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BACKGROUND: Exosomes derived from tumor cells contribute to the pathogenesis of cancers. Metformin, the most usually used drug for type 2 diabetes, has been frequently investigated for anticancer effects. Here, we examined whether metformin affects exosomes signaling in human ovary cancer cells in vitro. METHODS: Human ovary cancer cells, including A2780 and Skov3 cells, were treated with metformin for either 24-48 h. Cell viability and caspase-3 activity were determined by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) and colorimetric assays respectively. Oil-Red-O staining and in vitro, scratch assays were used to examine cellular toxicity and wound healing rate. After treatment with metformin, exosomes were isolated from cells and quantified by acetylcholinesterase (AChE) assay, Dynamic Light Scattering (DLS), and their markers. Genes related to exosomes signaling were analyzed by real-time PCR or western blotting. RESULTS: Our results showed that metformin decreased the viability of both cells dose/time-dependently (P < 0.05). Metformin increased the activity of caspase-3 (P < 0.05) as well as the number of Oil-Red-O positive cells in both cell lines. In vitro scratch assay showed that the cell migration rate of metformin-treated cells was decreased (P < 0.05), whereas AChE activity of exosomes from metformin-treated cells was increased (P < 0.05). Concurrent with an increase in CD63 protein levels, expression of Alix, CD63, CD81, Lamp-2, and Rab27b up-regulated in treated cells (P < 0.05). CONCLUSION: Results indicated that metformin had a cytotoxic effect on ovary cancer cells and enhanced exosome biogenesis and secretion.
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BACKGROUND: Immune escape, a process by which tumor cells evade immune surveillance, remains a challenge for cancer therapy. Tumor cells produce extracellular vesicles (EVs) that participate in immune escape by transferring bioactive molecules between cells. EVs refer to heterogeneous vesicles that participate in intercellular communication. EVs from tumor cells usually carry tumor antigens and have been considered a source of tumor antigens to induce anti-tumor immunity. However, evidence also suggests that these EVs can accelerate immune escape by carrying heat shock proteins (HSPs), programmed death-ligand 1 (PD-L1), etc. to immune cells, suppressing function and exhausting the immune cells pool. EVs are progressively being evaluated for therapeutic implementation in cancer therapies. EVs-based immunotherapies involve inhibiting EVs generation, using natural EVs, and harnessing engineering EVs. All approaches are associated with advantages and disadvantages. The EVs heterogeneity and diverse physicochemical properties are the main challenges to their clinical applications. SHORT CONCLUSION: Although EVs are criminal; they can be useful for overcoming immune escape. This review discusses the latest knowledge on EVs population and sheds light on the function of tumor-derived EVs in immune escape. It also describes EVs-based immunotherapies with a focus on engineered EVs, followed by challenges that hinder the clinical translation of EVs that are essential to be addressed in future investigations. Video Abstract.
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Vesículas Extracelulares , Neoplasias , Humanos , Escape del Tumor , Inmunoterapia , Antígenos de Neoplasias , Neoplasias/terapiaRESUMEN
Exosomes, heterogeneous, membrane-bound nanoparticles that originated from eukaryotic cells, contribute to intracellular communication by transferring various biomolecules both on their surface and as internal cargo. One of the most significant current discussions on cancer progression is noncoding RNAs cargo of exosomes, which can regulate angiogenesis in tumor. A growing body of evidence shows that exosomes from tumor cells contain various microRNAs, long noncoding RNAs, and circular RNAs that can promote tumor progression by inducing angiogenesis. However, some noncoding RNAs may inhibit cancer angiogenesis. Targeting angiogenic noncoding RNA of exosomes may serve as a hopeful implement for cancer therapy. In this review, we discuss the latest knowledge of the roles of exosomal noncoding RNAs in tumor angiogenesis Understanding the biology of exosomal noncoding RNAs can help scientists plan exosomes-based innovations for the treatment of cancer angiogenesis and cancer biomarkers.
