Associations of demographic, socioeconomic, self-rated health, and metastasis in colorectal cancer in Iran.

Background: Metastasis in Colorectal Cancer (CRC) is important because of the costs imposed on the individual. Self-Rated Health (SRH) can be useful for preventing cancer. Considering the role of Socio-Economic Status (SES) in CRC, our study was conducted to evaluate the relationship between demographic, SES, SRH, and metastasis of this type of cancer in Markazi province, Iran. Methods: This cross-sectional, descriptive study (April to July 2018) was conducted on 411 patients suffering from CRC. These patients were hospitalized in one of the medical centers affiliated to Arak University of Medical Sciences (Arak, Iran), and with non-random sampling (available sampling) they were imported to the study. A reliable and valid questionnaire about levels of SES and SRH was filled by patients. For analyzing the data, Binomial logistic regression and chi-square tests were executed using Stata 11 software. Results: The mean age was 60.01 years. According to the results of this study, as compared with poorest SES patients, the OR estimate of metastasis was 0.80 (95% CI: 0.36, 1.78) among the richest SES patients, in patients with age of >60 years was 9.92 (95% CI: 1.53, 64.39) in comparison with patients with age of <40 years, in male patients was 3.26 (95% CI: 1.76, 6.04) compared with female ones; in divorced/widowed patients was 0.52 (95% CI: 0.11, 2.51) in comparison with single ones; among those with academic level of education was 4.28 (95% CI: 1.49, 12.26) compared with illiterate patients; and compared with poor SRH-age of patients, was 3.78 (95% CI: 2.09, 6.85) among those with good SRH-age. Conclusion: Patient's education and SES are important variables in metastasis and SRH of CRC in Iranian patients. All diagnostic tests and medical possibilities should be available for all individuals with adequate interventions. Patient's education and awareness should also be increased.

Tunable leaky-wave radiation by graphene-covered corrugated surfaces.

In this paper, we propose a graphene-covered subwavelength metallic grating where the Fermi level of graphene is sinusoidally modulated as a leaky-wave antenna at terahertz frequencies. This structure can convert spoof surface plasmon guided waves to free-space radiation due to the tunability of graphene. Analysis and design of the proposed leaky-wave antenna are discussed based on sinusoidally modulated surface impedance. The surface impedance is obtained by an analytical circuit model. The sinusoidal surface impedance is realized using modulation of the conductivity of graphene by applying a bias voltage. The proposed leaky-wave antenna is capable of electronic beam scanning with an almost constant gain and low sidelobe level by tuning the graphene Fermi level. In addition, a mode-converting section is proposed that drastically improves the return loss of the antenna.

Terahertz spectrum splitting by a graphene-covered array of rectangular grooves.

We propose a bidirectional terahertz (THz) spectrum splitter using a practically simple metamaterial structure consisting of rectangular grooves covered by graphene. Thanks to the graphene optoelectronic tunability and by adjusting the grooves width, this structure provides nearly 2π phase shift. At the same time, the reflection efficiency is acceptable throughout the phase shifts. We design each of the meta-atoms using a circuit model, and then we synthesize the final supercell based on the generalized Snell's law so that the structure reflects different frequency waves to totally different directions. The full-wave simulations demonstrate the beam splitting with a remarkable efficiency of around 80%.

Does moral sensitivity contribute to patient satisfaction? A cross-sectional survey in educational hospitals.

Introduction: Our study aims to assess interactions between the moral sensitivity of physicians and the satisfaction of patients. Methods: This is a cross-sectional study. Data were collected by a standard questionnaire of the physicians' moral sensitivity about decision-making and a researcher-made patient satisfaction questionnaire. The physicians were selected through the census method, and patients were selected using quota sampling to equal the selection of each physician from each work shift. All information was analyzed by SPSS statistical software version 23. Results: The mean score for physicians' moral sensitivity was 91.6 ± 0.63 which shows a high level of moral sensitivity. The average patient satisfaction was 61.97 ± 3.55 out of the total score (23-115) which shows a moderate level of satisfaction with the highest scores in the domain of "professionalism" and the lowest scores were related to the domain of "Technical Quality of Care". Conclusion: For improving patient satisfaction, adopting appropriate strategies like performing the periodic evaluation of this phenomenon and providing some codified training in this regard are required to increase the level of moral sensitivity of physicians and provide high-quality care.

Inverse design of compact power divider with arbitrary outputs for 5G applications.

