Multi-Channel Soft Dry Electrodes for Electrocardiography Acquisition in the Ear Region.

In-ear acquisition of physiological signals, such as electromyography (EMG), electrooculography (EOG), electroencephalography (EEG), and electrocardiography (ECG), is a promising approach to mobile health (mHealth) due to its non-invasive and user-friendly nature. By providing a convenient and comfortable means of physiological signal monitoring, in-ear signal acquisition could potentially increase patient compliance and engagement with mHealth applications. The development of reliable and comfortable soft dry in-ear electrode systems could, therefore, have significant implications for both mHealth and human-machine interface (HMI) applications. This research evaluates the quality of the ECG signal obtained with soft dry electrodes inserted in the ear canal. An earplug with six soft dry electrodes distributed around its perimeter was designed for this study, allowing for the analysis of the signal coming from each electrode independently with respect to a common reference placed at different positions on the body of the participants. An analysis of the signals in comparison with a reference signal measured on the upper right chest (RA) and lower left chest (LL) was performed. The results show three typical behaviors for the in-ear electrodes. Some electrodes have a high correlation with the reference signal directly after inserting the earplug, other electrodes need a settling time of typically 1-3 min, and finally, others never have a high correlation. The SoftPulseTM electrodes used in this research have been proven to be perfectly capable of measuring physiological signals, paving the way for their use in mHealth or HMI applications. The use of multiple electrodes distributed in the ear canal has the advantage of allowing a more reliable acquisition by intelligently selecting the signal acquisition locations or allowing a better spatial resolution for certain applications by processing these signals independently.

A preliminary study on heavy metal monitoring in soil and guar (Cyamopsis tetragonoloba) biomass amended with sewage sludge.

Applying sewage sludge in agricultural soils is an interesting source of organic matter. This study aimed to monitor concentrations of heavy elements in soil and guar plants, which can pose a risk to the health of humans and animals if they enter the food chain through the soil-plant system. The experiment revealed that applying sludge increased the amount of organic matter, total nitrogen, potassium, and phosphorus in the soil. Additionally, the concentration of heavy metals such as Pb, Co, Cr, Ni, Cu, and Zn in all treatments remained below the permissible limits for soil. The highest plant height and plant dry weight were recorded in the sludge and sludge + fertilizer treatments. The dry weight of the guar varied from 629 g m-1 in the control treatment to 1050 g m-1 in the sludge + fertilizer plots. The use of sludge increased the accumulation of heavy metals in the above-ground parts of the guar plant compared to the control. However, the level of heavy metal remained within the normal range and below the toxic concentration. Our results also showed that the application of sludge along with fertilizer improved the quality of the guar forage by increasing the levels of crude protein, digestible dry matter and water-soluble carbohydrates. Overall, the results indicated that using sludge as organic fertilizer can improve soil properties, reduce the use of inorganic fertilizers, and decrease the harmful effects of heavy metals on the environment and health in the research area.

Therapeutic benefits of rutin and its nanoformulations.

BACKGROUND: Rutin as a natural flavonoid compound has revealed an extensive range of therapeutic potentials. PURPOSE: The current paper is focused on the numerous studies on rutin nanoformulations regarding its broad spectrum of therapeutic potentials. STUDY AND METHODS: A review was conducted in electronic databases (PubMed) to identify relevant published literature in English. No restrictions on publication date were imposed. RESULTS: The literature search provided 7,078 results for rutin. Among them, 25 papers were related to the potential biological activities of rutin nanoformulations. Polymeric nanoparticles were the most studied nanoformulations for rutin (14 titles) and lipid nanoparticles (5 titles) were in second place. The reviewed literature showed that rutin has been used as an antimicrobial, antifungal, and anti-allergic agent. Improving the bioavailability of rutin using novel drug-delivery methods will help the investigators to use its useful effects in the treatment of various chronic human diseases. CONCLUSION: It can be concluded that the preparation of rutin nanomaterials for the various therapeutic objects confirmed the enhanced aqueous solubility as well as enhanced efficacy compared to conventional delivery of rutin. However, more investigations should be conducted to confirm the improved bioavailability of the rutin nanoformulations.

Effect of trabeculectomy on optic nerve head and macular vessel density: an optical coherence tomography angiography study.

