Prospective Deep Learning-based Quantitative Assessment of Coronary Plaque by CT Angiography Compared with Intravascular Ultrasound

AIMS

Coronary computed tomography angiography provides noninvasive assessment of coronary stenosis severity and flow impairment. Automated artificial intelligence analysis may assist in precise quantification and characterization of coronary atherosclerosis, enabling patient-specific risk determination and management strategies. This multicenter international study compared an automated deep-learning-based method for segmenting coronary atherosclerosis in coronary computed tomography angiography (CCTA) against the reference standard of intravascular ultrasound (IVUS).

METHODS AND RESULTS

The study included clinically stable patients with known coronary artery disease from 15 centers in the U.S. and Japan. An artificial intelligence (AI)-enabled plaque analysis service was utilized to quantify and characterize total plaque (TPV), vessel, lumen, calcified plaque (CP), non-calcified plaque (NCP), and low attenuation plaque (LAP) volumes derived from CCTA and compared with IVUS measurements in a blinded, core laboratory-adjudicated fashion. In 237 patients, 432 lesions were assessed; mean lesion length was 24.5 mm. Mean IVUS-TPV was 186.0 mm3. AI-enabled plaque analysis on CCTA showed strong correlation and high accuracy when compared with IVUS; correlation coefficient, slope, and Y intercept for TPV were 0.91, 0.99, and 1.87, respectively; for CP volume 0.91, 1.05, and 5.32, respectively; and for NCP volume 0.87, 0.98, and 15.24, respectively. Bland-Altman analysis demonstrated strong agreement with little bias for these measurements.

CONCLUSIONS

Artificial intelligence enabled CCTA quantification and characterization of atherosclerosis demonstrated strong agreement with IVUS reference standard measurements. This tool may prove effective for accurate evaluation of coronary atherosclerotic burden and cardiovascular risk assessment.[ClinicalTrails.gov identifier: NCT05138289].

Clinical Outcomes Based on Coronary Computed Tomography-Derived Fractional Flow Reserve and Plaque Characterization

BACKGROUND

Coronary computed tomography angiography (CTA) followed by computed tomography angiography-derived fractional flow reserve (FFRCT) is now commonly used for the management of chronic coronary syndrome (CCS). CTA-verified high-risk plaque (HRP) characteristics have also been reported to be associated with a greater likelihood of adverse cardiac events but have not been used for management decisions.

OBJECTIVES

The aim of this study was to evaluate clinical outcomes based on a combination of point-of-care computed tomography angiography-derived fractional flow reserve (POC-FFRCT) and the presence of HRP in CCS patients initially treated medically or with revascularization based on invasive coronary angiography findings.

METHODS

CTA was performed as the initial test in 5,483 patients presenting with CCS between September 2015 and December 2020 followed by invasive coronary angiography and revascularization as necessary. POC-FFRCT assessment and HRP characterization were obtained subsequently in 745 consecutive patients. We investigated how HRP and POC-FFRCT, which were not available during the original clinical decision making, correlated with the endpoint defined as a composite of cardiac death, acute coronary syndrome, and a need for unplanned revascularization.

RESULTS

Cardiac events occurred in 20 patients (2.7%) during a median follow-up of 744 days. The event rate was significantly higher in patients with POC-FFRCT <0.80 compared with POC-FFRCT ≥0.8 (5.4 vs 0.5 per 100 vessel years; log-rank P < 0.0001) and in patients with HRP compared to those without HRP (3.6 vs 0.8 per 100 vessel years; log-rank P = 0.0001). POC-FFRCT <0.80 and the presence of HRP were the independent predictors of cardiac events (HR: 16.67; 95% CI: 2.63-105.39; P = 0.002) compared with POC-FFRCT ≥0.8 and absent HRP. For the vessels with POC-FFRCT <0.80 and HRP, a significantly higher rate of adverse events was observed in patients who did not undergo revascularization compared with those revascularized (16.4 vs 1.4 per 100 vessel years; log-rank P = 0.006).

CONCLUSIONS

POC-FFRCT <0.80 and the presence of HRP were the independent predictors of cardiac events, and revascularization of HRP lesions with abnormal POC-FFRCT was associated with a lower event rate.

Interaction of AI-Enabled Quantitative Coronary Plaque Volumes on Coronary CT Angiography, FFRCT, and Clinical Outcomes: A Retrospective Analysis of the ADVANCE Registry

BACKGROUND

Luminal stenosis, computed tomography-derived fractional-flow reserve (FFRCT), and high-risk plaque features on coronary computed tomography angiography are all known to be associated with adverse clinical outcomes. The interactions between these variables, patient outcomes, and quantitative plaque volumes have not been previously described.

METHODS

Patients with coronary computed tomography angiography (n=4430) and one-year outcome data from the international ADVANCE (Assessing Diagnostic Value of Noninvasive FFRCT in Coronary Care) registry underwent artificial intelligence-enabled quantitative coronary plaque analysis. Optimal cutoffs for coronary total plaque volume and each plaque subtype were derived using receiver-operator characteristic curve analysis. The resulting plaque volumes were adjusted for age, sex, hypertension, smoking status, type 2 diabetes, hyperlipidemia, luminal stenosis, distal FFRCT, and translesional delta-FFRCT. Median plaque volumes and optimal cutoffs for these adjusted variables were compared with major adverse cardiac events, late revascularization, a composite of the two, and cardiovascular death and myocardial infarction.

RESULTS

At one year, 55 patients (1.2%) had experienced major adverse cardiac events, and 123 (2.8%) had undergone late revascularization (>90 days). Following adjustment for age, sex, risk factors, stenosis, and FFRCT, total plaque volume above the receiver-operator characteristic curve-derived optimal cutoff (total plaque volume >564 mm3) was associated with the major adverse cardiac event/late revascularization composite (adjusted hazard ratio, 1.515 [95% CI, 1.093-2.099]; P=0.0126), and both components. Total percent atheroma volume greater than the optimal cutoff was associated with both major adverse cardiac event/late revascularization (total percent atheroma volume >24.4%; hazard ratio, 2.046 [95% CI, 1.474-2.839]; P<0.0001) and cardiovascular death/myocardial infarction (total percent atheroma volume >37.17%, hazard ratio, 4.53 [95% CI, 1.943-10.576]; P=0.0005). Calcified, noncalcified, and low-attenuation percentage atheroma volumes above the optimal cutoff were associated with all adverse outcomes, although this relationship was not maintained for cardiovascular death/myocardial infarction in analyses stratified by median plaque volumes.

CONCLUSIONS

Analysis of the ADVANCE registry using artificial intelligence-enabled quantitative plaque analysis shows that total plaque volume is associated with one-year adverse clinical events, with incremental predictive value over luminal stenosis or abnormal physiology by FFRCT.

REGISTRATION

URL: https://www.clinicaltrials.gov; Unique identifier: NCT02499679.

Chest Pain Evaluation: Diagnostic Testing

Chest pain/discomfort (CP) is a common symptom and can be a diagnostic dilemma for many clinicians. The misdiagnosis of an acute or progressive chronic cardiac etiology may carry a significant risk of morbidity and mortality. This review summarizes the different options and modalities for establishing the diagnosis and severity of coronary artery disease. An effective test selection algorithm should be individually tailored to each patient to maximize diagnostic accuracy in a timely fashion, determine short- and long-term prognosis, and permit implementation of evidence-based treatments in a cost-effective manner. Through collaboration, a decision algorithm was developed (www.chowmd.ca/cadtesting) that could be adopted widely into clinical practice.

