Quantitative SPECT/CT Metrics in Early Prediction of [177Lu]Lu-DOTATATE Treatment Response in Gastroenteropancreatic Neuroendocrine Tumor Patients.

Our objective is to explore quantitative imaging markers for early prediction of treatment response in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) undergoing [177Lu]Lu-DOTATATE therapy. By doing so, we aim to enable timely switching to more effective therapies in order to prevent time-resource waste and minimize toxicities. Methods: Patients diagnosed with unresectable or metastatic, progressive, well-differentiated, receptor-positive GEP-NETs who received 4 sessions of [177Lu]Lu-DOTATATE were retrospectively selected. Using SPECT/CT images taken at the end of treatment sessions, we counted all visible tumors and measured their largest diameters to calculate the tumor burden score (TBS). Up to 4 target lesions were selected and semiautomatically segmented. Target lesion peak counts and spleen peak counts were measured, and normalized peak counts were calculated. Changes in TBS (ΔTBS) and changes in normalized peak count (ΔnPC) throughout treatment sessions in relation to the first treatment session were calculated. Treatment responses were evaluated using third-month CT and were binarized as progressive disease (PD) or non-PD. Results: Twenty-seven patients were included (7 PD, 20 non-PD). Significant differences were observed in ΔTBSsecond-first, ΔTBSthird-first, and ΔTBSfourth-first (where second-first, third-first, and fourth-first denote scan number between the second and first, third and first, and fourth and first [177Lu]Lu-DOTATATE treatment cycles), respectively) between the PD and non-PD groups (median, 0.043 vs. -0.049, 0.08 vs. -0.116, and 0.109 vs. -0.123 [P = 0.023, P = 0.002, and P < 0.001], respectively). ΔnPCsecond-first showed significant group differences (mean, -0.107 vs. -0.282; P = 0.033); ΔnPCthird-first and ΔnPCfourth-first did not reach statistical significance (mean, -0.122 vs. -0.312 and -0.183 vs. -0.405 [P = 0.117 and 0.067], respectively). At the optimal threshold, ΔTBSfourth-first exhibited an area under the curve (AUC) of 0.957, achieving 100% sensitivity and 80% specificity. ΔTBSsecond-first and ΔTBSthird-first reached AUCs of 0.793 and 0.893, sensitivities of 71.4%, and specificities of 85% and 95%, respectively. ΔnPCsecond-first, ΔnPCthird-first, and ΔnPCfourth-first showed AUCs of 0.764, 0.693, and 0.679; sensitivities of 71.4%, 71.4%, and 100%; and specificities of 75%, 70%, and 35%, respectively. Conclusion: ΔTBS and ΔnPC can predict [177Lu]Lu-DOTATATE response by the second treatment session.

Effect of Garlic (Allium sativum) Supplementation on Premenstrual Disorders: A Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: Premenstrual disorders involve physical, behavioral, and mood variations that affect women of childbearing age and interfere with family relationships, household responsibilities, professional duties, and social activities. OBJECTIVES: Considering the side effects of conventional medications, their use is not recommended except in severe cases of premenstrual disorders. Nowadays, there is a tendency to use traditional and complementary medicine that offers various treatments. The purpose of the current study was to investigate the impacts of garlic as a herbal medicine on the severity of premenstrual symptoms. METHODS: This study was a double-blind, randomized, controlled trial. After identification of participants with moderate-to-severe PMS through the premenstrual symptoms screening tools questionnaire (PSST), they were randomly assigned to placebo (n = 64) or garlic (n = 65) groups. Each participant received one tablet daily for three consecutive cycles and logged the severity of their symptoms in the PSST questionnaire during the intervention period. RESULTS: There was no significant difference between the two groups in the baseline level of premenstrual symptoms before the intervention. After treatment with garlic for three consecutive cycles, the total score of the severity of premenstrual symptoms significantly (P < 0.001) reduced from 34.09 ± 7.31 to 11.21 ± 7.17. In the placebo group, this score changed from 33.35 ± 7.96 to 24.28 ± 7.22. The difference between mean changes in the two groups was 13.78, with a 95% Confidence Interval (CI) of 11.23-16.33. No serious side effects were observed in either group. CONCLUSION: Our findings highlight the potential effect of garlic in reducing the severity of premenstrual symptoms; therefore, the use of garlic can be considered as an alternative therapy in the prevention and treatment of premenstrual disorders.