PURPOSE: To investigate the effect of trabeculectomy on peripapillary and macular vessel density (VD) using optical coherence tomography angiography (OCT-A) in patients with primary open-angle glaucoma. METHODS: This is a prospective, interventional study on 32 glaucoma eyes (21 patients) who underwent trabeculectomy. Optic nerve head (ONH) and macular structural and OCT-A scans were performed before surgery and at one and six months postoperatively with the Avanti device (AngioVue System, Optovue Inc., Fremont, CA). The primary outcomes of interest were changes in global and regional peripapillary and macular VD. RESULTS: The average (standard deviation) age and visual field mean deviation of the sample were 58.9(9.9) years and -14.5(9.0) dB, respectively. The average (standard deviation) baseline intraocular pressure significantly decreased from 24.5(10.4) mmHg to 9.6(2.1) mmHg, 6 months after the surgery (P< 0.001). The mean (standard deviation) whole image VD of ONH had increased from 37.6(8.3)% to 40.5(9.1)% at 6 months after the surgery (P = 0.01) while its changes were not significant at month 1 (38.1(9.5)%, P = 0.64). The average of radial peripapillary circle (RPC) VD increased from 36.5(10.3)% to 39.3(10.8)% at 6 months (P = 0.04) compared to 1-month post-trabeculectomy (37.0(11.4)%, P = 0.71). Similar patterns at postoperative months 1 and 6 were also observed in RPC VD at superior and inferior hemifields as well as nasal and temporal quadrants. The observed changes in VD of macular, foveal, peri-, and parafoveal were not significant at superficial or deep slabs at 1 and 6 months after trabeculectomy (all P values > 0.05). CONCLUSION: Our study demonstrated significant improvements in peripapillary vessel density at 6-month following trabeculectomy.

Novel therapeutic strategies for Alzheimer's disease: Implications from cell-based therapy and nanotherapy.

Alzheimer's disease (AD) is a multifactorial neurodegenerative disease which leads to progressive dysfunction of cognition, memory and learning in elderly people. Common therapeutic agents are not only inadequate to suppress the progression of AD pathogenesis but also produce deleterious side effects; hence, development of alternative therapies is required to specifically suppress complications of AD. The current review provides a commentary on conventional as well as novel therapeutic approaches with an emphasis on stem cell and nano-based therapies for improvement and management of AD pathogenesis. According to our overview of the current literature, AD is a multi-factorial disorder with various pathogenic trajectories; hence, a multifunctional strategy to create effective neuroprotective agents is required to treat this disorder.

Visfatin as marker of isolated coronary artery ectasia and its severity.

Several studies have demonstrated the relationship between visfatin and increased risk of diseases caused by inflammation, however, the relationship between visfatin and coronary artery ectasia (CAE) is still unknown. The aim of our study is to investigate the association between serum visfatin with presence of coronary ectasia and its severity. We enrolled 85 individuals including 35 CAE patients (mean age: 58.40 ±â€¯9.82 years) and 50 control persons (mean age: 53.24 ±â€¯8.81 years). These participants underwent some biochemical tests including visfatin, fasting blood glucose and lipid profiles. In univariate analysis, the serum level of visfatin was significantly associated with ectasia in all patients with CAE and CAD coexisting with CAE groups, but a trend toward significance in isolated CAE group. In multivariate analysis, visfatin showed independently significant association with presence of ectasia in all patients with ectasia and in CAD coexisting with ectasia groups, but not significant in isolated CAE group. Visfatin was also independently associated with severity of ectasia according to MARKIS classification. We conclude that visfatin independently can be the useful predictor for the presence and severity of coronary ectasia.

Genetic differentiation between bitter and sweet asafetida plants using ISSR markers.

