Deep photonic network platform enabling arbitrary and broadband optical functionality.

Expanding applications in optical communications, computing, and sensing continue to drive the need for high-performance integrated photonic components. Designing these on-chip systems with arbitrary functionality requires beyond what is possible with physical intuition, for which machine learning-based methods have recently become popular. However, computational demands for physically accurate device simulations present critical challenges, significantly limiting scalability and design flexibility of these methods. Here, we present a highly-scalable, physics-informed design platform for on-chip optical systems with arbitrary functionality, based on deep photonic networks of custom-designed Mach-Zehnder interferometers. Leveraging this platform, we demonstrate ultra-broadband power splitters and a spectral duplexer, each designed within two minutes. The devices exhibit state-of-the-art experimental performance with insertion losses below 0.66 dB, and 1-dB bandwidths exceeding 120 nm. This platform provides a tractable path towards systematic, large-scale photonic system design, enabling custom power, phase, and dispersion profiles for high-throughput communications, quantum information processing, and medical/biological sensing applications.

Broad spectrum post-entry inhibitors of coronavirus replication: Cardiotonic steroids and monensin.

A small molecule screen identified several cardiotonic steroids (digitoxin and ouabain) and the ionophore monensin as potent inhibitors of HCoV-229E, HCoV-OC43, and SARS-CoV-2 replication with EC50s in the low nM range. Subsequent tests confirmed antiviral activity in primary cell models including human nasal epithelial cells and lung organoids. Addition of digitoxin, ouabain, or monensin strongly reduced viral gene expression as measured by both viral protein and RNA accumulation. Furthermore, the compounds acted post virus entry. While the antiviral activity of digitoxin was dependent upon activation of the MEK and JNK signaling pathways but not signaling through GPCRs, the antiviral effect of monensin was reversed upon inhibition of several signaling pathways. Together, the data demonstrates the potent anti-coronavirus properties of two classes of FDA approved drugs that function by altering the properties of the infected cell, rendering it unable to support virus replication.

Unsupervised Stereo Matching with Surface Normal Assistance for Indoor Depth Estimation.

To obtain more accurate depth information with stereo cameras, various learning-based stereo-matching algorithms have been developed recently. These algorithms, however, are significantly affected by textureless regions in indoor applications. To address this problem, we propose a new deep-neural-network-based data-driven stereo-matching scheme that utilizes the surface normal. The proposed scheme includes a neural network and a two-stage training strategy. The neural network involves a feature-extraction module, a normal-estimation branch, and a disparity-estimation branch. The training processes of the feature-extraction module and the normal-estimation branch are supervised while the training of the disparity-estimation branch is performed unsupervised. Experimental results indicate that the proposed scheme is capable of estimating the surface normal accurately in textureless regions, leading to improvement in the disparity-estimation accuracy and stereo-matching quality in indoor applications involving such textureless regions.

Thyme extract could overcome diabetes-induced reproductive dysfunction by inhibiting oxidative damage and increasing the expression of insulin receptor substrate and pyruvate kinase in the rat sperm.

OBJECTIVES: Oxidative stress and disruption of energy metabolism in the reproductive system, especially sperm, play a significant role in diabetes-related infertility. Zataria multiflora Boissis (ZMB), a medicinal plant containing various bioactive compounds, may have efficacy in treating metabolic diseases and reproductive disorders. Therefore, the aim of this study was to investigate the effects of different doses of ZMB extract on diabetes-induced reproductive dysfunction by assessing oxidative damage and the gene expression of insulin receptor substrate (IRS) and pyruvate kinase (PK) in male rats' sperm. METHODS: Sixty adult male Wistar rats were randomly divided into six groups; control (C), diabetes (D), and diabetic animals treated with glibenclamide (G, 50 mg/kg) and thyme extract (T100, T200, and T400). Diabetes was induced by intraperitoneal injection of Streptozotocin (STZ) (50 mg/kg). Insulin, glucose, oxidative and pro-inflammatory markers in the serum, and gene expressions of IRS, and PK were measured in the stored sperms in the epididymis. Changes in the process of spermatogenesis were assessed through the histological evaluation of the testis. Gas chromatography-mass spectrometry (GC-MS) was used to analyze the quantity and quality of thyme extract. KEY FINDINGS: The study results indicated that body weight, food intake, and sperm parameters significantly improved in a dose-dependent manner in the T200 group compared to the other groups. Additionally, in the same group, pro-inflammatory biomarkers, DNA fragmentation, and MDA levels decreased, while the levels of catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) enzymes in the stored epididymal sperm significantly improved compared to the other groups. The expression of IRS and PK, along with the mean counts of spermatogenesis cell lines (especially Sertoli cells), significantly increased in the T200 group. SUMMARY: In conclusion, thymol appears to alleviate diabetes-induced reproductive dysfunction by inhibiting oxidative damage, improving the metabolic state, and upregulating the expression of IRS and PK genes in the sperm of male rats.

