Gold nanostructure-enhanced immunosensing: ultra-sensitive detection of VEGF tumor marker for early disease diagnosis.

We present an advanced electrochemical immunosensor designed to detect the vascular endothelial growth factor (VEGF) precisely. The sensor is constructed on a modified porous gold electrode through a fabrication process involving the deposition of silver and gold on an FTO substrate. Employing thermal annealing and a de-alloying process, the silver is eliminated from the electrode, producing a reproducible porous gold substrate. Utilizing a well-defined protocol, we immobilize the heavy-chain (VHH) antibody against VEGF on the gold substrate, facilitating VEGF detection through various electrochemical methods. Remarkably, this immunosensor performs well, featuring an impressive detection limit of 0.05 pg/mL and an extensive linear range from 0.1 pg/mL to 0.1 µg/mL. This emphasizes it's to measure biomarkers across a wide concentration spectrum precisely. The robust fabrication methodology in this research underscores its potential for widespread application, offering enhanced precision, reproducibility, and remarkable detection capabilities for the developed immunosensor.

Social disparities and inequalities in healthcare access and expenditures among Iranians exposed to sulfur mustard: a national study using spatio-temporal analysis.

BACKGROUND: Sulfur Mustard (SM) is a chemical warfare agent that has serious short-term and long-term effects on health. Thousands of Iranians were exposed to SM during the eight-year Iran-Iraq conflict and permanently injured while the socioeconomic imbalance in their healthcare utilization (HCU) and health expenditures remains. This study aims to describe the HCU of SM-exposed survivors in Iran from 2018 to 2021; identify high-risk areas; and apply an inequality analysis of utilization regarding the socioeconomic groups to reduce the gap by controlling crucial determinants. METHODS: From Oct 2018 to June 2021, the Veterans and Martyrs Affairs Foundation (VMAF) recorded 58,888 living war survivors with eye, lung, and skin ailments. After cleaning the dataset and removing junk codes, we defined 11 HCU-related variables and predicted the HCU for the upcoming years using Bayesian spatio-temporal models. We explored the association of individual-level HCU and determinants using a Zero-inflated Poisson (ZIP) model and also investigated the provincial hotspots using Local Moran's I. RESULTS: With ≥ 90% confidence, we discovered eleven HCU clusters in Iran. We discovered that the expected number of HCU 1) rises with increasing age, severity of complications in survivors' eyes and lungs, wealth index (WI), life expectancy (LE), and hospital beds ratio; and 2) decreases with growing skin complications, years of schooling (YOS), urbanization, number of hospital beds, length of stay (LOS) in bed, and bed occupancy rate (BOR). The concentration index (CInd) of HCU and associated costs in age and wealth groups were all positive, however, the signs of CInd values for HCU and total cost in YOS, urbanization, LOS, and Hospital beds ratio groups were not identical. CONCLUSIONS: We observed a tendency of pro-rich inequity and also higher HCU and expenditures for the elderly population. Finally, health policies should tackle potential socioeconomic inequities to reduce HCU gaps in the SM-exposed population. Also, policymakers should allocate the resources according to the hotspots of HCU.

Evaluation of the Golden Ratio in Nasal Conchae for Surgical Anatomy.

PURPOSE: The golden ratio is reached by the fractal model of the number sequence which is known as the "Fibonacci series" and has a convergent ratio of approximately 1.618 between 2 consecutive Fibonacci numbers. Golden ratio relationships have been shown in several plants in the nature and several organs and structures in the human body. The conchae, which form an important part of the nasal valve, have a special geometric significant in terms of providing turbulence to the laminar airflow that passes to the nasal cavity. METHODS: This study made golden ratio calculations on 34 adults aged 20 to 45 years over computed tomography (CT) images. Totally, 34 volunteers (male, n = 18 and female, n = 16) with no nasal pathologies participated in the study. Using Adobe Photoshop, golden ratio calculations were made by applying the Fibonacci spiral on the images that best showed the conchae and meatuses on the CT images. RESULTS: The intersection points of the spiral that was projected on the inferior and middle nasal concha were determined as S0, S1, S2, S3, and S4. The distances of S0-S1, S1-S2, S2-S3, and S3-S4 were measured. The concha measurements of the women showed significantly similar values to the golden ratio constant of ∼1.618 in the RS3/S4 and LS3/S4 measurements. CONCLUSION: We found that the S3/S4 region that captured the golden ratio in our study corresponds to the base part of the inferior nasal concha, and its place of spiraling in the nasal cavity is observed to have an important role in creating vortices.

Anatomical considerations of safe drilling corridor upper sacral segment screw insertion.

The upper segment of sacrum is an important for screw insertions of unstable lumbosacral spine. Measurements of the S1-S2 as sacral wings, pedicles, sacral foraminas and sacral canal were taken from 87 sacrums. The mean depths of S1 pedicle and sacral wing were estimated as 25.8 ±â€¯2.3 mm and 50.1 ±â€¯1.7 mm, respectively. Angles screw trajectory of sacral pedicle anteromedial and sacral wing were measured as 29.6 ±â€¯0.9° and 29.7 ±â€¯2.1°, respectively. To avoid injury to the vascular structures anteriorly and nerve roots medially, depth and angle of screw trajectory is important for the entrance off pedicular screw placement to the S1.