COVID-19 stress and coping strategies among older adults: a systematic review of qualitative evidences

BACKGROUND

The COVID-19 pandemic has brought about far more stressful conditions for people worldwide. As a vulnerable group, older adults have suffered various psychological problems, such as stress, because of this pandemic and have applied various strategies to cope with the dire consequences. This study aimed to synthesize qualitative evidence regarding coping strategies for stressful situations among older adults throughout the COVID-19 pandemic.

METHODS

We searched electronic databases, including Scopus, Embase, PubMed, ProQuest, and the Cochrane Library, based on PRISMA standards. The protocol of this systematic review was registered on the PROSPERO (registration code: CRD42022364831). All relevant English-language articles published between 2019 and November 10, 2022, were searched. We reviewed the reference lists for all the included studies and key references. Two reviewers conducted screening, data extraction, and quality appraisal independently, with disagreements resolved by consensus with all team members. The Joanna Briggs Institute (JBI) checklist was used to assess the quality of studies. A thematic synthesis of the selected studies was conducted.

RESULTS

We included 13 studies in our review. Most studies were conducted in the early months of the COVID-19 pandemic. The stress caused by the COVID-19 pandemic was classified into six categories: health management challenges, stress caused by quarantine, economic challenges, media and bad news stress, virus threats, and challenges related to the use of communication technologies. The strategies used by older adults to cope with these challenges were categorized into five categories: protective strategies, avoidance strategies, maintaining social connections, meaning-based strategies, and fun strategies. This research showed that depending on the situation and conditions, older adults use various strategies to cope with COVID-19.

CONCLUSION

Older adults experience much stress during the COVID-19 pandemic. In most cases, older adults can cope with these challenges with simple strategies from previous experiences and learnings. Older people require educational interventions in some cases, such as those involving communication skills. A better understanding of older adults coping strategies may enable policymakers to develop more effective policies and manage the problems of older adults in post-COVID situations.

Arthroscopic management of ankle primary synovial chondromatosis (Reichel's syndrome): A case report with literature review

INTRODUCTION AND IMPORTANCE

Primary Synovial chondromatosis is a rare disease characterized by metaplastic cartilaginous nodules originating from the synovium, which rarely involves the ankle joint. To date, there has been a limited number of reported cases regarding the arthroscopic treatment of this disease, which can be attributed to its rare incidence. This article aims to illuminate the advantages and challenges of this technique by presenting a case study. Furthermore, we delve into the existing literature to assess the different treatments used for this disease and their outcomes.

CASE PRESENTATION

A 59-year-old male patient presented with ankle pain, swelling and limited dorsiflexion. Subsequent imaging findings led to the diagnosis of anterior ankle primary synovial chondromatosis. Following this, the patient underwent arthroscopic assisted loose body removal and partial anterior synovectomy, conducted via anteromedial and anterolateral portals. During the five-year follow-up period, no recurrence was observed, and the American Orthopedic Foot and Ankle Score (AOFAS) was assessed as 88.

CLINICAL DISCUSSION

Given the uncommon occurrence of this disease, no standardized treatment approach has been established in the literature. While many researchers advocate for surgical intervention to alleviate symptoms and prevent potential complications like osteoarthritis and malignancy, there exists a diversity of perspectives concerning the specific strategies and techniques to employ.

CONCLUSION

Partial anterior synovectomy and loose body removal using arthroscopy via anteromedial and anterolateral portals demonstrate a notably efficacious and low-risk technique for addressing primary synovial chondromatosis affecting the anterior chamber of the ankle.

Exploring the coping strategies of women after self-immolation: A qualitative study

BACKGROUND

Women confront a slew of issues following self-immolation, and it is crucial to examine how women react after self-immolation and live with their scars. Therefore, this study was conducted with the aim of exploring the coping strategies of Kurdish women following self-immolation using a qualitative methodology.

METHODS

The conventional content analysis approach was used in this qualitative investigation. Semi-structured face-to-face and phone interviews were conducted with 26 Kurdish women who had self-immolated and were chosen using purposeful sampling and snowballing for this study. To reinforce the research, Guba and Lincoln's trustworthiness criteria were fulfilled.

RESULTS

The data analysis yielded 2 categories, 11 subcategories, and 85 initial codes. Positive coping is one of the categories and subcategories (spirituality, rebuilding their body, psychological rehabilitation, hiding the scars, restoring self-confidence, changing the lifestyle, forming a new life) 2- Negative coping (separation from society, neglecting the body and mind, violence and aggression, staying in the past).

CONCLUSION

Using the capacity of religious organizations to help victims of self-immolation, providing appropriate conditions and facilities to heal the scars caused by self-immolation, and facilitating access to counseling services can provide the conditions for women to better adapt after self-immolation.

Gefitinib derivatives and drug-resistance: A perspective from molecular dynamics simulations

Epidermal-growth factor receptor (EGFR) is a transmembrane tyrosine kinase (TK) with a significant role in cell survival. EGFR is upregulated in various cancer cells and known as a druggable target. Gefitinib is a first-line TK inhibitor used against metastatic non-small cell lung cancer (NSCLC). Despite initial clinical response, a conserved therapeutic effect could not be achieved due to the occurrence of resistance mechanisms. Point mutations in EGFR genes are one of the major causes of rendered tumor sensitivity. To aid in the development of more efficient TKIs, chemical structures of prevailing drugs and their target binding patterns are very important. The aim of the present study was to propose synthetically-accessible gefitinib congeners with enhanced binding fitness to clinically frequent EGFR mutants. Docking simulations of intended molecules identified 1-(4-(3-chloro-4-fluorophenylamino)-7-methoxyquinazolin-6-yl)-3-(oxazolidin-2-ylmethyl) thiourea (23) as a top-binder structure inside G719S, T790 M, L858R and T790 M/L858R-EGFR active sites. Superior docked complexes were subjected to the entire 400 ns molecular dynamics (MD) simulations. Analysis of data revealed the stability of mutant enzymes upon binding to molecule 23. All mutant complexes with the exception of a T790 M/L858R-EGFR, were majorly stabilized through cooperative hydrophobic contacts. Pairwise analysis of H-bonds proved Met793 as the conserved residue with stable H-bond participations as hydrogen bond donor (Frequency 63-96%). Amino acid decomposition analysis confirmed the probable role of Met793 in complex stabilization. Estimated binding free energies indicated the proper accommodation of molecule 23 inside target active sites. Pairwise energy decompositions of stable binding modes revealed the energetic contribution of key residues. Although wet lab experiments are required to unravel the mechanistic details of mEGFR inhibition, MD results provide structural basis for those events that are difficult to address experimentally. The outputs of the current study may assist to design small molecules with high potency to mEGFRs.