Bitter (Ferula pseudalliacea) and sweet (Ferula assa-foetida) asafetida (Apiaceae family) are well-known economic and medicinal herbs owing to their gum. This study investigates genetic differentiation of F. pseudalliacea and F. assa-foetida using ISSR markers, to determine the effective primer and to assess the possibility of separating sweet and bitter plant populations from each other. Results showed that among 22 primers, eight markers reproduced obvious DNA patterns and revealed 234 scorable DNA bands. ISSR-16 and ISSR-55 primers had better performance than other primers according to the number of bands, PIC and Marker Index. Bitter population showed polymorphic loci (224), percentage of polymorphic loci (95.73%) and observed number of alleles (1.96 ± 0.2), while sweet populations showed the amount of these parameters as 218, 93.16% and 1.93 ± 0.25, respectively. Estimated Gst of sweet population was 0.09 and Gst of bitter population was 0.06. Comparing gene flow in bitter and sweet populations showed a lower level of gene flow between sweet populations (Nm = 4.93) compared to bitter ones (Nm = 7.89). Within group genetic similarity of sweet asafetida population was higher than between group variation of bitter and sweet populations. The highest similarity was observed between bitter populations (0.95). The highest genetic dissimilarity was also estimated between bitter and sweet populations (0.08). Cluster analysis grouped four studied populations into 13 clusters using Jaccard's similarity coefficient and UPGMA method. Principal coordinate analysis showed that 61.02% of total variance was explained using three components and it could completely separate populations as well as cluster analysis. These grouping correspond nearly with geographical distribution. Analysis of molecular variance showed that genetic variation within populations (87%) was more than among populations (13%). The results indicated that ISSR marker is suitable to investigate genetic diversity of asafetida populations and could separate populations of the same genera with similar germplasm.

Change in Lower Eyelid Position After Ptosis Repair in Patients With Unilateral Myogenic Versus Aponeurotic Blepharoptosis.

PURPOSE: To compare preoperative and postoperative lower eyelid scleral show in patients with unilateral myogenic (MP) and aponeurotic (AP) ptosis, analyze the factors correlated with them, and assess the rate of postoperative lower eyelid symmetry in both groups. METHODS: Patients (older than 5 years old) with unilateral MP (58) and AP (20) were included from June 2015 to April 2017. Excluded were patients with previous eyelid surgery, strabismus, levator function of ≤3, and associated procedures. Margin reflex distance (MRD) 1 and 2 and levator function were measured by the same observer before and at least 6 months after the ptosis repair. RESULTS: Lower scleral show was observed in 56.8% and 80% of MP and AP, respectively. Margin reflex distance 2 was significantly (r = -0.37, p = 0.002) associated with MRD1 in the MP group (multiple regression analysis). Both groups showed a significant improvement of MRD2, postoperatively resulting in symmetric MRD2 in 91.4% of MP and 80% of AP group. It was not changed in 43% of MP and 25% of AP group. Multiple regression analysis showed that preoperative MRD2 was the only significant factor associated with postoperative improvement of scleral show in the MP group. CONCLUSIONS: Lower scleral show was significantly improved after ptosis repair in both MP and AP. The more severe MP was significantly associated with more severe preoperative scleral show. Preoperative MRD2 was the only factor predicting postoperative improvement of scleral show in the MP. No factor was significantly associated with MRD2 in the AP group.

Is primary optic nerve sheath schwannoma a misnomer? Report of two cases and literature review.

Aims: To report clinicopathological characteristics of two patients with optic nerve sheath schwannoma (ONSS) and review the literature. Method: The first patient (22-year-old man) presented with left eye proptosis and decreased vision in 2012 whose orbital imaging showed a large cystic lesion around the optic nerve. The second patient (52-year-old man) presented with decreased vision in the left eye (without proptosis) in the 2006. His imaging showed a small orbital apex lesion between the medial rectus and optic nerve. Both lesions were histopathologically consistent with ONSS. ONSS has previously been reported in 12 patients. Results: Orbital biopsy and subsequently external beam radiotherapy were performed for the first patient who showed a temporary improvement of vision. However, his proptosis progressed and vision decreased to light perception (LP) a few months after radiotherapy when the lesion was resected in April 2013. Second patient declined any procedure until his vision gradually decreased to LP in October 2007. It was then removed through a combined medial and lateral orbitotomy procedure. Both patients ended up with visual acuity of no LP and no recurrence in their last follow up visits in April 2018. No histopathological evidence was found to show that optic nerve sheath could be the origin for presenting and previously reported cases in the literature. Conclusion: Presenting cases and literature review imply that ONSS is a misnomer and all the lesions are different types of orbital schwannomas with optic nerve sheath attachment.

Investigation of synergic effects of nanogroove topography and polyaniline-chitosan nanocomposites on PC12 cell differentiation and axonogenesis.

