To evaluate responsiveness and minimal important change (MIC) for the Persian versions of FABQ, TSK, and PCS.

INTRODUCTION: Fear avoidance beliefs questionnaire (FABQ), Tampa scale of kinesiophobia (TSK), and pain catastrophizing scale (PCS) are tools widely used to measure fear-avoidance beliefs, fear of movement, and pain-related catastrophic thinking in people with chronic spinal disorders. PURPOSE: To evaluate responsiveness and minimal important change (MIC) for the Persian version of FABQ, TSK, and PCS. METHOD: One hundred people with chronic non-specific neck pain participated in an intervention program including routine physiotherapy plus pain neuroscience education. They fulfilled FABQ, TSK, and PCS questionnaires at baseline and 4-week follow-up. The 7-point global rating of change (GRC) as the external anchor was also completed in follow-up by patients. Responsiveness was evaluated using receiver operating characteristic (ROC) curve analysis and correlation analysis. According to GRC, patients were classified into two groups (improved vs. unimproved). The best cutoff or MIC was estimated via the ROC curve. RESULTS: Acceptable responsiveness obtained for FABQ, TSK, and PCS with the area under the curve ranging from 0.84 to 0.94 and spearman coefficient > 0.6. The MIC values reflecting improvement were 9.5, 10.5, and 12.5 points, respectively, for FABQ, TSK, and PCS. CONCLUSIONS: The results of this study demonstrated that the Persian version of FABQ, TSK, and PCS have sufficient responsiveness and good ability to measure meaningful clinical changes in people with patient CNNP. The MIC scores of the FABQ, TSK, and PCS can help clinicians and researchers to detect changes significant to the patient following a rehabilitation program.

Cross-Cultural Adaptation and Validation of the Persian Version of the Functional Arm Scale for Throwers.

BACKGROUND: The Functional Arm Scale for Throwers (FAST) is a reliable and valid region-specific tool designed to evaluate health-related quality of life in throwing athletes with upper-extremity injuries. The purpose of this study was to adapt, translate, and evaluate the psychometric properties of the Persian version of the Functional Arm Scale (FAST-Persian) for use in throwing athletes. MATERIALS AND METHODS: The study was conducted based on 5 steps of cross-cultural adaptation including forward translation, synthesis, backward translation, expert committee review, and pretesting. The final Persian questionnaire, along with Persian versions of Disabilities of the Arm, Shoulder, and Hand and Kerlan-Jobe Orthopedic Clinic questionnaires, was completed by 177 throwing athletes for validity analysis. After 7 to 14 days, the FAST-Persian was reanswered by 80 throwers, who had no changes in this time interval. Internal consistency and test retest reliability were used to evaluate reliability of the questionnaire. Standard error of measurement and smallest detectable changes were also calculated. Construct validity was determined by correlational analysis with Disabilities of the Arm, Shoulder, and Hand and Kerlan-Jobe Orthopedic Clinic questionnaires. Dimensionality was evaluated with factor analysis. RESULT: Cronbachs alpha was .99, and the interclass correlation coefficient levels for total score and 5 subscales of the FAST-Persian ranged between .98 and .99. The standard error of measurement and smallest detectable changes were 3.17 and 8.80, respectively. The FAST-Persian had a high correlation with Disabilities of the Arm, Shoulder, and Hand (r = .98, P < .0001) and Kerlan-Jobe Orthopedic Clinic (r = .98, P < .0001) scores. Factor analysis revealed one factor with a total variance of 75.23%. CONCLUSION: The FAST-Persian is a reliable and valid measurement tool that can be used to evaluate health-related quality of life in overhead athletes and throwers.

Drug Targeting Strategies Based on Charge Dependent Uptake of Nanoparticles into Cancer Cells.

