Genipin-Cross-Linked Silk Fibroin/Alginate Dialdehyde Hydrogel with Tunable Gelation Kinetics, Degradability, and Mechanical Properties: A Potential Candidate for Tissue Regeneration

Genipin-cross-linked silk fibroin (SF) hydrogel is considered to be biocompatible and mechanically robust. However, its use remains a challenge for in situ forming applications due to its prolonged gelation process. In our attempt to facilitate the in situ fabrication of a genipin-mediated SF hydrogel, alginate dialdehyde (ADA) was utilized as a reinforcement template. Here, SF/ADA-based hydrogels with different compositions were synthesized covalently and ionically. Incorporating ADA into the SF hydrogel increased pore size (44.66-174.66 μm), porosity (61.59-80.40%), and the equilibrium swelling degree (7.60-30.17). Moreover, a wide range of storage modulus and compressive modulus were obtained by adjusting the proportions of SF and ADA networks within the hydrogel. The in vitro cell analysis using preosteoblast cells (MC3T3-E1) demonstrated the cytocompatibility of all hydrogels. Overall, the covalently and ionically cross-linked SF/ADA hydrogel represents a promising solution for in situ forming hydrogels for applications in tissue regeneration.

Type 2 diabetes patients requiring empagliflozin in Southeast of Iran: Frequency and guideline adherence (2022-2023)

INTRODUCTION

Empagliflozin plays a beneficial role in individuals with type 2 diabetes at high risk of cardiovascular complications. This study aimed to assess the prevalence of individuals with type 2 diabetes who required empagliflozin based on clinical guidelines between the years 2022 and 2023.

MATERIAL AND METHODS

This study was a descriptive-analytical cross-sectional study conducted on a target population of patients with type 2 diabetes. Patient data, including demographic characteristics, smoking status, hypertension, hyperlipidemia, renal insufficiency, retinopathy, and proteinuria, were collected. The indication for prescribing empagliflozin was determined based on the risk of cardiovascular complications.

RESULTS

A total of 398 individuals with type 2 diabetes with a mean age of 58.4 years were examined. Overall, 87.4% of the patients had an indication for empagliflozin prescription. The indication for empagliflozin prescription was significantly higher in men, individuals with hyperlipidemia, those over 55 years of age, obese individuals, and smokers. The mean age, body mass index, and triglyceride levels were higher in candidates for empagliflozin prescription. Male candidates for empagliflozin had significantly higher rates of smoking and systolic blood pressure compared to females.

CONCLUSIONS

The findings of this study demonstrated that a significant percentage of individuals with type 2 diabetes had an indication for empagliflozin prescription based on clinical and laboratory criteria.

ATP releasing channels and the ameliorative effects of high intensity interval training on diabetic heart: a multifaceted analysis

Type 2 diabetes (T2D) can cause severe cardiac complications at functional, histologic and molecular levels. These pathological complications could be mediated by ATP-releasing channels such as Panx1 and ATP receptors, in particular P2X7. The aim of our study was to investigate the effect of high-intensity interval training (HIIT) on T2D-induced cardiac complications at the functional, histopathological and molecular levels, with a particular focus on ATP-releasing channels. 48 male Wistar rats at the age of 8 weeks were randomly allocated into four groups: control (Con), Diabetes (T2D), Training (TR), and Diabetes + Training (T2D + TR). T2D was induced by a high-fat diet plus a low dose (35 mg/kg) of STZ administration. Rats in the TR and T2D + TR groups underwent an 8-weeks training program involving intervals ranging from 80 to 100% of their maximum running speed (Vmax), with 4-10 intervals per session. Protein expression of Interleukin 1β (IL1β), Interleukin 10 (IL-10), Pannexin 1 (Panx1), P2X7R (purinergic P2X receptor 7), NLRP1 (NLR Family Pyrin Domain Containing 1), BAX, and Bcl2 were measured in the heart tissue. Additionally, we assessed heart function, histopathological changes, as well as insulin resistance using the homeostasis model assessment of insulin resistance (HOMA-IR). In contrast to the T2D group, HIIT led to increased protein expression of Bcl2 and IL-10 in the heart. It also resulted in improvements in systolic and diastolic blood pressures, heart rate, ± dp/dt (maximum and minimum changes in left ventricular pressure), while reducing protein expression of IL-1β, Panx1, P2X7R, NLRP1, and BAX levels in the heart. Furthermore, left ventricular diastolic pressure (LVDP) was reduced (P ≤ 0.05). Moreover, heart lesion scores increased with T2D but decreased with HIIT, along with a reduction in fibrosis percentage (P ≤ 0.05). The results of this study suggest that the cardioprotective effects of HIIT on the diabetic heart may be mediated by the modulation of ATP-releasing channels. This modulation may lead to a reduction in inflammation and apoptosis, improve cardiac function, and attenuate cardiac injury and fibrosis.

Caffeine attenuates spermatogenic disorders in mice with induced chronic scrotal hyperthermia

OBJECTIVE

Chronic scrotal hyperthermia (SHT) can lead to serious disorders of the male reproductive system, with oxidative stress playing a key role in the onset of these dysfunctions. Thus, we evaluated the impact of caffeine, a potent antioxidant, on cellular and tissue disorders in mice with chronic SHT.

METHODS

In this experimental study, 56 adult male NMRI mice were allocated into seven equal groups. Apart from the non-treated control group, all were exposed to heat stress. Two groups, termed "preventive" and "curative," were orally administered caffeine. The preventive mice began receiving caffeine immediately prior to heat exposure, while for the curative group, a caffeine regimen was initiated 15 consecutive days following cessation of heat exposure. Each treated group was subdivided based on pairing with a positive control (Pre/curative [Cur]+PC) or a vehicle (Pre/Cur+vehicle). Upon conclusion of the study, we assessed sperm characteristics, testosterone levels, stereological parameters, apoptosis, antioxidant and oxidant levels, and molecular markers.

RESULTS

Sperm parameters, testosterone levels, stereological parameters, biochemical factors (excluding malondialdehyde [MDA]), and c-kit gene expression were significantly elevated in the preventive and curative groups, especially the former, relative to the other groups. Conversely, expression levels of the heat shock protein 72 (HSP72) and nuclear factor kappa beta (NF-κβ) genes, MDA levels, and apoptotic cell density were markedly lower in both caffeine-treated groups relative to the other groups, with more pronounced differences observed in the preventive group.

CONCLUSION

Overall, caffeine attenuated cellular and molecular abnormalities induced by heat stress in the testis, particularly in the mice treated under the preventive condition.

Novel nucleotide variations in the thrombomodulin (THBD) gene involved in coagulation pathways can increase the risk of recurrent pregnancy loss (RPL)

Recurrent pregnancy loss (RPL) is a common but complex complication in fertility conditions, affecting about 15-20% of couples. Although several causes have been proposed for RPL, it occurs in about 35-60% of cases without a known explanation. A strong assumption is that genetic factors play a role in the etiology and pathophysiology of PRL. Therefore, several genes are proposed as candidates in the pathogenesis of RPL. The current study aimed to investigate the effects of nucleotide changes in the THBD (thrombomodulin) gene as an RPL-related candidate gene. This gene encodes a cell receptor for thrombin and is involved in reproductive loss in RPL cases. Its involvement in the natural anticoagulant system has been extensively studied. By genetic screening of the entire coding and noncoding regions of the THBD gene, we found twenty-seven heterozygous and homozygous nucleotide changes. Ten of them led to amino acid substitutions, seven variants were identified in the promoter region, and eight of them occurred in 3'UTR. Potentially, the pathogenicity effects of these variations on THBD protein were evaluated by several prediction tools. The numerous genomic variations prompted noticeable modifications of the protein's structural and functional properties. Furthermore, in-silico scores were consistent with deleterious effects for these mutations. The results of this study provide genetic information that will be useful in the future for clinicians, scientists, and students to understand the unknown causes of RPL better. It may also pave the way for developing diagnostic/prognostic approaches to help treat PRL patients.

