Detection of receptor tyrosine kinase-orphan receptor-2 using an electrochemical immunosensor modified with electrospun nanofibers comprising polyvinylpyrrolidone, soy, and gold nanoparticles.

An electrochemical immunosensing platform was developed for the detection of receptor tyrosine kinase-orphan receptor-2 (ROR2) at a glassy carbon electrode (GCE) modified with the electrospun nanofiber containing polyvinylpyrrolidone (PVP), soy, and Au nanoparticles (AuNPs). The PVP/soy/AuNP nanofiber exhibited good electrochemical behavior due to synergistic effects between PVP, soy, and AuNPs. The PVP/soy in the modified film provided good mechanical strength, high porosity, flexible structures, and high specific surface area. On the other hand, the presence of AuNPs effectively improved conductivity, as well as the immobilization of anti-ROR2 on the modified GCE, leading to enhanced sensitivity. Various characterization approaches such as FE-SEM, FTIR, and EDS were used for investigating the morphological and structural features, and the elemental composition. The designed immunosensor performance was investigated using electrochemical impedance spectroscopy (EIS), cyclic voltammetry (CV), and differential pulse voltammetry (DPV). Under optimum conditions with a working potential range from -0.2 to 0.6 V (vs. SCE), sensitivity, linear range (LR), limit of detection (LOD), and correlation coefficient (R2) were acquired at 122.26 µA/cm2 dec, 0.01-1000 pg/mL, 3.39 fg/mL, and 0.9974, respectively. Furthermore, the determination of ROR2 in human plasma samples using the designed immunosensing platform was examined and exhibited satisfactory results including good selectivity against other proteins, reproducibility, and cyclic stability.

Evaluation of Hydatid Cyst Antigen for Serological Diagnosis.

Background: Hydatidosis, a chronic zoonotic disease, has a distribution worldwide and is caused by the larval stage of the Echinococcus helminth. The Dot-ELISA test can diagnose hydatidosis quickly and accurately. Additionally, unlike other hydatid disease tests now used, this quick and affordable enzyme immunoassay is very serum-conservative and antigen-conservative, needing just nanogram levels of parasite antigen. Methods: In the present cross-sectional study, crude and B antigens of hydatid cyst fluid were obtained to diagnose human hydatidosis using CIEP (Counter Immunoelectrophoresis), ELISA (Enzyme-linked Immuno Sorbent assay), and Dot- ELISA (Dot Enzyme linked Immuno Sorbent Assay) methods. Infected liver with a hydatid cyst was collected from Tehran's slaughterhouses to prepare cyst fluid in different stages. After extracting and purifying the Cyst fluid, it is centrifuged at 4ºc, then prepared to concentrate. The study also included sera from hydatidosis (n=60), samples of helminth parasites (n=55), fascioliasis (n=35), toxocariasis (n=20) and negative control (n=35) were tested by CIEP (Counter Immunoelectrophoresis), ELISA (Enzyme-linked Immune Sorbent assay), and Dot- ELISA (Dot Enzyme linked Immuno Sorbent Assay) methods. All statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) for Windows release 25.0 (SPSS Inc., Chicago, IL, USA). Results: Crude antigen of hydatid cyst showed a specificity of 76.7%, a sensitivity of 93.3% using the ELISA method, and B antigen showed a specificity of 96.7% and sensitivity of 88.3% using the same method. The crude antigen of the hydatid cyst exhibited a specificity of 68.9% and a sensitivity of 86.7% using CIEP. The B antigen showed a specificity of 87.8% and sensitivity of 83.3% using the same method.The crude antigen of hydatid cyst having serum dilution at 1:800 exhibited a specificity of 83.3% and sensitivity of 100% using the Dot-ELISA method and B antigen having serum dilution at 1:800 serum showed a specificity of 100% and sensitivity of 98.3% using the same method. The results of this finding showed that B antigen has the maximum specificity to diagnose hydatid test using the Dot- ELISA method. Conclusion: Hydatid cysts present with varied symptomatology. History of exposure to infected animals may not be present. A high degree of clinical suspicion combined with meticulous history and clinical examination supported by laboratory investigations are required for its diagnosis. The Dot-ELISA system with native antigen B is a viable approach for the immunodiagnosis of human hydatidosis that is preferred to infection.