Advances in Coronary Computed Tomographic Angiographic Imaging of Atherosclerosis for Risk Stratification and Preventive Care

The diagnostic evaluation of coronary artery disease is undergoing a dramatic transformation with a new focus on atherosclerotic plaque. This review details the evidence needed for effective risk stratification and targeted preventive care based on recent advances in automated measurement of atherosclerosis from coronary computed tomography angiography (CTA). To date, research findings support that automated stenosis measurement is reasonably accurate, but evidence on variability by location, artery size, or image quality is unknown. The evidence for quantification of atherosclerotic plaque is unfolding, with strong concordance reported between coronary CTA and intravascular ultrasound measurement of total plaque volume (r >0.90). Statistical variance is higher for smaller plaque volumes. Limited data are available on how technical or patient-specific factors result in measurement variability by compositional subgroups. Coronary artery dimensions vary by age, sex, heart size, coronary dominance, and race and ethnicity. Accordingly, quantification programs excluding smaller arteries affect accuracy for women, patients with diabetes, and other patient subsets. Evidence is unfolding that quantification of atherosclerotic plaque is useful to enhance risk prediction, yet more evidence is required to define high-risk patients across varied populations and to determine whether such information is incremental to risk factors or currently used coronary computed tomography techniques (eg, coronary artery calcium scoring or visual assessment of plaque burden or stenosis). In summary, there is promise for the utility of coronary CTA quantification of atherosclerosis, especially if it can lead to targeted and more intensive cardiovascular prevention, notably for those patients with nonobstructive coronary artery disease and high-risk plaque features. The new quantification techniques available to imagers must not only provide sufficient added value to improve patient care, but also add minimal and reasonable cost to alleviate the financial burden on our patients and the health care system.

Coxiella burnetii Pathogenesis: Emphasizing the Role of the Autophagic Pathway

Coxiella burnetii (C. burnetii), the etiological agent of the Q fever disease, ranks among the most sporadic and persistent global public health concerns. Ruminants are the principal source of human infections and diseases present in both acute and chronic forms. This bacterium is an intracellular pathogen that can survive and reproduce under acidic (pH 4 to 5) and harsh circumstances that contain Coxiella-containing vacuoles. By undermining the autophagy defense system of the host cell, C. burnetii is able to take advantage of the autophagy pathway, which allows it to improve the movement of nutrients and the membrane, thereby extending the vacuole of the reproducing bacteria. For this method to work, it requires the participation of many bacterial effector proteins. In addition, the precise and prompt identification of the causative agent of an acute disease has the potential to delay the onset of its chronic form. Moreover, to make accurate and rapid diagnoses, it is necessary to create diagnostic devices. This review summarizes the most recent research on the epidemiology, pathogenesis, and diagnosis approaches of C. burnetii. This study also explored the complicated relationships between C. burnetii and the autophagic pathway, which are essential for intracellular reproduction and survival in host cells for the infection to be effective.

The contribution of amyloid deposition in the aortic valve to calcification and aortic stenosis

Calcific aortic valve disease (CAVD) and stenosis have a complex pathogenesis, and no therapies are available that can halt or slow their progression. Several studies have shown the presence of apolipoprotein-related amyloid deposits in close proximity to calcified areas in diseased aortic valves. In this Perspective, we explore a possible relationship between amyloid deposits, calcification and the development of aortic valve stenosis. These amyloid deposits might contribute to the amplification of the inflammatory cycle in the aortic valve, including extracellular matrix remodelling and myofibroblast and osteoblast-like cell proliferation. Further investigation in this area is needed to characterize the amyloid deposits associated with CAVD, which could allow the use of antisense oligonucleotides and/or isotype gene therapies for the prevention and/or treatment of CAVD.

Genistein attenuates neuroinflammation and oxidative stress and improves cognitive impairment in a rat model of sepsis-associated encephalopathy: potential role of the Nrf2 signaling pathway

Oxidative stress and inflammation seem to be the main factors responsible for cognitive impairment in sepsis. Genistein (GEN) is claimed to exert many beneficial effects on health, however, its possible effects on brain sepsis remains unclear. Here, we assess the influence and underling mechanisms of GEN on cognitive impairments in cecal ligation and puncture (CLP)-induced septic model. Rats were randomly divided into Sham, Sham + GEN, CLP, CLP + GEN gropus. Rats were treated with GEN (15 mg/kg at 0 and 12 h after CLP, i.p). Twenty-four hours after CLP, protein levels of cytokines, NF-kB and Nrf2, myeloperoxidase (MPO) activity, oxidative damage to lipids and proteins, the activities of antioxidant enzymes and the expression of Nrf2-target genes were evaluated in the hippocampus. At 10 days after sepsis induction, behavioral tests were conducted to evaluate cognitive impairment. The results indicate that GEN can enhance survival percentage and improve cognitive function. Genistein administration significantly reduced TNF-α and IL-1β levels, MPO activity and protein level of NF-kB in the hippocampus of septic rats. Genistein also decreased the levels of oxidative stress parameters (MDA and protein carbonyls) and elevated the activities of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) in septic rats. Furthermore, nuclear Nrf2 and the expression of HO-1 and NQO-1 were also elevated by GEN treatment. These findings suggest that GEN improves cognition impairment in septic rats via decreasing inflammatory responses and oxidative stress, and activation of the Nrf2 pathway.

Preparatory Brain Activity and Anticipatory Postural Control in Cervical Myofascial Trigger Point

Introduction: Neck pain is a highly prevalent disorder in developed countries. A myofascial trigger point (MTrP) is distinguished under the name of the fundamental excessive menstruation for it and certain reason for musculoskeletal dysfunction. MTrP refers to a sensitive spot in a taut band whose stretch and compression can induce pain. Modifications in the motor cortex, sensory input, irritability, and integration are the adaptive mechanisms to pain. Accordingly, this study aimed to investigate the preparatory brain activity and anticipatory postural control in chronic neck pain. Materials and Methods: The study participants included 25 women with an active MTrP in the upper trapezius muscle and 25 healthy women in the control group. We recorded the brain activities from Cz, Pz, and Fz regions and muscle activities of both sides of the upper trapezius, anterior deltoid, cervical and lumbar paraspinal, sternocleidomastoid, and medial head of the gastrocnemius. The participants had to flex their arms in reply to the second sound stimulus, followed by the first sound. Then, their reaction time and brain activity were evaluated. Results: Significant differences between the two groups were detected in brain activities’ measurements and the onset of muscle activation (P<0.001). The exception was the onset of gastrocnemius muscle activation (P>0.05). Conclusion: The current study suggests that active MTrP induces latency and lengthens the muscle reaction time; thus, the production of suitable motion after the stimulus will be affected. Brain alteration after pain damages movement changes and postural control mechanism.

Evaluation of stability and antibacterial properties of extracted chlorophyll from alfalfa (Medicago sativaL.)

This study aims to the evaluation of stability and antibacterial properties of the extracted chlorophyll from alfalfa. For this purpose, chlorophylls a and b from alfalfa were extracted by enzymatic and ultrasound methods. The results show that the content of chlorophyll a in alfalfa is higher than chlorophyll b and also the enzymatic method demonstrates higher yield in chlorophyll extraction. In the present study, the chlorophyll stability was evaluated in different conditions including temperature (-18, 4 and 25 °C), time (15, 30 and 45 days), pH (4.5 and 5.5) and NaCl concentration (50, 100 and 150mM). Also, antibacterial effects were investigated at different concentrations of chlorophyll (20, 40, 60 and 100μM) against some bactriaes by agar disk diffusion and microdilution (MIC and MBC) methods. The results demonstrate that 50 mM of NaCl, temperature -18 °C, pH = 4.5 and time15 days are associated with the highest chlorophyll a and b contents. Furthermore, the resistance of bacterias in agar disk diffusion and microdilution methods observe Listeria < Staphylococcus < Salmonella < Escherichia < Pseudomonas and Listeria<(Staphylococcus = Escherichia = Salmonella)<Pseudomonas, respectively. Also, there are significant differences between different chlorophyll concentrations against Listeria and Staphylococcus in evaluation of inhibition effects of total extracted chlorophyll (p < 0.05).