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Exosomas , MicroARNs , Neoplasias , ARN Largo no Codificante , Humanos , Angiogénesis , Estudios Prospectivos , Neoplasias/genética , Neoplasias/patología , MicroARNs/genética , ARN no Traducido/genética , ARN Largo no Codificante/genética , Exosomas/genética , Exosomas/patología , Biomarcadores de Tumor/genéticaRESUMEN
BACKGROUND: With the ongoing coronavirus disease (COVID-19) pandemic, along with the development of new mutations of the virus and an increase in the number of cases among pediatrics, physicians should be aware and alerted on the atypical presentations of the disease, especially in less expected individuals. CASE PRESENTATION: Here we present a 12-year-old obese boy (BMI = 37.5 kg/m2) who presented with empyema, which was following SARS-CoV-2 infection. The patient had no history of fever. Due to the onset of dyspnea, a chest tube was inserted for him which was later altered to a pleural drainage needle catheter. CONCLUSION: Our case is the first report of COVID-19 presenting as empyema among pediatrics. Pleural empyema should be considered as a rare complication of COVID-19. Since there is still no guideline in the management of empyema in the context of COVID-19, delay in diagnosis and intervention may cause morbidity and mortality in children.
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COVID-19 , Empiema Pleural , Pediatría , Niño , Empiema Pleural/diagnóstico , Empiema Pleural/etiología , Empiema Pleural/terapia , Humanos , Masculino , Obesidad , SARS-CoV-2RESUMEN
BACKGROUND: The implementation of the electronic prescribing system follows certain objectives, and users' perspectives can contribute to understanding the efficiency and effectiveness of this system. This study aimed to evaluate physicians' perspectives on the efficiency and effectiveness of the electronic prescribing system. METHODS: This study was conducted on all physicians using the electronic prescribing system in clinics and hospitals affiliated with the treatment deputy of the Social Security Organization (SSO) in Sistan and Baluchistan Province in Iran. Data were collected using a self-administered questionnaire containing three sections: (i) Six items related to demographic data and clinical experience, (ii) Specific questions based on a five-point Likert scale-related physicians' perspectives about efficiency (19 questions) and effectiveness (13 questions), and (iii) Open-ended questions about the positive and negative aspects of using the electronic prescribing system. RESULTS: The mean and standard deviation of the efficiency and effectiveness of the electronic prescribing system were 3.68 ± 0.67 and 3.84 ± 0.65, respectively. Patient safety had the highest mean score among all dimensions (4.0 ± 0.64). Most participants (n = 55, 79%) considered the efficiency and effectiveness of this system high. More than 90 percent of the physicians (n = 63) believed that the electronic prescribing system enables a better medication prescription by providing alerts and access to patients' medication history. CONCLUSION: The findings showed that most physicians believed that the electronic prescribing system of Iran's SSO has high efficiency and effectiveness. In particular, physicians believed that using this system improves patient safety and reduces costs.
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Prescripción Electrónica , Médicos , Humanos , Irán , Seguridad del Paciente , Encuestas y CuestionariosRESUMEN
The aim of this before-after study was to evaluate the effect of an educational intervention on the confidentiality status of unprotected information stored on computer desktop in a psychiatric hospital. All switched-on computer systems were inspected in 2017-2018 at the baseline and 7 months after placing an educational poster. The log-in conditions and files stored on the desktop were reviewed using a researcher-made checklist; moreover, users answered questions about the possible mechanism of deleting information stored on the desktop. The number of files stored on desktops, the number of systems left switched on and unused, and the number of systems without a log-in password decreased in the second phase than the first phase of this study. Furthermore, automatic locking of computers after a specified period increased. The educational intervention reduced significantly the storage of information on desktops and improved security mechanisms such as using passwords and autolock. This study showed using an educational poster can encourage users to preserve the security of information, comply with security guidelines such as locking unused computers, and prevent access to confidential information.