The immediate effect of synergistic muscles kinesio taping on function and balance of volleyball players with functional ankle instability: A randomized controlled trial.

OBJECTIVES: To determine the immediate effect of synergistic muscles Kinesio taping (KT) on the function and balance of volleyball players with functional ankle instability (FAI). DESIGN: Parallel, superiority randomized controlled trial. METHODS: Twenty-six semi-professional volleyball players with FAI were randomly assigned to either the intervention or control group. All participants received KT of fibularis longus, gastrocnemius, and gluteus maximus muscles for one session. The intervention group received KT with 35 % tension, while the control group received KT without tension. The function was assessed using the side hop and single hop distance tests. Dynamic balance was assessed with the Y Balance test. The outcomes were measured at baseline, 20 min after KT, and 24 h after KT. Statistical analyses were performed using Mixed-model repeated measures analysis of variance (ANOVA) and one-way ANOVA. RESULTS: The interactions of time*group for the outcomes of function using the single hop test and stability in the anterior direction of the Y Balance test were significant (p < 0.05). Within-group comparisons showed after KT, both groups experienced significant improvements in all outcomes compared to the baseline. Results of between-group comparisons revealed that the application of KT with tension compared to no tension significantly improved function and balance in the anterior of the Y Balance test. CONCLUSIONS: Kinesio taping can be an effective treatment option to improve function and balance in FAI. Additionally, Kinesio taping with tension compared to KT without tension had superiority.

The Effectiveness of Time in Treatment with Vitamin C and Broccoli Extract on Cadmium Poisoning in Mice: Histological Changes of Testicular Tissue and Cell Apoptotic Index.

The growth rate of reproductive system disorders caused by heavy metals is undeniable. The effect of time and interfering compounds are also of paramount importance. The main objective of this study was to compare the effects of broccoli extract and vitamin C in the context of cadmium poisoning on various reproductive parameters in mice, with a specific focus on the influence of time. A total of one hundred and forty-four male mice were randomly assigned to six groups. The control (C) group received only water and a standard diet without any interventions. The Cd group received a single intraperitoneal dose of cadmium chloride at 1.5 mg/kg. The cadmium intervention groups were administered broccoli extract at dosages of 100 mg/kg (Cd + B100), 200 mg/kg (Cd + B200), and 300 mg/kg (Cd + B300), respectively. Additionally, the Cd + VC group was treated with cadmium and vitamin C at 200 mg/kg intraperitoneally for a duration of 28 days. At the end of each week (four stages), five animals were randomly chosen from each group. Epididymal sperm were subjected to analysis for sperm parameters, while testicular tissue sections were examined for histological studies, apoptosis index, and markers of oxidative stress. The influence of time on body and testis weight gain was notably significant in the Cd + B300 and Cd + VC groups (p = 0.001). In all groups, except for Cd + B100, there were marked increases in spermatogenic cell lines and the Johnson coefficient compared to the Cd group (p = 0.001). These changes were particularly pronounced in the Cd + VC and Cd + B300 groups with respect to time (p < 0.001). Furthermore, there was a discernible positive impact of time on sperm count in the high-dose broccoli and vitamin C groups, although this effect did not reach significance in terms of sperm motility and vitality. Over time, the levels of superoxide dismutase (SOD) and catalase (CAT) enzymes increased, while malondialdehyde (MDA) levels decreased in the Cd + VC, Cd + B200, and Cd + B300 groups (p = 0.001). The apoptosis index in testicular tissue reached its highest level in the Cd group and its lowest level in the Cd + B300 and Cd + VC groups during the fourth week (p < 0.05). Linolenic acid, indole, and sulforaphane were identified as the most potent compounds in broccoli during this intervention. Consequently, vitamin C and broccoli extract at a dosage of 300 mg/kg demonstrated significant enhancements in reproductive performance in cases of cadmium poisoning. Overall, the influence of time significantly amplified the process of spermatogenesis and sperm production, with no observable changes in sperm viability and motility.