High-intensity interval training improves fat oxidation during submaximal exercise in active young men

This study aimed to examine the effects of four-weeks high-intensity interval training (HIIT) on fat oxidation responses during submaximal exercise in active young men. For this purpose, 20 active young men (who participated in the exercise three times per week) were divided into two groups, including a training group (age: 19.3±0.48 years, V̇O2peak 2.9±0.35 l/min, n=10) and a control group (age: 19.7±0.67 years, V̇O2peak 2.7±0.26 l/min, n=10). The training group performed high-intensity interval training for three sessions per week. Specifically, each session included 8-11 intensive cycling efforts comprising of 60 s duration. A 75 s low pedalling rate (30 W) was used as an active recovery between the intervals. Furthermore, a V̇O2peak test was performed prior to, at the end of two weeks and after the training period. Also, a 60 min constant cycling protocol was performed at ~60% V̇O2peak, in addition to the V̇O2peak test, before and after the training protocol. To assess plasma free fatty acids and glucose, blood samples were taken during a 60-min aerobic exercise prior to and following the training period. An increase (17.8%) in V̇O2peak was observed for the HIIT group after the training period compared to the control group (P<0.05). The HIIT group performed the 60 min sub-maximal exercise test at a lower percentage of V̇O2peak, and decreases in the respiratory exchange ratio were greater in the HIIT group than in the control group (P<0.05). Compared to the pre-test values and control group results, the HIIT group used less carbohydrate and more lipid oxidation during submaximal exercise (P<0.05). The present study’s results indicate that short-term low volume HIIT can increase aerobic capacity and fat oxidation during submaximal exercise.

Current Status and Structure Activity Relationship of Privileged Azoles as Antifungal Agents (2016-2020)

Fungal infections have major contribution to the infectious related deaths in recent century. The issue has gotten worse with the advent of immunity impairing conditions such as HIV epidemic. Eukaryote nature of fungal pathogens leads to harder eradication than bacterial infections. Given the importance of the problem, considerable efforts have been put on the synthesis and biological assessment of azole-based chemical scaffolds and their bioisosteres. The emergence of validated macromolecular targets within different fungal species inspires structure-based drug design strategies toward diverse azole-based agents. Despite of advantageous features, emergence of drug-resistant fungal species restrict the applicability of current azoles as the first-line antifungal agents. Consequently, it appears advisable to elucidate SARs and chemical biodiversity within antifungal azoles. Current contribution was devoted to a brief look at clinically applied drugs, structure-based classification of azole antifungals and their structure activity relationships (SARs). Reviewed molecules belong to the antifungal structures that were reported throughout 2016-2020.

Impact of ZnO and Fe3O4 magnetic nanoscale on the methyl violet 2B removal efficiency of the activated carbon oak wood

In the current study, activated carbon oak wood (ACOW600) and modified activated carbon using ZnO (ACOW600/ZnO) and Fe₃O₄ (ACOW600/ZnO/Fe₃O₄) nanoparticles were used to remove methyl violet 2B dye (MV2B) from aqueous solutions. ACOW was synthesized at different temperatures (300-700 °C), and then the maximum MV2B removal efficiency (92.76 %) was achieved using ACOW synthesized at 600 °C. The morphology and characteristics of ACOW600, ACOW600/ZnO, and ACOW600/ZnO/Fe₃O₄ were studied using surface analyzes. According to the results, the adsorbents indicated a high ability to absorb MV2B from liquid solution, and their kinetic behavior follows a pseudo-second-order kinetic. In addition, the equilibrium study revealed that the MV2B uptake by the ACOW600/ZnO/Fe₃O₄ magnetic nanocomposite followed the Freundlich model. In contrast, the Langmuir model described the MV2B adsorption process using ACOW600 and ACOW600/ZnO. The maximum adsorption capacity (q_m) of MV2B using ACOW600, ACOW600/ZnO, and ACOW600/ZnO/Fe₃O₄ was determined 26.16 mg g^-1, 37.05 mg g^-1, and 48.59 mg g^-1, respectively, indicating that modification of ACOW600 led to improve its performance in removing MV2B. The enthalpy (ΔH), entropy (ΔG), and Gibbs free energy (ΔS) parameters revealed that the decontamination of MV2B using the studied adsorbents was exothermic and spontaneous. Also, random interactions of MV2B molecules and adsorbent surfaces were reduced during the adsorption process. Textile wastewater was significantly treated by ACOW600, ACOW600/ZnO, and ACOW600/ZnO/Fe₃O₄ adsorbents. The recycling of the adsorbents was demonstrated that the investigated adsorbents could be re-utilized many times in the MV2B removal process.

A novel multilayer thin-film membrane with high durability: preparation, characterization, performance investigation

The main aim of this research is the improvement of the performance in desalination of polyamide (PA) thin film composite nanofiltration membranes by modification of nanofibrous polyvinylidene fluoride as a support layer.

Posterior First and Second Cervical Vertebrae Fusion by Screw Fixation Technique using the Modern Pre-fabricated Template Method on Cadaver Samples

Introduction

C1 lateral mass and C2 pedicular screws insertion are used for C1-C2 posterior fusion. Fluoroscopy Guided technique is routinely used for screw placement but it is associated with risk of injury to spinal cord and vertebral artery. 3D printing has developed rapidly in the fields of medicine. It is helpful in improving precise treatment and used for instrumentation in spine. We want to evaluate the accuracy of C1 lateral mass screws and C2 pedicle screws insertion by Pre-Fabricated Template made by three-dimensional (3D) printing.

Materials and methods

Five cervical samples were obtained from cadavers. Based on fine-cut CT scan 3D-images reconstructed and the path of the screws designed by special software. A template produced by 3D-printer from 3D images. After printing the templates, they were fixed on the relevant vertebra in the operation room and based on the template path, C1 lateral mass screw and C2 pedicular screws were inserted. Placement of the screws was evaluated using CT scans post-operatively.

Results

A total of 14 screws were inserted by above-mentioned method. After evaluation with CT scans none of the screws were entered in the spinal canal. Two screws had vertebral artery canal perforation with less than 50% breach. Violation was judged as noncritical and would probably not have resulted in injury to vertebral artery.

Conclusions

The accuracy of C1 lateral mass screw and C2 pedicle screw insertion is acceptable with pre-fabricated template and can provide a useful aid for screw placement.

Primary Testis Leiomyosarcoma: A Case Report

Primary leiomyosarcoma in testis is an uncommon tumor with few cases reported. It generally develops after radiotherapy or long-term taking anabolic steroid medication. We report a 53-year-old male patient with primary testis leiomyosarcoma who presented with painless testicular enlargement without any known predisposing factors. Ultrasound revealed a large heterogeneous left testicular solid lesion. Alpha-fetoprotein (AFP) and beta-human chorionic gonadotrophin (beta-HCG) levels in serum were normal. Left radical orchidectomy following with histology assessment established a diagnosis of primary leiomyosarcoma of testis. No data of cancer metastasis was established. The patient didn't receive any adjuvant therapy. There wasn't any evidence of recurrence after 1 year follow-up. Leiomyosarcoma must be one of the differential diagnoses of seronegative tumors in testis. The motivation for this paper is the extreme infrequency of the situation and the differential diagnosis by all expansive inguinoscrotal tumors.