The aim of this review was to describe the preferred charged nano-particles (CNPs) for targeted delivery in tumor cells. Zeta Potential (ZP), which represents the surface charge of NPs was highlighted in cell entrance and interactions. In this regard, various types of endocytosis pathways which are involved in NPs' uptake were first introduced. Then, significance of positively charged NPs (PCNPs) in proton sponge effect corresponding to lysosomal escape was discussed. Cells prefer to endocyte the NPs with positive charge in passive targeting and gene delivery, while in active targeting; the charge of receptors' ligand binding site determines the NPs cellular uptake. Moreover, pH-sensitive NPs represent charge reversible behavior depending on pH changes which leads to longer blood circulation residence and higher uptake at acidic microenvironment of the cancer media. Role of the CNPs in overcoming multidrug resistance (MDR) and bypassing p-glycoprotein was further investigated.

The Responsiveness of the Persian Version of Neck Disability Index and Functional Rating Index Following Physiotherapy Intervention in People with Chronic Neck Pain.

BACKGROUND: Clinicians and researchers commonly use responsive outcome measures to interpret changes in a patient's condition as a result of an intervention. This study was conducted to assess the ability of the Persian version of Neck Disability Index and Functional Rating Index to detect responsiveness in the patients with neck pain. METHODS: A diagnostic accuracy study was done in Ahvaz, Iran, 2016. A convenience sample of 57 Persian-speaking patients with non-specific chronic neck pain completed the Neck Disability Index and the Functional Rating Index at the beginning and after physiotherapy intervention. The responsiveness was investigated by the receiver operating characteristics method and the correlation analysis. Statistical analysis was done using SPSS (version 21), with a P<0.05 as the level of significance. RESULTS: The Functional Rating Index showed that the area under the curve was greater than 0.70 (range=0.651-0.942). The optimal cutoff points for the Functional Rating Index and the Neck Disability Index were 9.5 and 7.5, respectively. Gamma correlation between change scores of the Functional Rating Index and the Neck Disability Index and the Global Rating of Change Scores was 0.53 and 0.33, respectively. CONCLUSION: The results indicated that the Persian version of the Functional Rating Index could detect clinical changes following physiotherapy intervention in a group of patients with chronic non-specific neck pain. Therefore, we recommend that this instrument be used as a responsive measure of neck pain disability in patients with neck pain.

Postural stability in patients with non-specific chronic neck pain: A comparative study with healthy people.

Background: Impairment of cervical sensory input in patients with neck pain may disturb postural stability. The purpose of present study was to assess the dynamic postural stability of subjects with chronic neck pain compared to a matched control group. Methods: In this case-control study, 22 chronic non-specific neck pain and 22 healthy individuals participated. Postural stability was measured with Techno-body Prokin tilting platform. Subjects performed balance tests under two conditions: eyes open and closed. The parameters for assessment of postural stability were total stability index (TSI), anteroposterior stability index (APSI), mediolateral stability index (MLSI), and trunk deviation which demonstrated total trunk sway in medio-lateral and antero-posterior. We used a separate 2 (group) by 2 (postural difficulty) mixed-design analysis of variance (ANOVA) for analysis of postural performance. Results: There were significant differences between the chronic neck pain and matched control groups in APSI, MLSI, and TSI, p<0.001 in both eyes opened and closed conditions. The trunk deviation was greater for non-specific neck pain in comparison to healthy subjects, p<0.05 in both conditions of eyes open and closed. Conclusion: The results of this study showed that patients with chronic neck pain have poorer postural control than healthy subjects. The findings suggest that clinicians take into account the importance of dynamic postural stability assessment in patients with chronic non-specific neck pain and consider the application of intervention programs for improvement of the dynamic balance.

Post-COVID-19 physical and cognitive impairments and associations with quality of life: a cross-sectional study.

