Opportunities and challenges of artificial intelligence and distributed systems to improve the quality of healthcare service

The healthcare sector, characterized by vast datasets and many diseases, is pivotal in shaping community health and overall quality of life. Traditional healthcare methods, often characterized by limitations in disease prevention, predominantly react to illnesses after their onset rather than proactively averting them. The advent of Artificial Intelligence (AI) has ushered in a wave of transformative applications designed to enhance healthcare services, with Machine Learning (ML) as a noteworthy subset of AI. ML empowers computers to analyze extensive datasets, while Deep Learning (DL), a specific ML methodology, excels at extracting meaningful patterns from these data troves. Despite notable technological advancements in recent years, the full potential of these applications within medical contexts remains largely untapped, primarily due to the medical community's cautious stance toward novel technologies. The motivation of this paper lies in recognizing the pivotal role of the healthcare sector in community well-being and the necessity for a shift toward proactive healthcare approaches. To our knowledge, there is a notable absence of a comprehensive published review that delves into ML, DL and distributed systems, all aimed at elevating the Quality of Service (QoS) in healthcare. This study seeks to bridge this gap by presenting a systematic and organized review of prevailing ML, DL, and distributed system algorithms as applied in healthcare settings. Within our work, we outline key challenges that both current and future developers may encounter, with a particular focus on aspects such as approach, data utilization, strategy, and development processes. Our study findings reveal that the Internet of Things (IoT) stands out as the most frequently utilized platform (44.3 %), with disease diagnosis emerging as the predominant healthcare application (47.8 %). Notably, discussions center significantly on the prevention and identification of cardiovascular diseases (29.2 %). The studies under examination employ a diverse range of ML and DL methods, along with distributed systems, with Convolutional Neural Networks (CNNs) being the most commonly used (16.7 %), followed by Long Short-Term Memory (LSTM) networks (14.6 %) and shallow learning networks (12.5 %). In evaluating QoS, the predominant emphasis revolves around the accuracy parameter (80 %). This study highlights how ML, DL, and distributed systems reshape healthcare. It contributes to advancing healthcare quality, bridging the gap between technology and medical adoption, and benefiting practitioners and patients.

Associations between food insecurity and Sleep Duration, Quality, and Disturbance among older adults from six low- and middle-income countries

OBJECTIVES

Although food insecurity has been associated with poor sleep outcomes in young and middle-aged adults, few studies have examined this relationship in older adults. This study aimed to examine the relationship between food insecurity and sleep duration, quality, and disturbance among older adults in six low-income countries (LMICs).

DESIGN AND SETTING

We analyzed nationally representative cross-sectional data from 33,460 adults (≥50 years) from the Study on global AGEing and adult health (SAGE).

MEASUREMENTS

Food insecurity (FI) was assessed using two questions regarding the frequency of eating less and hunger caused by a lack of food. Sleep outcomes included self-reported sleep duration, sleep quality, and sleep disturbances (difficulty falling asleep, frequent sleep interruptions, and early awakening) assessed based on self-reports over two nights. Multivariable logistic regression was used to assess country-specific relationships between food insecurity and sleep outcomes, and random-effects models were used to estimate pooled associations.

RESULTS

The prevalence of FI among older adults in the overall population was 16.2%. In pooled analyses, FI was significantly associated with long sleep duration ≥ 9 h (OR=1.58, 95% CI: 1.30 to 1.93; P=0.001). There were also significant pooled associations between FI and poor sleep quality (OR=1.34, 95% CI: 1.14 to 1.56; P < 0.001) and sleep disturbances (OR=1.44, 95% CI: 1.08 to 1.91; P = 0.014).

CONCLUSIONS

In conclusion, the current study found that FI is adversely associated with sleep duration, quality and disturbances in older adults, with some heterogeneity by country. The findings suggest food policies and intervention programs are needed for vulnerable households.