The Effectiveness of Cognitive-Behavioral Intervention on Dental Anxiety during Pulpotomy in 7-10 Year-Old Children: A Clinical Trial.

Objectives: Dental anxiety is a common phenomenon experienced by children in the dental setting. However, there is limited research on the effectiveness of cognitive-behavioral interventions in managing this anxiety. Therefore, the aim of this study was to evaluate the impact of a cognitive-behavioral psychologic intervention on dental anxiety in children. Materials and Methods: A total of thirty children, aged 7-10 years, underwent prophylaxis and fluoride therapy. The baseline anxiety levels of the children were determined using the Modified Child Dental Anxiety Scale (MCDAS). The intervention group (N=15) received two 30-minute sessions of cognitive-behavioral exercises. Additionally, a short film demonstrating a cooperative child undergoing pulpotomy was created and parents were instructed to show it to their children at home. During the treatment session, the exercises were reinforced at each step, and the MCDAS questionnaire was administered again. The children's behavior was also assessed using the Venham Clinical Cooperation Scale. Independent t-test, Mann-Whitney, chi-square, and Pearson's correlation coefficient were used for statistical analysis and P<0.05 was considered statistically significant. Results: Postoperatively, the MCDAS score in the intervention group was significantly lower compared to the control group. Notably, the intervention group demonstrated a downward trend in anxiety scores, while the control group showed an increase (P<0.001). Conclusion: Cognitive-behavioral interventions were found to be successful in decreasing dental anxiety in children undergoing pulpotomy. These interventions can be successfully implemented in clinical settings.

The quality of care index for low back pain: a systematic analysis of the global burden of disease study 1990-2017.

BACKGROUND: . Low back pain is one of the major causes of morbidity worldwide. Studies on low back pain quality of care are limited. This study aimed to evaluate the quality of care of low back pain worldwide and compare gender, age, and socioeconomic groups. METHODS: . This study used GBD data from 1990 to 2017 from the Institute for Health Metrics and Evaluation (IHME) website. Extracted data included low back pain incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs). DALYs to prevalence ratio and prevalence to incidence ratio were calculated and used in the principal component analysis (PCA) to make a proxy of the quality-of-care index (QCI). Age groups, genders, and countries with different socioeconomic statuses regarding low back pain care quality from 1990 to 2017 were compared. RESULTS: The proxy of QCI showed a slight decrease from 36.44 in 1990 to 35.20 in 2017. High- and upper-middle-income countries showed a decrease in the quality of care from 43.17 to 41.57 and from 36.37 to 36.00, respectively, from 1990 to 2017. On the other hand, low and low-middle-income countries improved, from a proxy of QCI of 20.99 to 27.89 and 27.74 to 29.36, respectively. CONCLUSION: . Despite improvements in the quality of care for low back pain in low and lower-middle-income countries between 1990 and 2017, there is still a large gap between these countries and higher-income countries. Continued steps must be taken to reduce healthcare barriers in these countries.

Comparison of Dentinal Defects Formation in Straight, Moderate and Severely Curved Canals by Three Distinctive Nickel Titanium Instruments: An in vitro Study.

