Photo-crosslinked hyaluronic acid hydrogels designed for simultaneous delivery of mesenchymal stem cells and tannic acid: Advancing towards scarless wound healing.

The quest for scarless wound healing is imperative in healthcare, aiming to diminish the challenges of conventional wound treatment. Hyaluronic acid (HA), a key component of the skin's extracellular matrix, plays a pivotal role in wound healing and skin rejuvenation. Leveraging the advantages of HA hydrogels, this research focuses first on tuning the physicochemical and mechanical properties of photo-crosslinkable methacrylated HA (MAHA) by varying the methacrylation degree, polymer concentration, photo-crosslinker concentration, and UV exposure time. The optimized hydrogel, featuring suitable porosity, swelling ratio, degradability, and mechanical properties, was then used for the combined delivery of tannic acid (TA), known for its hemostatic, antibacterial, and antioxidant properties, and Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) cultured on the MAHA-TA hydrogel to enhance skin regeneration. The composite MAHA-TA-MSC hydrogel demonstrated favorable pores and biocompatibility, evidenced by cell viability, and promoted cell proliferation. When applied to dorsal wounds in rats, this composite hydrogel accelerated wound healing and reduced scarring. Additionally, molecular and histopathological analyses revealed increased expression of IL-10, the TGF-ß3/TGF-ß1 ratio, and the Collagen III/Collagen I ratio. These findings suggest that the MAHA-TA-MSC hydrogel is a promising candidate for scarless acute wound healing.

Anticancer potentiality of Hottentotta saulcyi scorpion curd venom against breast cancer: an in vitro and in vivo study.

Scorpion venom may include pharmacological substances that have the potential to provide benefits. Multiple scientific investigations have shown that particular scorpion venoms induce apoptosis and inhibit the development of cancerous cells. The present study investigated the potential anticancer properties of the crude venom derived from Hottentotta saulcyi (H. saulcyi) on both in vivo mice models and in vitro breast carcinoma cells. The venom of scorpions belonging to the species H. saulcyi was obtained with the application of electrical stimulation at voltages of 8 and 10 V. The determination of the Average Lethal Dose 50 (LD50) was conducted. The present work assessed the in vitro cytotoxicity and morphological characteristics of H. saulcyi venom using fluorescence microscopy, MTT assay, and flow cytometry assessment. Additionally, research was performed to assess the cytotoxic effects in vivo on a mouse model with breast cancer. The examination of MCF-7 cells treated with scorpion venom at a microscopic level revealed the existence of cells undergoing apoptosis. The venom of H. saulcyi has anticancer properties, as shown by the observation that MCF-7 cells had a 62.12% apoptotic rate when exposed to a dose of 1.47 mg/L. Based on the results obtained, it can be shown that the viability of MCF-7 cells has exhibited a substantial reduction (P < 0.01). Furthermore, the findings indicated that the venom of H. saulcyi resulted in a significant increase in the synthesis of TNF-α, IL-6, IL-10, TGF-ß, and caspase (P < 0.05). The treatment groups administered with H. saulcyi venom exhibited a significant augmentation in the expression of proapoptotic genes compared to the control group of healthy individuals. The transcription of the BCL2 gene exhibited a statistically significant increase in the healthy control group compared to both the healthy venom-treated group (P < 0.05) and the malignant venom-treated group (P < 0.01). The crude venom of H. saulcyi has considerable promise in demonstrating anticancer properties. Further investigation may be warranted to explore the potential of using H. saulcyi crude venom as a medicinal platform for the prevention of breast cancer.

Exploring non-thermal plasma technology for microalgae removal.