Axonal damage is the main characteristic of neurodegenerative diseases. This research was focused on remodeling cell morphology and developing a semi-tissue nanoenvironment via mechanobiological stimuli. The combination of nanogroove topography and polyaniline-chitosan enabled the manipulation of the cells by changing the morphology of PC12 cells to spindle shape and inducing the early stage of signal transduction, which is vital for differentiation. The nanosubstarte embedded with nanogooves induced PC12 cells to elongate their morphology and increase their size by 51% as compared with controls. In addition, the use of an electroconductive nanocomposite alongside nanogrooves resulted in the differentiation of PC12 cells into neurons with an average length of 193 ±7 µm for each axon and an average number of seven axons for each neurite. Our results represent a combined tool to initiate a promising future for cell reprogramming by inducing cell differentiation and specific cellular morphology in many cases, including neurodegenerative diseases.

The Best Surgical Treatment for Cervical Radiculopathy: A Systematic Review and Network Meta-Analysis.

A case with an inflamed or damaged nerve root in the cervical spine is defined as cervical radiculopathy.The purpose of the current study is to recognize the most effective surgical procedures in cervical radiculopathy subjects. All related studies were taken using PubMed searching international databases, Scopus, ISI Web of Science (WoS), and Science direct with no limit of until November 20th, 2021. Finally, based on the inclusion and exclusion criteria, after reviewing all randomized controlled trial studies which had the related data the researchers were looking for, they conducted meta-analysis with the seven remaining studies including eight different treatments. Heterogeneity was evaluated by Cochran's Q and Higgins I2 using R software for the network. In the results presented in this study, the neck disability index (NDI) changes as a result of taking cervical anterior discectomy without (ACD) and with fusion (ACDF) and ACD arthroplasty were -0.003, -1.659, and -1.656, respectively. According to the final diagram of the network, 11 comparisons were made in pairs. When each treatment group is compared with ACDF, it is shown that there was a significant mean effect among the patients who receive Mobi-C, Kineflx|C, and ADR, with mean differences of - 8.60 [CI 95% (- 12.75, - 4.45)], - 1.10 [CI 95% (- 5.22, 3.02)], and - 1.00 [CI 95% (- 7.18, 5.18)], respectively. The most effective surgical treatments for cervical radiculopathy were Mobi-c, Kineflx|C, and artificial disc replacement compared to ACDF treatment, respectively.

Cell-Penetrating Peptidic GRP78 Ligand-Conjugated Iron Oxide Magnetic Nanoparticles for Tumor-Targeted Doxorubicin Delivery and Imaging.

Although chemotherapy is regarded as an essential option in cancer treatment, it is still far from being perfect. Inadequate tumor drug concentration and systemic toxicity along with broad biodistribution have diminished the utility of chemotherapy. Tumor-targeting peptide-conjugated multifunctional nanoplatforms have emerged as an effective strategy for site-directed tumor tissues in cancer treatment and imaging. Herein, Pep42-targeted iron oxide magnetic nanoparticles (IONPs) functionalized with ß-cyclodextrin (ßCD) containing doxorubicin (DOX) (Fe3O4-ßCD-Pep42-DOX) were successfully developed. The physical effects of the prepared NPs were characterized by employing various techniques. Transmission electron microscopy (TEM) images disclosed that the developed Fe3O4-ßCD-Pep42-DOX nanoplatforms had a spherical morphology and a core-shell structure with a size of nearly 17 nm. Fourier transform infrared (FT-IR) spectroscopy showed that ß-cyclodextrin, DOX, and Pep42 molecules were successfully loaded on the IONPs. In vitro cytotoxicity analysis revealed that the fabricated multifunctional Fe3O4-ßCD-Pep42 nanoplatforms possessed excellent biosafety toward BT-474, MDA-MB468 (cancerous cells), and MCF10A normal cells, while Fe3O4-ßCD-Pep42-DOX exhibited great cancer cell killing ability. The high cellular uptake along with intracellular trafficking of Fe3O4-ßCD-Pep42-DOX highlights the usefulness of the Pep42-targeting peptide. In vivo results strongly supported the in vitro results, i.e., significant tumor size reduction was observed by single-dose injection of Fe3O4-ßCD-Pep42-DOX into tumor-bearing mice. Interestingly, in vivo MR imaging (MRI) of Fe3O4-ßCD-Pep42-DOX revealed T2 contrast improvement in the tumor cells and therapeutic ability in cancer theranostics. Taken together, these findings provided strong evidence for the potential capability of Fe3O4-ßCD-Pep42-DOX as a multifunctional nanoplatform in cancer therapy and imaging and opens up a new avenue of research in this area.