Efficient and specific bioaccumulation of arsenic in the transgenic Escherichia coli expressing ArsR1 from Corynebacterium glutamicum.

The toxic nature of arsenic has left a trail of disastrous health consequences around the world. Microorganisms have developed various strategies to deal with arsenic. The presence of plasmid and chromosomal ars operons is one of the most important mechanisms for the detoxification of arsenic in bacteria. ArsR is a trans-acting regulatory protein and acts as a repressor on ars operon. The gene encoding ArsR from Corynebacterium glutamicum (CgArsR1) was cloned in expression vectors pET28a. The resulting constructs were transformed into Escherichia coli strains Rosetta (DE3) and Rosetta gami 2. Following the induction with Isopropyl ß-D-1-thiogalactopyranoside, the protein His-CgArsR1 was found in the soluble fraction of strain Rg-CgArsR1. For comparison, ArsR from E. coli was also overexpressed in E. coli (strain Rosetta gami 2) as His-EcArsR. A strain containing empty vector pET28a was also used as a control strain. In the medium containing either arsenite (0.5 mM) or arsenate (0.5 mM), the strain Rg-CgArsR1 and Rg-EcArsR were able to accumulate 1200 and 700 µg/g DCW As3+, respectively. In comparison, the accumulation of As5+ in these strains was 338 and 232 µg/g DCW, respectively. Whereas both strains Rg-CgArsR1 and Rg-EcArsR were able to accumulate higher amounts of As3+ and As5+ with respect to control strain, the accumulation of arsenic in the strain Rg-CgArsR1 was significantly more efficient than strain Rg-EcArsR for removing As3+ and As5+. Based on the results the gene encoding CgArsR1 is a useful and efficient target gene for the modification of bacteria for bioremediation of arsenic from polluted soil and water.

Effect of Field of View on Detection of Condyle Bone Defects Using Cone Beam Computed Tomography.

In maxillofacial imaging, cone beam computed tomography (CBCT) is currently the modality of choice for assessment of bony structures of the temporomandibular joint (TMJ). Factors affecting the quality of CBCT images can change its diagnostic accuracy. This study aimed to assess the effect of field of view (FOV) and defect size on the accuracy of CBCT scans for detection of bone defects of the TMJs. This study was conducted on 12 sound TMJs of 6 human dry skulls. Erosions and osteophytes were artificially induced in 0.5, 1, and 1.5-mm sizes on the anterior-superior part of the condyle; CBCT scans were obtained with 6, 9, and 12-inch FOVs by NewTom 3G CBCT system. Two maxillofacial radiologists evaluated the presence/absence and type of defects on CBCT scans. The Cohen kappa was calculated to assess intra- and interobserver reliability. The Mann-Whitney U test was applied to compare the diagnostic accuracy of different FOVs.In comparison of 6- and 12-inch, 9- and 12-inch FOVs in detection of different sizes of erosive lesions, difference was significant (P <0.05), whereas difference between 6- and 9 inch just in 0.5-mm erosive lesion was significant (P = 0.04). In comparison of 6- and 12-inch FOVs in detection of different sizes of osteophyte lesion, difference was significant (P < 0.05), whereas between 6- and 9-inch FOVs statistically significant difference was not observed (P > 0.05). The highest and the lowest diagnostic accuracy of CBCT scans for condyle defects were obtained with 6-inch and 12-inch FOVs, respectively. Diagnostic accuracy of CBCT scans increased with an increase in size of bone defects.

Electrospun EU/HPMC nanofibers decorated by ZIF-8 nanoparticle as the advanced electrochemical biosensor modifier for sensitive and selective detection of c-MET cancer biomarker in human plasma sample.