Background and objective: This study aimed to compare physical and cognitive functions between post-coronavirus disease 2019 (COVID-19) participants and healthy matched controls and investigate associations between physical and cognitive impairments with quality of life. Methods: Twenty-three post-COVID-19 participants and 23 age and sex-matched healthy people without a history of COVID-19 were included. Physical function was assessed using the Medical Research Council Sum Score (MRC-SS), 2 min Step Test, Modified Borg Scale, and Short Physical Performance Battery (SPPB) Test. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), and Stroop test, and the quality of life was evaluated using the Euro Quality of Life-5 Dimensions-3 Levels (EQ-5D-3l) questionnaire. Assessments were performed by a physical therapist in one session. Results: Mann-Whitney U test showed that in the post-COVID-19 group, compared to the control group, the number of steps in the 2 min Step Test (p < 0.001, ES = 0.57) and the scores of the SPPB (p = 0.03, ES = 0.32), MoCA (p = 0.003, ES = 0.44), Stroop test (p < 0.001, ES = 0.75), and the EQ-5D-3l visual analog scale (p = 0.027, ES = 0.32) were significantly lower. In addition, the Modified Borg Scale score (p < 0.001, ES = 0.6), TMT-A (p = 0.013, ES = 0.36) and TMT-B (p = 0.016, ES = 0.35) times, and the Stroop time (p < 0.001, ES = 0.61) were significantly higher in the post-COVID-19 group. There were no significant between-group differences in the MRC-SS score (p = 0.055, ES = 0.28). Furthermore, there were significant moderate to high associations between physical and cognitive functions and the quality of life in post-COVID-19 participants. Conclusions: On average 4 months after symptomatic COVID-19, post-COVID-19 participants had significant impairments in physical and cognitive functions compared to healthy matched controls that were significantly correlated with the quality of life. These findings highlight the need for a comprehensive assessment to plan appropriate management strategies.

Therapeutic potential of thymoquinone and its nanoformulations in neuropsychological disorders: a comprehensive review on molecular mechanisms in preclinical studies.

Thymoquinone (THQ) and its nanoformulation (NFs) have emerged as promising candidates for the treatment of neurological diseases due to their diverse pharmacological properties, which include anti-inflammatory, antioxidant, and neuroprotective effects. In this study, we conducted an extensive search across reputable scientific websites such as PubMed, ScienceDirect, Scopus, and Google Scholar to gather relevant information. The antioxidant and anti-inflammatory properties of THQ have been observed to enhance the survival of neurons in affected areas of the brain, leading to significant improvements in behavioral and motor dysfunctions. Moreover, THQ and its NFs have demonstrated the capacity to restore antioxidant enzymes and mitigate oxidative stress. The primary mechanism underlying THQ's antioxidant effects involves the regulation of the Nrf2/HO-1 signaling pathway. Furthermore, THQ has been found to modulate key components of inflammatory signaling pathways, including toll-like receptors (TLRs), nuclear factor-κB (NF-κB), interleukin 6 (IL-6), IL-1ß, and tumor necrosis factor alpha (TNFα), thereby exerting anti-inflammatory effects. This comprehensive review explores the various beneficial effects of THQ and its NFs on neurological disorders and provides insights into the underlying mechanisms involved.

Responsiveness and minimal clinically important changes to physical therapy interventions of Persian versions of copenhagen neck functional disability index, neck bournemouth questionnaire and spine functional index questionnaires in people with chronic neck pain.

BACKGROUND AND PURPOSE: Chronic neck pain has a significant impact on the patient's quality of life. Specific outcome measures like Copenhagen Neck Functional Disability Index (CNFDI), Neck Bournemouth questionnaire (NBQ), and Spine Functional Index (SFI) are reliable and valid measures that have been used for comprehensively evaluating neck-related disabilities. However, responsiveness has not yet been investigated. The aim of this study was to examine the responsiveness and clinically meaningful changes of the CNFDI, NBQ, and SFI for Persian patients with chronic neck pain. METHODS: Prospective recruitment of 145 patients with chronic neck pain was conducted. Participants completed the Persian versions of CNFDI, NBQ, and SFI at baseline and after 4 weeks of physical therapy. Also, the Global Rating of Change Scale (GRCS) was completed in the post-intervention assessment. The Receiver Operating Characteristics (ROC) curve and correlational analysis were used for evaluating the responsiveness. In addition, the Minimal Clinically Important Change (MCIC) was determined. RESULTS: All selected outcome measures revealed an area under the curve of 0.96. The MCICs of 10, 7, and 10 points were found for the CNFDI, NBQ, and SFI, respectively. The results showed an excellent Gamma correlation coefficient of the CNFDI (γ = 0.98), NBQ (γ = 0.99), and SFI (γ = 0.99) with the GRCS. CONCLUSION: The Persian versions of the CNFDI, NBQ, and SFI have acceptable responsiveness properties for evaluating the changes in health status in patients with chronic neck pain following physical therapy interventions.