Mesoporous Starch Cryoaerogel Material as an Emerging Platform for Oral Drug Delivery: Synthesis and In Vitro Evaluation.

In this study, a starch cryoaerogel formulation was developed as a carrier for poorly water-soluble drugs, like atorvastatin. Cryoaerogels were generated through a sol-gel method combined with a freeze-drying technique, and atorvastatin was incorporated into the obtained mesoporous systems during the solvent exchange stage. The formulated drug-loaded polymer structures were characterized in terms of their physicochemical properties, solid-state behavior, and cytotoxicity. They had a pore size of 27.56 nm and a drug loading size of 38.60%. Fourier transform infrared (FTIR) and scanning electron microscopy (SEM) analyses indicated that atorvastatin was successfully incorporated into the cryoaerogel pores. The amorphous nature of the loaded drug was confirmed via X-ray diffraction (XRD). Furthermore, after the atorvastatin incorporation into the cryogel, the volume of nitrogen adsorbed on one gram of cryoaerogel (Vm), as well as the specific surface area (aBET) were reduced. The comparison between the drug release profiles of crystalline atorvastatin and the loaded formulation of atorvastatin showed that by including the drug into the pores of the developed cryoaerogel matrix its solubility was significantly improved-the time for the dissolution of 30% pure atorvastatin (t30%) was approximately 4 h, whereas the determined t30% for the formulated cryoaerogels was only 1 h. Moreover, the data from the MTT assay illustrated that the designed cryoaerogel could be used as a safe oral atorvastatin delivery system. According to obtained results, it could be concluded that the starch cryoaerogel formulation is a promising candidate for oral delivery of poorly water-soluble therapeutic agents.

Design, optimization and characterization of a novel antibacterial chitosan-based hydrogel dressing for promoting blood coagulation and full-thickness wound healing: A biochemical and biophysical study.

The use of hydrogel dressings has become increasingly popular as a scaffold for skin tissue engineering. Herein, we have developed an innovative wound dressing using chitosan, fibrinogen, nisin, and EDTA as an effective antibacterial scaffold for wound treatment. The structural and functional characteristics of the hydrogel, including morphology, mechanical strength, drug encapsulation and release, swelling behaviors, blood coagulation, cytotoxicity, and antibacterial activity, were studied. Spectroscopic studies indicated that the attachment of chitosan to fibrinogen is associated with minimal change in its secondary structure; subsequently, at higher temperatures, it is expected to preserve fibrinogen's conformational stability. Mechanical and blood coagulation analyses indicated that the incorporation of fibrinogen into the hydrogel resulted in accelerated clotting and enhanced mechanical properties. Our cell studies showed biocompatibility and non-toxicity of the hydrogel along with the promotion of cell migration. In addition, the prepared hydrogel indicated an antibacterial behavior against both Gram-positive and Gram-negative bacteria. Interestingly, the in vivo data revealed enhanced tissue regeneration and recovery within 17 days in the studied animals. Taken together, the results obtained from in vitro and histological assessments indicate that this innovatively designed hydrogel shows good potential as a candidate for wound healing.

Early Macular Thickness Changes after Trabeculectomy and Combined Phaco-Trabeculectomy.

Purpose: To assess postoperative changes in central retinal thickness (RT) following trabeculectomy and combined phaco-trabeculectomy using spectral domain-optical coherence tomography. Methods: In a prospective interventional comparative study, 64 consecutive glaucoma patients who underwent trabeculectomy (32 eyes) or phaco-trabeculectomy (32 eyes) were included. A macular thickness map using the Early Treatment Diabetic Retinopathy Study circles of 1 mm, 3 mm, and 6 mm was the standard to evaluate the 9-subfield thickness preoperatively and again at 1 and 3 months after surgery. Four subfields in each of the 3 mm and 6 mm rings were considered parafoveal and perifoveal regions, respectively. Results: Preoperative measurements were similar in the two groups, except patients in the combined group which were older (P = 0.002). The mean RT in the combined phaco-trabeculectomy group at month 1 was significantly higher than baseline measurements at central subfield retinal thickness (CSRT) (P = 0.01), temporal (P = 0.001), and inferior (P = 0.04) parafoveal and temporal (P = 0.01), superior (P = 0.02), and nasal (P < 0.001) perifoveal quadrants; however, RT changes in the trabeculectomy-only group were not statistically significant at months 1 and 3 (P > 0.05). The increase in the temporal perifoveal RT of the combined phaco-trabeculectomy group persisted at month 3 (P = 0.01), while the RT in other sectors returned to preoperative values. The two treatment groups did not differ in terms of changes in the CSRT over time (P = 0.37). In addition, no difference was observed between the treatment groups regarding the parafoveal RTs at each time points (0.06 ≤ P ≤ 0.29). Conclusions: There was no significant difference in the pattern of changes of CSRT and parafoveal RT between trabeculectomy and combined phaco-trabeculectomy treatment groups up to 3 months after surgery. Some detectable increase in RT in the combined phaco-trabeculectomy will reverse to baseline values 3 months after surgery, except in the temporal perifoveal region.