Statement of the Problem: It is stated that engine-driven instruments might cause dentinal defects during root canal preparation. These defects might spread and progress into greater fractures or vertical root fracture. Purpose: This study aimed to compare the incidence of dentinal defects that might arise all through preparation of root canals, using One Shape, RaCe, and WaveOne systems in canals with a curvature (0-20°) and (20-40°). Materials and Method: In this in vitro study, 150 mandibular first molars were enrolled. Based on the degree of curvature in the mesial roots, the samples were divided into two groups (n=75) of straight and moderately curved canals (0-20º), and severely curved canals (20-40°). Then each group was randomly divided into four sub-groups. In subgroups 1 to 3 from each group, canals were prepared using WaveOne, One Shape, and RaCe. Then all roots were sectioned at 3, 6 and 9-mm distances from the apex. The slices were evaluated using stereomicroscope at 12× magnification. The data were analyzed using the Chi-square and Fisher's exact tests and the level of significance was set at 0.05. Results: Fracture and other defects were not found in the control groups. In canals with curvature (0-20°), WaveOne caused the maximum dentinal defects and RaCe produced the least. Moreover, in canals with curvature (20-40°), One Shape caused the maximum dentinal defects while WaveOne and RaCe caused equal dentinal defects approximately. Conclusion: There was a statistically significant relationship between the performance of RaCe and One Shape in canals with curvature (0-20º) and (20-40º), (pValue< 0.05) while no statistically significant difference was observed in connection to the performance of WaveOne (p> 0.05).

Habitual physical activity modulates cardiometabolic health in long-term testicular cancer survivors.

PURPOSES: Physical activity (PA) may mitigate late cardiometabolic toxicity of cisplatin-based chemotherapy in testicular germ cell tumor (TGCT) long-term survivors. In this cross-sectional study, we evaluated the effects of habitual PA on metabolic syndrome (MetS) prevalence, and on the markers of cardiometabolic health and chronic inflammation in a population of long-term TGCT survivors. METHODS: MetS prevalence was evaluated, and habitual PA was assessed using Baecke's habitual PA questionnaire in TGCT survivors (n=195, age=41.1±8.1years, 11.7±5.2years post-therapy) and healthy male controls (n=41, age=38.2±8.8years). Participants were stratified into low- and high-PA groups based on median values. Differences were examined between low- and high-PA groups (in the entire sample, TGCT survivor sub-samples differing in disease stage, and healthy controls), and between TGCT survivors and controls. Next, TGCT survivors were stratified into age- and BMI-matched sub-groups based on post-treatment time (5-15/15/30years) and number of chemotherapy cycles (≤3/>3), allowing us to detect age- and BMI-independent effects of habitual PA on cardiometabolic health in the given TGCT survivor sub-populations. A correlation matrix of habitual PA and sport activity with cardiometabolic and pro-inflammatory markers was generated. RESULTS: TGCT survivors had higher MetS prevalence than controls. Patients with high habitual PA had lower waist circumference and Systemic Inflammation Index. Habitual PA scores correlated positively with HDL-cholesterol and negatively with waist circumference and atherogenic risk. Furthermore, cardiometabolic benefits of habitual PA were more pronounced in patients with disease stages 1 and 2. Effects of habitual PA on patients sub-populations stratified by chemotherapy dose and post-treatment time clearly showed that higher levels of habitual PA were associated with lower numbers of MetS components, except for patients who received more than 3 chemotherapy cycles and were examined more than15 years post-therapy. CONCLUSIONS: Higher levels of habitual PA effectively mitigated cardiometabolic toxicity in TGCT survivors. Patients with higher cumulative doses of chemotherapy may need structured exercise interventions involving higher-intensity physical activity to achieve significant improvements in cardiometabolic health.

Adding a back care package to the primary healthcare; a community-based cluster-randomized trial.