A Pilot Study In to the Effects of Cervical Manual Therapy Plus Conventional Physical Therapy on Clinical Outcomes and Electrodiagnostic Findings in People With Carpal Tunnel Syndrome.

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that has a significant impact on patients' quality of life. Current physical therapy treatment options show limited effects or low-quality evidence, especially in the long term. To date, there has been little research to look at the effects of treating the cervical spine on decreasing symptoms distally to the carpal tunnel. This study aimed to evaluate the effects of cervical manual therapy plus conventional physical therapy on patients with carpal tunnel syndrome. Methods: This pilot pretest/posttest and six-month follow-up clinical study included 15 adult patients with CTS. For two weeks, each patient received 10 sessions of supervised intervention treatment. The efficacy of the therapies was assessed at baseline (T0), immediately after treatment (T1), and six months after treatment (T2). The visual analog scale (VAS), a symptom severity scale, the functional capacity scale of the Boston Carpal Tunnel Questionnaire (BCTQ), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, median nerve motor distal latency (mMDL), and median sensory nerve conduction velocity (mSNCV) were outcome measures. Results: There were significant improvements in all measures between the baseline values at T0 and those recorded immediately after the treatment at T1 or six months later at T2 (p<.05). Conclusion: This pilot study indicates that cervical manual therapy plus conventional physical therapy applied for two weeks improves clinical outcomes and electrodiagnostic findings in people with CTS.

Prangos ferulacea (L.) ameliorates behavioral alterations, hippocampal oxidative stress markers, and apoptotic deficits in a rat model of autism induced by valproic acid.

BACKGROUND: Prenatal exposure to valproic acid (VPA) may enhance the risk of autism spectrum disorder (ASD) in children. This study investigated the effect of Prangos ferulacea (L.) on behavioral alterations, hippocampal oxidative stress markers, and apoptotic deficits in a rat model of autism induced by valproic acid. METHODS: Pregnant rats received VPA (600 mg/kg, intraperitoneally [i.p.]) or saline on gestational day 12.5 (E 12.5). Starting from the 30th postnatal day (PND 30), the pups were i.p. administered Prangos ferulacea (PF, 100 and 200 mg/kg), or the vehicle, daily until PND 58. On PND 30 and 58, various behavioral tasks were used to evaluate pups, including the open field, elevated plus-maze, hot-plate, and rotarod test. On PND 65, the animals were euthanized, and their brains were removed for histopathological and biochemical assay. RESULTS: Prenatal exposure to VPA caused significant behavioral changes in the offspring, reversed by administering an extract of Prangos ferulacea (L.). Additionally, prenatal VPA administration resulted in increased levels of malondialdehyde and deficits in antioxidant enzyme activities in the hippocampus, including catalase and glutathione, ameliorated by PF. Likewise, postnatal treatment with PF improved VPA-induced dysregulation of Bax and Blc2 in the hippocampus and reduced neuronal death in CA1, CA3, and dentate gyrus. CONCLUSION: The findings of this study suggest that postnatal administration of PF can prevent VPA-induced ASD-like behaviors by exhibiting antiapoptotic and antioxidant properties. Therefore, PF may have the potential as an adjunct in the management of ASD.

The comparative evaluation of the effects of quercetin, α-tocopherol, and chlorhexidine dentin pretreatments on the durability of universal adhesives.