Kdr genotyping and the first report of V410L and V1016I kdr mutations in voltage-gated sodium channel gene in Aedes aegypti (Diptera: Culicidae) from Iran

BACKGROUND

Aedes aegypti is the main vector of arboviral diseases worldwide. The species invaded and became established in southern Iran in 2020. Insecticide-based interventions are primarily used for its control. With insecticide resistance widespread, knowledge of resistance mechanisms is vital for informed deployment of insecticidal interventions, but information from Iranian Ae. aegypti is lacking.

METHODS

Fifty-six Ae. aegypti specimens were collected from the port city of Bandar Lengeh in Hormozgan Province in the South of Iran in 2020 and screened for kdr mutations. The most common kdr mutations in Latin America and Asia (V410L, S989P, V1016G/I and F1534C), especially when present in combinations, are highly predictive of DDT and pyrethroid resistance were detected. Phylogenetic analyses based on the diversity of S989P and V1016G/I mutations were undertaken to assess the phylogeography of these kdr mutations.

RESULTS

Genotyping all four kdr positions of V410L, S989P, V1016G/I and F1534C revealed that only 16 out of the 56 (28.57%) specimens were homozygous wild type for all kdr mutation sites. Six haplotypes including VSVF (0.537), VSVC (0.107), LSVF (0.016), LSIF (0.071), VPGC (0.257) and LPGC (0.011) were detected in this study. For the first time, 11 specimens harbouring the V410L mutation, and 8 samples with V1016I mutation were found. V410L and V1016I were coincided in 8 specimens. Also, six specimens contained 1016G/I double mutation which was not reported before.

CONCLUSIONS

The relatively high frequency of these kdr mutations in Iranian Ae. aegypti indicates a population exhibiting substantial resistance to pyrethroid insecticides, which are used widely in control operations and household formulations. The detection of the 410L/1016I kdr mutant haplotype in Iranian Ae. aegypti suggests possible convergence of invasive populations from West Africa or Latin America. However, as Iran has very limited maritime/air connections with those African countries, a Latin American origin for the invasive Ae. aegypti in Iran is more plausible.

High-intensity intermittent training ameliorates methotrexate-induced acute lung injury

Inflammation and oxidative stress are recognized as two primary causes of lung damage induced by methotrexate, a drug used in the treatment of cancer and immunological diseases. This drug triggers the generation of oxidants, leading to lung injury. Given the antioxidant and anti-inflammatory effects of high-intensity intermittent training (HIIT), our aim was to evaluate the therapeutic potential of HIIT in mitigating methotrexate-induced lung damage in rats. Seventy male Wistar rats were randomly divided into five groups: CTL (Control), HIIT (High-intensity intermittent training), ALI (Acute Lung Injury), HIIT+ALI (pretreated with HIIT), and ALI + HIIT (treated with HIIT).HIIT sessions were conducted for 8 weeks. At the end of the study, assessments were made on malondialdehyde, total antioxidant capacity (TAC), superoxide dismutase (SOD), glutathione peroxidase (Gpx), myeloperoxidase (MPO), interleukin 10 (IL-10), tumor necrosis factor-alpha (TNF-α), gene expression of T-bet, GATA3, FOXP3, lung wet/dry weight ratio, pulmonary capillary permeability, apoptosis (Caspase-3), and histopathological indices.Methotrexate administration resulted in increased levels of TNF-α, MPO, GATA3, caspase-3, and pulmonary edema indices, while reducing the levels of TAC, SOD, Gpx, IL-10, T-bet, and FOXP3. Pretreatment and treatment with HIIT reduced the levels of oxidant and inflammatory factors, pulmonary edema, and other histopathological indicators. Concurrently, HIIT increased the levels of antioxidant and anti-inflammatory factors.

Inhalation of Spray-Dried Extract of Salvia rosmarinus Spenn Alleviates Lung Inflammatory, Oxidative, and Remodeling Changes in Asthmatic Rats

INTRODUCTION

For centuries, Salvia rosmarinus Spenn has been applied as folk medicine to cure different diseases due to its anti-inflammatory, antibacterial, antioxidant, antifungal, and antitumor effects. To find bioactive medicinal herbs exerting a protective effect on airway inflammation and remodeling, we assessed the anti-oxidative and anti-inflammatory effects of an aqueous spray-dried extract of Salvia rosmarinus Spenn. (rosemary) in an ovalbumin-induced asthmatic rat model.

METHODS

Rats were randomly divided into normal control (control), asthma, asthma+rosemary extract (RE) (13 mg/kg), asthma+RE (50 mg/kg), and asthma+budesonide groups. After 50 days, animals were anesthetized, and then blood, bronchoalveolar lavage fluid (BALF), and lung tissues were collected for subsequent serological and pathological studies. Histopathology of lung tissues was evaluated by H&E staining. The oxidative stress parameters and airway inflammation factors in BALF and lung tissue were explored.

RESULTS

Using thin layer chromatography, the presence of rosmarinic acid was confirmed in aqueous extract of rosemary. Furthermore, RE markedly decreased immunoglobulin E levels (50 mg/kg; p < 0.001 vs. asthma group) and inflammatory cytokines (50 mg/kg; p < 0.001 vs. asthma group) and increased antioxidant enzymes (50 mg/kg, p < 0.001 vs. asthma group). Furthermore, RE at a concentration of 50 mg/kg obviously reduced the number of inflammatory cells, goblet cells, and pathological changes compared to the asthma group.

CONCLUSION

The results showed that RE administration might prevent or alleviate allergic asthma-related pathological change, probably via antioxidant and anti-inflammatory mechanisms.

Ameliorating effects of Acacia arabica and Ocimum basilicum on acetic acid-induced ulcerative colitis model through mitigation of inflammation and oxidative stress

Introduction

Ulcerative colitis (UC) is a chronic recurrent inflammatory disease of the large intestine and rectum. The disease is characterized by oxidative stress and severe inflammation. Research has shown the anti-oxidative and anti-inflammatory effects induced by consuming the Acacia arabia and Ocimum basilicum. The present study aimed to evaluate the effect of treatment with O. basilicum together with A. arabica on healing, inflammation, and oxidative stress in the course of experimental colitis in rats.

Methods

A total number of 50 male rats were selected and randomly assigned to five groups of 10 rats each. Colitis was induced in rats by enemas with a 4 % acetic acid solution. Four days after the colitis induction, the rats were orally treated for the next 4 days with saline or a combination of A. arabica and O. basilicum (1000 mg/kg) or sulfasalazine (100 mg/kg).

Results

Acetic acid-induced colitis increased the colon's macroscopic and histopathological damage scores; increased colon levels of MDA (Malondialdehyde), MPO (Myeloperoxidase), TNF-α (Tissue necrosis factor α), IL6 (Interleukin 6), and IL17 (Interleukin 17); and decreased SOD (Superoxide Dismutase), GPx (Glutathione Peroxidase), and IL10 (Interleukin 10) levels in the treated rats compared with the control group (P < 0.001). Overall, a combination of A. arabica and O. basilicum reduced macroscopic and histopathological damage scores (P < 0.01) of the colon, and MDA, MPO, TNF-α, IL6 (P < 0.001), and IL17 (P < 0.01) levels of the colon. Furthermore, it increased SOD, GPx, and IL10 levels compared to the colitis group (P < 0.01).

Conclusion

A. arabica and O. basilicum have improving effects on UC by reducing inflammation and oxidative stress.

The effect of electronic error-reporting forms on nurse's stress and the rate of error-reporting

OBJECTIVES

The patient safety culture includes a systematic approach that promotes safe care for patients and the leadership that supports it. Medical errors threaten patient safety. A significant portion of medical errors is committed by nurses. Although error-reporting provides valuable information to prevent errors, most nurses do not report their errors due to their high level of stress. This study was to investigate the effect of electronic error-reporting forms on nurses' stress and the rate of error-reporting.

METHODS

The nurses' level of stress was compared when using paper error-reporting and 6 months after using electronic forms. A revised version of the Coudron questionnaire was completed by 186 nurses. Data were analyzed by SPSS 23 using Wilcoxon test. The number of reported errors in paper and electronic media was compared over the same period.

RESULTS

Implementation of the electronic error-reporting form reduced the job stress of nurses by 22.22 points (p=.00) and increased the error-reporting rate by 12.86% (p<.05).