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Seguridad Computacional , Hospitales Psiquiátricos , Sistemas de Computación , Computadores , Confidencialidad , HumanosRESUMEN
One hundred and twenty one-day-old chukar partridges were randomly divided into eight groups which received diets with different supplementations. There were four unchallenged groups. One group received salinomycin (50 ppm), two groups received cinnamaldehyde (CINN) (100 and 200 mg/kg of diet), and another one received only the basal diet from the 1st to the 31st day. There were also four corresponding groups orally challenged by 3 × 105Eimeria kofoidi sporulated oocysts at the 21st day. Three samplings were done at the 24th, 26th, and 31st days of rearing for pathological and biochemical assessments. Fecal samples were daily taken to check the pattern of oocyst shedding from the 26th to 31st day. The body weight of birds was measured at 21st and 31st days. Along with the in vivo experiment, an in vitro sporulation inhibition test was carried out. The in vitro results showed that CINN decreased sporulation rate at 1 and 0.5 mg/ml. In vivo, it was found that CINN did not prevent the oocyst shedding. Furthermore, the histopathological findings revealed that CINN and salinomycin had no effect on infection establishment. However, our findings showed that CINN (200 mg/kg of diet) could enhance the body weight and improve antioxidant status. Although our results did not support the in vivo anticoccidial activity of CINN, it had a promising potential to improve antioxidant status and body weight in the chukar partridge.
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Acroleína/análogos & derivados , Enfermedades de las Aves/parasitología , Coccidiosis/veterinaria , Eimeria/efectos de los fármacos , Galliformes/parasitología , Acroleína/farmacología , Acroleína/uso terapéutico , Alimentación Animal/análisis , Animales , Antioxidantes/metabolismo , Enfermedades de las Aves/tratamiento farmacológico , Peso Corporal , Coccidiosis/tratamiento farmacológico , Coccidiosis/parasitología , Coccidiostáticos/farmacología , Coccidiostáticos/uso terapéutico , Heces/parasitología , Galliformes/crecimiento & desarrollo , Intestinos/parasitología , Intestinos/patología , Recuento de Huevos de Parásitos/veterinaria , Piranos/farmacología , Piranos/uso terapéutico , Distribución Aleatoria , Esporas Protozoarias/efectos de los fármacos , Esporas Protozoarias/fisiología , Aumento de Peso/efectos de los fármacosRESUMEN
BACKGROUND: Mobile health (mHealth) due to its popularity and accessibility can be widely applied in different health areas such as the management of chronic diseases. However, its success depends on the acceptance of their users. Therefore, the aim of this study was to survey the attitudes of patients with chronic disease toward mHealth technology and their willingness to use it. METHODS: This study was conducted within a 2-year period (2016-2018) to determine and compare the attitude and willingness of patients with asthma, diabetes, and multiple sclerosis (MS) toward using mHealth technology in a province in Iran. RESULTS: In total, 222 patients participated in this study. More than 93 percent of the patients with diabetes and MS, and 65 percent of the asthmatic patients preferred using mHealth services rather than consulting a physician (p < .0001). About 98, 94, and 49 percent of the MS, diabetic, and asthmatic patients, respectively felt comfortable if their health conditions checked by physicians through mHealth technology (p < .0001). CONCLUSIONS: Our results showed that the majority of the patients felt comfortable and preferred using mHealth technology rather than consulting the physicians. The attitudes of diabetic and MS patients toward mHealth technology were rather more positive compared to asthmatic patient attitude. These results may be helpful for the developers of mHealth technology, and researchers who design mHelath interventions for patients with chronic disease.
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Enfermedad Crónica/terapia , Conocimientos, Actitudes y Práctica en Salud , Aceptación de la Atención de Salud/psicología , Telemedicina/métodos , Adulto , Asma/terapia , Diabetes Mellitus/terapia , Femenino , Humanos , Irán , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/terapia , Factores SocioeconómicosRESUMEN
BACKGROUND: User satisfaction with PACS is considered as one of the important criteria for assessing success in using PACS. The objective of this study was to determine the level of user satisfaction with PACS and to compare its functional features with traditional film-based systems. METHODS: This study was conducted in 2017. Residents at three large university hospitals in Kerman filled-out a self-administered questionnaire consisting of three parts: demographic information of participants, user satisfaction with PACS, comparing features of the two digital and traditional imaging systems. The validity of this questionnaire was approved by five medical informatics, radiology, and health information management specialists and its reliability was confirmed by Cronbach's alpha (86%). Data were analyzed using descriptive statistics and the Spearman, Mann Whitney U and Kruskal-Wallis statistical tests. RESULTS: The mean of the participants' ages was 31.4 (±4.4) years and 59% of the participants were females. The mean of physicians' satisfaction with PACS' had no significant relationship with their age (P = 0.611), experience of using PACS (P = 0.301), specialty (P = 0.093), and percent of interpretation of images with PACS (P = 0.762). It had a significant relationship with the participants' computer skills (P = 0.022). CONCLUSIONS: The mean of physicians' satisfaction with PACS was at a moderate to a high level, yet there are still problems in the successful implementation of these systems and establishing interoperability between them. PACS has not fully met all the demands of physicians and has not achieved its predetermined objectives, such as all-access from different locations.