Pharmacological and biochemical properties of Zingiber zerumbet (L.) Roscoe ex Sm. and its therapeutic efficacy on osteoarthritis of knee.

Osteoarthritis (OA) as the most frequent form of knee arthritis is one of the most annoying complications amongst old peoples. There are different pharmacological and non-pharmacological remedies which could be applied for treatment of knee OA. It's while, significant side effects mostly in patients who are older are the dangerous limiting factors. Integrative, supplementary, traditional remedies have been applied from long time ago in treatment of such chronic diseases like OA. Various topical and oral remedies have been presented in treatment of OA worldwide. In spite of the fact there are multiple remedies for reduction symptoms of patients who suffer from disorders and related inabilities which could enhance their life quality. Remedies which have been applied for a long time for treatment of OA have newly discovered to induce injury to some patients. On the other side, additional knowledge about alternative and supplementary remedies is a main way for enhancing health of patients who suffer from OA disorders. Zingiber zerumbet (Z. zerumbeton) is a kind of herb of the ginger family and is a natural compound with various biomedical characteristics like anti-proliferative, anti-inflammatory, and antioxidant effect. However, Z. zerumbet could be applied for reduction of OA symptoms because of its circulatory stimulant and anti-inflammatory effects. Anyway, up to now there is not any methodical literature review for evaluating the Z. zerumbet clinical effectiveness productiveness in treatment of OA. The main aim of the current study is to review scientific resources around therapeutic effectiveness of Zingiber zerumbet in treatment of adverse symptoms of OA disorder.

PERFect: PERmutation Filtering test for microbiome data.

The human microbiota composition is associated with a number of diseases including obesity, inflammatory bowel disease, and bacterial vaginosis. Thus, microbiome research has the potential to reshape clinical and therapeutic approaches. However, raw microbiome count data require careful pre-processing steps that take into account both the sparsity of counts and the large number of taxa that are being measured. Filtering is defined as removing taxa that are present in a small number of samples and have small counts in the samples where they are observed. Despite progress in the number and quality of filtering approaches, there is no consensus on filtering standards and quality assessment. This can adversely affect downstream analyses and reproducibility of results across platforms and software. We introduce PERFect, a novel permutation filtering approach designed to address two unsolved problems in microbiome data processing: (i) define and quantify loss due to filtering by implementing thresholds and (ii) introduce and evaluate a permutation test for filtering loss to provide a measure of excessive filtering. Methods are assessed on three "mock experiment" data sets, where the true taxa compositions are known, and are applied to two publicly available real microbiome data sets. The method correctly removes contaminant taxa in "mock" data sets, quantifies and visualizes the corresponding filtering loss, providing a uniform data-driven filtering criteria for real microbiome data sets. In real data analyses PERFect tends to remove more taxa than existing approaches; this likely happens because the method is based on an explicit loss function, uses statistically principled testing, and takes into account correlation between taxa. The PERFect software is freely available at https://github.com/katiasmirn/PERFect.

Effect of Nepeta bracteata Benth. on allergic rhinitis symptoms: A randomized double-blind clinical trial.

BACKGROUND: Allergic rhinitis (AR) is one of the health problems in the world. It is necessary to develop new treatment procedure for control of this disease. The aim of this study was to assess the effect of Zofa (Nepeta bracteata Benth) on AR patients. MATERIALS AND METHODS: In this double-blind randomized clinical trial study, 71 patients (37 patients in treatment and 34 in placebo group) participated. In treatment group, N. bracteata syrup (NBS) was used for 4 weeks as three times a day. The efficacy of the drug regarding AR symptoms (rhinorrhea, sneezing, nasal obstruction, itchy nose, and ocular symptoms) were evaluated through a visual analog scale (VAS) by 0-10 before administration and at the end of the whole treatment period. The collected information was entered in the SPSS software (version 18) and was analyzed using the Fisher's exact test, Chi-square test, independent sample t-test, and paired sample test. RESULTS: The improvement of AR symptoms in the group receiving NBS was significantly higher compared to control group (4.73 ± 1.84 vs. 0.38 ± 2.06; P < 0.0001). Furthermore, the mean of total VAS before and after the treatment (in case group) was 7.10 ± 1.92 and 2.37 ± 1.76, respectively (P < 0.001). CONCLUSION: The results of this study indicate that N. bracteata has significant effects on improving the symptoms of AR. Hence, it can be a good alternative to AR symptoms relief.