CONCLUSIONS

Although nurse's stress significantly decreases after implementing electronic error-reporting forms, their level of stress is still high and they are still at risk for physical and mental problems. Using methods like modifying the error-reporting form will increase the error-reporting rate.

Investigation of osteogenesis and angiogenesis in perfusion bioreactors using improved multi-layer PCL-nHA-nZnO electrospun scaffolds

PURPOSE

Bone tissue engineering aims to create a three-dimensional, matured, angiogenic scaffold with a suitable thickness that resembles a natural bone matrix. On the other hand, electrospun fibers, which researchers have considered due to their good biomimetic properties, are considered 2D structures. Due to the highly interwoven network and small pore size, achieving the desired thickness for bone lesions has always been challenging. In bone tissue engineering, bioreactors are crucial for achieving initial tissue maturity and introducing certain signals as flow parameters for differentiation.

METHODS

In the present study, Human bone marrow mesenchymal stem cells (hBMSCs) and human umbilical vein endothelial cells (HUVECs) were co-cultured in a perfusion bioreactor on treated (improved pore size by gelatin sacrification and subsequent ultrasonication) 5-layer polycaprolactone-nano hydroxyapatite-nano zinc oxide (T-PHZ) scaffolds to investigate osteogenesis and angiogenesis simultaneously. The flow parameters and stresses on the cells were studied using two patterns of parallel and vertical scaffolds relative to the flow of the culture medium. In dynamic vertical flow (DVF), the culture medium flows perpendicular to the scaffolds, and in dynamic parallel flow (DPF), the culture medium flows parallel to the scaffolds. In all evaluations, static samples (S) served as the control group.

RESULTS

Live/dead, and MTT assays demonstrated the biocompatibility of the 5-layer scaffolds and the suitability of the bioreactor's functional conditions. ALP activity, EDAX analysis, and calcium content measurements exhibited greater osteogenesis for T-PHZ scaffolds in DVF conditions. Calcium content increased by a factor of 2.2, 1.8, and 1.6 during days 7 to 14 of culture under DVF, DPF and S conditions, respectively. After 21 days of co-culturing, an immunohistochemistry (IHC) test was performed to investigate angiogenesis and osteogenesis. Five antibodies were investigated in DVF, CD31, VEGFA, and VEGFR2 for angiogenesis, osteocalcin, and RUNX2 for osteogenesis. Compressive stress applied in DVF mode has increased osteogenic activity compared to DPF.

CONCLUSION

The results indicated the development of ideal systems for osteogenesis and angiogenesis on the treated multilayer electrospun scaffolds in the perfusion bioreactor.

Comparison of preventive and therapeutic effects of continuous exercise on acute lung injury induced with methotrexate

Methotrexate (Mtx) is used to treat various diseases, including cancer, arthritis and other rheumatic diseases. However, it induces oxidative stress and pulmonary inflammation by stimulating production of reactive oxygen species and cytokines. Considering the positive effects of physical activity, our goal was to investigate the preventive and therapeutic role of continuous training (CT) on Mtx-induced lung injury in rats. The rats were divided into five groups of 14 animals: a control group (C); a continuous exercise training group (CT; healthy rats that experienced CT); an acute lung injury with Mtx group (ALI); a pretreatment group with CT (the rats experienced CT before ALI induction), and a post-treatment group with CT (the rats experienced CT after ALI induction). One dose of 20 mg/kg Mtx intraperitoneal was administered in the Mtx and training groups. Forty-eight hours after the last exercise session all rats were sacrificed. According to our results, the levels of tumour necrosis factor-α (TNF-α), malondialdehyde (MDA), myeloperoxidase (MPO), GATA binding protein 3 (GATA3) and caspase-3 in the ALI group significantly increased compared to the control group, and the levels of superoxide dismutase (SOD), glutathione peroxidase (GPX), total antioxidant capacity (TAC), interleukin-10 (IL-10), forkhead box protein 3 (FOXP3), and T-bet decreased. In contrast, compared to the acute lung injury group, pretreatment and treatment with CT reduced TNF-α, MDA, MPO, GATA3 and caspase-3 and increased SOD, GPX, TAC, IL-10, FOXP3 and T-bet levels. The effects of CT pretreatment were more significant than the effects of CT post-treatment. Continuous exercise training effectively reduced oxidative stress and inflammatory cytokines and ameliorated Mtx-induced injury, and the effects of CT pretreatment were more significant than the effects of CT post-treatment. NEW FINDINGS: What is the central question of this study? Considering the high prevalence of lung injury in society, does exercise as a non-pharmacological intervention have ameliorating effects on lung injury? What is the main finding and its importance? Exercise can have healing effects on the lung after pulmonary injury through reducing inflammation, oxidative stress and apoptosis. Considering the lower side effects of exercise compared to drug treatments, the results of this study may be useful in the future.

The Diabetic Lung Can Be Ameliorated by Citrullus colocynthis by Reducing Inflammation and Oxidative Stress in Rats with Type 1 Diabetes

Background

Diabetes impacts various organs in the body and some reports showed that the lung is also affected by diabetes, and an imbalance of inflammation and oxidative stress may participate to diabetic lung impairments. The present study is conducted to assess the impacts of Citrullus colocynthis (CC) on some aspects of these impairments.

Methods

Frothy two male Wistar rats (3-4 months old and weighing 200-250 g) were used in the present research. Animals were divided into 3 groups of control, Diabetes, and Diabetes + Drug. CC was administered to diabetic rats orally. The lung tissue and BALF oxidative stress and inflammatory indices including the MDA, TAC, SOD, Gpx, TNFα, IL-6, IL-17, and IL-10 were evaluated by the ELISA method.

Results

Our observations disclosed the ameliorative impacts of CC administration against oxidative stress and inflammation imbalance. Also, it was found that CC improved body weight and fasting blood sugar in rats with diabetes.

Conclusion

We can conclude that the administration of CC can be effective in improving diabetic lungs in rats.

Evaluation of Laboratory Findings of Patients with Coronavirus Disease 2019 in Kerman, Iran

Background & Objective

Since December 2019 in Wuhan, China there is a new form of pneumonia and after expansion in other countries, World Health Organization (WHO) called it Coronavirus Disease 2019 (COVID-19). Since the clinical laboratory findings have played an important role in the progression of the disease, this study aimed to evaluate the laboratory findings in COVID-19 patients (before vaccination).

Methods

In this case-control study that was conducted from February to August 2020; the laboratory test status in 101 positive COVID-19 patients was evaluated and compared with 101 healthy individuals.

Results

The results of our study showed that 21% of patients had low WBC, 24.75% low RBC, 37.62%, low Hb, 18.81% with low HCT, 29.7%, low Plt, 41.58% had High PT, 71.29% high CRP, 17.82% high urea, 11.88% high CR, 15.84% high LDH, 10.89% low sodium, 14.75% low potassium (K). The quantitative examination of blood factors showed that lymph%, mixed%, PLT, HCT, Hb, and RBC were higher in the control group than in the case group. While Neu%, WBC, PTT, CRP, UREA, LDH, K in the patient group were higher than in the control group.

Conclusion

According to the results of the study, it can be concluded that in the clinical treatment of COVID-19 patients, much attention should be paid to the laboratory indicators to identify and intervene early in critically ill patients.

Selective preparation of crystalline or fibrous nano-cellulose carboxylate to fabricate an anti-bacterial hydrogel in co-operation with ZnO and recycled gelatin

Bio-polymeric based nano-composites and hydrogels are newsworthy nano-biomaterials. Herein, crystalline or fibrous nano-cellulose carboxylate (NCCC and NCCF) were selectively prepared via the controllable direct oxidative-hydrolysis of MC in alkaline NaClO₂ at 1:2 mol ratio, 90 °C, and 24 h for NCCC and at 1:1 mol ratio, 70 °C, and 20 h for NCCF. Characterization of NCCC and NCCF were performed by comparative Fourier transform infrared (FT-IR) spectroscopy, field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), thermal gravimetric analysis (TGA), and energy dispersive X-ray spectroscopy (EDS). Then, NCCC was cross-linked to the recycled gelatin (Gel) from the medicine capsules and the as-prepared nano-ZnO by maleic anhydride (MA) to give the novel hydrogel Gel/MA/NCCC/nano-ZnO. Nano-ZnO plays multi-roles in this hydrogel preparation, as either catalyst for the esterification of cellulose hydroxyls and amidation of gelatin amino groups or as the anti-bacterial part of hydrogel. The in vitro anti-bacterial activity results against the three gram-negative and gram-positive bacteria by well diffusion method confirmed Gel/MA/NCCC/nano-ZnO as an antibacterial agent with the activity order of P. aeruginosa > S. aureus > E. coli. The top anti-bacterial activity of this hydrogel against the gram-negative resistant bacteria of P. aeruginosa suggests its potential for biomedical applications.