Designing a new alginate-fibrinogen biomaterial composite hydrogel for wound healing.

Wound healing is a complex process and rapid healing necessitates a proper micro-environment. Therefore, design and fabrication of an efficacious wound dressing is an impressive innovation in the field of wound healing. The fabricated wound dressing in this scenario was designed using a combination of the appropriate coagulating and anti-bacterial materials like fibrinogen (as coagulating agent), nisin (as anti-bacterial agent), ethylenediaminetetraacetic acid (as anti-bacterial agent), and alginate (as wound healing agent). Biophysical characterization showed that the interaction of fibrinogen and alginate was associated with minor changes in the secondary structure of the protein. Conformational studies showed that the protein was structurally stable at 42 °C, is the maximum temperature of the infected wound. The properties of the hydrogel such as swelling, mechanical resistance, nisin release, antibacterial activity, cytotoxicity, gel porosity, and blood coagulation were assessed. The results showed a slow release for the nisin during 48 h. Antibacterial studies showed an inhibitory effect on the growth of Gram-negative and Gram-positive bacteria. The hydrogel was also capable to absorb a considerable amount of water and provide oxygenation as well as incorporation of the drug into its structure due to its sufficient porosity. Scanning electron microscopy showed pore sizes of about 14-198 µm in the hydrogel. Cell viability studies indicated high biocompatibility of the hydrogel. Blood coagulation test also confirmed the effectiveness of the synthesized hydrogel in accelerating the process of blood clot formation. In vivo studies showed higher rates of wound healing, re-epithelialization, and collagen deposition. According to the findings from in vitro as well as in vivo studies, the designed hydrogel can be considered as a novel attractive wound dressing after further prerequisite assessments.

Immunoengineering Biomaterials in Cell-Based Therapy for Type 1 Diabetes.

Type 1 diabetes (T1D) is caused by low insulin production and chronic hyperglycemia due to destruction of pancreatic ß-cells. Cell transplantation is an attractive alternative approach compared to insulin injection. However, cell therapy has been limited by major challenges, including life-long requirement for immunosuppressive drugs to prevent host immune responses. Encapsulation of the transplanted cells can solve the problem of immune rejection, by providing a physical barrier between the transplanted cells and the recipient's immune cells. Despite current disputes in cell encapsulation approaches, thanks to recent advances in the fields of biomaterials and transplantation immunology, extensive effort has been dedicated to immunoengineering strategies, in combination with encapsulation technologies, to overcome the problem of host's immune responses. This review summarizes the most commonly used encapsulation and immunoengineering strategies combined with cell therapy, which have been applied as a novel approach to improve cell replacement therapies for management of T1D. Recent advances in the fields of biomaterial design, nanotechnology, as well as deeper knowledge about immune modulation had significantly improved cell encapsulation strategies. However, further progress requires combined application of novel immunoengineering approaches and islet/ß-cell transplantation. Impact statement Cell encapsulation shows promising potential in preventing host's immune responses and rejection of islets or ß-cells by providing a selectively permeable barrier between the host and the transplanted cells. Innovative materials, conformal nanocoatings, and immunomodulation have provided promising approaches in the field of encapsulation technology. Novel nanocarriers have been synthesized to release and deliver immunosuppressive agents to islets/ß-cells within the capsules in a controlled manner. The immunoengineering approach (immunosuppressive and immunomodulatory agents) could overcome the challenges of cell replacement therapy in type 1 diabetes.

The Factors Determining the Skin Penetration and Cellular Uptake of Nanocarriers: New Hope for Clinical Development.