Introduction: The clinical course of LBP is complex and chronicity is more frequent than once thought. Moreover, insufficient evidence was found in support of any specific approach at the level of the general population. Research question: This study aimed to evaluate the effectiveness of providing a back care package through the primary healthcare system in decreasing the rate of CLBP in the community. Material and methods: Clusters were primary healthcare units with the covered population as participants. The intervention package comprised both exercise and educational content in the form of booklets. Data regarding LBP were collected at baseline, 3 and 9-month follow-ups. The LBP prevalence and the incidence of CLBP in the intervention group compared to the control group were analyzed using logistic regression through GEE. Results: Eleven clusters were randomized including 3521 enrolled subjects. At 9 months, the intervention group showed a statistically significant decrease in both the prevalence and the incidence of CLBP, compared to the control group (OR â€‹= â€‹0.44; 95% CI â€‹= â€‹0.30-0.65; P â€‹< â€‹0.001 and OR â€‹= â€‹0.48; 95% CI â€‹= â€‹0.31-0.74; P â€‹< â€‹0.001, respectively). Discussion and conclusion: The population-based intervention was effective in reducing the LBP prevalence and CLBP incidence. Our results suggest that preventing CLBP through a primary healthcare package including exercise and educational content is achievable.

A data-driven optimization model to response to COVID-19 pandemic: a case study.

COVID-19 is a highly prevalent disease that has led to numerous predicaments for healthcare systems worldwide. Owing to the significant influx of patients and limited resources of health services, there have been several limitations associated with patients' hospitalization. These limitations can cause an increment in the COVID-19-related mortality due to the lack of appropriate medical services. They can also elevate the risk of infection in the rest of the population. The present study aims to investigate a two-phase approach to designing a supply chain network for hospitalizing patients in the existing and temporary hospitals, efficiently distributing medications and medical items needed by patients, and managing the waste created in hospitals. Since the number of future patients is uncertain, in the first phase, trained Artificial Neural Networks with historical data forecast the number of patients in future periods and generate scenarios. Through the use of the K-Means method, these scenarios are reduced. In the second phase, a multi-objective, multi-period, data-driven two-stage stochastic programming is developed using the acquired scenarios in the previous phase concerning the uncertainty and disruption in facilities. The objectives of the proposed model include maximizing the minimum allocation-to-demand ratio, minimizing the total risk of disease spread, and minimizing the total transportation time. Furthermore, a real case study is investigated in Tehran, the capital of Iran. The results showed that the areas with the highest population density and no facilities near them have been selected for the location of temporary facilities. Among temporary facilities, temporary hospitals can allocate up to 2.6% of the total demand, which puts pressure on the existing hospitals to be removed. Furthermore, the results indicated that the allocation-to-demand ratio can remain at an ideal level when disruptions occur by considering temporary facilities. Our analyses focus on: (1) Examining demand forecasting error and generated scenarios in the first phase, (2) exploring the impact of demand parameters on the allocation-to-demand ratio, total time and total risk, (3) investigating the strategy of utilizing temporary hospitals to address sudden changes in demand, (4) evaluating the effect of disruption to facilities on the supply chain network.

The prevalence and contributing risk factors of coronavirus disease 2019 infection in patients with metabolic syndrome.

BACKGROUND: Components of metabolic syndrome (MetS) was reported to contribute to severe and worse outcomes of coronavirus disease 2019 (COVID-19). Hereby, we evaluated the association of MetS and its components with susceptibility to COVID-19. METHODS: Here, 1000 subjects with MetS were recruited that were diagnosed via the International Diabetes Federation (IDF) criterion. Real-time PCR was exerted to detect SARS-CoV-2 in the nasopharyngeal swabs. RESULTS: Among the MetS patients, 206 (20.6%) cases were detected to have COVID-19. Smoking (OR = 5.04, 95%CI = 3.53-7.21, P < 0.0001) and CVD (OR = 1.62, 95%CI = 1.09-2.40, P = 0.015) were associated with increased chance of COVID-19 infection in the MetS patients. BMI was significantly higher (P = 0.0001) in MetS cases with COVID-19 than those without COVID-19. Obesity was associated with increased susceptibility to COVID-19 in MetS patients (OR = 2.00, 95%CI = 1.47-2.74, P < 0.0001). Total cholesterol, TG, LDL were significantly higher in the MetS cases with COVID-19 than those without COVID-19. Dyslipidemia was associated with increased chance of COVID-19 (OR = 1.50, 95%CI = 1.10-2.05, P = 0.0104). FBS level was significantly higher in the MetS cases with COVID-19. T2DM was associated with increased risk of COVID-19 in MetS patients (OR = 1.43, 95%CI = 1.01-2.00, P = 0.0384). Hypertension was associated with increased chance of COVID-19 in the MetS patients (OR = 1.44, 95%CI = 1.05-1.98, P = 0.0234). CONCLUSIONS: MetS and its components, like obesity, diabetes, dyslipidemia, cardiovascular complications were associated with increased chance of COVID-19 infection development and probably with aggravated symptoms in such patients.