Modification of Extracellular Vesicle Surfaces: An Approach for Targeted Drug Delivery

Extracellular vesicles (EVs) are a promising drug delivery vehicle candidate because of their natural origin and intrinsic function of transporting various molecules between different cells. Several advantages of the EV delivery platform include enhanced permeability and retention effect, efficient interaction with recipient cells, the ability to traverse biological barriers, high biocompatibility, high biodegradability, and low immunogenicity. Furthermore, EV membranes share approximately similar structures and contents to the cell membrane, which allows surface modification of EVs, an approach to enable specific targeting. Enhanced drug accumulation in intended sites and reduced adverse effects of chemotherapeutic drugs are the most prominent effects of targeted drug delivery. In order to improve the targeting ability of EVs, chemical modification and genetic engineering are the most adopted methods to date. Diverse chemical methods are employed to decorate EV surfaces with various ligands such as aptamers, carbohydrates, peptides, vitamins, and antibodies. In this review, we introduce the biogenesis, content, and cellular pathway of natural EVs and further discuss the genetic modification of EVs, and its challenges. Furthermore, we provide a comprehensive deliberation on the various chemical modification methods for improved drug delivery, which are directly related to increasing the therapeutic index.

Preparation of gum tragacanth/poly (vinyl alcohol)/halloysite hydrogel using electron beam irradiation with potential for bone tissue engineering

Nanocomposite hydrogels based on tyramine conjugated gum tragacanth, poly (vinyl alcohol) (PVA), and halloysite nanotubes (HNTs) were prepared by electron beam irradiation and characterized. The FTIR, ¹H NMR, and TGA results confirmed the chemical incorporation of HNTs into gum tragacanth. Gel content and swelling of hydrogels decreased with HNTs loading up to 20 % wt. The mechanical strength of hydrogels increased by increasing HNTs content up to 10 % with 371 kPa fracture stress at 0.95 fracture strain, compared to 312 kPa stress at 0.79 strain for gum tragacanth/PVA hydrogel. Hydrogel's biocompatibility and osteogenic activity were tested by seeding rabbit bone marrow mesenchymal stem cells. The cell viability was >85 % after 7 days of culture. In vitro secretion of ALP and calcium deposition on hydrogels in alizarin red assay after 21 days of culture indicated hydrogel potential for bone tissue engineering.

Comparing maternal and neonatal prooxidant-antioxidant balance during delivery

Introduction

Oxidative stress (OS) is a disturbing factor in the balance between the production of free radicals and antioxidant defense, and in fact, the same victory of free radicals on the antioxidant defense of the body. Pregnancy and especially delivery are associated with increased OS. The relationship between maternal and infant prooxidant-antioxidant balance (PAB) is unclear. Therefore, the present study aimed to compare the PAB in the mother and baby.

Material and Methods

This cross-sectional study was conducted on 104 mothers and normal term infants during 2017-2020. Healthy mothers were checked for PAB before delivery and their umbilical cord after delivery. Data on the infant characteristics including age, gestational age, birth weight, Apgar score, and maternal history including the duration of mother's education, weight of the last month, and the gravidity were collected using a researcher-made questionnaire. Then, the cord and the PAB of the mothers before delivery were measured and compared by statistical methods.

Results

In this study, the mean PAB of the neonates and mothers was 30.76 and 214.87 HK, respectively. The results revealed a moderate association between the PAB neonate and maternal PAB before delivery but it was not significant.

Conclusion

Overall, the level of oxidants and antioxidants reduced during pregnancy and before delivery, and it was found that the relative incidence of neonatal PAB increases by increasing maternal PAB.

Evaluating the usability of a cancer registry system using Cognitive Walkthrough, and assessing user agreement with its problems

OBJECTIVE/AIM

Good design of cancer registry systems makes them easy to use, while poor design of their user interfaces leads to user dissatisfaction and resistance. The objective of this study was to evaluate the usability of a cancer registry system using Cognitive Walkthrough (CW) and to assess users' agreement with its usability problems.

METHODS

CW was used to evaluate the registry system. We developed a checklist to help evaluators speed up the evaluation process, a problems form to collect the usability issues identified by the evaluators, and a problems severity form to determine the severity of problems by the evaluators. The problems were classified into two categories according to the CW questions and the system tasks. The agreement of the users with the system problems was examined by an online questionnaire. Users' agreement with the problems was then analyzed using the Interclass Correlation Coefficient in the SPSS 22 (Statistical Package for Social Science).

RESULTS

In this study, 114 problems were identified. In the categorization of problems based on the CW questions, 41% (n = 47) of the problems concerned the issue of "users do not know what to do at each stage of working with the system", 24% (n = 27) were classified as "users cannot link what they intend to do with system controls", and 22% (n = 25) were related to "user's lack of understanding of the system processes". Based on user tasks, about 36% (n = 41) of the problems were related to "removing patient duplication" and 33% (n = 38) were related to "registration of patient identification information". User agreement with the problems was high (CI 95% = 0.9 (0.96, 0.98)).

CONCLUSION

System problems often originate from user ignorance about what to do at each stage of using the system. Also, half of the system problems concern a mismatch between what users want to do and the system controls, or a lack of understanding about what the system does at different stages. Therefore, to avoid user confusion, designers should use clues and guides on the screen for users, design controls consistent with the user model of thinking, and provide appropriate feedback after each user action to help users understand what the system is doing. The high agreement of users with the problems showed that in the absence of users system designers can use CW to identify the problems that users face in the real environment.

Perillyl alcohol (PA) mitigates inflammatory, oxidative, and histopathological consequences of allergic asthma in rats

Allergic asthma is an inflammatory and chronic condition, which is the most common asthma phenotype. It is usually defined by sensitivity to environmental allergens and leads to the narrowing of the airways. Around 300 million individuals are suffering from asthma worldwide. The purpose of the current research was to evaluate the effect of perillyl alcohol (PA) on oxidative stress and inflammation parameters in rats with allergic asthma. Experimental asthma was induced by ovalbumin (OVA) sensitization and inhalation in five groups of rats including control, asthma, asthma + vehicle, asthma + PA, and asthma + dexamethasone (Dexa). PA (50 mg/kg) or Dexa (2.5 mg/kg) were administered intraperitoneally for seven consecutive days following asthma induction. Histopathological evaluation was performed via hematoxylin and eosin (H&E) and Masson's trichrome staining. The enzyme-linked immunosorbent assay (ELISA) was used for the evaluation of the cytokine levels, including tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-17, and IL-10, as well as oxidative stress biomarkers including reactive oxygen species (ROS), superoxide dismutase (SOD), malondialdehyde (MDA), total antioxidant capacity (TAC), and glutathione peroxidase (GPx) in the lung tissue and bronchoalveolar lavage fluid (BALF). Real-time polymerase chain reaction (PCR) was utilized for assessing the mRNA expression of FOXP3 and GATA3 and western blot analysis was used for the measurement of nuclear factor kappa B (NF-κB) protein expression. PA and Dexa decreased the pathological alterations and the expression levels of inflammatory factors (cytokines, GATA3, and NF-κB) in the lung tissue and BALF of asthmatic rats. PA restored GPx, SOD, and TAC levels and reduced ROS, MDA, nitrite, and total protein in the lung and BALF. Overall, our findings demonstrated that PA can be used as a therapeutic agent in asthma patients, but it is essential to monitor its effects in future clinical studies.