This research presents a selective and sensitive electrochemical biosensor for the detection of the mesenchymal-epithelial transition factor (c-MET). The biosensing is based on a modification of the SPCE (screen-printed carbon electrode) with the electrospun nanofiber containing eudragit (EU), hydroxypropyl methylcellulose (HPMC), and Zeolite imidazolate frameworks (ZIF-8) nanoparticles. EU/HPMC/ZIF-8 nanofibers have presented a high capability of electron transfer, and more active surface area than bare SPCE due to synergistic effects between EU, HPMC, and ZIF-8. On the other hand, EU/HPMC nanofibers provided high porosity, flexible structures, high specific surface area, and good mechanical strength. The presence of ZIF-8 nanoparticles improved the immobilization of anti-c-MET on the modified SPCE and also resulted in increasing the conductivity. By c-MET incubation on the modified SPCE, c-MET was connected to anti-c-MET, and consequently the electrochemical signal of [Fe(CN)6]3-/4- as the anion redox probe was reduced. In order to investigate the structural and morphological characteristics and elemental composition of electrospun nanofibers, various characterization methods including FE-SEM, XRD, FTIR, and EDS were used. Under optimum conditions with a working potential range -0.3-0.6 V (vs. Ag/AgCl), linear range (LR), correlation coefficient (R2), sensitivity, and limit of detection (LOD) were acquired at 100 fg/mL-100 ng/mL, 0.9985, 53.28 µA/cm2.dec, and 1.28 fg/mL, respectively. Moreover, the mentioned biosensor was investigated in a human plasma sample to determine c-MET and showed ideal results including reproducibility, stability, and good selectivity against other proteins.

Antimalarial Effects of Nano Chloroquine Loaded Curcumin In vivo.

BACKGROUND: Malaria is still the deadliest parasitic disease caused by Plasmodium spp. Due to drug resistance and their unpleasant side effects, of conventional researchers are enormously seeking to achieve antimalarial drugs with more curative effective, less toxic and cost-affordable drugs using more advanced technology such as nanodrugs. PURPOSE: The present study aimed to examine the antimalarial effects of a novel synthesized nonochloroquine-loaded curcumin relying on dendrimer G2 in susceptible mice. METHODS: Antimalarial activity and toxicity of the nanocomposite were examined on BALB/C mice with microscopy, checking RBCs morphology and related enzymatic activity rate. RESULTS: The maximum inhibitory effect of the nanocomposite was seen at 10 mg/kg, killing 98% of P. berghei compared to sole chloroquine, whereas ED50 was reported at 5.5 mg/kg. The safety of the synthesized nanocomposite was confirmed with biochemical tests with no detrimental effects on mice. The sustainability and longevity of the nanodrug increased significantly with the NDC-CQ assay compared to the control groups. CONCLUSION: The study showed that nonochloroquine-loaded curcumin had a promising inhibitory effect on P. berghei growth in infected mice compared to standard drugs. However, further studies and clinical trials with large samples are recommended to study different aspects of using nanodrug.

Tannic acid-reinforced soy protein/oxidized tragacanth gum-based multifunctional hemostatic film for regulation of wound healing.

With recent advances in the field of tissue engineering, composite films with biocompatibility, antimicrobial properties, and wound healing properties have gained potential applications in the field of wound dressings. In this research work, composite films of soy protein (S)/oxidized tragacanth gum (G) were successfully made using the solution casting process. The metal-organic framework containing curcumin (MOF) with concentrations of 5 and 10 wt% and tannic acid (TA) with concentrations of 6 and 12 wt% were entered into the polymer film. Surface morphology with scanning electron microscope (FE-SEM), thermal stability, mechanical properties, chemical structure, antioxidant, water absorption, cell viability, antibacterial activity, and biodegradability of the prepared films were investigated in laboratory conditions. In addition, the toxicity of the films in the cell environment was investigated, and the results showed that cell growth and proliferation improved in the presence of the prepared films, especially films SG/MOF10/TA6 and SG/MOF10/TA12 due to the presence of TA and MOF containing curcumin. Also, the antibacterial activity of the films showed that the presence of tannic acid and curcumin in the structure of the films increases their ability against pathogens. According to the obtained results, the newly produced nanocomposite film (SG/MOF10/TA12) has a high potential to be used for wound dressing due to its favorable characteristics and was considered the optimal film.

Label-free electrochemical immunosensor for detection of insulin-like growth factor-1 (IGF-1) using a specific monoclonal receptor on electrospun Zein-based nanofibers/rGO-modified electrode.