OBJECTIVE: The aim of this study was to evaluate and compare the effects of chlorhexidine, quercetin, and α-tocopherol on the shear bond strength of universal adhesives in the short (24h) and long term (6 months). MATERIAL AND METHODS: Ninety-six extracted sound molars were collected and divided randomly into four groups: control (no treatment), 2% chlorhexidine, 10% α-tocopherol, and 1% quercetin. The solutions were prepared and applied to the teeth for 60 s, followed by application of All-Bond universal adhesive and composite build-up. Half of the specimens in each group (n = 12) were tested for shear bond strength (SBS) after 24 h of storage and the other half were kept in distilled water for 6 months and then tested for shear bond strength. The shear bond strength test was performed and the failure modes were determined using a stereomicroscope. The data were analyzed using two-way analysis of variance and Tukey's post hoc tests with p ˂ .05 as the significance level. RESULTS: The results of the two-way analysis of variance test showed that there was no significant difference in immediate SBS, and after 6 months, α-tocopherol had the lowest SBS in comparison to the control and CHX subgroups (p < .05). The t-test showed that the shear bond strength in the α-tocopherol and quercetin groups was significantly decreased after 6 months. CONCLUSION: It can be concluded that the solutions used in this study had no adverse effect on immediate SBS. After 6 months, the CHX could preserve SBS in comparison to other groups.

A protocol for a randomized trial on pain neuroscience education vs. routine physical therapy in people with chronic neck pain.

The aim of this study is to investigate the effects of combining routine physical therapy with pain neuroscience education (PNE) on psychosocial factors, physical performance, and the experienced pain in patients with chronic neck pain (CNP). This study is a double-blind randomized clinical trial in which patients will be randomly allocated to two groups, routine physical therapy with and without PNE. Patients will be assessed at the baseline, post intervention, and three months later. The results of this research will be used to establish effectiveness of treatment strategies for CNP. Due to the rigorous scientific methods used in this research, the suggested interventions would be clinically applicable in the health care systems.

Comparative evaluation of the postbleaching application of sodium ascorbate, alpha-tocopherol, and quercetin on shear bond strength of composite resin to enamel.

OBJECTIVE: This study aimed to evaluate and compare the impacts of the postbleaching application of sodium ascorbate, alpha-tocopherol, and quercetin on the shear bond strength (SBS) of composite resin. MATERIAL AND METHODS: 60 extracted intact maxillary first premolars were collected and were randomly divided into five experimental groups as follows (n=12): Group A (negative control): no bleaching, Group B (positive control): bleaching with 40% hydrogen peroxide (HP), Group C: HP±10% sodium ascorbate for 10min, Group D: HP±10% alpha-tocopherol for 10min, and Group E: HP±1% quercetin for 10min. Composite bonding was done immediately after bleaching for Groups B-E and without any treatment for Group A. After being stored in distilled water at room temperature for 24h, all specimens were tested for SBS in the universal testing machine. One-way analysis of variance and Tukey's post-hoc test were used to analyze the SBS values of all groups. RESULTS: The results showed that the bonding of composite to the unbleached group exhibited the highest mean value of SBS (22.68±2.91MPa). Among the antioxidant-treated groups, the highest SBS value was detected in quercetin-treated specimens (15.45±1.58MPa), which was significantly different from the positive control group (p<.05). CONCLUSION: It could be concluded that 10% quercetin applied for 10min increased the bond strength to bleached enamel, but it was not able to reverse it completely.

The effect of bacterial cellulose nanocrystals on the shear bond strength of resin modified glass ionomer cement to dentin.

BACKGROUND: The present study aimed to investigate the effect of bacterial cellulose nanocrystals (BCNC) on the shear bond strength (SBS) of resin modified glass ionomer cement (RMGIC) to dentin. MATERIAL AND METHODS: A total of 48 freshly extracted intact third molars were randomly divided into four main groups with three different concentrations (0.3%, 0.5% and 1% wt) of BCNC with RMGIC and control group without BCNC. These specimens were kept in distilled water at 37° C for 24h. Shear bond strength was examined, using the universal testing machine. Kruskal-Wallis test and Dunn`s post-hoc test were applied for analysis of data. P<0.05 was considered as the level of significance. RESULTS: The addition of a 1%wt of BCNC to the RMGIC led to a significant increase in the shear bond strength (7.17 ± 2.14) compared to the control group (2.09 ± 1.80) (P=0.007). The shear bond strength was improved up to 343%. CONCLUSIONS: It was found that the incorporation of 1% wt BCNC to the RMGICs enhanced the SBS properties of the RMGIC significantly. Modifying RMGIC with BCNC might be advantageous in terms of improving the restorative material. Key words:Bacterial cellulose nanocrystals, RMGIC, Shear bond strength.