Potential Role of Bilirubin in Preventing Retinopathy of Prematurity

BACKGROUND

One of the most common problems in preterm neonates is retinopathy of prematurity (ROP). It has been shown antioxidants may be effective in preventing the development and progression of ROP. Considering the antioxidant properties of bilirubin, we decided to investigate the bilirubin level in neonates with ROP and compare it with healthy neonates.

METHODS

This case-control study was performed on VLBW neonates admitted to the NICU of Ghaem Hospital in Mashhad between 2014 and 2020 for a Jaundice evaluation. Complete neonate's characteristics, maternal history and laboratory results were collected in a questionnaire. Then the neonates were examined for ROP by a fellowship of the retina of an ophthalmologist at 32 weeks or four weeks after birth. The highest bilirubin levels during their hospitalization were also recorded.

RESULTS

Of 427 neonates examined, 121 (37.7%) had a normal eye examination, and 266 (62.3%) had ROP. The mean weight, gestational age and bilirubin were 1455.8 ± 431.4 grams, 31.6 ± 2.3 weeks and 8.8 ± 2.4 mg/dl, respectively. There was a significant difference between controls and neonates with ROP with regard to birth weight, duration of intermittent positive pressure ventilation (IPPV), duration of oxygen therapy, first and fifth minute Apgar scores, the maximum level of bilirubin and gestational age (P < 0.05). It was observed that the maximum level of bilirubin was lower in neonates with higher stages of ROP.

CONCLUSION

According to the results of this study, higher levels of bilirubin in neonates may be a protective factor against ROP. Moreover, increased levels of bilirubin are associated with reduced severity of ROP. Therefore, prophylaxis phototherapy in premature infants may need to be reconsidered.

Cellular Genome-Scale Metabolic Modeling Identifies New Potential Drug Targets Against Hepatocellular Carcinoma

Genome-scale metabolic modeling (GEM) is one of the key approaches to unpack cancer metabolism and for discovery of new drug targets. In this study, we report the Transcriptional Regulated Flux Balance Analysis-CORE (TRFBA-), an algorithm for GEM using key growth-correlated reactions using hepatocellular carcinoma (HCC), an important global health burden, as a case study. We generated a HepG2 cell-specific GEM by integrating this cell line transcriptomic data with a generic human metabolic model to forecast potential drug targets for HCC. A total of 108 essential genes for growth were predicted by the TRFBA-CORE. These genes were enriched for metabolic pathways involved in cholesterol, sterol, and steroid biosynthesis. Furthermore, we silenced a predicted essential gene, 11-beta dehydrogenase hydroxysteroid type 2 (HSD11B2), in HepG2 cells resulting in a reduction in cell viability. To further identify novel potential drug targets in HCC, we examined the effect of nine drugs targeting the essential genes, and observed that most drugs inhibited the growth of HepG2 cells. Some of these drugs in this model performed better than Sorafenib, the first-line therapeutic against HCC. A HepG2 cell-specific GEM highlights sterol metabolism to be essential for cell growth. HSD11B2 downregulation results in lower cell growth. Most of the compounds, selected by drug repurposing approach, show a significant inhibitory effect on cell growth in a wide range of concentrations. These findings offer new molecular leads for drug discovery for hepatic cancer while also illustrating the importance of GEM and drug repurposing in cancer therapeutics innovation.

The use of various appointment systems among patients visiting academic outpatient centers in Kerman and the evaluation of patients’ perspective and satisfaction

Background

To optimize appointment systems, it is necessary to assess their users’ perspectives. This study aims to determine the use of various appointment systems among patients in academic outpatient centers and to investigate their perspectives and satisfaction.

Methods

This survey study was conducted on 332 patients or those accompanying patients in academic outpatient centers. A five-part questionnaire consisting of (1) demographic information, (2) willingness to use systems, (3) problems when using these systems, (4) problems after reserving the appointment, (5) recommendations and critics was used. The relationship between the system of interest and the available tools was examined by the Chi-square test, and the relationship between demographic characteristics and satisfaction was assessed using multiple regression.

Results

The participants’ overall satisfaction towards appointment systems, regardless of the type of system, was 49.12 ± 16.04 (out of 100). Satisfaction with the appointment system using Unstructured Supplementary Service Data (USSD) was significantly higher than the other two systems (p = 0.03). Web-based application and Interactive Voice Response (IVR) were the most frequently used systems with 61% and 48%, respectively. More than half of those who had access to a telephone (56%) preferred the IVR appointment system, and most of those who had Internet access (71%) preferred the web-based application (p < 0.05). Among 137 participants who had access to both the Internet and telephone, 49% (n = 67) stated that they would rather arrange their appointment through the web-based application.

Conclusion

The web-based application and IVR are the most frequently used and favorable appointment system among the patients or those accompanying patients. Despite the availability of the infrastructure, the participant had moderate satisfaction with these systems due to their failures. Therefore, to have more efficient systems and increase patients or those accompanying patients satisfaction with these systems, healthcare authorities should have a plan to solve the problems of these systemes and use the capacity of information resources to inform the community regarding these systems.

Chondroitin sulfate modified chitosan nanoparticles as an efficient and targeted gene delivery vehicle to chondrocytes

Conventional treatments for osteoarthritis (OA), including drug delivery and tissue engineering approaches, could not offer a high yield of cartilage repair due to the compact and exclusive structure of cartilage. Targeted and high-efficiency delivery of gene sequences is necessary to rebalance the lost homeostatic properties of the cartilage in OA. Herein, we synthesized chitosan (CH)-chondroitin sulfate (CS) nanoparticles (NPs) as a platform for delivering gene sequences. These new nanoparticles benefit from two natural polymers that minimize the toxicity, and the presence of CS can be in favor of targeted delivery. The CAG-GFP plasmid was used as a gene sequence model, and the nanoparticles could successfully encapsulate approximately all of them in their structure. Loaded nanoparticles were characterized in terms of morphology, size, zeta potential, the efficiency of encapsulation and, DNA release pattern. Cell viability and uptake of new nanoparticles were compared to the chitosan nanoparticles and Lipofectamine. After substituting TPP with CS, NPs exhibited a significant decrease in size. In addition, there was little difference in zeta potential between nanoparticles. Furthermore, a tremendous increase in plasmid uptake and cell viability was observed by CH-CS NPs compared to CH-TPP NPs and Lipofectamine. In the final stage, the knockdown level of MMP13 was evaluated with real-time RT-PCR for confirming the potential uptake of CH-CS NPs. The results revealed cellular uptake of siRNA loaded NPs and effective knockdown of MMP13 in chondrocytes. In conclusion, CH-CS nanoparticles can be considered as a candidate for gene therapy purposes in cartilage diseases.

A supramolecular injectable hydrogel based on β-cyclodextrin-grafted alginate and pluronic-amine loaded with kartogenin for chondrogenic differentiation of mesenchymal stem cells

Owing to the similarity of hydrogels to cartilage ECM, they have been extensively utilized in the chondral lesions. Moreover, their tunable administration properties are desirable for reducing injuries in lesion sites. Generally, injectable hydrogels are mechanically weak, requiring some modifications for being used as a cell carrier in place of articular cartilage. In this study, a combination of β-cyclodextrin-grafted alginate (Alg-β-CD) and pluronic-amine (PA) with multiple physical crosslinking was used for the first time. Supramolecular interactions, including electrostatic forces, host-guest interaction, and hydrophobic interaction with increasing temperature maintain injectability of hydrogels while these interactions boost mechanical properties to the extent that shear modulus surpassed 40 kPa. Vacant β-CD cavities in conjunction with gel network was exploited for kartogenin (KGN) loading. All groups had gel time of less than one minute and gel temperature was 28 ℃. No toxic effect of hydrogels on encapsulated cells was observed. While the optimum combination of polymers provided a sustainable release for KGN, it also extended the in vitro degradation time of hydrogels from 6 days to 2 weeks. KGN facilitated encapsulated mesenchymal stem cells (MSCs) differentiation towards chondrocytes. Taken together, the synthesized hydrogel proved to be a promising candidate for being utilized in cartilage regeneration.

