a universally accepted cut-off for styloid process length, the diagnosis should be confirmed by length of process greater than one-third of the length of mandibular ramus in addition to other clinical symptoms and signs. There are both surgical and pharmacological treatment options for these patients. Summary Eagle syndrome is a rare clinical condition and its diagnosis is made by physical examination and radiography. When it is suspected by physical examination, definitive diagnosis is confirmed by computed tomography scans of the skull, as the gold standard. Location, degree of elongation of styloid process, and severity and reproducibility of symptoms are important factors in deciding the most appropriate approach. Surgery is frequently the treatment of choice in Eagle syndrome patients. With proper diagnosis and treatment, the prognosis is favourable and recurrence is uncommon.

Neuroinflammation as a potential therapeutic target in neuroimmunological diseases

Abstract: Neuroinflammatory processes are associated with inducing neurodegeneration and impairing neurogenesis. These processes are known to contribute to the underlying pathophysiology of various neurological disorders such as Parkinson’s disease (PD), Alzheimer’s disease (AD), stroke, multiple sclerosis (MS), and cognitive dysfunction. Therefore, targeting neuroinflammation may unlock new strategies to improve these conditions. This chapter discusses the recent findings regarding the therapeutic agents affecting neuroinflammation. We aimed to discuss the effects of herbal medicine and organic compounds, endogenous neuroactive substances, repurposed drugs (existing medications such as antibiotics, antidiabetic, etc. for new therapeutic purposes), and nonpharmacological approaches such as alcohol consumption and dietary modification on neuroinflammation.

Experiences of patient education among people affected by cardiovascular disease: a qualitative study based on Andragogy model

Abstract: Abstract Background Patient education is a key component of patient care, positively affecting health promotion and self-care ability. In this regard, an extensive body of research supports the use of the andragogy model in patient education. The study aimed to explore the experiences of people with cardiovascular disease in patient education. Methods This qualitative study involved 30 adult patients with cardiovascular disease who were hospitalized or had a history of hospitalization. They were purposively recruited with maximum variation from two large hospitals in Tehran, Iran. Data were gathered by conducting semi-structured interviews. Data collection was done by conducting semi-structured interviews. Then, the data were analyzed using directed content analysis and a preliminary framework based on six constructs of the andragogy model. Results Data analysis resulted in the development of 850 primary codes, which were reduced to 660 during data reduction. These codes were grouped into nineteen subcategories under the six primary constructs of the andragogy model, i.e., need-to-know, self-concept, prior experience, readiness for learning, orientation to learning, and motivation for learning. The most common problems in patient education were associated with self-concept, previous experience, and readiness for learning components. Conclusion This study provides valuable information about the problems of patient education for adults with cardiovascular disease. Correction of the issues identified can improve care quality and patient outcomes.

Cord blood antibodies following BBIBP‐CorV (Sinopharm) vaccination during pregnancy

Abstract: Objective This study aimed to evaluate the maternal and umbilical cord blood antibody levels, after COVID vaccination during pregnancy. Method The women who received the COVID-19 vaccine (Sinopharm) during pregnancy were included. Maternal and cord blood samples were tested to detect the severe acute respiratory syndrome coronavirus 2 receptor binding domain (RBD) specific antibodies. In addition, obstetric information and side effects after vaccination were gathered. Result A total of 23 women were included. Eleven pregnant women took two doses and 12 cases received a single dose of the vaccine. No IgM antibody was detected in any maternal blood or cord blood samples. The RBD-specific Immunoglobulin G (IgG) antibody was positive in mothers receiving 2 doses of the vaccine and their infants. But the antibody titers were under the positive cut-off threshold for the other 12 women who were vaccinated with a single dose. Women who received both doses of vaccine had significantly higher IgG levels than a single dose of Sinopharm (p = .025). The same result was demonstrated in infants born to these mothers (p = .019). Conclusion There was a significant correlation between maternal and neonatal IgG concentrations. Although, receiving both doses of the BBIBP-CorV vaccine (not 1 dose) during pregnancy is highly beneficial for increasing humoral immunity for the mother and fetus.