Evaluation of the periodontal disease on oral microorganisms during pregnancy: A systematic review and meta-analysis.

Background and Aim: In the present study, the potential changes of oral microbes during pregnancy were investigated by examining the findings of the previous studies and comprehensively examining their results. The relationship between oral microorganisms and birth outcomes and adverse labor outcomes was investigated; to provide sufficient evidence. The purpose of the present study was to evaluate periodontal disease in oral microorganisms during pregnancy. Materials and Methods: All articles were published between January 2011 and January 2023 in international databases, including PubMed, Scopus, Science Direct, and Embase. To answer the research questions, the Google Scholar search engine employed the PECO strategy. STATA.V17 software was used to analyze the data. Results: Two hundred and eighteen studies were found in the initial search; 63 full texts were reviewed; and finally, 14 articles were included in the analysis. The mean differences in salivary S. mutans carriage before and after prenatal dental treatment were 0.92 (MD; 95 CI [0.57, 1.27], P > 0.05). The odds ratio of association between perinatal mortality and periodontal treatment was -0.88 (OR; 95 CI [-2.53, 0.76], P > 0.05) and the odds ratio of association between pre-term birth and periodontal treatment was -0.31 (OR; 95 CI [-0.70, 0.09], P > 0.05). There was a statistically significant relationship between birth weight and periodontal treatment during pregnancy. Conclusion: According to the present meta-analysis, periodontal treatment can reduce the odds ratio of perinatal mortality and pre-term birth by 88% and 31%, respectively. High association of microorganisms between pregnancy and postpartum requires further study. Relevance for Patients: In the findings of the present study, it is observed that during pregnancy, there is a direct relationship between periodontal disease with low birth weight, perinatal mortality, and pre-term delivery; however, the high association of microorganisms between pregnancy and postpartum requires further study. Oral microforms are reported to be affected in pregnant women, and they should take extra care of their mouth and teeth. Sufficient and strong evidence can help to improve the health outcomes of mothers and children.

Multi-temporal assessment of land surface temperatures as an indicator of land use/cover changes and climate variability in the Develi Basin, Turkey.

Land surface temperature (LST) is an important parameter that reflects land surface processes of water and energy balance and has been used in assessment of land use/cover changes. However, the use of LST in monitoring changes in non-urban areas such as agricultural areas and wetlands is still limited. In this study, we aim to determine the spatial and temporal changes in LST in a semi-arid agricultural basin in Turkey (Develi Basin), where land use/cover and climatic conditions showed considerable variability since 1980s. Irrigated agriculture have expanded in the basin since 1987, after the construction of a large irrigation project. The basin hosts an internationally important wetland, called the Sultan Marshes, affected negatively by irrigation expansion. The study covers a 39-year period from 1984 to 2022. Four Landsat Thematic Mapper (TM) images acquired in 1984, 1987, 2003, and 2007 and two Landsat 8 OLI/TIRS images acquired in 2014 and 2022 were used in the analyses. The land use/cover changes were evaluated based on Normalized Difference Vegetation Index (NDVI). LST was estimated through top-of-atmosphere brightness temperature from thermal bands of Landsat images. Climate variability from 2014 to 2022 was analyzed with statistical methods. The results indicated that Develi Basin faced both spatial and temporal land use/cover changes. The area covered with natural steppe vegetation and water bodies decreased in the basin. In contrast, the sparsely and densely vegetated soil covers, which mostly denote agricultural areas, increased. Changes in LST values were observed from 1984 to 2022 as a result of climatic factors and land use/cover changes. LST changes were variable across different land use/cover types; LST decreased in irrigated areas and increased in lakes that went dry over years. LST changes proved useful for evaluating land use/cover changes and climatic variations in agricultural basins.