Evaluation of the Surface Hardness and Roughness of a Resin-Modified Glass Ionomer Cement Containing Bacterial Cellulose Nanocrystals.

The purpose of this study was to evaluate the performance of a resin-modified glass ionomer cement (RMGIC) to which bacterial cellulose nanocrystals (BCNs) were added. BCNs were incorporated into the RMGIC powder in ratios of 0.3%, 0.5%, and 1% (w/w). One control and three experimental groups were enrolled in the study: unmodified RMGIC (control), 0.3% (w/w) BCN-modified RMGIC, 0.5% (w/w) BCN-modified RMGIC, and 1% (w/w) BCN-modified RMGIC. The surface hardness and surface roughness were the parameters assessed. The materials were characterized by scanning electron microscopy (SEM). The data were analyzed using the one-way ANOVA and Kruskal-Wallis tests for surface hardness and roughness, respectively. The addition of BCN resulted in the improvement of surface roughness in all the specimens compared with the control material. The RMGIC modified by 1% (w/w) BCN showed the lowest surface roughness (decreased by 52%) among all tested groups. However, BCN had a negative effect on the surface hardness of RMGIC. The group with 0.3% (w/w) BCN had the least decrease in microhardness (13%). According to the results, the RMGIC group modified by 1% (w/w) BCN had a smoother surface than the other groups. The surface microhardness of the RMGIC decreased after BCNs were added to it.

Effects of Bacterial Cellulose Nanocrystals on the Mechanical Properties of Resin-Modified Glass Ionomer Cements.

OBJECTIVES: The purpose of this study was to evaluate the effect of bacterial cellulose nanocrystals (BCNCs) on the mechanical properties of resin-modified glass ionomer cements (RMGICs) including compressive strength (CS), diametral tensile strength (DTS), and modulus of elasticity (E). MATERIALS AND METHODS: BCNCs were incorporated into RMGIC at various concentrations (0.3, 0.5, and 1 wt%). Unmodified RMGIC was used as the control group. The specimens were stored in distilled water at 37°C for 24 hours. CS and DTS, as well as modulus of elasticity, were evaluated using a universal testing machine. The nanostructure of BCNCs was observed via field emission scanning electron microscopy. STATISTICAL ANALYSIS: One-way analysis of variance and post-hoc Tukey tests were used for data analysis. Level of significance was at p < 0.05. RESULTS: The addition of BCNCs to RMGIC led to an increase in all of the tested mechanical properties compared with the control group, with a significant increase observed for 1 wt% BCNC. CS and DTS improved up to 23%, and modulus of elasticity increased by 44%. CONCLUSIONS: The addition of BCNCs to the RMGIC improved the mechanical properties, including CS, elastic modulus, and DTS. Thus, the newly developed RMGICs with BCNCs might represent an ideal and promising novel dental material in restorative dentistry.

Cervical movement kinematic analysis in patients with chronic neck pain: A comparative study with healthy subjects.

BACKGROUND: Several studies have investigated cervical kinematic performance in patients with chronic neck pain, especially with fast movements. A recent systematic review recommended further study of cervical spine kinematics cervical motions in individuals with neck pain. OBJECTIVES: This study aimed to examine cervical spine kinematics of naturally paced cervical motions in patients with chronic neck pain compared with a group of asymptomatic participants. Also, the relationships between cervical kinematic measures with neck pain intensity and disability were determined. METHOD: Kinematic performance was measured in 20 individuals with chronic nonspecific neck pain and 20 healthy controls. Data were captured using a 7-camera motion analysis system. Parameters were range of cervical motion, peak velocity, duration of movement, and jerk index (smoothness of movement). Pain intensity and Neck Disability Index were also measured. RESULTS: Duration of movements, peak velocities, and jerk indexes were significantly different between the two groups (p < 0.05). Pain intensity was significantly associated with duration of movement, range of motion, peak velocity, and smoothness predominantly in extension (r range = 0.4 to 0.6, p < 0.05). CONCLUSION: This study's findings indicated altered cervical kinematic performance during naturally paced motions (particularly reduced smoothness of movement)in patients with chronic nonspecific neck pain compared to asymptomatic participants. Also, pain intensity was moderately associated with most kinematic measures, especially in extension. This study's results can help to understand better the impairments associated with chronic nonspecific neck pain.