In silico study of the impact of oxidation on pyruvate transmission across the hVDAC1 protein channel

The overexpression of voltage dependent anion channels (VDACs), particularly VDAC1, in cancer cells compared to normal cells, plays a crucial role in cancer cell metabolism, apoptosis regulation, and energy homeostasis. In this study, we used molecular dynamics (MD) simulations to investigate the effect of a low level of VDAC1 oxidation (induced e.g., by cold atmospheric plasma (CAP)) on the pyruvate (Pyr) uptake by VDAC1. Inhibiting Pyr uptake through VDAC1 can suppress cancer cell proliferation. Our primary target was to study the translocation of Pyr across the native and oxidized forms of hVDAC1, the human VDAC1. Specifically, we employed MD simulations to analyze the hVDAC1 structure by modifying certain cysteine residues to cysteic acids and methionine residues to methionine sulfoxides, which allowed us to investigate the effect of oxidation. Our results showed that the free energy barrier for Pyr translocation through the native and oxidized channel was approximately 4.3 ± 0.7 kJ mol-1 and 10.8 ± 1.8 kJ mol-1, respectively. An increase in barrier results in a decrease in rate of Pyr permeation through the oxidized channel. Thus, our results indicate that low levels of CAP oxidation reduce Pyr translocation, resulting in decreased cancer cell proliferation. Therefore, low levels of oxidation are likely sufficient to treat cancer cells given the inhibition of Pyr uptake.

The applications of machine learning techniques in medical data processing based on distributed computing and the Internet of Things

Medical data processing has grown into a prominent topic in the latest decades with the primary goal of maintaining patient data via new information technologies, including the Internet of Things (IoT) and sensor technologies, which generate patient indexes in hospital data networks. Innovations like distributed computing, Machine Learning (ML), blockchain, chatbots, wearables, and pattern recognition can adequately enable the collection and processing of medical data for decision-making in the healthcare era. Particularly, to assist experts in the disease diagnostic process, distributed computing is beneficial by digesting huge volumes of data swiftly and producing personalized smart suggestions. On the other side, the current globe is confronting an outbreak of COVID-19, so an early diagnosis technique is crucial to lowering the fatality rate. ML systems are beneficial in aiding radiologists in examining the incredible amount of medical images. Nevertheless, they demand a huge quantity of training data that must be unified for processing. Hence, developing Deep Learning (DL) confronts multiple issues, such as conventional data collection, quality assurance, knowledge exchange, privacy preservation, administrative laws, and ethical considerations. In this research, we intend to convey an inclusive analysis of the most recent studies in distributed computing platform applications based on five categorized platforms, including cloud computing, edge, fog, IoT, and hybrid platforms. So, we evaluated 27 articles regarding the usage of the proposed framework, deployed methods, and applications, noting the advantages, drawbacks, and the applied dataset and screening the security mechanism and the presence of the Transfer Learning (TL) method. As a result, it was proved that most recent research (about 43%) used the IoT platform as the environment for the proposed architecture, and most of the studies (about 46%) were done in 2021. In addition, the most popular utilized DL algorithm was the Convolutional Neural Network (CNN), with a percentage of 19.4%. Hence, despite how technology changes, delivering appropriate therapy for patients is the primary aim of healthcare-associated departments. Therefore, further studies are recommended to develop more functional architectures based on DL and distributed environments and better evaluate the present healthcare data analysis models.

The relationship of circulating neuregulin 4 and irisin, and traditional and novel cardiometabolic risk factors with the risk and severity of coronary artery disease

BACKGROUND AND AIMS

Neuregulin 4 (NRG4) and irisin are adipokines that have been suggested to be associated with cardiometabolic risk factors and coronary artery disease (CAD), but the data are inconclusive. This study aimed to investigate the relationship between circulating NRG4 and irisin and cardiometabolic risk factors with CAD risk and severity.