The global population and economic development surge has substantially increased water demand, resulting in heightened sewage and pollutant generation, posing environmental hazards. Addressing this challenge necessitates the implementation of efficient and cost-effective water reclamation methods. Non-thermal plasma technology (NTP) has emerged as a promising solution, garnering attention for its superior efficiency compared to alternatives. While existing studies have predominantly focused on energy efficiency and pollutant removal, limited research has delved into the biological removal aspect, particularly concerning algae. This study utilized a dielectric barrier plasma diffuser to eliminate Spirulina microalgae (Spirulina platensis) from wastewater solutions, demonstrating higher algae removal and superior mass transfer compared to alternative plasma methods. The effect of sample volume, input voltage and power, flow rate, and initial solution concentration on the algae removal was investigated. Investigation of operational parameters revealed the best condition resulting in a 98 % removal rate and 20 g/kWh energy efficiency. The best conditions for the removal of Spirulina microalgae were considered in a sample volume of 50 mL, a voltage of 7.6 kV, a flow rate of 700 mL/min, and an initial solution concentration of 1280 mg/liter. Scanning Electron Microscope (SEM) images illustrated the impact of active species on cell structure, leading to the destruction of spiral form and loss of reproductive ability. The study underscores the potential of NTP for efficient algae removal and identifies key active species involved in the process. The removal of Spirulina microalgae was attributed to a combination of singlet oxygen (1O2), hydroxyl radicals, and ozone.

Troublesome Weight Loss: A Case Report of Large Gastric Phytobezoar.

Gastric bezoar is a very rare clinical condition and hard to treat. Phytobezoars are one of the most common types of bezoars, which happens with the consumption of indigestible fibers. In this report, we presented an elderly man with gastric phytobezoar who presented with peptic ulcer and was treated successfully with proton pump inhibitor (PPI) and Coca-Cola. Surveillance endoscopy showed a completely healed ulcer. It was shown that cautious use of Coca-Cola can be helpful and safe in treating concomitant phytobezoar and gastric ulcers. To the best of our knowledge, this is the first report of phytobezoar from Iran, which was treated with cola.

A dose-response meta-analysis of the relationship between number of pregnancies and risk of gynecological cancers.

BACKGROUND: Despite several investigations, the association between the number of pregnancies and gynecological cancers remains inconclusive. To address this issue, we conducted a dose-response meta-analysis of observational studies. METHODS: We searched PubMed, Web of Science, and Scopus databases up to Jun 8, 2023, to identify observational studies that examined the association between the number of pregnancies and gynecologic cancers. To assess the heterogeneity across studies, we used the χ2 test and I2 statistics. We also explored the possibility of publication bias using Begg's and Egger's tests. The overall effect sizes were reported as odds ratios (ORs) with a 95% confidence interval (CI) using a random-effects model. RESULTS: Out of the 87,255 studies initially identified, a total of 101 studies involving 8,230,754 participants were included in the final meta-analysis. Our analysis revealed a positive trend between the number of pregnancies and cervical cancer; however, this association was not found to be statistically significant except for fifth pregnancy. Conversely, our findings showed a significant decreasing trend between the number of pregnancies and the risk of endometrial and ovarian cancers. There was insufficient evidence to establish a relationship between the number of pregnancies and the risk of vaginal, vulvar, and fallopian tube cancers. CONCLUSIONS: Our study found a positive trend between the number of pregnancies and cervical cancer and a significant decreasing trend between the number of pregnancies and endometrial and ovarian cancers. These findings may have implications for counseling women about their reproductive health and the potential risks and benefits of pregnancy.

Inferior Vena Cava Placement of a Transhepatic Tunneled Dialysis Catheter in a Patient with Atypical Hepatic Venous Anatomy: A Case Report.

A transhepatic hemodialysis (HD) catheter serves as a final option for obtaining HD vascular access in patients whose conventional access sites, including internal jugular veins, external jugular veins, and femoral veins, are no longer viable. This could be due to intravascular thrombosis or central venous stenosis, among others. The ideal catheter tip position in transhepatic tunneled dialysis catheter is the right atrium for optimal blood flow necessary for dialysis. The report presents a case of a 46-year-old female, in whom the traditional vascular access sites for dialysis were not achievable and, thus, required the use of the hepatic access route. However, her case was further complicated due to the unique hepatic vascular anatomy, causing repeated retraction of the catheter tip from the right atrium to the inferior vena cava (IVC) and hepatic vein. This was circumvented by the atypical placement of the catheter tip down to the suprarenal IVC, deep enough to lodge the catheter in place with adequate flow for successful HD.

Does Gabapentin Have A Role in the Improvement of Feeding Resistance in Infants?