Fast-dissolving oral films containing dextromethorphan/phenylephrine for sinusitis treatment: formulation, characterization and optimization

This work uses optimization study to formulate a patient-friendly antitussive fast-dissolving oral film based on phenylephrine hydrochloride (Phen) and dextromethorphan hydrobromide (Dex). The designed films were based on hydroxypropylmethyl cellulose (HPMC) with two grades (E5 and E50) as a film-forming polymer by the solvent-casting method. Polyethylene glycol with two molar masses (400 and 1000) was used as a plasticizer, while aspartame was used as a sweetener and microcrystalline cellulose intended to act as a disintegrant. To find an optimum formulation, a response surface methodology and a central composite design were employed. The percentage of HPMC E50, and PEG, as a plasticizer, were considered to be the design factors. Film thickness, surface pH, disintegration time, dissolution percent, tensile strength, elongation percent and folding endurance were considered to be the responses. A film with 11.46% E50, 88.54% E5, 25% of two drugs (8.4% of Phen and 16.6% of Dex) and 18.54% plasticizer is designed and prepared as the optimum formulation for Phen/Dex fast-dissolving oral films, with 95% confidence levels.

Effects of social hierarchy on innate fear‑induced panic responses

Studies have previously demonstrated a relationship between social status and anxiety disorders such as panic disorder. Repeated episodes of panic attacks do not occur in combination with an actual fear stimulus or stressor. However, social ranking modulates the perception of the social signals of a threat or stressor. The hypothalamic nuclei are well‑known for their role in the elaboration of fear‑induced reactions. The dorsomedial hypothalamus (DMH) and the ventromedial hypothalamic (VMH) nuclei are hypothalamic subnuclei involved in the processing of threatening stimuli‑evoked aversive response and innate fear development. These structures are also located in the medial amygdala‑hypothalamus‑brainstem circuit that modulates innate fear‑induced defensive behaviors. This work aimed to investigate the relationship between social hierarchy and innate fear‑induced panic‑like responses in male rats. In our study, the dominance tube test was used to determine the social hierarchy. Then, DMH/VMH nuclei were unilaterally implanted with a guide cannula. After intra‑DMH/VMH injection of bicuculline (GABAA receptor antagonist), both innate fear induction and differences in dominant/subordinate rats were evaluated by the open field test. Intra‑DMH/VMH bicuculline increased the frequency of defensive immobility, forward escape movements, and crossing behaviors, as well as the duration of defensive immobility and forward escape movements in dominant rats. Subordinate rats showed a higher frequency of defensive attention, defensive immobility, and crossing than dominant rats. Additionally, dominant rats demonstrated a lower duration of defensive attention and defensive immobility than subordinate rats. Dominant rats seemed to adopt a form of innate‑fear characterized by increased proactivity with the environment. In contrast, subordinate rats exhibited a reactive form of innate‑fear characterized by passivity and freezing.

Lymphadenopathy Associated with COVID-19 Vaccination Mimicking Breast Cancer Related Axillary LAP: Imaging Findings in Review of 880 Cases

Background: With an increasing rate of lymphadenopathies (LAP) reported following COVID-19 vaccination with various vaccines’ types, which can mimic breast cancer (BC), a comprehensive review, can disclose some practical information about BC workup that reduces the incidence and mortality of the disease along with unnecessary steps. Methods: We conducted a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), Cochrane library, and Google Scholar. Keywords of literature search included “COVID-19”, “coronavirus disease”, “Vaccine”, and “Vaccination”, “LAP”, “Adverse event*”, “Lymph node”, “Cancer, breast”, and “Lymphadenopathy”. Results: In total, 59 studies (n = 880 cases), including 412 (46.8%) females, 146 (16.6%) males, and 322 (36.6%) cases with unknown gender were reviewed. We reviewed the LAP presentation after vaccination of first or second dosage of Pfizer-BioNTech (n = 754, 85.7%), Moderna (n = 38, 4.3%), Oxford-AstraZeneca (n = 39, 4.4%), Sputnik V (n = 1, 0.1%), Johnson & Johnson/Janssen (n = 1, 0.1%), CureVac (n = 1, 0.1%), and in 46 (5.3%) cases, the type of vaccine was not reported. The most common LAP locations were axillary (n = 540) and followed by axillary and supraclavicular (n = 271). We found that imaging findings of LAP associated with vaccination were seen from the first day to two months after vaccination of the first or second dosage of different types of COVID-19 vaccines. Conclusion:  This review study can draw a broad perspective by focusing on patients with cancer, especially BC, for clinicians to proceed with the right approach at the right time without additional invasive measures and not to hold the necessary action in high-risk patients at the same time.

Osteochondral regeneration in rabbit using xenograft decellularized ECM in combination with different biological products; platelet-rich fibrin, amniotic membrane extract, and mesenchymal stromal cells

This study aimed to investigate the regenerative effect of decellularized osteochondral ECM xenograft in combination with various biological products in an osteochondral (OC) defect. OC tissue from the sheep femur were obtained and decellularized. The decellularized ECM (dECM) was combined with either platelet-rich fibrin (PRF), amniotic membrane extract (AME), or rabbit bone marrow-derived mesenchymal stromal cells (rBMSCs). The hybrid dECM-biological products were then utilized for the treatment of rabbit OC critical size defects. The regenerative potential of different groups was compared using; MRI, macroscopic assessment, histopathology, and histomorphometry. All characterizations analysis verified successful decellularization. Three months post-surgery, macroscopic findings indicated that dECM was better compared to controls. Also, dECM in combination with AME, PRF, and rBMSCs showed enhanced OC regeneration compared to only dECM (AME: +100%, PRF: +61%, rBMSCs: +28%). In particular, the dECM+AME group results in the best integration of new cartilage into surrounding cartilage tissue. The histomorphometric evaluations demonstrated enhancement in new cartilage formation and bone tissue (86.5 ± 5.9% and 90 ± 7.7%, respectively) for the dECM+AME group compared to other groups. Furthermore, histological results for the dECM+AME elucidated a mature hyaline cartilage tissue that covered the new and symmetrically formed subchondral bone, exhibiting a significantly higher regenerative effect compared to all other treated groups. This finding was also confirmed with MRI images. The current study revealed that in addition to the benefits of dECM alone, its combination with AME indicated to have a superior regenerative effect on OC regeneration. Overall, dECM+AME may be considered a suitable construct for treating knee OC injuries.

Effect of turmeric extract on bone healing in an experimental model of femoral bone fracture

Objective

Following bone trauma, several factors participate in making a balance between the activity of osteoblasts and osteoclasts. The receptor activator of nuclear factor kappa B ligand (RANKL), receptor activator of nuclear factor kappa B (RANK), and osteoprotegerin (OPG) molecules play critical roles in the healing process via regulation of osteoclasts function. Turmeric is suggested to have an anti-osteogenic potential; however, its effect on accelerating bone healing has not been adequately studied. Here, we used a rat model of femur fracture to explore the effect of treatment with turmeric extract on the bone repair and the expression of RANK, RANKL, and OPG molecules.

Materials and Methods

Eight rats were subjected to surgery, randomly divided into two groups, and treated orally with turmeric (200 mg/kg), or olive oil. Four oil-treated rats without bone fracture were used as control group. After six weeks of treatment, the femurs of animals were examined for radiological, histological, and gene expression analysis.

Results

X-ray radiography showed thicker callus and a more obscure fracture line in the turmeric group. Furthermore, higher osteoblast percentages but no osteoclasts were observed in turmeric-treated animals, representing better repair of bone in the fracture site. Also, real-time analyses showed that treatment with turmeric reduced RANK and RANKL expression (p<0.0001) and lowered RANKL/OPG ratio (p=0.01) in femoral bone tissue.

Conclusion

Our findings indicated the turmeric ability to facilitate bone hemostasis and optimize the expression of key markers involved in the bone metabolism.