Characterization of CRISPR Mutants Targeting Genes Modulating Pectin Degradation in Ripening Tomato.

Tomato (Solanum lycopersicum) is a globally important crop with an economic value in the tens of billions of dollars, and a significant supplier of essential vitamins, minerals, and phytochemicals in the human diet. Shelf life is a key quality trait related to alterations in cuticle properties and remodeling of the fruit cell walls. Studies with transgenic tomato plants undertaken over the last 20 years have indicated that a range of pectin-degrading enzymes are involved in cell wall remodeling. These studies usually involved silencing of only a single gene and it has proved difficult to compare the effects of silencing these genes across the different experimental systems. Here we report the generation of CRISPR-based mutants in the ripening-related genes encoding the pectin-degrading enzymes pectate lyase (PL), polygalacturonase 2a (PG2a), and ß-galactanase (TBG4). Comparison of the physiochemical properties of the fruits from a range of PL, PG2a, and TBG4 CRISPR lines demonstrated that only mutations in PL resulted in firmer fruits, although mutations in PG2a and TBG4 influenced fruit color and weight. Pectin localization, distribution, and solubility in the pericarp cells of the CRISPR mutant fruits were investigated using the monoclonal antibody probes LM19 to deesterified homogalacturonan, INRA-RU1 to rhamnogalacturonan I, LM5 to ß-1,4-galactan, and LM6 to arabinan epitopes, respectively. The data indicate that PL, PG2a, and TBG4 act on separate cell wall domains and the importance of cellulose microfibril-associated pectin is reflected in its increased occurrence in the different mutant lines.

Anatomical topography of the inferior lumbar triangle for transversus abdominis block.

BACKGROUND: Rapid development of anesthetic techniques of thoracic paravertebral block required to redefine anatomical landmarks of the inferior lumbar (Petit) triangle (ILT). Anesthesiologists are mainly interested in the ILT to perform the transversus abdominis plane (TAP) block. The aim of this study was to provide comprehensive information of the ILT to improve the success of TAP block. METHODS: Descriptional anatomy of ILTs such as dimensions, space, area, and types was analyzed in 25 preserved adult male cadavers. RESULTS: The ILT was identified in 100% out of all explored cadavers' lumbar regions. The predominant triangle was the acute-angled shaped (46%). The ILT in terms of the surface area was classified into four distinct types: Type I with a surface area <8 cm2 was identified in 50%. Type II or intermediate triangles with a surface area of 8-12 cm2 were detected in 36%. Type III or large triangles with a surface area >12 cm2 were found in 14%. Type 0 or no triangle did not exhibit a triangle. For the orientation zone over the posterior lumbar region, it was measured with the distances from the posterior median line (M) to the apex (A), medial point (B), and lateral point (C) of the triangle. MA; as M1A transverse line: 103.3 ± 21.3 mm (left) and 106.4 ± 18.4 mm (right), MB; as M2B transverse line; 102.4 ± 21.8 mm (left) and 105 ± 17.9 mm (right), MC; as M3C transverse line; 119 ± 20.5 mm (left) and 120 ± 19.2 mm (right) were measured. In addition, the measurements of the vertical lines were measured. M1A-M2B and M1A-M3C vertical lines were 20.1-22.8 mm (left-right) and 30-29 mm (left-right), respectively. CONCLUSIONS: The shape, the size, useful points, geometry, and topography of the ILT are important to determine the orientation points during block procedures. It is possible to visualize the needle pathway in different shape of ILT to ultrasound-guided TAP block. Anesthetic intervention needs to be individualized, depending upon the size of the triangle. The findings may be useful in establishing the area with the highest probability of localization of the ILT which can improve both the safety and efficiency of TAP block.

Digitalized analysis of philtral anatomy for planning individual treatment.

OBJECTIVE: Restoration of the philtral region following traumatic, cleft, and tumor surgeries is often difficult due to influence of this feature to whole facial beauty. The aim of this study is to investigate the types and measurements of the philtrum and its relationship with the upper lip using a software. METHODS: Standard personal photographs of the philtral region were obtained from 200 young adults participated in this study. Linear analyses (the lengths of philtral column and dimple; the philtral width) and angular analyses (apex and central angles of Cupid's bow) were measured as reference points. As for the shape of the philtral column, it was categorized as four distinct types: parallel, triangular, concave, and unclear type. RESULTS: The philtral width was 11.37 ± 1.9 mm in males, 10.21 ± 1.80 mm in females. The length of the philtral dimple was 18.16 ± 3.6 mm in males, 18.16 ± 3.6 mm in females. Compared with women, both of the measured average philtral reference lengths displayed a significantly greater value in men. In the meanwhile, compared to women, the angular measurements of Cupid's bow (i.e., the apex and central angle of Cupid's bow) were smaller in men. It was 127.47 ± 12.74° mm in males, 134.1 ± 11.38° mm in females. The triangular and concave types were associated with a substantial fraction in men, whereas the triangular and parallel types were predominant in women. There were significant gender differences in the esthetic rankings of philtral column shapes. CONCLUSIONS: These results suggest digitalized reference values relative to the philtral column which may increase the success of the individual reconstructive treatment of the surgical procedures and reduce possible asymmetrical appearance. With the help of certain software, this research has made possible to investigate the ideal parameters of philtral construction in defining the best surgical solution for the patient.