Background: Eating disorders in some infants can be due to the inability to reach a level of relaxation necessary to start the feeding process. Gabapentin (GB) has been proposed as a stabilizer of nerve function in improving this disorder. This study aimed to investigate the effect of GB on improving feeding resistance in infants aged 3-6 months. Materials and Methods: This randomized, controlled, double-blind clinical trial was done on 64 infants aged 3-6 months with feeding resistance who were referred to the pediatric clinics and assigned to two groups of 32. The case group was given a dose of 5 mg/kg of GB in the first week, and if not too much sedation, it was increased to 10 mg/kg in the second week every 8 hours, whereas the control group received a placebo. The number of effective breastfeeding and the volume of formula in cc before and after 2 weeks of drug usage were recorded in both groups. Results: The number of breastfeeding sessions significantly had a higher increase in the GB group compared with placebo (median [IQR]: 1 [0,1] vs. 0 [0,1], P = 0.005) as well as an increase in consumed formula volume (mean ± SD: 42.81 ± 24.49 vs. 18.67 ± 14.57, P = 0.003). Conclusion: Considering the significant increase in formula consumption and the number of breastfeeding sessions in the GB group, it is possible to use this drug as a nerve-stabilizer and pain reducer to treat this disorder.

Hospital Managers' Decision-Making Puzzle.

Background: Decision-making is choosing one option from among different options. Most decision-making models were developed in the general industry. Specific decision-making models are needed due to the special nature of the hospital and its services. We aimed to propose and validate a decision-making model for hospital managers. Methods: This research used the modified Delphi technique to develop and validate a decision-making model for hospital managers. A data collection form was used to collect data. The search of English databases covered the period from 1990 to 2020. The first draft of the model was introduced through a scoping review and semi-structured interviews. Two rounds of Delphi were conducted with 33 experts to verify the proposed model. Results: Many factors affect the quality and outcome of a hospital manager's decision. The decision-making model developed in this study has 10 constructs grouped into three components (i.e., inputs, processes, and outputs). These constructs include decision maker, decision implementer, organization, client, subject, analysis, identification, evaluation & selection, implementation and control. This model provides a guide for each decision stage and determines the conditions necessary for a good decision. Conclusion: Using the decision-making puzzle and considering the set of inputs, processes, and outcomes of the decision making together alongside with specifying the details of each decision-making stage make it easy for hospital managers to decide. Such a scientific, objective and systematic approach in decision-making will result in desired results for staff, patients, managers and the hospital. This puzzle is also a good tool for pathology of hospital managers' decisions.

Mechanistic Insights of Amino Acid Binding to Hydroxyapatite: Molecular Dynamics Charts Future Directions in Biomaterial Design.

Extensive efforts have been made to improve the understanding of hard tissue regeneration, essential for advancing medical applications like bone graft materials. However, the mechanisms of bone biomineralization, particularly the regulation of hydroxyapatite growth by proteins/peptides, remain debated. Small biomolecules such as amino acids are ideal for studying these mechanisms due to their simplicity and relevance as protein/peptide building blocks. This study investigates the binding affinity of four amino acids including glycine (Gly), proline (Pro), lysine (Lys), and aspartic acid (Asp) to the hydroxyapatite (HAP) (100) surface through molecular dynamics simulations. Our findings reveal that aspartic acid exhibits the most energetically favorable binding affinity, attributed to its additional carboxylate group (-COO-), which facilitates stronger interactions with Ca2+ ions on the HAP surface compared to other amino acids with single carboxylate groups. This highlights the critical role of specific functional groups in modulating binding strength, emphasizing that the presence of multiple binding sites in amino acids enhances binding stability. Interestingly, the study also uncovers the significance of water-mediated interactions, as the compact water layer above the HAP surface acts as a barrier, complicating direct binding and underscoring the need to consider solvation effects in simulations. Glycine, due to its small size, demonstrates a unique ability to penetrate this tightly bound water monolayer, suggesting that molecular size influences binding dynamics. These simulations offer detailed insights into the atomic-level interactions, providing a deeper understanding of binding affinity and stability. These insights are pertinent for designing peptides or proteins with enhanced interactions with biomaterials, particularly in mimicking natural bone-binding processes.

Evaluation of a Workplace Diabetes Prevention Program Delivered via Distance Learning: A Qualitative Study.