Evaluation of a Persian version of the Adelaide driving self-efficacy scale among Iranian older adults

OBJECTIVE

Our aim in the present study was to estimate the psychometric properties of the full-length Adelaide driving self-efficacy scale (ADSES) for use among community-based resident older adults in Tehran, Iran.

METHODS

We recruited older adults (60+ years) from various sampling units nested in the Tehran district's general urban population (20 subjects/questionnaire-item). The questionnaire was translated and back-translated by using recommended pathways. Multiple forms of validity and reliability, including Cronbach alpha, were estimated. Also, we measured intra-class correlation coefficient, and did confirmatory factor analysis (CFA).

RESULTS

A total of 243 participants (mean age: 65.8, 95%CI 65.4-66.3) met our inclusion criteria. For ADSES, the alpha coefficient was 0.77, the intraclass correlation coefficient was 0.97 (95% CI: 0.95-0.98), and the average item-test correlation was 0.67. Upon CFA, we found a 0.95 comparative fit index, a coefficient of determination = 92.6%, and standardized size of the residual = 0.04.

CONCLUSION

Our Persian language ADSES was found to have adequate validity and factor structure parameters for evaluating driving self-efficacy among community-based older adults in a non-western context. Our questionnaire is an essential first step toward evaluating driving self-efficacy among older adults, especially where no such tool is available, to help develop driving self-efficacy as a healthy aging measure.

Zn2+ removal from the aqueous environment using a polydopamine/hydroxyapatite/Fe3O4 magnetic composite under ultrasonic waves

In this study, an easily magnetically recoverable polydopamine (PDA)-modified hydroxyapatite (HAp)/Fe₃O₄ magnetic composite (HAp/Fe₃O₄/PDA) was suitably synthesized to exploit its adsorption capacity to remove Zn²⁺ from aqueous solution, and its structural properties were thoroughly examined using different analytical techniques. The effect of multiple parameters like pH, ultrasonic power, ultrasonic time, adsorbent dose, and initial Zn²⁺ concentration on the adsorption efficiency was assessed using RSM-CCD. According to the acquired results, by increasing the adsorbent quantity, ultrasonic power, ultrasonic time, and pH, the Zn²⁺ adsorption efficiency increased and the interaction between the variables of ultrasonic power/Zn²⁺ concentration, pH/Zn²⁺ concentration, pH/absorbent dose, and ultrasonic time/adsorbent dose has a vital role in the Zn²⁺ adsorption. The uptake process of Zn²⁺ onto PDA/HAp/Fe₃O₄ followed Freundlich and pseudo-second order kinetic models. The maximum capacity of Zn²⁺ adsorption (q _m) obtained by PDA/HAp/Fe₃O₄, HAp/Fe₃O₄, and HAp was determined as 46.37 mg g^-1, 40.07 mg g^-1, and 37.57 mg g^-1, respectively. Due to its good performance and recoverability (ten times), the HAp/Fe₃O₄/PDA magnetic composite can be proposed as a good candidate to eliminate Zn²⁺ ions from a water solution.

Moderate grazing is the best measure to achieve the optimal conservation and soil resource utilization (case study: Bozdaghin rangelands, North Khorasan, Iran)

The study of the variability of physical and chemical factors of soil due to different intensities of livestock grazing can help in the management and maintenance of soil and vegetation. Accordingly, the effect of livestock grazing intensities on soil properties and vegetation in Bozdaghin rangelands of North Khorasan province was investigated. To investigate the effect of different livestock grazing intensities, Three 5-hectare plots in the study area were determined under different treatments (ungrazed (UG), moderate grazing (MG), and heavy grazing (HG)), and the effect of three grazing intensities on vegetation and soil physicochemical and erodibility properties (SPEP) was evaluated. The soil sampling process was performed at depths of 0-15, 15-30 cm and SPEP including soil saturation moisture (SSM), soil texture (percentage of clay, sand, and silt), absorbable potassium (K), electrical conductivity (EC), soil organic matter (SOM), absorbable phosphorus (P), acidity (pH), and bulk density were evaluated, and Soil Erodibility Index (SEI) was calculated by implementing the modified clay ratio relation. To assess the impact of various grazing intensities on all measured characteristics, multivariate analysis of variance (MANOVA) and Duncan tests were utilized to compare the means and their grouping. The results showed that HG compared to MG causes worrying consequences in the first soil depth. Also with increasing grazing intensity, plant production percentage (P < 0.05) and vegetation density (P < 0.01) decreased, and the amount of bare soil (P < 0.01) increased. Also, with increasing grazing intensity, the amount of pH, EC, clay, saturated moisture, and N decreased (P < 0.01), but the amount of silt, sand, K, P, calcium (Ca), lime, and SOM increased (P < 0.01). UG improves soil quality, MG intensity causes optimal conservation and utilization of soil resources, and HG intensity causes severe changes in rangeland soil properties. In areas with MG intensity, due to the increase of the percentage of vegetation (an increase of SOM and prevents the direct impact of raindrops on the soil aggregates) and as a result improvement of soil structure and texture, an increase of water infiltration, and decrease of runoff, and the rate of soil erodibility and water erosion, the rangeland soil decreases and results in sustainable production. This results in optimal conservation and utilization of soil resources. So to sustainably exploit and balance the conservation of biodiversity, livestock production, and soil carbon and nitrogen management, MG is recommended.

Incremental prognostic value of hybrid [15O]H2O positron emission tomography-computed tomography: combining myocardial blood flow, coronary stenosis severity, and high-risk plaque morphology

Aims 

This study sought to determine the prognostic value of combined functional testing using positron emission tomography (PET) perfusion imaging and anatomical testing using coronary computed tomography angiography (CCTA)-derived stenosis severity and plaque morphology in patients with suspected coronary artery disease (CAD).

Methods and results 

In this retrospective study, 539 patients referred for hybrid [¹⁵O]H₂O PET-CT imaging because of suspected CAD were investigated. PET was used to determine myocardial blood flow (MBF), whereas CCTA images were evaluated for obstructive stenoses and high-risk plaque (HRP) morphology. Patients were followed up for the occurrence of all-cause death and non-fatal myocardial infarction (MI). During a median follow-up of 6.8 (interquartile range 4.8–7.8) years, 42 (7.8%) patients experienced events, including 23 (4.3%) deaths, and 19 (3.5%) MIs. Annualized event rates for normal vs. abnormal results of PET MBF, CCTA-derived stenosis, and HRP morphology were 0.6 vs. 2.1%, 0.4 vs. 2.1%, and 0.8 vs. 2.8%, respectively (P < 0.001 for all). Cox regression analysis demonstrated prognostic values of PET perfusion imaging [hazard ratio (HR) 3.75 (1.84–7.63), P < 0.001], CCTA-derived stenosis [HR 5.61 (2.36–13.34), P < 0.001], and HRPs [HR 3.37 (1.83–6.18), P < 0.001] for the occurrence of death or MI. However, only stenosis severity [HR 3.01 (1.06–8.54), P = 0.039] and HRPs [HR 1.93 (1.00–3.71), P = 0.049] remained independently associated.