External Dacryocystorhinostomy; Success Rate and Causes of Failure in Endoscopic and Pathologic Evaluations.

BACKGROUND AND OBJECTIVES: External dacryocystorhinostomy (DCR) is the method of choice to treat nasolacrimal duct (NLD) obstruction and the other approaches are compared with it, with a failure rate of 4% to 13%. The current study aimed to assess the causes of failure in external DCR by postoperative endoscopic and pathological evaluation. METHODS: The current retrospective cross sectional study followed-up113 patients with external DCR and silicone intubation for three months. Silicone tubes were removed after the third months. Failure was confirmed based on the clinical findings and irrigation test. Paranasal sinus computed tomography (CT) scanning, and endoscopic and pathological evaluations were performed in the failed cases. RESULTS: Totally, 113 patients underwent external DCR. The patients included 71 females and 42 males. The mean age of the patients was 55.91 years; ranged from 18 to 86. Epiphora was the most common complaint before surgery (90.3%). Clinically, epiphora continued in 17 cases (15%), of which 94.11% had at least one sinus CT abnormality and 82.35% had at least one endoscopic abnormality. The most common endoscopic findings were deviated septum (70.6%), scar tissue (52.94%), concha bullosa (46.9%), septal adhesion (47.05%), enlarged middle turbinate (41.2%), and sump syndrome (11.7%). The failure was significantly associated with the chronicity of the initial symptoms (P-value=0.00). Pathologically, there were significant relationship amongst the failure rate, scar formation, and allergic rhinitis (P-values =0.00 and <0.05, respectively). CONCLUSION: Preoperative endonasal evaluation and consultation with an otolaryngologist can improve surgical outcomes and help to have a better conscious to intranasal abnormalities before external DCR surgery.

A covert authentication and security solution for GMOs.

BACKGROUND: Proliferation and expansion of security risks necessitates new measures to ensure authenticity and validation of GMOs. Watermarking and other cryptographic methods are available which conceal and recover the original signature, but in the process reveal the authentication information. In many scenarios watermarking and standard cryptographic methods are necessary but not sufficient and new, more advanced, cryptographic protocols are necessary. RESULTS: Herein, we present a new crypto protocol, that is applicable in broader settings, and embeds the authentication string indistinguishably from a random element in the signature space and the string is verified or denied without disclosing the actual signature. Results show that in a nucleotide string of 1000, the algorithm gives a correlation of 0.98 or higher between the distribution of the codon and that of E. coli, making the signature virtually invisible. CONCLUSIONS: This algorithm may be used to securely authenticate and validate GMOs without disclosing the actual signature. While this protocol uses watermarking, its novelty is in use of more complex cryptographic techniques based on zero knowledge proofs to encode information.

Teamwork Endoscopic Endonasal Surgery in Failed External Dacryocystorhinostomy.

PURPOSE: The purpose of this study was to evaluate the results of a teamwork revision endoscopic dacryocystorhinostomy (DCR) in eyes with previously failed external DCR. METHODS: This retrospective study was performed on 50 failed external DCR subjects who underwent a teamwork revision endoscopic DCR by an ophthalmologist and an otolaryngologist. Paranasal sinus CT scanning was performed for each patient before the revision surgery. During surgery, any abnormal tissue noticed before silicone intubation was sent for pathological evaluation. RESULTS: Endoscopic revision DCR was performed on 50 failed external DCR subjects with one-year follow-up. Of these, 31 were female (62%). The age range of the subjects was 18-88 years (mean: 59.98 years). Sinus CT showed at least one abnormality in 94% of cases. Revision endoscopy showed septal deviation (66%), scar formation (32%), ostium problems (28%), and sump syndrome (6%). Pathologic and clinical findings showed that chronic inflammation had a significant association with scar tissue and septal synechia (P = 0.001 and 0.008, respectively). At the final follow-up, anatomical and functional success was achieved in 45 out of 50 (90%) of subjects. CONCLUSION: Endoscopic revision DCR when performed as cooperation of otolaryngologists and ophthalmologists may help resolve the endonasal problems and increase the success rate.