The skin provides a protective barrier against toxic environments and also offers a valuable route for topical drug delivery. The stratum corneum (SC) is the outermost layer of the skin and serves as the major barrier to chemical transfer through the skin. The human skin barrier is particularly difficult to overcome because of the complex composition and structure of the SC. Nanoparticulate carriers have gained widespread attention in topical drug delivery due to their tunable and versatile properties. The present review summarizes the main factors involved in skin penetration of nanocarriers containing the drug. Employment of nanotechnology in topical delivery has grown progressively during recent years; however, it is important to monitor the skin penetration of nanocarriers prior to their use to avoid possible toxic effects. Nanocarriers can act as a means to increase skin permeation of drugs by supporting direct interaction with the SC and increasing the period of permanence on the skin. Skin penetration is influenced by the physicochemical characteristics of nanocarriers such as composition, size, shape, surface chemistry, as well as skin features. Considering that the target of topical systems based on nanocarriers is the penetration of therapeutic agents in the skin layers, so a detailed understanding of the factors influencing skin permeability of nanocarriers is essential for safe and efficient therapeutic applications.

Ocular biometric changes after Ahmed glaucoma valve implantation.

PURPOSE: To investigate the ocular biometric changes after uneventful Ahmed glaucoma valve implantation. METHODS: Patients with refractory glaucoma who were candidate for Ahmed valve surgery were prospectively included in this study. Patients with a history of any kinds of corneal surgery were excluded. Refractive status, intraocular pressure, axial length, anterior chamber parameters including anterior and posterior mean keratometry, central corneal thicknesses, and anterior chamber depth, anterior chamber volume, and anterior chamber angle were evaluated at baseline and 1 and 3 months after surgery. RESULTS: A total of 20 eyes from 20 patients were included. Mean intraocular pressure at baseline was 33.4 ± 12.3 mm Hg that significantly decreased to 14.6 ± 6.2 mm Hg at 1 month and 13.5 ± 4.3 mm Hg at 3 months after Ahmed glaucoma valve implantation (p < 0.001). Mean number of medications was 3.6 ± 1.3 at baseline which significantly decreased to 1.0 ± 1.3 at 3 months after Ahmed glaucoma valve implantation (p < 0.001). Axial length decreased significantly from 23.69 ± 1.95 to 23.47 ± 1.91 mm (p < 0.001) at month 3. There were no significant changes in other parameters such as mean spherical equivalent, anterior chamber volume, anterior chamber angle, anterior chamber depth, and keratometry at the end of month 3 after surgery (p > 0.05 in all). CONCLUSION: Ahmed glaucoma valve implantation had a significant effect on axial length at 3 months after surgery but its effect on keratometry and other anterior chamber parameters was not significant.

The best drug supplement for obesity treatment: a systematic review and network meta-analysis.

BACKGROUND: Obesity is a complex disease with an increasing prevalence worldwide. There are different weight-management options for obesity treatment, including dietary control, exercise, surgery, and medication. Medications are always associated with different responses from different people. More safety and efficacy of drugs with fewer side effects are valuable for any clinical condition. In this systematic review and network meta-analysis, different anti-obesity drugs are compared to identify the most effective drug. METHODS: All relevant studies were extracted by searching national and international databases of SID, MagIran, ProQuest, PubMed, Science Direct, Scopus, Web of Science (WoS), and Google Scholar without time limit until October 2020. Finally, the meta-analysis was performed with the 11 remaining studies containing 14 different drug supplements. The standardized mean difference (SMD) was calculated at a 95% confidence interval (CI) to evaluate the effects of each treatment group compared with placebo. A random-effect model was used to evaluate the effect of individual studies on the final result. Heterogeneity and incompatibility of the network were assessed by Cochran's Q and Higgins I2, and the Net Heat chart, respectively. Data analysis was performed using R software. RESULTS: Our results showed that there were significant mean effects in people intervened with Phentermine 15.0 mg + Topiramate 92.0 mg, Phentermine 7.5 mg + Topiramate 46.0 mg, Pramlintide, Naltrexone + Bupropion 32, and Liraglutide, with SMD effects size = - 9.1, - 7.4, - 6.5, - 5.9, - 5.35, respectively. CONCLUSION: This study was performed to compare the effect of different drugs used for weight loss in obese patients. The most effective drugs for weight loss were phentermine and topiramate, pramlintide, naltrexone, bupropion, and liraglutide compared to placebo treatment, respectively. This study provides new insights into anti-obesity drugs and hopes to shed new light on future research to manage and treat obesity.