Conclusion 

PET-derived MBF, CCTA-derived stenosis severity, and HRP morphology were univariably associated with death and MI, whereas only stenosis severity and HRP morphology provided independent prognostic value.

A critical review of biogas production and usage with legislations framework across the globe

This review showcases a comprehensive analysis of studies that highlight the different conversion procedures attempted across the globe. The resources of biogas production along with treatment methods are presented. The effect of different governing parameters like feedstock types, pretreatment approaches, process development, and yield to enhance the biogas productivity is highlighted. Biogas applications, for example, in heating, electricity production, and transportation with their global share based on national and international statistics are emphasized. Reviewing the world research progress in the past 10 years shows an increase of ~ 90% in biogas industry (120 GW in 2019 compared to 65 GW in 2010). Europe (e.g., in 2017) contributed to over 70% of the world biogas generation representing 64 TWh. Finally, different regulations that manage the biogas market are presented. Management of biogas market includes the processes of exploration, production, treatment, and environmental impact assessment, till the marketing and safe disposal of wastes associated with biogas handling. A brief overview of some safety rules and proposed policy based on the world regulations is provided. The effect of these regulations and policies on marketing and promoting biogas is highlighted for different countries. The results from such studies show that Europe has the highest promotion rate, while nowadays in China and India the consumption rate is maximum as a result of applying up-to-date policies and procedures.

Society of Cardiovascular Computed Tomography / North American Society of Cardiovascular Imaging - Expert Consensus Document on Coronary CT Imaging of Atherosclerotic Plaque

Coronary computed tomographic angiography (CCTA) provides a wealth of clinically meaningful information beyond anatomic stenosis alone, including the presence or absence of nonobstructive atherosclerosis and high-risk plaque features as precursors for incident coronary events. There is, however, no uniform agreement on how to identify and quantify these features or their use in evidence-based clinical decision-making. This statement from the Society of Cardiovascular Computed Tomography and North American Society of Cardiovascular Imaging addresses this gap and provides a comprehensive review of the available evidence on imaging of coronary atherosclerosis. In this statement, we provide standardized definitions for high-risk plaque (HRP) features and distill the evidence on the effectiveness of risk stratification into usable practice points. This statement outlines how this information should be communicated to referring physicians and patients by identifying critical elements to include in a structured CCTA report - the presence and severity of atherosclerotic plaque (descriptive statements, CAD-RADS™ categories), the segment involvement score, HRP features (e.g., low attenuation plaque, positive remodeling), and the coronary artery calcium score (when performed). Rigorous documentation of atherosclerosis on CCTA provides a vital opportunity to make recommendations for preventive care and to initiate and guide an effective care strategy for at-risk patients.

The effect of lutein and Urtica dioica extract on in vitro production of embryo and oxidative status in polycystic ovary syndrome in a model of mice

BACKGROUND

Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrinopathies in women during the reproductive age. Herbal medicines are used increasingly alone or in supplement with chemical medicines for the treatment of different diseases and dysfunctions. This study was aimed to evaluate the effects of lutein and nettle (Urtica dioica) extract on the biochemical parameters and the reproductive function in the PCOS model of mice.

METHODS

Following the induction of PCOS by dehydroepiandrosterone (DHEA), the mice (n = 98) were randomly assigned into seven groups, each consisting of fourteen mice; the groups were included control group (received solvent), PCOS group (received 6 mg/100 g B.W/day IP, DHEA for 21 days), PCOS+ Nettle extract (200 and 400 mg/kg), PCOS+ Lutein (125 and 250 mg/kg), and PCOS+ NL (200 mg/kg nettle extract and 125 mg/kg lutein). The nettle extract and lutein were administrated using gavage for 30 consecutive days after PCOS induction. Malondialdehyde (MDA), total antioxidant capacity (TAC), and estrogen were measured in serum, ovary, and uterus samples by the ELISA method. The total number of oocytes, oocyte quality, fertilization rate, 2-cell blastocyst, and arrested embryos (type I, type II, and type III) were also investigated.

RESULTS

A combination treatment of the nettle and lutein produced the lowest concentration of MDA in comparison to other groups which affected by the PCOS. The lowest level of TAC was observed in the PCOS group without treatment. The number of oocytes, oocyte quality, fertilization rate, and 2-cell blastocyst were significantly higher in the control group, but the lowest values were observed in the PCOS group without any treatment.

CONCLUSIONS

The most favorable findings include improving antioxidant capacity, oocyte and embryo quality were observed in the PCOS+ 125 L group.

Long-term grazing exclosure: implications on water erosion and soil physicochemical properties (case study: Bozdaghin rangelands, North Khorasan, Iran)

Grazing exclosure (GE) is used to improve rangelands in the dry area of the world, so it is important to investigate its effects on soil physicochemical and erodibility properties. This study was conducted to evaluate the effect of long-term GE on the physicochemical and erodibility properties of soil and vegetation as compared with open grazing (OG) areas in Bozdaghi region of North Khorasan province, Iran. Soil and vegetation data were sampled from two sites in the grazing exclosure and the open grazing in early autumn in a randomized complete block design with three replications. Therefore, in each area (GE and OG), three transects of 500-m length and 200-m intervals) were set up. Along each transect, five soil samples were taken at the depths of 0-15 and 15-30 cm in a random-systematic method (15 soil samples in each area) and transferred to the laboratory. In the laboratory, some soil physicochemical properties such as saturation percentage, soil texture (clay, silt, and sand), bulk density, porosity, percentage of soil organic matter (SOM), total nitrogen (TN), exchangeable sodium, potassium, pH, and electrical conductivity (EC) were measured and Soil Erodibility Index (SEI) was calculated by using the modified clay ratio relation. After installing the transects (with a length of 50 m) in three blocks in each area, the parameters of species composition and canopy cover were investigated by the linear-contact method. Data analysis was performed by using an independent t test on Statistical Package for Social Sciences (SPSS) v. 23 software. The results indicate that the application of GE in the Bozdaghi area has a significant positive effect on soil physicochemical properties (P < 0.05). Also, the application of GE has increased the amount of SOM and TN in the surface layer of the soil by about twice as much as the OG pastures. Due to these changes, during 20 years in the GE area, the effects of GE can be positively assessed. According to the obtained results, especially the positive changes in vegetation and the soil physicochemical and erodibility properties, it is recommended to execute the GE plan in the study area.

The Effects of Knee Orthosis with Two Degrees of Freedom Joint Design on Gait and Sit-to-Stand Task in Patients with Medial Knee Osteoarthritis

Objectives

Knee bracing as a conservative treatment option for patients with medial knee osteoarthritis (KOA) is of great interest to health practitioners and patients alike. Optimal orthotic knee joint structure is essential to achieve biomechanical and clinical effectiveness. Therefore, this study aimed to identify the effects of a knee orthosis with a new two-degrees-of-freedom (DOF) joint design on selected gait parameters and in a sit-to-stand task in patients with mild-to-moderate medial KOA.

Methods

This study was conducted both at the Physical Medicine and Rehabilitation Clinic in Shahid Modarres Academic Hospital and the Biomechanical Laboratory of Rehabilitation Faculty of Iran University of medical Sciences in Tehran, Iran from September 2015 to October 2017. The gait performance of 16 patients was assessed without an orthosis, using a common one-DOF (DOF) knee orthosis and using the same knee orthosis with a two-DOF orthotic joint design. The interactive shearing force between limb and brace in the shell area during a sit-to-stand test was also identified. Repeated measures analysis of variance was used to analyse the data.