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Actitud del Personal de Salud , Satisfacción Personal , Médicos/psicología , Intensificación de Imagen Radiográfica , Sistemas de Información Radiológica , Radiología , Adulto , Actitud hacia los Computadores , Femenino , Sistemas de Comunicación en Hospital , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
BACKGROUND: Designing a standard data set is necessary to overcome the dispersion of data among different health information systems. The objective of this study was to evaluate the current demographic and clinical minimum data sets (MDSs) of Iranian National Electronic Health Record (known as SEPAS) and to identify most necessary data elements. METHODS: Data were collected using a list of current demographic and clinical data of SEPAS and a self-administered questionnaire. All faculty members of six health related fields and the hospital authorities, and IT and HIM administrators of 6 hospitals in Kerman University of Medical Sciences were invited to participate in this study. The content validity of the questionnaire was confirmed by six medical informatics and HIM experts and the reliability was determined by Cronbach's alpha (α =0.95). SPSS v18 was used to generate descriptive statistics. RESULTS: Survey results indicated that 15 data elements should become mandatory elements of MDS for communicating data to SEPAS. These elements include patient's name, surname, father's name, nationality, cell number, job, residential address, residence place, passport number (for non-Iranian patients), diagnosis date, death time, death place and the unit of the hospital where the patient died. Moreover, participants suggested 33 additional demographic and clinical data elements to be communicated mandatorily to SEPAS. CONCLUSION: The results of this study showed that the minimum data sets of Iranian national electronic health record needs to be revised. Using the proposed MDSs by this study can improve the quality and efficiency of information and reduce redundancy by adding necessary data and preventing communication of unnecessary data. The method employed in this study can be used for investigating, refining and completing the MDSs of other health information systems.
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Registros Electrónicos de Salud , Demografía , Investigación sobre Servicios de Salud , Hospitales , Humanos , Irán/epidemiología , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
Evaluating user satisfaction is one of the methods to ensure the usability of information systems. Considering the importance of nursing information systems in patient health, the objective of this study is to evaluate nurses' satisfaction with two widely used nursing information systems (Peyvand Dadeh and Tirazhe) in Iran. This descriptive-analytical study was done on 230 nurses in all teaching hospitals of Kerman University of Medical Sciences in 2015. Data were collected using an augmented version of a questionnaire developed by IBM. Data were analyzed by SPSS.16 using descriptive and analytical statistical methods including t test, analysis of variance, and Pearson correlation coefficient. The mean of overall satisfaction with the two systems was 61 ± 2.2 and 74 ± 2.4, respectively. The mean of satisfaction with different systems dimensions, that is, ease of use, information quality, and interface quality, was, respectively, 24 ± 1.9, 26 ± 9.7, and 12 ± 4.7 for Tirazhe and 29 ± 1.1, 39 ± 1.04 and 13 ± 5.3 for Peyvand Dadeh system. Nurses' satisfaction with both systems was at a medium level. The majority of nurses were relatively satisfied with the information quality and user interface quality of these systems. The results suggest that designing nursing information systems in accordance with their users' need improves usability. Hence, policy and decision makers of healthcare institutions should invest on usability when purchasing such systems.