Dry needling in a multimodal rehabilitation protocol following rotator cuff repair surgery: study protocol for a double-blinded randomized sham-controlled trial.

BACKGROUND: Rotator cuff tear (RCT) is one of the main causes of shoulder pain and dysfunction. Rotator cuff repair (RCR) is a common surgical procedure for the management of RCTs. Presence of myofascial trigger points (MTrP) as a result of surgical procedure can aggravate postoperative shoulder pain. The purpose of this protocol is to describe a randomized controlled trial design to evaluate the effect of implementing 4 sessions of myofascial trigger point dry needling (MTrP-DN) within a multimodal rehabilitation protocol following RCR surgery. METHODS: Forty-six participants aged 40-75 will be recruited having postoperative shoulder pain after RCR and meeting the inclusion criteria. Participants will be randomly divided into 2 groups: One group will undergo MTrP-DN, manual therapy, exercise therapy and electrotherapy and the other will receive sham dry needling (S-DN), manual therapy, exercise therapy and electrotherapy. This protocol will cover 4 weeks of intervention. The primary outcome measure will be the Numeric Pain Rating Scale (NPRS) for pain. Secondary outcome measures will be Shoulder Pain and Disability Index (SPDI), range of motion (ROM), strength and adverse events. DISCUSSION: This is the first study to investigate the use of 4 sessions of MTrP-DN in combination with a multimodal rehabilitation protocol for postoperative shoulder pain, restriction, weakness and dysfunction following RCR. The results of this study may help to determine the effect of MTrP-DN on various outcomes after RCR surgery. TRIAL REGISTRATION: This trial was registered at the ( https://www.irct.ir ), (IRCT20211005052677N1) on 19/2/2022.

Effect of progressive muscle relaxation as an add-on to pulmonary telerehabilitation in discharged patients with COVID-19: A randomised controlled trial.

BACKGROUND: and purpose: Most patients with coronavirus disease 2019 (COVID-19) experience persistent physical and psychological symptoms. This study aimed to investigate the effects of pulmonary telerehabilitation (PTR) combined with progressive muscle relaxation (PMR) on the physical and psychological outcomes of discharged patients with COVID-19. MATERIALS AND METHODS: This randomised, assessor-blinded, parallel-group study was conducted in hospitals affiliated with Qom University of Medical Sciences between May and October 2021. Discharged COVID-19 patients aged 18-65 years were randomly assigned to two groups of 26 patients each. The experimental group underwent PTR and PMR for six weeks, while the comparison group received PTR alone. Primary (functional capacity) and secondary (dyspnoea, anxiety, depression, fatigue, sleep quality, and quality of life) outcomes were evaluated at baseline and after six weeks. RESULTS: The experimental group showed significantly higher sleep quality (P = 0.001, 95% confidence interval [CI]: 1.20-4.09) and significantly lower fatigue (P = 0.041, 95% CI: 4.79-5.25) and anxiety (P = 0.001, 95% CI: 1.21-4.47) than the comparison group. No between-group differences were observed in terms of other outcomes (P > 0.05). CONCLUSION: PTR coupled with PMR was more effective for promoting sleep quality and alleviating anxiety and fatigue than PTR alone.

Nasopharyngeal epithelial cells from patients with coronavirus disease 2019 express abnormal levels of Toll-like receptors.