Results

Compared with walking with no orthosis, both orthosis conditions reduced the external knee adduction moment significantly (P ≤0.05). A significant increase between the one-DOF and two-DOF conditions in terms of walking speed (P = 0.041 and P = 0.009, respectively) and stride length (P = 0.028 and P = 0.038, respectively) was observed. In a sit-to-stand test, wearing the orthosis significantly decreased knee transverse plane range of motion (P ≤0.05). There was a 41.31 ± 8.34 Newtons reduction in knee flexion constraint force.

Conclusion

The two-DOF knee orthosis was more comfortable compared to the one-DOF knee orthosis during deep knee flexion. Otherwise, the one-DOF- and two-DOF-braces performed similarly.

The Relationship Between Coronary Calcification and the Natural History of Coronary Artery Disease

OBJECTIVES

The aim of the current study was to explore the impact of plaque calcification in terms of absolute calcified plaque volume (CPV) and in the context of its percentage of the total plaque volume at a lesion and patient level on the progression of coronary artery disease.

BACKGROUND

Coronary artery calcification is an established marker of risk of future cardiovascular events. Despite this, plaque calcification is also considered a marker of plaque stability, and it increases in response to medical therapy.

METHODS

This analysis included 925 patients with 2,568 lesions from the PARADIGM (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging) registry, in which patients underwent clinically indicated serial coronary computed tomography angiography. Plaque calcification was examined by using CPV and percent CPV (PCPV), calculated as (CPV/plaque volume) × 100 at a per-plaque and per-patient level (summation of all individual plaques).

RESULTS

CPV was strongly correlated with plaque volume (r = 0.780; p < 0.001) at baseline and with plaque progression (r = 0.297; p < 0.001); however, this association was reversed after accounting for plaque volume at baseline (r = -0.146; p < 0.001). In contrast, PCPV was an independent predictor of a reduction in plaque volume (r = -0.11; p < 0.001) in univariable and multivariable linear regression analyses. Patient-level analysis showed that high CPV was associated with incident major adverse cardiac events (hazard ratio: 3.01: 95% confidence interval: 1.58 to 5.72), whereas high PCPV was inversely associated with major adverse cardiac events (hazard ratio: 0.529; 95% confidence interval: 0.229 to 0.968) in multivariable analysis.

CONCLUSIONS

Calcified plaque is a marker for risk of adverse events and disease progression due to its strong association with the total plaque burden. When considered as a percentage of the total plaque volume, increasing PCPV is a marker of plaque stability and reduced risk at both a lesion and patient level. (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging [PARADIGM]; NCT02803411).

Increasing the COP of a refrigeration cycle in natural gas liquefaction process using refrigerant blends of Propane-NH3, Propane-SO2 and Propane-CO2

This paper investigates the feasibility of using inexpensive techniques to enhance the coefficient of performance (COP) of the refrigeration cycle used in the liquefaction of natural gas. The effect of mixing the propane refrigerant with ammonia, sulfur dioxide and carbon dioxide on the performance and the work of the compressor is studied. It is shown that the mixture of ammonia-propane and sulfur dioxide-propane enhances the overall COP by 7% and 9%, respectively. The addition of ammonia and sulfur dioxide to the propane refrigerant reduces the overall compressor work by reducing the overall mass flowrate required to absorb a constant heat from the natural gas. On the other hand, the mixture of carbon dioxide-propane degrades the overall COP by 70%. The addition of carbon dioxide increases the overall mass flowrate required to absorb a constant heat from the natural gas. Interestingly, the proposed method requires small capital and running costs.

From Subclinical Atherosclerosis to Plaque Progression and Acute Coronary Events: JACC State-of-the-Art Review

It has been believed that most acute coronary events result from the rupture of mildly stenotic plaques, based on studies in which angiographic information was available from many months to years before the event. However, serial studies in which angiographic data were available from the past as also within 1 to 3 months of myocardial infarction have clarified that nonobstructive lesions progressively enlarged relatively rapidly before the acute event occurred. Noninvasive computed tomography angiography imaging data have confirmed that lesions that did not progress voluminously over time rarely led to events, regardless of the extent of luminal stenosis or baseline high-risk plaque morphology. Therefore, plaque progression could be proposed as a necessary step between early, uncomplicated atherosclerosis and plaque rupture. On the other hand, it has been convincingly demonstrated that intensive lipid-lowering therapy (to a low-density lipoprotein cholesterol level of <70 mg/dl) halts plaque progression. Given the current ability to noninvasively detect the presence of early atherosclerosis, the importance of plaque progression in the pathogenesis of myocardial infarction, and the efficacy of maximum lipid-lowering therapy, it has been suggested that plaque progression is a modifiable step in the evolution of atherosclerotic plaque. A personalized approach based on the detection of early atherosclerosis can trigger the necessary treatment to prevent plaque progression and hence plaque instability. Therefore, this approach can redefine the traditional paradigm of primary and secondary prevention based on population-derived risk estimates and can potentially improve long-term outcomes.

The role of bentonite clay and bentonite clay@MnFe2O4 composite and their physico-chemical properties on the removal of Cr(III) and Cr(VI) from aqueous media

In this investigation, bentonite clay (BC) and bentonite clay@MnFe2O4 composite (BCMFC) were applied as efficient adsorbents for adsorbing Cr(III) and Cr(VI) ions from aqueous media. Different analyses such as FTIR, SEM, EDX, Map, BET, and XRD were used to characterize the adsorbents. The results showed that the removal efficiency of Cr(III) and Cr(VI) using BC were found to be 95.21 and 95.74%, while the corresponding values to the BCMFC were 97.37 and 98.65%, respectively. Also, the equilibrium and kinetic studies showed that the Freundlich isotherm model and the quasi-second-order kinetic model could better describe the equilibrium and kinetic behaviors of the adsorption process. The maximum adsorption capacity of the BC for the adsorption of Cr(III) and Cr(VI) ions were evaluated as 151.5 mg/g (25oC, pH 6, 90 min, and 1 g/L) and 161.3 mg/g (25oC, pH 3, 90 min, and 1 g/L), respectively, while the BCMFC showed the maximum capacities of 175.4 mg/g (25oC, pH 6, 60 min, and 1.5 g/L) and 178.6 mg/g (25oC, pH 3, 60 min, and 1.5 g/L) for Cr(III) and Cr(VI) ions, respectively, which were remarkable amounts. In addition, the thermodynamic study indicated that the adsorption process was physical, spontaneous, and exothermic. High removal efficiency, high chromium adsorption capacity, and low-cost magnetic adsorbent were significant features of the BCMFC for removal of Cr (III) and Cr (VI).

Subcutaneous Hydatid Cyst in Laboratory Mice: Is it a Suitable Method for Evaluating Therapeutic Agents against Hydatid Cyst?