Comparison of Electric Toothbrush, Persica and Chlorhexidine Mouthwashes on Reduction of Gingival Enlargement in Orthodontic Patients: A Randomised Clinical Trial.

PURPOSE: To compare the efficacy of chlorhexidine, Persica mouthwash and electric toothbrushes in improving gingival enlargement in patients with fixed orthodontic appliances. MATERIALS AND METHODS: Seventy-two orthodontic patients with at least two sites of gingival enlargement were randomly allocated into four equal groups: 1) manual toothbrush; 2) electric toothbrush; 3) manual toothbrush+Persica mouthwash; 4) manual toothbrush+chlorhexidine mouthwash. All participants were instructed to brush their teeth at least twice a day. The subjects in groups 3 and 4 were instructed to use Persica or chlorhexidine according to the respective manufacturer's instructions. Bleeding on probing (BOP) index, gingival index (GI), O'Leary's plaque index (PI) and constructed hyperplastic index (HI) of all the subjects were measured in a blind manner at the start of the study and 2 weeks later. Changes of indices in the entire oral cavity and individual affected teeth were analysed with SPSS 16 using chi-square, ANOVA, ANCOVA, LSD and the paired t-test. RESULTS: In the entire oral cavity, there was a statistically significant improvement in indices in all the groups except for HI, which significantly improved only in group 4 (p=0.001). Data of individual teeth with hyperplastic gingiva showed significant reduction of all the variables except for HI in group 1 (p=0.08). No significant differences were found between groups 1 and 2 or between groups 3 and 4. CONCLUSION: The efficacy of Persica was similar to that of chlorhexidine in improving gingival conditions. None of the treatment modalities could reduce gingival enlargement to the clinically acceptable level of health.

Insomnia in Iranian traditional medicine.

CONTEXT: Insomnia is one of the most prevalent sleep disorders characterized by sleep difficulty that impairs daily functioning and reduces quality of life. The burden of medical, psychiatric, interpersonal, and societal consequences of insomnia expresses the importance of diagnosing and treatment of insomnia. The aim of study was to investigate causes of insomnia from the viewpoint of Iranian traditional medicine. EVIDENCE ACQUISITION: In this review study, we searched insomnia in a few of the most famous ancient textbooks of Iranian traditional medicine from different centuries. This books includeThe Canon of Medicine by Avicenna (the first version of Beirut), Zakhire Kharazmshahi by Jurjani (the scanned version of Bonyade Farhang-e Iran), Malfaregh by Razes (the first version of Iran University of Medical Sciences), and Aqili's cure by Aqili (the first version of Iran University of Medical Sciences). RESULTS: This study found that in Iranian traditional medicine manuscripts, insomnia was called sahar and even though many factors induce insomnia, most of them act through causing brain dystemperament. CONCLUSIONS: The brain dystemperament is considered one of the main causes of insomnia and insomnia can be well managed with an organized line of treatment, by correcting the brain dystemperament through elimination of causes. This study helps to find new solutions to treat insomnia.

Efficacy of Viola odorata in Treatment of Chronic Insomnia.

BACKGROUND: Insomnia is the most common sleep disorder that reduces quality of life. OBJECTIVES: Due to side effects of hypnotic drug and the increasing demand for alternative medicine substitutes, violet oil (VO) was used in this study. VO is a known medication in Iranian traditional medicine that induces sleep in insomniac patients. PATIENTS AND METHODS: This study was conducted as an experimental pretest-posttest evaluation on VO efficacy in 50 patients with chronic insomnia in Iranian Traditional Medicine Clinic of Mashhad University of Medical Sciences, Mashhad, Iran. Treatment consisted of intranasal drop of VO, two drops containing 66 mg of VO in each nostril nightly before sleeping for one month. All patients were asked to complete an Insomnia Severity Index (ISI) questionnaire before the start of the trial and after one month of treatment. RESULTS: Improvements in sleep and ISI scores were significantly greater in patients after a month receiving VO drop in comparison with before starting treatment (P < 0.05). A few patients reported some complications about VO consumption, most of which were mild and no serious adverse event was encountered. CONCLUSIONS: VO can be presented as a safe, well-tolerated, and effective herbal preparation in patients with chronic insomnia.