Aberrant activation of the immune system has been attributed with etiology and pathogenesis of coronavirus disease 2019 (COVID-19). Here, the transcript levels of toll-like receptors (TLRs) were measured in the nasopharyngeal epithelial cells obtained from COVID-19 patients to assess the involvement of these molecules in the clinical outcome of COVID-19 patients. Nasopharyngeal swab samples were used to obtain epithelial cells from 120 COVID-19 patients and 100 healthy controls. COVID-19 cases were classified into those having clinical symptoms/needing for hospitalization, having clinical symptoms/not needing for hospitalization, and those without clinical symptoms|. The mRNA expression levels of TLRs were measured in the nasopharyngeal epithelial cells. Overall, mRNA expression of TLR1, TLR2, TLR4, and TLR6 was significantly higher in COVID-19 cases compared to controls. The mRNA expression of TLRs were all higher significantly in the samples from COVID-19 patients having clinical symptoms and needing hospitalization as well as in those with clinical symptoms/not needing for hospitalization in comparison to controls. TLR expression was significantly higher in those with clinical symptoms/needing for hospitalization and those with clinical symptoms/not needing for hospitalization compared to COVID-19 cases without clinical symptoms. In cases with clinical symptoms/needing for hospitalization and those with clinical symptoms/not needing for hospitalization, there was a correlation between TLR expression and clinicopathological findings. In conclusion, aberrant expression of TLRs in the nasopharyngeal epithelial cells from COVID-19 cases may predict the severity of the diseases and necessity for supportive cares in the hospital.

Effective machine learning, Meta-heuristic algorithms and multi-criteria decision making to minimizing human resource turnover.

Employee turnover is one of the most important issues in human resource management, which is a combination of soft and hard skills. This makes it difficult for managers to make decisions. In order to make better decisions, this article has been devoted to identifying factors affecting employee turnover using feature selection approaches such as Recursive Feature Elimination algorithm and Mutual Information and Meta-heuristic algorithms such as Gray Wolf Optimizer and Genetic Algorithm. The use of Multi-Criteria Decision-Making techniques is one of the other approaches used to identify the factors affecting the employee turnover in this article. Our expert has used the Best-Worst Method to evaluate each of these variables. In order to check the performance of each of the above methods and to identify the most significant factors on employee turnover, the results are used in some machine learning algorithms to check their accuracy in predicting the employee turnover. These three methods have been implemented on the human resources dataset of a company and the results show that the factors identified by the Mutual Information algorithm can show better results in predicting the employee turnover. Also, the results confirm that managers need a support tool to make decisions because the possibility of making mistakes in their decisions is high. This approach can be used as a decision support tool by managers and help managers and organizations to have a correct insight into the departure of their employees and adopt policies to retain and optimize their employees.

The Effects of Orthodontic Tooth Movement on Clinical Attachment Level Changes in Treated Periodontitis Adult Patients with Malocclusion: A Systematic Review and Meta-analysis

ABSTRACT Objective: To investigate the effects of orthodontic tooth movement on clinical attachment level (CAL) changes in treated periodontitis in adult patients with malocclusion. Material and Methods: Present study is based on PRISMA guidelines; all articles published in international databases such as PubMed, Scopus, Science Direct, and Embase between 2012 to May 2022 are included. 95% confidence interval (CI) for mean difference with fixed effect modal and inverse-variance were calculated. Data analysis was performed using STATA.V16 software. Results: In the initial review, duplicate studies were eliminated, abstracts of 175 studies were reviewed, two authors reviewed the full text of 21 studies, and finally, eleven studies were selected. The mean of CAL gain was 2.29 mm (MD, 95% CI -2.47 mm, -2.12 mm; p=0.00) (I2=91.81%; p=0.00; high heterogeneity). The mean difference of PPD changes was -1.93 mm (MD, 95% CI -2.07 mm, -1.80 mm; p=0.00) (I2=98.52%; p=0.00; high heterogeneity). Conclusion: Due to the limitations of the study and based on the meta-analysis, it is observed that orthodontic treatment is performed with higher success after reconstructive surgery with periodontal improvement.