Hydatid disease is an economic and public health concern in many countries. Currently, surgery is the main treatment option for hydatid disease. In the surgical treatment of hydatidosis, the use of scolicidal agents is very important due to inactivating live protoscoleces and preventing the recurrence of infection. Therefore, it is necessary to investigate newscolicidal agents and novel medications with higher safety and efficacy. In the previous in vitro studies, the scolicidal effects of the methanolic extracts and aromatic water of Zataria multiflora (Z. multiflora) have been demonstrated. Consequently, in this study, the impact of the nanoemulsion of Z. multiflora essential oil on subcutaneous hydatid cysts was compared with albendazole (ABZ). Fifty laboratory male mice were inoculated with 300 viable protoscoleces subcutaneously on the two sides of the abdomen. Following five months of infection, the remaining infected mice (n=42) were allocated into two treatment and one control (without treatment) groups containing fourteen animals each. Group A received ABZ at the dose of 50 mg/kg for 60 days, group B received the nanoemulsions of Z. multiflora at the dose of 50 mg/kg in drinking water for 60 days, and group C was considered as the control group. All the infected mice were euthanized and necropsied two months post-intervention. Afterwards, the cysts were cautiously collected and their number, size, and weight were compared between the mice of different groups. The mean number of hydatid cysts indicated that the nanoemulsion of Z. multiflora essence had a relative superiority to ABZ. On the other hand, the therapeutic effect of ABZ was higher than the nanoemulsion of Z. multiflora essential oil in terms of the mean weight and mean size of hydatid cysts. However, no significant difference was observed between the groups (P&amp;gt;0.5). Overall, the number, weight, and size of cysts were not significantly different between the groups in this investigation. The lack of satisfactory therapeutic results in this study might be due to the location of hydatid cysts in the subcutaneous space.

The effect of pre-breeding vitamin E and selenium injection on reproductive performance, antioxidant status, and progesterone concentration in estrus-synchronized Mehraban ewes

The present study was conducted to assess the effects of pre-breeding vitamin E and selenium (ESe) injections on the reproductive performance, antioxidant status, and serum progesterone (P₄) concentration in estrus-synchronized Mehraban ewes. During the breeding season, 38 ewes (3-4 years) were divided into two groups (n = 18), and the synchronization of estrus was achieved by intravaginal insertion of 0.3 g progesterone CIDR device for 13 days followed by 350 IU eCG at CIDR withdrawal. Ewes were kept under pasture conditions and exposed to Mehraban rams 48 h following CIDR withdrawal. The experimental treatments were control and ESe injection. The ESe group was received three intramuscular (5 mL) injections of Ese (0.5 mg/mL of selenium as sodium selenite and 50 IU vitamin E as DL-α- tocopheryl) once every 2 weeks. Specifically, Ese was administered at 2 weeks before CIDR insertion, at the times of CIDR insertion and CIDR withdrawal. Fertility, prolificacy, lambing rate, and birth weight were recorded after parturition. Blood samples were collected at CIDR insertion, CIDR withdrawal, 5, 10, and 15 days after ram exposure. Fertility, prolificacy, lambing rate, and birth weight did not improve by Ese treatment, but viability of lambs was higher in ESe than control (P < 0.05). Serum total antioxidant capacity at day 5 and P₄ at day 10 after ram exposure was higher in ESe than control (P < 0.05). In conclusion, sheep breeders can use ESe at CIDR insertion and withdrawal times to potentiate antioxidant status and progesterone profile of estrus-synchronized Mehraban ewes.

Tris(hydroxymethyl)aminomethane-grafted polyamine nanofiltration membrane: enhanced antifouling and pH resistant properties

In this study, to fabricate a pH resistant membrane with antifouling properties, a Tris-grafted polyamine thin film composite (TFC) membrane has been synthesized.

Comparison of pressure release, phonophoresis and dry needling in treatment of latent myofascial trigger point of upper trapezius muscle

BACKGROUND

Latent myofascial trigger point (LMTP) is a small hypersensitive area in skeletal muscles that becomes painful under compression or stimulation. LMTPs are relevant for various musculoskeletal disorders. Although several treatments have been introduced to treat LMTP, the most efficient one is yet to be found.

OBJECTIVE

The main purpose of the present study was to compare pressure release, phonophoresis of betamethasone and dry needling on the upper trapezius latent myofascial trigger point.

METHODS

Sixty participants (mean ± SD age, 23.6 ± 2.1 y), with at least one latent myofascial trigger point in the upper trapezius muscle, participated in this study. Subjects were randomly divided into three groups (pressure release, phonophoresis with betamethasone and dry needling groups) for two weeks. Pain intensity, pain pressure threshold and active cervical range of motion were assessed.

RESULTS

Significant pain decrease, active cervical range of motion and pain pressure threshold increase were observed in the three groups (p< 0.001). The dry needling and phonophoresis groups reported more significant improvement compared to the pressure release group (p< 0.001). There was no difference between the dry needling and phonophoresis groups.

CONCLUSIONS

Considering the significant, positive effects of all three methods, dry needling and phonophoresis seem to be more effective than pressure release.

The intra- and inter-observer reliability of interface pressure measurements of the Milwaukee brace in adolescents with hyperkyphosis

BACKGROUND

There is a lack of evidence in reliability of the modified sphygmomanometer to measure the brace-interface pad pressure in adolescents with Scheuermann's kyphosis (SK).

OBJECTIVES

To evaluate the intra- and inter-observer reliability of modified sphygmomanometer for measuring interface pad pressure in the Milwaukee brace.

METHODS

Two observers measured the pressure of the shoulder and kyphosis pads in Milwaukee brace on 33 adolescents with SK with an average age of 14.67 ± 1.72 years and Cobb angle 64.48∘± 7.53∘. All measurements were obtained in one day. The measurements were done in the inhalation and exhalation of tidal breathing during standing and sitting positions. The intraclass correlation coefficient (ICC), 95% confidence interval (CI), and linear mixed model ANOVA effects were calculated.

RESULTS

The intra-observer reliability varied from a good ICC of 0.81 (0.66-0.90) to an excellent of 0.97 (0.95-0.98). The inter-observer reliability also varied from a good ICC of 0.82 (0.67-0.91) to an excellent of 0.96 (0.93-0.98). The linear mixed model ANOVA analysis showed that the rater, position, and breathing had a significant effect on the pad pressure measurements.

CONCLUSIONS

The modified sphygmomanometer is a reliable tool to measure the pad pressure of the Milwaukee brace for adolescents with SK.

Effect of exercise on static balance and Cobb angle during the weaning phase of brace management in idiopathic scoliosis and hyperkyphosis: A preliminary study

BACKGROUND

Exercises are usually prescribed in association with orthotic intervention for management of idiopathic scoliosis, however the role of these exercises on the efficacy of brace and/or balance is not clear yet.

OBJECTIVES

To investigate the role of exercise (the Blount and Moe protocol) on static balance and Cobb angle changes in adolescents with spinal deformities during weaning from brace.

METHODS

Seventeen brace users were allocated into 3 groups (good, moderate, and weak), according to their exercise quality and quantity static balance was evaluated on 4 conditions (standing on a platform/foam; with/without brace) using a force platform. Center of pressure displacement parameters were compared among the 3 groups. The mean Cobb angles of scoliosis and kyphosis at the beginning of brace use and at the start of the weaning phase were compared in general and among the 3 analogous groups.

RESULTS

No significant difference was found in the static balance parameters and also in Cobb angles among the 3 groups. However, scoliosis and kyphosis Cobb angles were improved significantly as a result of using the brace (p< 0.01).

CONCLUSIONS

The exercise quantity and quality in association with bracing, up to the weaning phase, has no effect on static balance and changes in scoliosis and kyphosis, but the curvature of scoliosis and kyphosis is reduced after wearing a brace.