A novel electrochemical immunosensor was developed for ultrasensitive determination of the hormone insulin-like growth factor 1 (IGF-1) based on immobilization of a specific monoclonal antibody on the electrospun nanofibers of Polyacrylonitrile (PAN)/Zein-reduced graphene oxide (rGO) nanoparticle. The nanofibers deposited on glassy carbon electrode (GCE) showed good electrochemical behaviors with synergistic effects between PAN, Zein, and rGO. PAN/Zein nanofibers were used due to flexibility, high porosity, good mechanical strength, high specific surface area, and flexible structures, while rGO nanoparticles were used to improve the detection sensitivity and anti-IGF-1 immobilizing. Different characterization techniques were applied consisting of FE-SEM, FT-IR, and EDS for the investigation of morphological features and nanofiber size. The redox reactions of [Fe(CN)6]4-/3- on the modified electrode surface were probed for studying the immobilization and determination processes, using differential pulse voltammetry (DPV) and cyclic voltammetry (CV). Under optimal conditions, LOD (limit of detection) and LOQ (limit of quantification) were obtained as 55.72 fg/mL and 185.73 fg/mL respectively, and sensitivity was acquired 136.29 µA/cm2.dec. Moreover, a wide linear range was obtained ranging from 1 pg/mL to 10 ng/mL for IGF-1. Furthermore, the proposed method was applied for the analysis of IGF-1 in several human plasma samples with acceptable results, and it also exhibited high selectivity, stability, and reproducibility.

Home health care of Iranian elderly with dementia: Study protocol for guideline adaptation.

BACKGROUND: Advanced stages of dementia interfere with elderly self-care. Consequently, they need caregivers who take responsibility for their care in the long-term. Restrictions to the caregiver's access to information, resources, and organizational support have created problems in their caregiver role, which is why the World Health Organization (WHO) emphasizes caring for caregivers by providing evidence-based information and training programs. As there is no clinical practice guideline for home care in the Islamic Republic of Iran, this study aims to develop a home health care guideline for the elderly with dementia. MATERIALS AND METHODS: The ADAPTE process provided by the Guidelines International Network was considered as the basis. In order to identify the care needs of Iranian patients with dementia, semi-structured interviews were added to this guideline. DISCUSSION: The identification and implementation of the perspectives of patients and caregivers during the process of guidelines adaptation increase the applicability of the guidelines. Improved quality of life for the patients in their place of residence is one of the expected consequences of this guideline's implementation. The developed guidelines will be used at home health care centers, and dementia and Alzheimer's associations in Iran.

Electrochemical-Based Sensing Platforms for Detection of Glucose and H2O2 by Porous Metal-Organic Frameworks: A Review of Status and Prospects.

Establishing enzyme-free sensing assays with great selectivity and sensitivity for glucose and H2O2 detection has been highly required in biological science. In particular, the exploitation of nanomaterials by using noble metals of high conductivity and surface area has been widely investigated to act as selective catalytic agents for molecular recognition in sensing platforms. Several approaches for a straightforward, speedy, selective, and sensitive recognition of glucose and H2O2 were requested. This paper reviews the current progress in electrochemical detection using metal-organic frameworks (MOFs) for H2O2 and glucose recognition. We have reviewed the latest electrochemical sensing assays for in-place detection with priorities including straightforward procedure and manipulation, high sensitivity, varied linear range, and economic prospects. The mentioned sensing assays apply electrochemical systems through a rapid detection time that enables real-time recognition. In profitable fields, the obstacles that have been associated with sample preparation and tool expense can be solved by applying these sensing means. Some parameters, including the impedance, intensity, and potential difference measurement methods have permitted low limit of detections (LODs) and noticeable durations in agricultural, water, and foodstuff samples with high levels of glucose and H2O2.

Investigating the Anti-tumor and Apoptosis-inducing Effects of Coumarin Derivatives as Potent 15-Lipoxygenase Inhibitors on PC-3 Prostate Cancer Cells.