Since the recent on-demand applications need more sophisticated circuits and subsystems, components with configurable capabilities attract attention more than before in commercial systems, specifically the fifth generation (5G). Power dividers play a crucial role in 5G phased array systems, and their role becomes more significant if the output powers ratio is adjustable. Here, we suggest a design methodology by which planar power splitters with arbitrary output power levels can be designed in light of very simple perturbations, i.e., vias. Through our design procedure, we find an optimized pattern for hybrid vias-some of them are made of PEC, and others are dielectric, e.g., air, high-permittivity materials. Thanks to deep neural networks, we demonstrate that this technique can be employed to design power splitters whose output ports have different amplitudes. In light of the proposed method, we fabricated and measured a 4-way power divider realizing Chebyshev coefficients for sidelobe reduction of a 4-element array at 28 GHz as a proof-of-concept. We believe that this methodology in which hybrid perturbation is the key spot paves a way to implement complex functions in various platforms and other structures, e.g., SIWs, ridge waveguides, rather than the one we investigated (planar/microstrip).

Particle inhalability of a standing mannequin with large airways in a ventilated room.

This study presents a series of numerical simulations for airflow field and particle dispersion and deposition around a mannequin inside a ventilated room. A 3-D airway system of a volunteer subject with a large respiratory system was reconstructed from the nostril inlet to the end of the tracheobronchial tree 4th generation and was integrated into a standing mannequin at the center of a room. The room ventilation system supplied air through a diffuser and expelled air via a damper in three modes. The airflow field was first evaluated by solving the governing equations and the k-ω SST transitional turbulence model using the Ansys-Fluent software. Then spherical particles with various diameters were released into the room, and their trajectories were evaluated using the Lagrangian approach. Aspiration fraction and particle deposition for inhalation flow rates of 15 and 30 L/min were analyzed using a modified discrete random walk (DRW) stochastic model using a user-defined function (UDF) coupled to the Ansys-Fluent discrete phase model. For the first ventilation mode, a recirculation flow region formed behind the mannequin that led the airflow streamlines to the breathing zone. A recirculation flow formed in front of the face for the second ventilation mode that led the airflow streamlines out of the mannequin breathing zone. For the third mode, however, there was no strong recirculation flow zone around the mannequin. Simulation results showed that the aspiration fraction in the first ventilation mode was higher than the other modes. In addition, the regional deposition rates and deposition patterns of particles inside the respiratory system were presented for each region. Accordingly, most large particles were trapped in the nasal passage; however, some large particles penetrated deeper into the airway due to the large airway size. For the higher breathing rate, the percentage of large escaped particles from the lobe branches dropped by a factor of 7 compared to the lower breathing rate.

Reconfigurable Meta-Coupler Employing Hybrid Metal-Graphene Metasurfaces.

Efficient excitation of surface wave (SW) remains one of the most challenging considerations in the photonics and plasmonics areas. Inspired by recent investigations of metasurfaces, we propose a hybrid metal-graphene transmitarray converting incident propagating wave (PW) to SW, as a solution for SW excitations-a meta-coupler. The structure comprises ultra-thin four-layer transparent metasurfaces in which H-shaped etched metal films together with graphene patches are employed, and also all four layers are identical. Full-wave simulations demonstrate that the suggested meta-coupler possesses an efficiency of 46% and a directivity of 19 dB, which is promising in the terahertz (THz) range. At the same time, in light of unique graphene characteristics, the proposed device is tunable and easily reconfigurable, i.e., the direction of converted SWs can be electrically switched from right to left and vice versa. We believe that this system responds to emerging applications such as THz communications and sensing, and furthermore the employed architecture introduce electrostatically tunable building blocks being able to develop graphene plasmonic components effectively.

Socio-Economic Status Inequity in Self Rated Health in Patients with Breast Cancer.

AIM: We investigate the evaluation of socio-economic status (SES) inequality on self-rated health (SRH) at women with breast cancer. STUDY DESIGN: Cross-sectional study. METHODS: The current study conducted on all 270 breast cancer patients that were admitted to one of the hospitals of Arak University Medical Sciences (Arak, Iran from April to July 2018) by census (using non-random sampling (accessible sampling). SES was calculated by asset-based questionnaire and Principle Component Analysis (PCA) was performed to estimate the families' SES. Concentration Index (C) and Curve (CC) was used to measure SES inequality in SRH. The data were analysed with Stata software. RESULTS: The number of persons with good SRH by the level of SES was 165 (61.1%) and with poor SRH was 105 (38.9%). The number of persons with good SRH in comparison to same-aged people by level of SES was 135 (50%) and with poor SRH was 135 (50%). Concentration index of SRH in all level of SES was 0.061 (SE = 0.03). Also, Concentration index for SRH in comparison to same-aged people at different levels of SES was -0.044 (SE = 0.03). CONCLUSION: The results of this study showed that there is inequality in SRH in a patient with breast cancer of the richest level of SES.