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Sistemas de Información/estadística & datos numéricos , Personal de Enfermería en Hospital/psicología , Satisfacción Personal , Adulto , Femenino , Humanos , Irán , Masculino , Encuestas y Cuestionarios , Interfaz Usuario-ComputadorRESUMEN
Amplification of MYCN is the signature genetic aberration of 20-25% of neuroblastoma and a stratifying marker associated with aggressive tumor behavior. The detection of heterogeneous MYCN amplification (hetMNA) poses a diagnostic dilemma due to the uncertainty of its relevance to tumor behavior. Here, we aimed to shed light on the genomic background which permits hetMNA in neuroblastoma and tied the occurrence to other stratifying markers and disease outcome. We performed SNP analysis using Affymetrix Cytoscan HD arrays on 63 samples including constitutional DNA, tumor, bone marrow and relapse samples of 26 patients with confirmed hetMNA by MYCN-FISH. Tumors of patients ≤18m were mostly aneuploid with numeric chromosomal aberrations (NCAs), presented a prominent MNA subclone and carried none or a few segmental chromosomal aberrations (SCAs). In older patients, tumors were mostly di- or tetraploid, contained a lower number of MNA cells and displayed a multitude of SCAs including concomitant 11q deletions. These patients often suffered disease progression, tumor dissemination and relapse. Restricted to aneuploid tumors, we detected chromosomes with uniparental di- or trisomy (UPD/UPT) in almost every sample. UPD11 was exclusive to tumors of younger patients whereas older patients featured UPD14. In this study, the MNA subclone appears to be constraint by the tumor environment and thus less relevant for tumor behavior in aggressive tumors with a high genomic instability and many segmental aberrations. A more benign tumor background and lower tumor stage may favor an outgrowth of the MNA clone but tumors generally responded better to treatment.
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Amplificación de Genes , Heterogeneidad Genética , Neuroblastoma/genética , Proteínas Nucleares/genética , Proteínas Oncogénicas/genética , Adolescente , Aneuploidia , Niño , Preescolar , Aberraciones Cromosómicas , Deleción Cromosómica , Femenino , Humanos , Hibridación Fluorescente in Situ , Lactante , Masculino , Proteína Proto-Oncogénica N-Myc , Neuroblastoma/patología , Polimorfismo de Nucleótido SimpleRESUMEN
The orientations of liquid crystals (LCs) anchored on monolayers formed from mixtures of chiral versus achiral molecules were compared. Changes in the enantiomeric excess of mixed monolayers of chiral dipeptides gave rise to continuous changes in the orientations of nematic LCs, allowing arbitrary tuning of the azimuthal orientations of LCs over a range of ≈100°. In contrast, the same LCs exhibited discontinuous changes in orientation on surfaces presenting mixtures of achiral molecules. These striking differences in the anchoring of LCs on surfaces presenting chiral versus achiral molecules provide insights into the molecular origins of ordering transitions of LCs, and provide new principles based on chiral monolayers for the rational design of surfaces that permit continuous tuning of the orientations of LCs.
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Cristales Líquidos , EstereoisomerismoRESUMEN
Electrochemiluminescence (ECL) is a bioanalytical technique with numerous advantages, including the potential for high temporal and spatial resolution, a high signal-to-noise ratio, a broad dynamic range, and rapid measurement capabilities. To reduce the complexity of a multi-electrode approach, we use a single-electrode electrochemiluminescence (SE-ECL) configuration to achieve the simultaneous emission and detection of multiple colors for applications that require multiplexed detection of several analytes. This method exploits intrinsic differences in the electric potential applied along single electrodes built into electrochemical cells, enabling the achievement of distinct colors through selective excitation of ECL luminophores. We present results on the optimization of SE-ECL intensity for different channel lengths and widths, with sum intensities being 5 times larger for 6 cm vs. 2 cm channels and linearly increasing with the width of the channels. Furthermore, we demonstrated for the first time that applying Alternating Current (AC) voltage within the single electrode setup for driving the ECL reactions has a dramatic effect on the emitted light intensity, with square waveforms resulting in higher intensities vs sine waveforms. Additionally, multiplexed multicolor SE-ECL on a 6.5 mm × 3.6 mm CMOS semiconductor image sensor was demonstrated for the first time, with the ability to simultaneously distinguish four different colors, leading to the ability to measure multiple analytes.