Antibacterial activity of lactobacilli from buffalo milk and yoghurt in Bandar-e Gaz, North-West Iran

A cross-sectional study was conducted from April to June 2016 to determine the inhibitory effect of Lactobacillus strains isolated from buffalo milk and yogurt in Bandar-e Gaz, Golestan province, North-West Iran. The raw milk and yogurt samples were collected and cultivated on MRS medium by anaerobical incubation at 37 °C for 48 h. The suspected colonies were identified on the basis of Gram’s staining and conventional biochemical tests. The antibacterial activity of the cell-free supernatant extracted from Lactobacillus strains was determined using the agar well diffusion method against standard strains Escherichia coli ATCC 11303, Staphylococcus aureus ATCC 29213, Bacillus cereus ATCC 19115, Listeria monocytogenes ATCC 19111, E. coli and S. aureus isolates from local cheese samples. A total of 10 Lactobacillus spp. were isolated and identified as L. plantarum, L. casei, L. acidophilus. L. plantarum A1 and L. acidophilus R1 exhibited relatively strong inhibitory effect against S. aureus and B. cereus, respectively. Both isolates had no inhibitory effect against L. monocytogenes. L. casei B1 showed moderate inhibitory effects against L. monocytogenes. This study showed that Lactobacilli from buffalo dairy products had good inhibitory activity towards Gram-positive indicator organisms and were one of the best choices to control these pathogens in food products.

The impact of the emergency medical services (EMS) automation system on patient care process and user workflow

Background

One of the important components of the health system is the emergency medical services (EMS) system. The EMS system was implemented at Kerman University of Medical Sciences teaching hospitals to communicate the situation of patients being transferred to the hospital by EMS and to provide facilities tailored to the patient's condition. The objective of this study was to investigate the impact of the EMS system on the patient care process and the workflow of users.

Methods

The hospital information system (HIS) report was used to investigate the impact of the EMS system on the patient care process and a questionnaire was distributed among 244 participants to determine its impact on the workflow of the users. Mann–Whitney U was used to analyze HIS reports, and Chi-square was used to analyze the data collected by questionnaires.

Results

The EMS system reduced the patient's stay in hospital by an average of 3 h and 45 min. It also increased the number of patients' discharge from the emergency room to 2.2% and reduced the death rate by 1.3% (p < 0.001). Besides, 78% of physicians, 75% of nurses and 83% of technicians stated that this system has positively influenced their workflow.

Conclusions

The EMS system reduced the patient's stay in hospital and mortality, and increased the speed of patient service, readiness of users to provide patient care and the number of discharged patients. However, problems such as inappropriate technical infrastructure of the EMS system should be solved to improve patients' recovery, reduce mortality and improve user satisfaction.

Prevalence of Burnout Syndrome and Its Related Factors Among Dentists in Qom Province, Iran

Background & Aims of the Study: Occupational burnout is a process of biopsychological fatigue caused by constant and continuous emotional stress due to long-term involvement in humans. Dentistry is one profession with extant biopsychological fatigue that can lead to burnout. This study aimed to determine the prevalence of burnout and related influential factors in dentists in Qom Province, Iran. Materials and Methods: This cross-sectional descriptive-analytical study was conducted on 158 general and specialist dentists in Qom Province, Iran (2018-2019) who were randomly selected. The instrument for collecting data was Maslach's standard burnout questionnaire and questions about demographic information and occupational factors. The obtained data were analyzed in SPSS using Analysis of Variance (ANOVA), t-test, Chi-squared test, and Pearson correlation coefficient. Results: This study suggested that the burnout score in all studied dentists was moderate in Qom (n=158). It is revealed that 9.1% of subjects had severe emotional exhaustion, 11.4% had severe depersonalization, and 8.2% had severe individual accomplishment loss. The lack of regular exercise, general dentistry, the lack of educational responsibility, job dissatisfaction, conflict in the role, ambiguity in the role, and work overload are the predictors of burnout in dentists in Qom Province, Iran. Conclusion: The obtained data revealed that although burnout is not a common problem in dentists in Qom Province; however, strategies for coping with it should be evaluated and managed continuously. Further studies are recommended in this field.

Increased super-conditioning temperature of corn grain affects performance, skeletal growth, and blood metabolites in Holstein dairy calves

We aimed to evaluate the effects of feeding super-conditioned corn at different temperatures on intake, growth performance, total-tract starch digestibility, rumen fermentation, blood metabolites, and feeding behavior of dairy calves. Thirty-six Holstein female dairy calves (40 ± 1.72 kg of body weight, ± SD) were randomly assigned to 1 of the following 3 treatments: (1) ground corn (control; CON; n = 12), (2) corn super-conditioned at 75°C (T-75; n = 12), and (3) corn super-conditioned at 95°C (T-95; n = 12). Three mash starter feeds with an identical nutritional composition were blended with 5% chopped alfalfa hay and fed to individually-housed calves from d 3 to 77 of their birth. All calves were fed 4 L/d of pasteurized whole milk twice daily since d 3 to 56, followed by 2 L/d of morning feeding from d 57 to 63 of age. Calves were weaned on d 63 and remained in the study until d 77. The T-75 and T-95 diets increased total-tract starch digestibility compared with the CON diet. Dry matter intake and weaning or final BW were not affected by treatments; however, average daily gain and feed efficiency increased in calves fed T-95 in the overall period. The T-95 diet increased withers height and tended to increase hip height compared with other diets, but feeding behavior did not change throughout the experimental period. Ruminal pH decreased in calves fed the T-95 diet compared with T-75 and CON diets. The molar proportion of ruminal propionate increased, whereas the acetate-to-propionate ratio tended to decrease in calves fed the T-95 compared with CON diet. Calves fed the T-95 diet had the highest blood glucose concentration, whereas a trend for increased insulin concentration was observed in calves fed T-95 compared with other diets. In conclusion, super-conditioning temperature of corn (T-95 vs. T-75 and CON) improved the average daily gain, feed efficiency, and skeletal growth, but did not influence dry matter intake during the first 77 d of age. Finally, the total-tract starch digestibility increased, whereas ruminal pH dropped during the postweaning period as super-conditioning temperature elevated.

Assessing parents' awareness about children's "first thousand days of life": a descriptive and analytical study

Background

Many adulthood illnesses are rooted in childhood, especially in the “first thousand days of life”. Despite parents’ role in children’s development, no study has examined parental awareness concerning this period. This study aimed to examine the awareness of parents concerning the “first thousand days of life” and the relationship between parents’ demographics and their awareness.

Methods

This study was conducted on 135 parents in Kerman, Iran, using a valid and reliable questionnaire developed by researchers based on the opinion of experts and relevant references. The relationship between participants’ demographics and their awareness was examined by multiple regression. The relationship between homogeneity of couples’ education degree and awareness was analyzed using ANOVA. Chi-square was used to examine the relationship between information sources and parents’ familiarity and to compare parents’ preferred sources.

Results

The average parental awareness was 41.96 ± 11.90. Eighty-three percent of the parents have not heard about the “first thousand days of life”. The source of information for 57% of the parents was friends and relatives (p < 0.0001). Overall, 87% of the parents desired to know about this period, and 47% liked using mobile applications for information (p < 0.0001).

Conclusions

Parents’ awareness about the “first thousand days of life” is lower than the average. Since the source of information concerning this period for most parents is friends and relatives and most parents are very interested in obtaining information, it is recommended that policy-makers use the capacity of other sources to increase parents’ awareness. Given the greater tendency of parents to obtain information through mobile applications, we suggest investing more in this source.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-021-00673-6.

Effects of kartogenin/PLGA nanoparticles on silk scaffold properties and stem cell fate

Cartilage is an avascular and aneural connective tissue with poor self-healing capability. Recently, tissue engineering opens up new horizons for staving off or treating cartilage lesions. In this work, kartogenin (KGN), a small chondro-inductive molecule, was loaded into poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs), which in turn was embedded in a silk fibroin (SF) scaffold, to prepare an appropriate microenvironment for mesenchymal stem cell (MSC) differentiation. In this research, SF was opted to serve as a scaffold based on its approved biocompatibility and non-toxicity, excellent mechanical properties and processability. The data obtained from this study show that entrapment of KGN in NPs provides sustained release, which could promote the differentiation of MSCs into chondrocytes. Likewise, the scaffold containing KGN-loaded NPs induces glycosaminoglycan production by the seeded MSCs. The introduction of NPs into the scaffold, meanwhile, elevated the compressive strength of the structures (more than two times) without any significant effect on their swelling behavior. Taken together, the authors’ findings demonstrate that the prepared scaffold, with an optimal structure, could be a potential candidate for cartilage tissue regeneration.