Relationship of Socio Economic Status, Income, and Education with the Survival Rate of Breast Cancer: A Meta-Analysis.

BACKGROUND: Despite our awareness of the significant effect of Social Determinant of Health (SDoH) such as Socio Economic Status (SES), income and education on breast cancer survival, there was a serious lack of information about the effect of different level of these factors on breast cancer survival. So far, no meta-analysis has been conducted with this aim, but this gap was addressed by this meta-analysis. METHODS: Main electronic databases such as PubMed, Web of Science, and Scopus were investigated up to January 2019. Epidemiological studies focusing on the association between SDoH and breast cancer were singled out. Q-test and I2 statistic were used to study the heterogeneity across studies. Begg's and Egger's tests were applied to explore the likelihood of the publication bias. The results were reported as hazard ratio (HR) with 95% confidence intervals (CI) through a random-effects model. RESULTS: We identified 7,653 references and included 25 studies involving 1,497,881 participants. The HR estimate of breast cancer survival was 0.82 (0.67, 0.98) among high level of SES, 0.82 (0.70, 0.94) among high level of income and 0.72 (0.66, 0.78) among academic level of education. CONCLUSION: The SES, income, and education were associated with breast cancer survival, although the association was not very strong. However, there was a significant association between the levels of these factors and breast cancer survival.

Decomposing Socioeconomic Inequality in Health Literacy in Iran: A Concentration Index Approach.

BACKGROUND: Health literacy is a major factor for health promotion and well-being. In spite of several researches on health literacy, information on the subject of the status of health literacy in Asian countries such as Iran is inadequate. Therefore, this study aimed to assess the inequality of health literacy in an Iranian population and its influencing factors. METHODS: In this cross-sectional study, 736 families were selected by cluster random sampling. A validated questionnaire was used to measure the health literacy of participants. Socioeconomic status (SES) was calculated by asset-based approach, and principal component analysis (PCA) was performed to estimate the families' SES. Concentration index and curve were used to measure SES inequality in health literacy, and after that decomposed into its determinants. The data were analyzed by Stata software. RESULTS: The mean age of the participants was 34.81 years (standard deviation = 5.98 years). The value of concentration index for health literacy equals 0.2292 (95% confidence interval = 0.168-0.283), and this value indicates that there is inequality in distribution of health literacy in Iran and the inequality disfavors the poor. CONCLUSIONS: The results of this study revealed that there is inequality in distribution of health literacy in Iran, and people of higher economic status in Iran enjoy from better health literacy levels.

Frequency of FLT3 (ITD, D835) Gene Mutations in Acute Myelogenous Leukemia: a Report from Northeastern Iran.

BACKGROUND: FLT3 is mutated in about 1/3 of acute myelogenous leukemia (AML) patients. The aim of the present study was to report the prevalence of FLT3 mutations and comparison with prognostic factors in AML patients in the Northeastern of Iran. MATERIALS AND METHODS: This cross-sectional study concerned 100 AML cases diagnosed based on bone marrow aspiration and peripheral blood. DNA for every AML patient was extracted and underwent PCR with FLT3-ITD primers. RESULTS: The mean age at diagnosis was 28.5 years (range, 1-66 years), 52 patients (52%) being male. Out of 100 AML patients, 21 (21%) had FLT3 mutation, (17 with FLT3- ITD, 81%, and 4 with FLT3-D825, 19%). Of the 21, 14 (66.7%) had heterozygous mutation. There was no significant difference between age, sex and organomegaly between patients with FLT3 mutation versus FLT3 wild-type. CONCLUSIONS: Our frequency of FLT3 is in line with earlier fidnings of approximately 20 to 30% and also the prevalence of FLT3-ITD is more than FLT3-D35 mutation. There was no significant difference between prognostic factors (age and sex) in the patients with FLT3 mutation versus FLT3 wild-type. The prevalence of FLT3 heterozygous mutations is more that homozygous mutations in AML patients.

α-Cyperone of Cyperus rotundus is an effective candidate for reduction of inflammation by destabilization of microtubule fibers in brain.