Oral delivery of solid lipid nanoparticles: underlining the physicochemical characteristics and physiological condition affecting the lipolysis rate.

INTRODUCTION: Lipid-based nano-drug delivery systems (LBNDDSs) have gained widespread attention in oral drug delivery due to their tunable and versatile properties such as biocompatibility and biodegradability, which makes them promising delivery systems for a variety of therapeutics. Currently, different types of LBNDDSs including liposomes, micelles, nanoemulsions, and solid lipid nanoparticles (SLNs) are developed for drug delivery applications. SLNs can be used as a controlled drug delivery system for oral delivery applications. However, its lipidic context makes that susceptible to lipolysis. The lipolysis rate of SLNs is affected by many factors that raise many questions for developing a more efficient delivery system. AREAS COVERED: In the present work, we highlighted different factors affecting the digestion rate/level of SLNs in the gastrointestinal tract. This paper can be most useful for those researchers who are keen to develop a properly controlled drug delivery system based on SLNs for oral delivery applications. EXPERT OPINION: SLNs can be used as a controlled drug delivery system for oral delivery applications. However, its lipidic context makes that susceptible to lipolysis. The lipolysis rate of SLNs is affected by many factors that raise many questions for developing a more efficient delivery system.

Development and Usability Evaluation of Web-Based Telerehabilitation Platform for Patients After Myocardial Infarction.

INTRODUCTION: Cardiac rehabilitation (CR) is a multidisciplinary intervention that improves quality of life and reduces the risk of recurrent heart attack. Unlike all known benefits for CR, the patient participation in CR is low. Telerehabilitation has the potential to improve lifestyle and helps patients having long-term compliance with clinician advice. The objective of this study was the development of a web-based cardiac telerehabilitation platform to engage the post-myocardial infarction (MI) patients in self-management of disease. METHOD: Development process of creating and evaluating a telerehabilitation platform included four phases: (1) need assessment, (2) design the prototype, (3) implement the cardiac telerehabilitation platform, (4) usability evaluation. RESULT: Cardiac telerehabilitation platform consists of an Android-based application for patients and web-based dashboard for rehabilitation mentors. The modules of the application are daily self-assessment, weekly self-assessment, educational content, stress and sleep improvement skills, medication reminder, online chat, prescribed diet, prescribed physical activity and rehabilitation records. The self-assessment modules allow users to enter the data such as physical activity, diet, blood pressure, heart rate, and body weight. The patient data entries are interpreted in the system knowledge base and colored symbol feedbacks display for patients and mentors. In the dashboard, the mentors review the patient data entries and set the rehabilitation plan for next week. In a beta test of usability evaluation, the mean of SUS score for patients was 75.16, for clinicians was 73.33 and for medical informatics specialist was 72.33. These results showed that the usability of our system was at an acceptable level. CONCLUSION: The cardiac telerehabilitation platform is a convenient tool for post-MI patients who cannot attend at outpatient cardiac rehabilitation centers for any reason.

Liposome and immune system interplay: Challenges and potentials.

Liposome as a revolutionizing carrier, has exhibited favorable aspects in drug delivery. However, there are numerous challenges affecting its effectiveness. Hypersensitivity, accelerated blood clearance, opsonization, uptake by reticulo-endothelial system, and also immune suppression are known as the dominant manifestations of immune-related effects. They may cause failure to achieve the proof of regulatory approvals. In this review, liposome challenges in biologic environment have been discussed. Moreover, opsonization and liposome interactions with innate and acquired immune system have been investigated. Immune system elements including the corresponding receptors and cells were reviewed in this regard. By exploring immune related interactions of the liposome, it could be possible for the formulators to be aware of the immune related interactions of the administered liposomal formulation. On the other hand, immune targeted liposomes for immunotherapy and vaccination purposes could also be developed.