Interview Findings in Relation to Organ Donation in Iran

Abstract: The interviews carried out in Iran investigate how people view organ donation and relevant incentives. The data collected from the 18 interviewees with organ recipients, experts in the organ donation field, donors, and donor family members shows that all interviewees believed deceased organ donation is an excellent source for transplantation which can help grieving families. The interviewees also concur that donors deserve some compensation, but they are more in favor of honorary than compensationalist incentives. Among the proposed compensationalist incentive measures, funeral expenses were the only option that all interviewees agreed with. Meanwhile, the impact of familist incentives was believed to be limited. The interviews also show that public education is the preferred means of promoting organ donation in Iran.

Acetamide

Abstract: Acetamide (Chemical Abstracts Service Registry Number 60-35-5) is used as solublizer, stabilizer, plasticizer, and with industrial applications in cryoscopy, soldering, and the textile industry. This compound is not genotoxic and the carcinogenic response is related to the formation of hydroxylamine. In addition, hepatotoxicity and hematopoietic toxicity are observed for this compound.

Antimicrobial photodynamic therapy: modern technology in the treatment of wound infections in patients with burns

Abstract: Background: Staphylococcus aureus is one of the most frequently isolated microorganisms from burn wounds. Antimicrobial photodynamic therapy (aPDT) is a new strategy that may improve antimicrobial treatment. Method: This study evaluated three meticillin-resistant Staphylococcus aureus (MRSA) and three meticillin-sensitive Staphylococcus aureus (MSSA) clinical isolates, which produced a biofilm with 0.1mg/ml Toluidine Blue O (TBO) (Sigma-Aldrich, Germany) with an energy density of 45J/cm 2 and 90J/cm 2 , for MRSA and MSSA, respectively. The antibiofilm potential of aPDT with TBO was analysed using crystal violet assays and scanning electron microscopy. Results: TBO-aPDT significantly degraded the biofilm formed by MRSA and MSSA clinical isolates (p<0.05). Conclusion: Our results indicated that aPDT is an effective approach to combat bacterial biofilms associated with burn wound infection. aPDT could provide a supplemental to the treatment of wound and tissue infection, and patients with burns may benefit from combined treatments.

B cells and T cells abnormalities in patients with selective IgA deficiency

Abstract: Abstract Background Selective IgA deficiency (SIgAD) is the most prevalent inborn errors of immunity with almost unknown etiology. This study aimed to investigate the clinical diagnostic and prognostic values of lymphocyte subsets and function in symptomatic SIgAD patients. Methods A total of 30 available SIgAD patients from the Iranian registry and 30 age-sex-matched healthy controls were included in the present study. We analyzed B and T cell peripheral subsets and T cell proliferation assay by flow cytometry in SIgAD patients with mild and severe clinical phenotypes. Results Our results indicated a significant increase in naïve and transitional B cells and a strong decrease in marginal zone-like and switched memory B-cells in SIgAD patients. We found that naïve and central memory CD4 + T cell subsets, as well as Th1, Th2 and regulatory T cells, have significantly decreased. On the other hand, there was a significant reduction in central and effector memory CD8 + T cell subsets, whereas proportions of both (CD4 + and CD8 + ) terminally differentiated effector memory T cells (T EMRA ) were significantly elevated in our patients. Although some T cell subsets in severe SIgAD were similar, a decrease in marginal-zone and switched memory B cells and an increase in CD21 low B cell of severe SIgAD patients were slightly prominent. Moreover, the proliferation activity of CD4 + T cells was strongly impaired in SIgAD patients with a severe phenotype. Conclusion SIgAD patients have varied cellular and humoral deficiencies. Therefore, T cell and B cell assessment might help in better understanding the heterogeneous pathogenesis and prognosis estimation of the disease.

Life cycle assessment

Abstract: Life cycle assessment (LCA) is a method for evaluating potential environmental effects over the whole life cycle of a product, from resource acquisition through production and consumption to waste management (including disposal and recycling). Products include goods, digital tools, and services. LCA is a comprehensive analysis tool that considers the entire life cycle of a product and a variety of environmental aspects. These distinctive features of LCA make it easier to prevent problems due to moving from one stage of a product's life cycle or an environmental impact to the next. An outline of the methodology is provided in this article.