ETHNOPHARMACOLOGICAL RELEVANCE: Cyperus rotundus L. (Cyperaceae), commonly known as purple nutsedge or nut grass is one of the most invasive and endemic weeds in tropical, subtropical and temperate regions. This plant has been extensively used in traditional medicine for anti-arthritic, antidiarrheal and antiplatelet properties as well as treatment for several CNS disorders such as epilepsy, depression and inflammatory disorders. Inflammation is evidently occurring in pathologically susceptible regions of the Alzheimer's disease (AD) brain as well as other disorders. Many cellular processes are responsible in chronic inflammation. Microtubule-based inflammatory cell chemotaxis is a well-recognized process that influences production of cytokines and phagocytosis. The effect of α-Cyperone, one of main ingredients of Cyperus rotundus on microtubule assembly and dynamics has not been examined and is the purpose of this investigation. MATERIALS AND METHODS: Microtubules and tubulin were extracted in order to explore their interaction with α-Cyperone by utilization of turbidimetric examinations, intrinsic fluorescence and circular dichroism spectroscopy (CD) studies. The molecular docking analysis was executed in order to facilitate a more detail and stronger evidence of this interaction. The BINding ANAlyzer (BINANA) algorithm was used to evaluate and further substantiate the binding site of α-Cyperone. RESULTS: It was demonstrated that α-Cyperone had a pronounced influence on the tubulin structure, decreased polymerization rate and reduced concentration of polymerized tubulin in vitro. The CD deconvolution analysis concluded that significant conformational changes occurred, demonstrated by a drastic increase in content of ß-strands upon binding of α-Cyperone. The fluorescence spectroscopy revealed that a static type of quenching mechanism is responsible for binding of α-Cyperone to tubulin. Upon characterization of various biophysical parameters, it was further deduced that ligand binding was spontaneous and a single site of binding was confirmed. Transmission electron microscopy revealed that upon binding of α-Cyperone to microtubule the number and complexity of fibers were noticeably decreased. The computational analysis of docking suggested that α-Cyperone binds preferably to ß-tubulin at a distinct location with close proximity to the GTP binding and hydrolysis site. The ligand interaction with ß-tubulin is mostly hydrophobic and occurs at amino acid residues that are exclusively on random coil. The BINANA 1.2.0 algorithm which counts and tallies close molecular interaction by performing defined set of simulations revealed that amino acid residues Arg 48 and Val 62 have registered the highest scores and are possibly crucial in ligand-protein interaction. CONCLUSION: α-Cyperone binds and interacts with tubulin and is capable of distinctly destabilizing microtubule polymerization. The effect of this interaction could result in reduction of inflammation which would be highly beneficial for treatment of inflammatory diseases such as AD.

Successful clinical islet isolation using a GMP-manufactured collagenase and neutral protease.

In 2007, the islet community was notified that the collagenase product most commonly used for human islet isolations contained bovine neural tissue contaminants. To minimize this potential hazard, we adapted our human islet processing procedure to use a GMP-manufactured, bovine neural tissue-free collagenase blend. Here, we describe the factors that we consider most important for achieving reproducible and clinically useable islet isolations using this product.

Long-term renal function and cardiovascular disease risk in obese kidney donors.

BACKGROUND AND OBJECTIVES: Increasing demand for live-donor kidneys has encouraged the use of obese donors despite the absence of long-term outcome data and evidence that obesity can adversely affect renal function. We wished to determine whether obesity increased the risk for renal dysfunction and other medical comorbidities in donors several years after donation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Ninety-eight patients who donated a kidney 5 to 40 years previously were stratified according to body mass index (BMI) at donation and evaluated for renal dysfunction and risk factors for cardiovascular disease. Patients who were from the 2005 through 2006 National Health and Nutrition Examination Survey database; did not have renal disease; and were matched for age, gender, race, and BMI served as two-kidney control subjects. RESULTS: Renal function in obese (BMI > or =30) and nonobese (BMI <30) donors was similar, and both donor groups had reduced renal function compared with BMI-matched two-kidney control subjects. Obesity was associated with more hypertension and dyslipidemias in both donors and two-kidney control subjects; however, there were no significant differences between the two groups within each BMI category. CONCLUSIONS: These results indicate that obese donors are not at higher risk for long-term reduced renal function compared with nonobese donors and that the increased incidence of hypertension and other cardiovascular disease risk factors in obese donors is due to their obesity and is not further exacerbated by nephrectomy. These findings support the current practice of using otherwise healthy overweight and obese donors but emphasize the need for more intensive preoperative education and postoperative health care maintenance in this donor group.