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Técnicas Biosensibles , Técnicas Electroquímicas , Diseño de Equipo , Mediciones Luminiscentes , Técnicas Biosensibles/instrumentación , Mediciones Luminiscentes/instrumentación , Técnicas Electroquímicas/instrumentación , Miniaturización , Color , Electrodos , Semiconductores , HumanosRESUMEN
Detection of microbial pathogens is important for food safety reasons, and for monitoring sanitation in laboratory environments and health care settings. Traditional detection methods such as culture-based and nucleic acid-based methods are time-consuming, laborious, and require expensive laboratory equipment. Recently, ATP-based bioluminescence methods were developed to assess surface contamination, with commercial products available. In this study, we introduce a biosensor based on a CMOS image sensor for ATP-mediated chemiluminescence detection. The original lens and IR filter were removed from the CMOS sensor revealing a 12 MP periodic microlens/pixel array on an area of 6.5 mm × 3.6 mm. UltraSnap swabs are used to collect samples from solid surfaces including personal electronic devices, and office and laboratory equipment. Samples mixed with chemiluminescence reagents were placed directly on the surface of the image sensor. Close proximity of the sample to the photodiode array leads to high photon collection efficiency. The population of microorganisms can be assessed and quantified by analyzing the intensity of measured chemiluminescence. We report a linear range and limit of detection for measuring ATP in UltraSnap buffer of 10-1000 nM and 225 fmol, respectively. The performance of the CMOS-based device was compared to a commercial luminometer, and a high correlation with a Pearson's correlation coefficient of 0.98589 was obtained. The Bland-Altman plot showed no significant bias between the results of the two methods. Finally, microbial contamination of different surfaces was analyzed with both methods, and the CMOS biosensor exhibited the same trend as the commercial luminometer.
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Técnicas Biosensibles , Técnicas Biosensibles/métodos , Semiconductores , Adenosina TrifosfatoRESUMEN
INTRODUCTION: The aim of this study was to leverage label-efficient self-supervised learning (SSL) to train a model that can detect ECR and differentiate it from caries. METHODS: Periapical (PA) radiographs of teeth with ECR defects were collected. Two board-certified endodontists reviewed PA radiographs and cone beam computed tomographic (CBCT) images independently to determine presence of ECR (ground truth). Radiographic data were divided into 3 regions of interest (ROIs): healthy teeth, teeth with ECR, and teeth with caries. Nine contrastive SSL models (SimCLR v2, MoCo v2, BYOL, DINO, NNCLR, SwAV, MSN, Barlow Twins, and SimSiam) were implemented in the assessment alongside 7 baseline deep learning models (ResNet-18, ResNet-50, VGG16, DenseNet, MobileNetV2, ResNeXt-50, and InceptionV3). A 10-fold cross-validation strategy and a hold-out test set were employed for model evaluation. Model performance was assessed via various metrics including classification accuracy, precision, recall, and F1-score. RESULTS: Included were 190 PA radiographs, composed of 470 ROIs. Results from 10-fold cross-validation demonstrated that most SSL models outperformed the transfer learning baseline models, with DINO achieving the highest mean accuracy (85.64 ± 4.56), significantly outperforming 13 other models (P < .05). DINO reached the highest test set (ie, 3 ROIs) accuracy (84.09%) while MoCo v2 exhibited the highest recall and F1-score (77.37% and 82.93%, respectively). CONCLUSIONS: This study showed that AI can assist clinicians in detecting ECR and differentiating it from caries. Additionally, it introduced the application of SSL in detecting ECR, emphasizing that SSL-based models can outperform transfer learning baselines and reduce reliance on large, labeled datasets.
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Caries Dental , Diente , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Inteligencia Artificial , Tomografía Computarizada por Rayos X/métodos , Aprendizaje Automático SupervisadoRESUMEN
Rapidly growing interest in using nanoparticles (NPs) for biomedical applications has increased concerns about their safety and toxicity. In comparison with bulk materials, NPs are more chemically active and toxic due to the greater surface area and small size. Understanding the NPs' mechanism of toxicity, together with the factors influencing their behavior in biological environments, can help researchers to design NPs with reduced side effects and improved performance. After overviewing the classification and properties of NPs, this review article discusses their biomedical applications in molecular imaging and cell therapy, gene transfer, tissue engineering, targeted drug delivery, Anti-SARS-CoV-2 vaccines, cancer treatment, wound healing, and anti-bacterial applications. There are different mechanisms of toxicity of NPs, and their toxicity and behaviors depend on various factors, which are elaborated on in this article. More specifically, the mechanism of toxicity and their interactions with living components are discussed by considering the impact of different physiochemical parameters such as size, shape, structure, agglomeration state, surface charge, wettability, dose, and substance type. The toxicity of polymeric, silica-based, carbon-based, and metallic-based NPs (including plasmonic alloy NPs) have been considered separately.