Impact of psychological problems in chemical warfare survivors with severe ophthalmologic complication, a cross sectional study.

BACKGROUND: Sulfur mustard (SM) has been used as a chemical warfare agent since the early twentieth century. Despite the large number of studies that have investigated SM induced ocular injuries, few of those studies have also focused on the psychological health status of victims. This study has evaluated the most prominent influences on the psychological health status of patients with severe SM induced ocular injuries. METHODS: This descriptive study was conducted on 149 Iranian war veterans with severe SM induced eye injuries. The psychological health status of all patients was assessed using the Iranian standardized Symptom Check List 90-Revised (SCL90-R) questionnaire. The results of patients' Global Severity Index (GSI) were compared with the optimal cut-off point of 0.4 that has previously been calculated for GSI in Iranian community. The Mann-Whitney U test, T tests and effect sizes (using Cohen's d) were employed as statistical methods. Data were analyzed using SPSS software. RESULTS: The mean age of patients was 44.86 (SD=8.7) and mean duration of disease was 21.58 (SD=1.20) years. Rate of exposure was once in 99 (66.4%) cases. The mean GSI (1.46) of the study group was higher compared to standardized cut off point (0.4) of the Iranian community. The results of this study showed that the mean of total GSI score was higher in participants with lower educational levels (effect size=0.507), unemployment (effect size=0.464) and having more than 3 children (effect size=0.62). Among the participants, 87 (58.4%) cases had a positive psychological history for hospitalization or receiving outpatient cares previously and 62 (41.6%) cases had a negative psychological history. In addition, the mean of GSI in participants with negative psychological history was lower than those with positive psychological history (Mean Change Difference=-0.621 with SD=0.120). There was a significant difference between positive and negative psychological history with respect to GSI (P<0.001). CONCLUSION: The study showed that severe ophthalmologic complications in chemical survivors are accompanied with destructive effects on psychological health status. Appropriate management may improve psychological health status in these patients.

Reviewing the prevalence of (cigarette) smoking and its related factors in students of tehran university, iran.

BACKGROUND: This study aimed to determine the prevalence of smoking behaviors among students in Tehran University, Iran. METHODS: This was a cross-sectional study on 400 participants of Tehran University. A self-administrated, anonymous questionnaire was used for data gathering. FINDINGS: The mean age of students was 21.70 ± 2.73 years, and 92% of them were single. The prevalence of smoking was 27.3% including 35.4% of men and 12.6% of women (P < 0.001). The mean duration of smoking was 4.22 ± 3.05 years. There was a significant association between smoking behaviors among students and their age, gender, type of accommodation, field of study, income status, duration of study, and existence of smoking habits among family members. CONCLUSION: The prevalence of cigarette smoking among university students is high. The lack of adequate information about smoking related diseases indicates the incapability and inefficiency of educational programs on this issue.

Analysis of environmental effects of the use of stabilized dredged material from New York/New Jersey Harbor, USA, for construction of roadway embankments.

Since the 1997 local ban on ocean dumping of dredged sediments, the state of New Jersey has pursued a policy of environmentally sound solutions to the controversial problem of dredged material management, including beneficial use of dredged material stabilized with pozzolanic additives (SDM). A pilot study was initiated in 1998 to evaluate the use of SDM in the construction of highway embankments. Using 80,000 cubic yards of silty dredged material, 2 embankments were constructed from SDM on a commercial development area adjacent to the New York/New Jersey Harbor. This article presents the evaluation of the environmental effects of the SDM, including fugitive air emissions, leachate, and stormwater quality. Engineering properties, handling and management techniques of the SDM, constructability, and performance were also evaluated, the results of which are published elsewhere. The findings demonstrate that although there are measurable releases of contaminants to the environment from the SDM, these releases are not significant long-term threats to human health or the environment. Policies currently in place to regulate the management of SDM that include limiting placement options to previously contaminated sites with institutional and engineering controls will further reduce the potential for environmental impact and, in fact, have the potential to produce significant environmental benefit.