INTRODUCTION: Prostate cancer is the second most prevalent cancer among men. Despite different treatments, including surgery, chemotherapy, radiation therapy, hormone therapy and immunotherapy for this disease, patients ultimately progress to advanced states. Thus, there is a need for new treatment options targeting cell growth and apoptosis to better control the proliferation and metastasis of these cells. There are many reports indicating overexpression of the 15-lipoxygenase-1 (15-LOX-1) enzyme in prostate tumors. Studies have also shown that inhibition of this enzyme prevents the progression of prostate cancer. OBJECTIVE: This study was conducted to assess the anti-cancer properties of some coumarin derivatives as possible 15- LOX-1 inhibitors, on PC-3 prostate cancer cells. METHODS: In this study, the activity of 15-LOX-1 was evaluated in PC-3 cells by a spectrophotometric assay. In addition, due to high similarity between the 15-LOX-1 and soybean 15-lipoxygenase (SLO) (L1; EC 1, 13, 11, 12) active sites, the soybean SLO was used to investigate inhibitory effects of synthetic coumarin compounds 8- isopentenyloxycoumarin (8-IC), 8-isopentenyloxy-3-carboxycoumarin (8-ICC), 8-geranyloxycoumarin (8-GC), 8- geranyloxy-3-carboxycoumarin (8-GCC), and 8-farnesyloxy-3-carboxycoumarin (8-FCC) on this enzyme. Moreover, the cytotoxic and anticancer effects of the coumarin compounds were examined on PC-3 (Prostate Cancer) and HDF-1 (Human Dermal Fibroblast) cells by alamarBlue assay. Finally, apoptosis-inducing effects of all synthetic compounds were determined by flow cytometry. RESULTS: The IC50 values obtained by the alamarBlue test revealed that 8-IC, 8-GC and 8-GCC had cytotoxic effects on PC-3 cells. Treating both PC-3 and HDF-1 cells with 8-ICC and 8-FCC did not significantly reduce cell number. Furthermore, the IC50 values of 8-IC on HDF-1 cells showed cytotoxic effects, while treating these cells with 8-GC and 8- GCC did not show any significant cytotoxicity on these normal human fibroblasts. Assessing the ability of 4-MMPB (as a specific inhibitor of 15-LOX-1), 8-GC, and 8-GCC compounds to inhibit SLO revealed that these compounds exerted strong 15-LOX-1 inhibitory activity, while 8-IC and 8-FCC had a weak inhibitory effect and also 8-ICC showed no inhibitory effect on SLO enzyme. In addition, flow cytometric analysis by FITC (fluorescein isothiocyanate)- annexin V and propidium iodide showed that treatment with IC50 values of 8-GC and 8-GCC induced apoptosis in 35.2% and 30.8% of PC-3 cells, respectively. CONCLUSION: Thus, 8-GC and 8-GCC can be introduced as effective anticancer agents with apoptosis-inducing properties. Furthermore, our results suggest that the cytotoxic effects of these compounds might be related to the inhibition of 15-LOX-1 enzyme in PC-3 cells. On the other hand, the cytotoxic effects of 8-IC might be due to the inhibition of other signaling pathways in PC-3 cells. However, further in vivo experiments are required to determine the exact mechanisms involved in the anticancer effects of these coumarin compounds.

Rhinocerebral Mucormycosis Following COVID-19 Infection in Iran.

Background & Objective: Mucormycosis (also called black fungus) is an opportunistic serious fungal infection caused by mucormycetes. It can occur in diabetes mellitus patients and other immunosuppressive conditions with recent predisposing factors such as maxillofacial surgery and corticosteroid usage. Methods: In this study, 14 patients were referred to the otorhinolaryngology or ophthalmology ward of Shafa Hospital (Kerman, Iran) with primary symptoms of nasal fullness and facial nerve dysfunction; they were admitted to the hospital to rule out the fungal infection. An endoscopic biopsy was taken from facial sinuses or orbit, and a microscopic evaluation was performed using hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) staining methods to rule out mucormycosis. Results: In the histopathological examination, broad-based nonseptate branching fungal hyphae were found in nasal sinuses through the endoscopic biopsy. Most of the patients had diabetes mellitus with a primary symptom of facial nerve palsy; also, most of them received corticosteroids (intravenous [IV] or intramuscular [IM] injection). All patients have recently been infected with COVID-19 (less than 1 month ago). Conclusion: COVID-19 infection might be a predisposing factor for many opportunistic infections, such as fungal elements); thus, the physician should be aware of the dosage and duration of corticosteroid therapy to prevent the development of these infections.

Utilization of Continuous Positive Airway Pressure (CPAP) by Emergency Medical Services: Updated Systematic Review and Meta-analysis.