A Giant Solid-Cystic Mesenteric Fibromatosis with Unusual Synchronous Skin Fibromatosis

Mesenteric fibromatosis (MF) is a rare, locally aggressive tumor without distant metastasis, which has a high recurrence rate. Based on its location, it is classified as intra-abdominal, from abdominal wall, and extra-abdominal. The incidence of cystic-solid, retroperitoneal tumors is very low in comparison to other MF forms. Intra-abdominal MFs are asymptomatic in early stages, but their symptoms appear late in the tumor course. There is no specific imaging finding since radiological diagnosis is mostly impossible. Thus, diagnosis is made histopathologically. Nowadays, there is no consensus about its treatment although surgical resection is widely used. In the present study, a very rare case of cystic-solid retroperitoneal MF associated with separate synchronous skin tumors is reported.

Electrospun PCL scaffold modified with chitosan nanoparticles for enhanced bone regeneration

The encapsulation of ascorbic acid within chitosan nanoparticles (CHNs), embedded in a fibrous structure of a dexamethasone (Dex)-loaded PCL scaffold, provides a new plan for osteogenic differentiation of mesenchymal stem cells. This electrospun PCL fibrous scaffold can release Dex, as bone differentiation initiator, and ascorbic acid, as bone differentiation enhancer, in an approximately sustained release pattern for about 2 weeks. Ascorbic acid-loaded CHNs were prepared by electrospraying a mixture of chitosan and ascorbic acid, and Dex-containing PCL fibers were prepared by electrospinning a mixture of PCL and Dex. The final PCL/chitosan bilayer scaffolds were obtained by the sequential employment of electrospinning and electrospraying methods. Scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) confirmed that the CHNs were successfully incorporated into the fibrous PCL matrix. The improved proliferation of hMSCs cultured on the PCL/chitosan scaffolds was also verified. Osteogenic assays showed an increase in alkaline phosphatase activity and mineral deposits. The expression of bone-specific genes also confirmed the osteogenic differentiation of cells cultured on these PCL/chitosan bilayer scaffolds. Dual-drug-loaded PCL/chitosan scaffold enhanced the osteoblast differentiation of hMSC cells and can be served as a potential scaffold for bone tissue engineering.

Comparison of hyperbilirubinemia incidence between the newborns of zinc-taking and non-zinc-taking mothers during the third trimester of pregnancy

BACKGROUND

Identification and control of the risk factors for hyperbilirubinemia can reduce the incidence and complications of this condition. Serum zinc level in newborns is reported to be one of the factors affecting the severity and incidence of neonatal hyperbilirubinemia. Therefore, the present study was conducted to compare hyperbilirubinemia incidence in neonates of zinc-taking and non-zinc-taking mothers.

METHODS

In this observational study, we compared the incidence of hyperbilirubinemia during the first week of birth between newborns whose mothers had received zinc supplement during the third trimester of pregnancy (case group) with those whose mothers had not taken zinc supplement (control group). The checklist of newborns' conditions in both case and control groups was completed based on the obtained data regarding the infants, mothers, and laboratory findings. Data was analyzed using chi-squared test and t-test.

RESULTS

The mean serum levels of zinc were 79.76±15 mg/dl and 70.93±15.67mg/dl in mothers who had received zinc during the third trimester and those who had not taken zinc supplement, respectively. The mean serum level of zinc in newborns who underwent phototherapy was 41.68±9.21 mg/dl, while it was 68.53±20.85 mg/dl in neonates who did not receive phototherapy. In addition, 36% of the neonates whose mothers had not received zinc required phototherapy, while only 11% of newborns whose mothers had taken zinc supplement received phototherapy.

CONCLUSION

Zinc consumption during the third trimester of pregnancy increased the serum zinc level in both newborns and mothers and reduced the incidence and severity of idiopathic hyperbilirubinemia requiring treatment.

Expression of P63, P16 and CK17 in Atypical Squamous Metaplasia and Cervical Intraepithelial Neoplasia

Background & Objective:

Cervical intraepithelial neoplasia (CIN) is a dysmaturation process in squamous cells in epithelial layer, which highly increases the risk of developing cervical cancer. The aim of this study was to compare the expression of three biomarkers, p16, p63, and CK17 in patients with CIN and in those with atypical squamous metaplasia (ASM).

Methods:

In this study, 100 patients underwent a colposcopy-guided cervix biopsy. Immunostaining for the biomarkers was undertaken on tissue samples presented with ASM (n=50) and CIN (n=50).

Results:

A significant increase in immunostaining for CK7, P63, and P16 in patients with CIN was found compared to ASM subjects.

Conclusion:

Expression of CK17, P63, and P16 in CIN varied from those in ASM. Those biomarkers could be reliable factors to distinguish ASM from CIN; however, all the biomarkers could differentiate CIN from its mimics due to their high degree of sensitivity and specificity.

Effect of Artemisia absinthium ethanolic extract on oxidative stress markers and the TLR4, S100A4, Bax and Bcl-2 genes expression in the kidney of STZ-induced diabetic rats

OBJECTIVES

The present study was conducted to examine antidiabetic effects of Artemisia absinthium ethanolic extract [A. absinthium] and to investigate its effects on oxidative stress markers and the expression of TLR4, S100A4, Bax and Bcl-2 genes in the kidney of STZ-induced diabetic rats.

METHODS

Thirty six rats (weight 200-250 g) were randomly divided into diabetes and control groups. Induction of diabetes was performed using STZ (55 mg/kg.bw). Biochemical parameters and oxidative stress markers (SOD and MDA) were measured using spectrophotometry after 60 days of treatment. The expression of TLR4, S100A4, Bax and Bcl-2 were analyzed by real-time PCR. One-way analysis of variance (ANOVA) and Bonferroni post hoc test were used to compare the data.

RESULTS

Diabetes significantly impairs the serum fasting blood glucose (FBG), lipid profile, urea, creatinine and albumin. At the end of treatment with A. absinthium extract, these parameters were close to the normal range. The results showed that the A. absinthium extract significantly decreased the kidney expression of TLR4, S100A4, Bax and increased the expression of Bcl-2 and improved oxidative stress markers (SOD and MDA) in the kidney tissues of treated rats. Also, all of these beneficial effects of the A. absinthium were dose-dependent.

CONCLUSIONS

The extract of A. absinthium possesses antidiabetic effects. A. absinthium decreased the expression of TLR4, S100A4, Bax and increased the expression of Bcl-2 and improved oxidative stress. Therefore, this herbal extract can be used as an adjuvant treatment for diabetic complications.

Physicomechanical, rheological and in vitro cytocompatibility properties of the electron beam irradiated blend hydrogels of tyramine conjugated gum tragacanth and poly (vinyl alcohol)

In the present study, preparation of blend hydrogels of tyramine conjugated gum tragacanth and poly (vinyl alcohol) was carried out by electron beam irradiation, and modification of hydrogel properties with poly (vinyl alcohol) was demonstrated. Gel content, swelling behavior, pore size and mechanical and rheological properties of hydrogels prepared at 14, 28 and 56 kilogray (kGy) with different ratios of polymers were investigated. Gel content increased from 67 ± 2% for pure tyramine conjugated gum tragacanth hydrogel to >92% for blend hydrogels. However, the corresponding equilibrium swelling degree decreased from 35.21 ± 1.51 to 9.14 ± 1.66 due to the higher crosslink density of blend hydrogel. The mechanical strength of the hydrogels with interconnected pores increased significantly in the presence of poly (vinyl alcohol) and increasing irradiation dose up to 28 kGy with a twenty-fold enhancement of stress fracture and excellent elastic recovery in cyclic compression analysis. The equilibrium swelling degree of blend hydrogel containing 3% w/v tyramine conjugated gum tragacanth and 2% w/v poly (vinyl alcohol) prepared at 28 kGy was 16.59 ± 0.81. The biocompatibility of hydrogels was tested in the presence of rabbit bone marrow mesenchymal stem cells. The viability of cells exposed to hydrogel extract was >92% after 7 days of culture and indicated hydrogel biocompatibility with potential biomedical applications.