Little is known about how distance learning impacts delivery of the National Diabetes Prevention Program (DPP) despite a rapid shift to this platform during the coronavirus disease 2019 (COVID-19) public health emergency. We explored how a workplace DPP, delivered via distance learning, impacted knowledge, motivation, and behavioral skills of participants throughout the program. We conducted repeated qualitative interviews with distance learning participants at baseline, 6 months, and 12 months from September 2020 to July 2022. Three study team members coded interview data using individual responses as the unit of analysis. We used a thematic approach, using the information-motivation-behavioral skills framework, to analyze responses and generate understanding of the program's impact. The 27 individuals who participated in the interviews (89% women, mean age 56 years) reported the distance learning platform was effective in changing their behavior. The program's focus on food logging and setting limits on specific types of caloric intake was perceived as essential. Education on ideal levels of fat and sugar consumption, lessons on how to read food labels, and dissemination of recipes with healthy food substitutions allowed participants to initiate and sustain healthy decision-making. Strategies to increase physical activity, including breaking up exercise throughout the day, made reaching their goals more feasible. Participants reported food logging and weight reporting, as well as group support during sessions, either sustained or increased their motivation to adhere to the program over time. A workplace DPP delivered via distance learning successfully prompted improvements in the knowledge, motivation, and behavioral skills necessary to increase healthy eating and physical activity among participants.

Challenges and solutions to banning the advertisement of unhealthy products: a qualitative study.

Unhealthy products (food, alcohol, tobacco) are among the main risk factors of non-communicable diseases. To discourage the consumption of these products, Iran has passed a law banning the advertisement of unhealthy products in all media and for all age groups. The purpose of the present study was to identify the challenges of this approach and provide evidence to facilitate the enforcement process and the participation of stakeholders. In this qualitative study participants were selected from the policymakers and experts involved in the banning of advertisements on unhealthy products in Iran. Semi-structured interviews were conducted with 24 specialists and experts. The participants were selected through purposive and snowball sampling. Identified challenges and solutions were divided into three categories and nine themes: external (political, social, and economic); interorganizational (mission and communication); and internal (planning, organization, leadership, and control). Banning the advertisement of unhealthy products involves many challenges due to the existence of key players with different roles and missions. If these challenges are not managed effectively, they will hinder the enforcement and success of this law. Therefore, it is necessary for policymakers and health system managers to take the necessary measures to remove these obstacles.

Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study.

Background: Routine Doppler study is a common tool for early diagnosis of Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA) patients. It aimed to determine the role of the Foramen Ovale Pulsatility Index (FOPI) study beside routine Doppler study among patients with FGR and SGA fetuses. Methods: This prospective study was conducted on 35 FGR, 32 SGA, and 33 Appropriate for Gestational Age (AGA) fetuses. Demographic data, amniotic fluid index, neonatal outcome, and Doppler velocimetry, including Umbilical Artery Pulsatility Index (UMAPI), Uterine Artery Pulsatility Index (UTAPI), Middle Cerebral Artery Pulsatility Index (MCAPI), Ductus Venosus Pulsatility Index (DVPI), and FOPI were documented. Kolmogorov-Smirnov normality test, one-way ANOVA, Mann-Whitney U, Kruskal-Wallis, non-parametric pairwise comparisons adjusted for Bonferroni correction, Pearson correlation test, Chi square, Fisher's exact test, and Receiver Operating Characteristic Curve (ROC) analysis with Youden's Index (sensitivity+specificity-1) to estimate cut-off point were used to analyze the data at significance level <0.05 for all tests. Results: FOPI cut-off points were 2.24 (sensitivity=77%, specificity=94%) and 1.15 (sensitivity=90%, specificity=20%) to predict FGR and SGA, respectively. FOPI showed a positive correlation with UMAPI and UTAPI (r=0.52 and r=0.30, P<0.001 and P=0.006, respectively), but not with MCAPI and DVPI (r=0.08 and r=0.12, P=0.50 and P=0.30, respectively). Besides, UMAPI, UTAPI, and FOPI were altered among patients with stages I and II FGR. Umbilical cord potential hydrogen (umbilical cord pH), 1- and 5-min Apgar score significantly increased by Birth weight centile; however, UMAPI, FOPI, and UTAPI significantly decreased. Conclusion: UMAPI is recommended to predict short-term neonatal morbidities and demonstrate the early or late onset FGR. Besides, FOPI is suggested as the first-line Doppler study to detect abnormal growth velocity. More studies are warranted, especially considering long-term neonatal morbidities.