BACKGROUND: While new studies are being published on the prehospital continuous positive airway pressure (CPAP) application in patients with respiratory failure with conflicting results, previous meta-analyses are showing the benefits of CPAP in the prehospital transfer of patients with respiratory distress. Before the clinical application of high-level evidence, updated pooled estimates are needed based on the growing literature. This study aimed to compare prehospital CPAP with the usual standard oxygen therapy of respiratory failure patients. MATERIALS AND METHODS: PRISMA guidelines served as the framework for this updated review study. It is an extension of a prior systematic review. We conducted comprehensive searches across several databases, including PubMed, Web of Science, Embase, and Scopus, focusing on randomized trials that juxtaposed pre-hospital CPAP application against standard care. Our primary interest was to assess the in-hospital mortality risks, and we employed random effect models to aggregate risk ratios from the selected studies. RESULTS: Four articles were gathered based on the review of the updated literature (2013 to November 2022) in conjunction with the research incorporated in the preceding meta-analysis with a total number of 747 patients receiving prehospital CPAP with 101 events of in-hospital mortality. In the standard treatment control groups, there were 713 patients and 115 deaths occurred. Pooled mortality risk comparison between the group of prehospital CPAP and standard care patients had no statistically significant difference (P=0.16). There was no heterogenicity. A regression between the year of the studies and the effect size showed increased RR in new studies (P=0.017). CONCLUSION: Still more randomized trials are needed with higher sample sizes to conclude the lifesaving efficacy of the out-of-hospital CPAP.

BD PuraMatrix peptide hydrogel as a culture system for human fetal Schwann cells in spinal cord regeneration.

BD PuraMatrix peptide hydrogel, a three-dimensional cell culture model of nanofiber scaffold derived from the self-assembling peptide RADA16, has been applied to regenerative tissue repair in order to develop novel nanomedicine systems. In this study with PuraMatrix, self-assembling nanofiber scaffold (SAPNS) and Schwann cells (SCs) were isolated from human fetal sciatic nerves, cultured within SAPNS, and then transplanted into the spinal cord after injury (SCI) in rats. First, the peptide nanofiber scaffold was evaluated via scanning electron microscopy and atomic force microscopy. With phase-contrast microscopy, the appearance of representative human fetal SCs encapsulated in PuraMatrix on days 3, 5, and 7 in 12-well plates was revealed. The Schwann cells in PuraMatrix were cultured for 2 days, and the SCs had active proliferative potential. Spinal cord injury was induced by placing a 35-g weight on the dura of T9-T10 segments for 15 min, followed by in vivo treatment with SAPNS and human fetal SCs (100,000 cells/10 µl/injection) grafted into spinal cord 7 days after SCI. After treatment, the recovery of motor function was assessed periodically using the Basso, Beattie, and Bresnahan scoring system. Eight weeks after grafting, animals were perfusion fixed, and the survival of implanted cells was analyzed with antibody recognizing SCs. Immunohistochemical analysis of grafted lumber segments at 8 weeks after grafting revealed reduced asterogliosis and considerably increased infiltration of endogenous S100(+) cells into the injury site, suggesting that PuraMatrix may play an important role in the repair observed after SAPNS and human fetal SC transplantation.

The Effects of Resistance Training on some Inflammatory Markers, Appetite-Regulating Peptides and Insulin Resistance Index in Obese Women.

Purpose: Obesity is associated with a chronic inflammatory condition, which plays an important role in the development of insulin resistance and disorder in appetite regulation. Resistance training (RT) can improve low-grade systemic inflammation caused by obesity by improving body composition. Hence, this study aimed to investigate whether RT with improvement in inflammatory status leads to improvement of metabolic markers and appetite-regulating peptides in obese women. Methods: Sixteen obese and healthy women were randomly divided into RT and control groups. The RT group participated in 8 weeks of RT. Blood samples and anthropometric characteristics were taken before the start of the exercise protocol and 3 days after the last training session. Serum levels of leptin, ghrelin, adiponectin, tumour necrosis factor (TNF-α), fasting glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) were also measured. Results: After 8 weeks of training, body weight (BW) and body mass index (BMI) in the control group increased significantly (P < 0.01), but in the training group, anthropometric characteristics remained unchanged. Serum levels of ghrelin and leptin, adiponectin and tumour necrosis factor remained unchanged after 8 weeks of RT. A significant increase in insulin and homeostatic model assessment of insulin resistance levels was observed in the control group (P < 0.05). Conclusion: It seems that 8 weeks of RT is not enough to induce an anti-inflammatory response and improve body composition and subsequently improve appetite and metabolic markers.