Anatomy of the sacral hiatus and its clinical relevance in caudal epidural block.

PURPOSE: Caudal epidural anesthesia (CEB) is widely used for the prevention of chronic lower back pain, the control of intraoperative analgesia such as genitourinary surgery and labor pain cases in sacral epidural space approach for the implementation of analgesia. CEB is an anesthetic solution used into the sacral canal via sacral hiatus (SH). For optimal access into the sacral epidural space, detailed anatomical landmarks of SH are required. This study aims at exploring the anatomical structures and differences of the SH by using the sacral bone as a guide point to failure criteria for reviewing the caudal epidural anesthesia and improving the criteria for success in practice. MATERIALS AND METHODS: Detailed morphometric measurements of orientation points of the SH were taken in 87 sacral bones. The measurements were taken using digital calipers and calculated with photogrammetric methods using Image J program. RESULTS: Most commonly encountered shape of the SH was inverted U (33.33%), while 6.9% 3.45% often lack SH and bifida shape were found. The average length of the SH was 28.7 ± 7.1 mm, the average distance of the intercornual distance was 13.48 ± 2.69 mm, the average of the apex of SH and S2 sacral foramen was 34.68 ± 7.09 mm. There was no statistically significant difference determined in bilateral measurements (p > 0.05). Apex and base of SH were most commonly observed against S4 and S5 vertebrae, respectively. The level of maximum curvature of sacrum was S3 in 62.07% and S4 in 28.78%. Findings of spina bifida level were found 16.13% often in L5-S1 segment. Sacral cornua were marked by their bilateral presence in 55.26% and impalpable in 21.05% cases. Minimum distance between the S2 and the apex of the SH was 7.25 mm which suggested that it would not be safe to push the needle beyond 7 mm into the sacral canal so as to avoid dural puncture. In 8.77% cases, the depth of hiatus was less than 3 mm. CONCLUSIONS: Single bony landmark may not help in locating the SH because of the anatomical variations. Important anatomical landmarks of the CEB are the sacral cornu, lateral sacral crests, the apex of the SH, the base of the SH, the top portion of the median sacral crest, anteroposterior distance of the sacral canal, intercornual distance, distance of the apex of the SH to the S2 foramina. Depth of hiatus less than 3 mm may be one of the causes for the failure of needle insertion. Surrounding bony irregularities, different shapes of hiatus and defects in dorsal wall of sacral canal should be taken into consideration before undertaking CEB so as to avoid its failure. This guide can be done by considering the points and securing a successful venture.

Study of frontal hairline patterns for natural design and restoration.

OBJECTIVE: Hair loss is one of the most noticeable esthetic problems of the mankind. Hair transplantation has been a highly effective technique in reducing wide foreheads and recontouring the hairline. Creating a natural hairline is one of the most important elements of a successful hair transplant. This study aims at the requirements which are essential in designing hairline morphometrics and natural frontline. METHODS: Standard photographs of the forehead region were obtained from two hundred young Turkish adults participated in this study. The hairline contour was classified into five groups as round, M-shaped, rectangular, bell-shaped and triangular. Measurements of the forehead region, such as the height of the forehead, widths of the forehead and supraorbital region were calculated as reference points. RESULTS: In women, the average height of the forehead was 58.3 ± 6.6 mm, the average width of the forehead and the supraorbital region was 129 ± 14.4 mm and 125.3 ± 13.5 mm, respectively. The incidence of the hairline shapes was seen as; round (28%), M-shaped (19%), rectangular (30%), bell-shaped (5%), or triangular (18%). In men, the average height of the forehead was 61.4 ± 9.7 mm, the average width of the forehead and supraorbital region was 137.1 ± 18 mm and 133.9 ± 15.9 mm, respectively. The hairline contour among young male adults was classified as round in 27%, M-shaped in 46%, rectangular in 31%, bell-shaped in 4% and triangular in 2%. The rectangular and M-shaped hairlines resemble a more masculine appearance, whereas round shaped hairline resembles femininity. CONCLUSION: Ideal reconstruction of scalp defects relies on a comprehensive understanding of scalp anatomy and detailed information of patient factors. The classification of the hairline and measured forehead reference lengths will be beneficial in the correction of wide foreheads. There were significant gender differences in the esthetic rankings of the hairline contour. Compared to women, both of the measured average forehead reference lengths displayed a significantly greater value in men. Our results clearly showed that sex difference affected the predominance of the contour type. The M shape was the most common, and the triangular type was poorly classified in men, whereas the rectangular hairline was the most common type among women.