Divine noni's protective impact on Swiss albino mice's short-term memory impairment caused by cyclophosphamide: A behavioral and biochemical approach.

Cyclophosphamide (CYL) is a first-line cancer chemotherapeutic agent widely used for the treatment of cancer that has severe toxic effects. The primary mechanism by which CYL induces toxicity through free radical generation. Morinda citrifolia (Noni) fruit juice is an herbal remedy documented to have antioxidant properties. The aim of the current study was to investigate the protective effect of noni against CYL-induced memory impairment in Swiss albino mice. Treatment schedule: Group 1: Normal: Received vehicle; Group 2: CYL treatment: Received CYL (40.0 mg/kg b.w. i.p.) on day one; Group 3: NJ treatment: Received NJ (360 mg/b.w. p.o.) once daily for 14 days. Group 4: DNG treatment: DNG (360 mg/b.w. p.o.) once daily for 14 days, Group 5: NJ + CYL treatment: Received CYL (40.0 mg/kg b.w. i.p.) on day one and after half an hour of received NJ (360 mg/b.w. p.o.) once daily for 14 days. Group 6: DNG + CYL treatment: Received CYL (40.0 mg/kg b.w. i.p.) on day one and after half an hour received DNG (360 mg/b.w. p.o.) once daily for 14 days. Mice were subjected to the Morris water maze (MWM) challenge for two weeks as part of a behavioral study. Short-term memory impairment was observed in the behavioral activity of CYL-treated mice in the MWM test in the 1st week trial, and this effect was reversed in the 2nd week trial in the combination treatment group. The behavioral analysis proved that noni supplementation reduced the risk of memory impairment caused by CYL. Biochemical analysis revealed that CYL markedly increased the levels of AChE and MDA in brain tissue. Similarly, decreases in the levels of antioxidants, i.e., GSH, CAT, SOD and GST, were detected in the brain tissue of the mice exposed to CYL. Qualitative and quantitative examinations of histopathological examination of the mouse hippocampus supported the above findings. The results demonstrated that noni supplement therapy reversed the changes in the MDA, AChE, and antioxidant enzyme levels while improving the behavioral and histological alterations caused by CYL. Long-term hippocampal growth and memory are unaffected, suggesting that CYL is less harmful. According to our research, supplementing with noni in conjunction with CYL may be a helpful treatment strategy for treating memory impairment caused by CYL.

Influence of cephalexin on cadmium adsorption onto microplastic particles in water: Human health risk evaluation.

This paper explores the impact of environmental factors on the adsorption of cadmium (Cd) and cephalexin (CEX) onto polyethylene (PE) microplastics. The study focused on Cd adsorption behavior on microplastics (MPs) of various sizes, revealing that particles sized 30-63 µm exhibited the highest adsorption capacity compared to other sizes. Cd sorption was significantly influenced by initial pH and salinity levels. Experimental data closely matched both the Langmuir (R2 > 0.91) and Freundlich (R2 > 0.92) isotherms. Cd adsorption onto PE particles was greater than CEX adsorption, with the maximum Cd uptake capacity measured at 1.8 mg/g. FTIR analysis indicated that Cd and CEX adsorption onto MPs was likely governed by physical interactions, as no new functional groups were detected post-uptake. The desorption rates of Cd and CEX from PE microplastics were evaluated in various liquids, including aqueous solution, tap water, seawater, and synthetic gastric juice. The health risks associated with Cd, in combination with MPs and CEX, for both children and adults were assessed in groundwater and aqueous solutions. This study offers scientific insights and guidelines for examining the environmental behavior, migration, and transformation of microplastics and their related ecological risks in scenarios of combined pollution.

Psychological distress and coping skills used by individuals in the crisis caused by the COVID-19 pandemic.