Comparison of the Relationship Between SI and RASI Scores With the Outcome of Sepsis Patients.

The aim of this study was to compare the relationship between shock index (SI) and respiratory adjusted shock index (RASI) scores with the final outcome of sepsis patients referred to the emergency department. This was prospective research that examined individuals who had been diagnosed with sepsis, determined by the presence of at least two of the three quick sepsis-related organ failure assessment (qSOFA) criteria and the presence of an infectious disease based on a diagnosis made by a hospital physician of Imam Reza and Ghaemshahr of Mashhad in 2019. Demographic information of patients, SI score, RASI score, and information related to the patient's clinical symptoms were recorded in the checklist. The final outcome of this study was considered mortality. Data analysis was performed using descriptive and inferential tests. In the present study, a total of 178 patients, 46 patients (25.8%) were transferred to the intensive care unit, and 98 patients (55.1%) were admitted to the normal wards. Eighty-five patients (47.75%) died and the mean length of hospital stay of all patients was 11.07 ± 9.23 days. Forty-four patients (24.7%) had referred with a decreased level of consciousness and 44 patients (24.7%) presented with confusion. The rest of the patients reported normal levels of consciousness. Kaplan Mir analysis with log-rank was performed to determine the difference in survival distribution in different SI groups: Survival distribution was not statistically different for the four defined groups (based on statistical quartiles (P = 0.320). Receiver operator curves were considered as the date of death in the case of the deceased and the date of discharge from the hospital in the case of the living as censored. The AUC of the RASI scoring system for predicting mortality was 0.614 (P = 0.009) while this value was not significant for SI (P = 0.152). In logistic regression analysis, it was found that by adjusting for the variables of age, sex, sepsis etiology, blood pressure and heart rate, level of consciousness, and gender, patients with the lower respiratory rate (OR 1.6, z = -0.159 p = 0.007), younger age (OR 1.6, z = -0.029 p = 0.006) and higher RASI score are more in risk of mortality (OR 1.29, z = 1.209, p = 0.031). The results of our study showed that RASI scoring can be a good criterion for predicting the chance of mortality in patients with sepsis and could be used complementary to previous criteria such as SI. Patients with high RASI scores should be given more attention to reducing the chance of death.

Incidence of Pediatric Perforated Appendicitis during the COVID-19 Pandemic; a Systematic Review and Meta-Analysis.

INTRODUCTION: COVID-19 has affected the pattern of referral to medical centers and quarantine against COVID-19 might delay referral and management of surgical emergencies. This study aimed to compare the pooled event rate of pediatric perforated appendicitis before and during the COVID-19 pandemic. METHODS: This was a systematic review and meta-analysis study based on the PRISMA guidelines. Scopus, Web of Sciences, and PubMed databases were searched for studies reporting the rate of perforated appendicitis based on the post-appendectomy observations or imaging methods. The Egger bias test and funnel plot were used to detect and depict publication bias. Statistical analysis was performed in Comprehensive Meta-analysis package version 3. RESULTS: Twelve studies were eligible for inclusion in our study. The pooled prevalence of pediatric perforated appendicitis in the pre-COVID era was 28.5% (CI95%: 28.3 to 28.7%) with a heterogeneity of 99%. In the COVID era, the event rate proportion was 39.4% (CI95%: 36.6 to 42.3%) with a heterogeneity of 99%. There was a significant difference in the subgroup analysis within the pre-COVID and COVID era (P<0.001), showing a higher perforation rate in the COVID era. CONCLUSION: Our study showed that during the COVID-19 pandemic, the rate of perforated appendicitis has significantly increased in comparison to before the COVID-19 pandemic.

Point-of-Care Tests' Role in Time Metrics of Urgent Interventions in Emergency Department; a Systematic Review of Literature.