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Participation of main users in identifying key performance indicators (KPIs) for management dashboards contributes to their success. The aim of this study was to identify and prioritize the KPIs of hospital management dashboards from the viewpoint of hospital managers. This study was conducted on managers of public hospitals at a national level in Iran in 2020. Data were collected using a self-administrated questionnaire. The KPIs were classified into five categories, namely financial, operational, human resources, safety and quality of care, services provided to patients. A total of 234 hospital managers participated in this study. Totally, 25 KPIs were determined for the hospital management dashboard, including the patient falls rate, waiting time for patients in the emergency department, patient satisfaction, total hospital revenue, financial balance, bed occupancy rate, patients' discharge with own agreement, average length of stay, and personnel satisfaction. For designing hospital management dashboards, the domains of services provided to patients, safety and quality of care, financial resources, human resources, and operational are important from the hospital managers' viewpoint, respectively. The results of this study can be helpful for developers of business intelligence tools, such as hospital management dashboards, to visualize the most important indicators for managers.
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Administración Hospitalaria , Humanos , Personal de Salud , Hospitales Públicos , Servicio de Urgencia en Hospital , IránRESUMEN
BACKGROUND: The advancement in novel cancer therapeutics brought a platform combining the properties of exosomes with nanoparticles to precision medicine. The novel therapeutic approach aim is cancer-targeted therapy. Exosomes from mesenchymal stem cells (MSCs-Exo) exhibit unique properties in cancer therapies, which makes them an ideal tool for delivering therapeutic agents into tumor cells. The key role of natural MSCs-Exo is controversial in cancer therapy; however, they can be engineered at their surface or cargo to serve as a smart drug delivery system for cancer-targeted therapy. In the last few years, researchers harnessed nanotechnology to enforce MSCs-Exo for cancer management including, tumor cell tracking, imaging, and tumor cell killing. Different nanoparticles such as gold nanoparticles have particularly been incorporated into MSCs-Exo, which showed an efficient accumulation at the site of tumor with improved anticancer impact. These findings indicate that a hybrid of exosomes-nanoparticles may serve as combination therapy for the effective removal of cancers. SHORT CONCLUSION: Although exhibiting impressive potential, the use of nanoparticle-loaded MSCs-Exo as a drug-delivery tool has been troubled by some challenges, therefore, translation to clinic prerequisites further scrutiny. In this review, we focus on nanoparticle-loaded MSCs-Exo as a new cancer therapy and discuss engineered MSC-Exo for target therapy.
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Exosomas , Células Madre Mesenquimatosas , Nanopartículas del Metal , Neoplasias , Humanos , Oro , Nanopartículas del Metal/uso terapéutico , Neoplasias/terapiaRESUMEN
Biosensors exhibit high potential for the detection of analytes of interest at the point-of-need. Over the past two decades, the combination of novel biosensing systems - such as electrochemiluminescence (ECL) biosensors - and advances in microfluidic techniques has allowed the development of lab-on-a-chip devices with enhanced overall performance and simplified sample handling. However, recording data with conventional platforms requires advanced and complicated instruments, such as sensitive photodetectors coupled to microscopes, to capture the photons from the chemiluminescent reaction. In this work, we integrated microfluidic and luminol/hydrogen peroxide ECL systems on a complementary metal-oxide-semiconductor (CMOS) chip for sample handling and data collection on the same platform. This was achieved by the adaptation of a single electrode as an electrochemical transducer and a CMOS chip as a built-in detector. We demonstrated the application of this platform for the detection of uric acid (UA), a biomarker of gout disease. A linear detection range was observed from 25 to 300 µM, with a detection limit (LOD) as low as 26.09 µM. The device showed high reusability and reproducibility within the linear detection range while maintaining high selectivity for UA detection. The analytical performance has also been evaluated in simulated saliva and urine samples, demonstrating the potential utility in medical diagnosis at the point-of-need. Compared to other ECL imaging platforms, this device showed an eightfold increase in photon collection efficiency. Overall, this approach has promising potential as an inexpensive, portable, and efficient ECL platform for measuring analytes at the point-of-need.