BACKGROUND: Psychological distress, as a key indicator, describes a person's emotional problems and psychological reactions to adapt to the environment. This study aimed to investigate the relationship between psychological distress and coping strategies used by individuals during the crisis caused by COVID-19. MATERIALS AND METHODS: The current research is an analytical cross-sectional study that was designed in 2021. The sampling area included the three cities of Lar, Gerash, and Evaz in the south of Fars province in the south of Iran. The study population was the residents of these three cities during the COVID-19 pandemic. The final sample size in the present study was 384 people. Individuals were selected through available sampling. By answering questions from the self-assessment system of COVID-19 disease, the Ministry of Health and Medical Education filled out the necessary information for individual screening and registration of the symptoms of COVID-19 disease. Then, they completed the Coping Methods Questionnaire and the Psychological Distress Questionnaire. RESULTS: The mean age of the participants was 40.90 years. One hundred sixty-seven (43.5%) participants were male, and 217 (56.5%) were female. The mean score of problem-oriented coping style was significantly different between the levels of education (P = 0.001). The mean score of problem-solving coping style for the participants suspected of being infected with COVID-19 was 6.18 scores lower than others, and the difference was statistically significant (P = 0.001). Multiple regression with a forward selection also showed that among the studied variables, age, problem-oriented, and emotion-oriented coping strategies were important variables affecting mental distress. CONCLUSION: People who were not suspected of having COVID-19 symptoms had a higher mean problem-oriented coping score than those who were suspected of having COVID-19. Therefore, early identification of suspects and the implementation of counseling and training programs can be very effective.

Successful management of a ruptured cystic artery pseudoaneurysm with embolization and cholecystectomy: A case report.

Key Clinical Message: Cystic artery pseudoaneurysm is a rare phenomenon associated with cholecystitis. We describe the successful management of angioembolisation and cholecystectomy. Abstract: Cystic artery pseudoaneurysm (CAP) is a rare but clinically significant condition with various etiological factors. Cholecystitis is a prominent cause, often leading to inflammation-induced arterial wall erosion and pseudoaneurysm formation. CAP can present with a range of symptoms, including hemobilia, upper GI bleeding, and jaundice. Despite its rarity, CAP warrants attention in emergency care due to its potential for life-threatening arterial bleeding. Timely diagnosis is crucial, with imaging techniques playing a key role. Depending on the clinical context, management options include endovascular embolization and surgical intervention. Due to the limited cases, standard protocols remain elusive. A 64-year-old woman presented with abdominal pain, anorexia, and weight loss, prompting an evaluation for possible gallbladder cancer. She experienced sudden abdominal pain and upper gastrointestinal bleeding (hematemesis). Laboratory findings revealed leukocytosis, anemia, and abnormal liver function tests. Imaging showed gallbladder wall thickening, luminal contraction, and a pseudoaneurysm in the cystic artery. The patient underwent angioembolization followed by cholecystectomy, confirming acute cholecystitis and CAP with thrombosis. This case underscores the importance of early recognition and appropriate management in CAP, particularly when accompanied by acute cholecystitis.

Equity in the geographical distribution of general practitioners in Iran.

BACKGROUND: The equitable distribution of workforce is imperative for achieving public health goals. This study was conducted to evaluate the equity of the distribution of general practitioners (GPs) in Iran. METHODS: In this descriptive and cross-sectional study, data from the Information System of Benefits for Iranians and the Iranian Statistics Center were utilized. The study population encompasses all GPs operating in Iran in 2022. To assess equity in the geographical distribution of physicians, the Gini coefficient and Lorenz curve were calculated using Excel software. Additionally, ArcGIS software was used to create a distribution map. RESULTS: The population of Iran and active GPs in 2022 were 85,874,000 and 67,852 respectively, resulting in an average of 7.9 active GPs per 10,000 people. The provinces of Yazd, Tehran, Mazandaran, and Fars exhibited the highest concentration of active GPs per capita, collectively representing more than 28% of the population and 37% of the active GPs. Fifty percent of the active GPs were women. The Gini coefficients for the provincial and intercity distributions of GPs were 0.08 and 0.2, respectively. CONCLUSION: The distribution of GPs among provinces and cities was deemed fair and relatively fair, respectively. Iran has a lower ratio of GPs per capita than the European nations. Policymakers should pay more attention to the implementation of appropriate policies with the aim of increasing equity in the geographical distribution of GPs in the country.