Introduction: Point-of-Care Testing (POCT) could be helpful in clinical decisions, treatment selection, monitoring, prognostication, operational decision-making, and resource utilization. This study aimed to review the role of POCT in time metrics of performing urgent interventions in the emergency department (ED) or disposition time to proper care. Methods: This was a systematic review of the literature based on the PRISMA statement. PubMed, Scopus, Web of Science, and EMBASE databases were searched for studies reporting the application of the POCT in the ED with outcomes of the time to intervention or disposition. Results: After reviewing 3708 articles, 16 studies with 100,224 participants were included in this systematic review. There were 5 randomized clinical trials (RCTs), 5 retrospective cohorts, 2 prospective cohorts, and 4 before-after studies. All studies were performed in an ED setting except for one study of prehospital EMS air medical transport. Different panels, ultrasound, cardiac parameters, echocardiography, and polymerase chain reaction (PCR) POCTs were used in the studies. Regarding the outcome measures, studies with many types of patients referring to ED used different indices of time to intervention or time to disposition. Studies on different shock circumstances used the time to the first bolus of hydration or vasopressor or intravenous antibiotics for septic shock patients and central venous catheterization (CVC) placement time in one study. Time to imaging was considered as the outcome in some studies. Overall, there was a high risk of bias, especially in case of the randomization methods, and non-blinded designs in RCTs. There was lower possibility of bias in non-randomized studies but the studies did not have enough follow-ups and in case of studies using advanced panels of POCT, results do not seem to be easily applicable to public health care in many countries. Conclusion: In synthesis of the evidence, all included studies were reporting the benefits of the POCT in decreasing the time to proper interventions and increasing the time to negative interventions in the last lines of critical care as well as the intubation and CVC placement.

Percutaneous transluminal angioplasty and stenting of the vertebral artery ostium with balloon-mounted bare coronary stents.

BACKGROUND: Vertebral artery ostial stenosis (VAOS) is one of the most frequent causes of posterior circulation stroke. Percutaneous angioplasty and stenting (PTAS) is one of the treatment modalities. PATIENTS AND METHODS: This is a longitudinal observational study from September 2006 to February 2009, conducted at hospitals affiliated with the Shiraz University of Medical Sciences, Shiraz, southern Iran. The patient cohort included patients with posterior circulation stroke or transient ischemic attack (TIA) and more than 70% VAOS, and patients with asymptomatic VAOS of more than 70% and aplasia or total occlusion of the contralateral VA or subclavian artery. All the patients underwent PTAS with balloon-mounted bare coronary stents. Technical success, procedural complications, composite outcomes of death, stroke or TIA in the vertebrobasilar territory during the first 30 days, stroke or TIA in the vertebrobasilar territory, and restenosis during follow-up, were assessed. RESULTS: During the study period, 81 patients (mean age 68 + 8.9 years, 63 (78%) males, 71 symptomatic and 18 asymptomatic) underwent the procedure. Technical success was achieved in 88 (99%) patients. Procedure-related complications, other than puncture site complications, were seen in two patients (2.2%). The composite outcome of death, stroke or TIA in the vertebrobasilar territory during the first 30 days was 1%. None of the patients had clinical recurrence or restenosis during the follow-up (mean follow-up 14 months). CONCLUSION: Percutaneous transluminal angioplasty and stenting of the proximal VA was feasible and safe. The risk of restenosis should be analyzed in long-term studies with angiographic follow-up.

Multivariate optimization of removing of cobalt(II) with an efficient aminated-GMA polypropylene adsorbent by induced-grafted polymerization under simultaneous gamma-ray irradiation.

Nowadays, radiation grafting polymer adsorbents have been widely developed due to their advantages, such as low operating cost, high efficiency. In this research, glycidyl methacrylate monomers were grafted on polypropylene polymer fibers by simultaneous irradiation of gamma-ray with a dose of 20 kGy. The grafted polymer was then modified using different amino groups and tested for adsorption of cobalt ions in an aqueous solution. Finally, the modified polymer adsorbent with a high efficiency for cobalt ions adsorption was synthesized and tested. Different modes of cobalt ions adsorption were tested in other adsorption conditions, including adsorption contact time, pH, different amounts of adsorbent mass, and different concentrations of cobalt ions solution. The adsorbent structure was characterized with FT-IR, XRD, TG and SEM techniques and illustrated having an efficient grafting percentage and adsorption capability for cobalt removing by batch experiments. The optimum conditions were obtained by a central composite design: adsorbent mass = 0.07 g, initial concentration = 40 mg/L, time = 182 min, and pH = 4.5 with ethylenediamine as a modified monomer and high amination percentage. Kinetics and equilibrium isotherms observation described that the experimental data followed pseudo-second-order and Langmuir models, respectively. The maximum adsorption capacity from Langmuir isotherm capacity is obtained equal to 68.02 mg/g.