METHODS AND RESULTS

In this cross-sectional study, the presence of CAD and the severity of stenosis (gensini score) were documented based on coronary angiography in 166 adults. Circulating NRG4 and irisin, glucose homeostasis markers, hs-CRP, lipid profiles, blood pressure, and anthropometric measurements were assessed as well. Age (p = 0.005), sex (p = 0.008), SBP (p = 0.033), DBP (p = 0.04), MAP (p = 0.018), FBG (p = 0.012), insulin (p = 0.039) and HOMA-IR (p = 0.01) were significantly associated with odds of having CAD. The final logistic regression model showed that age, sex, HOMA-IR, and MAP were the most important determinants of having CAD. There were no significant associations between circulating irisin and NRG4 with odds of having CAD. The final general linear model showed that being men (β = 17.303, 95% CI: 7.086-27.52, P = 0.001), age (Aβ = 0.712, 95% CI: 0.21-1.214, P = 0.006), HOMA-IR (Aβ = 2.168, 95% CI: 0.256 to 4.079, P = 0.027), and NRG4 level (β = 1.836, 95% CI: 0.119-3.553, P = 0.036) were directly associated with higher gensini score. Participants with the three-vessel disease had a mean increase of about 5 units in circulating irisin compared to those with no clinical CAD (β = 5.221, 95% CI: 0.454-9.987, p = 0.032).

CONCLUSIONS

This study showed that the adipokines NRG4 and Irisin might be associated with the severity of coronary stenosis.

A new lung cancer detection method based on the chest CT images using Federated Learning and blockchain systems

With an estimated five million fatal cases each year, lung cancer is one of the significant causes of death worldwide. Lung diseases can be diagnosed with a Computed Tomography (CT) scan. The scarcity and trustworthiness of human eyes is the fundamental issue in diagnosing lung cancer patients. The main goal of this study is to detect malignant lung nodules in a CT scan of the lungs and categorize lung cancer according to severity. In this work, cutting-edge Deep Learning (DL) algorithms were used to detect the location of cancerous nodules. Also, the real-life issue is sharing data with hospitals around the world while bearing in mind the organizations' privacy issues. Besides, the main problems for training a global DL model are creating a collaborative model and maintaining privacy. This study presented an approach that takes a modest amount of data from multiple hospitals and uses blockchain-based Federated Learning (FL) to train a global DL model. The data were authenticated using blockchain technology, and FL trained the model internationally while maintaining the organization's anonymity. First, we presented a data normalization approach that addresses the variability of data obtained from various institutions using various CT scanners. Furthermore, using a CapsNets method, we classified lung cancer patients in local mode. Finally, we devised a way to train a global model cooperatively utilizing blockchain technology and FL while maintaining anonymity. We also gathered data from real-life lung cancer patients for testing purposes. The suggested method was trained and tested on the Cancer Imaging Archive (CIA) dataset, Kaggle Data Science Bowl (KDSB), LUNA 16, and the local dataset. Finally, we performed extensive experiments with Python and its well-known libraries, such as Scikit-Learn and TensorFlow, to evaluate the suggested method. The findings showed that the method effectively detects lung cancer patients. The technique delivered 99.69 % accuracy with the smallest possible categorization error.

Association between Food Insecurity and Vision Impairment among Older Adults: A Pooled Analysis of Data from Six Low- and Middle-Income Countries

OBJECTIVES

Food insecurity has gained attention as a potential risk factor for vision impairment. However, research on this topic is limited. This objective of this study was to investigate the relationship between food insecurity and visual impairment among adults aged 50 years or older using data from six low-and middle-income countries (LMIC).

DESIGN AND SETTING

Data from the longitudinal Study on global AGEing and adult health (SAGE) were analyzed in a community-based, cross-sectional, and nationally representative sample.

PARTICIPANTS

Adults aged 50 years or older from six low- and middle-income countries (LMICs) including China, India, Mexico, Russia, South Africa, and Ghana.

MEASUREMENTS

Food insecurity was evaluated using a questionnaire comprised of two questions that addressed the frequency of eating inadequately and hunger due to a lack of food in last 12 months. Distance and/or near vision impairment was considered as a visual acuity score of less than 6/18 in the eye with better vision.

RESULTS

The analytical sample consisted of 29,804 adults (mean (SD) for age: 63.2 (9.54) years; 54.3% female). The prevalence of food insecurity, near vision and distance vision impairment in the sample was 16.4%, 36.7%, and 13.9%, respectively. Adjusted pooled analyses across countries revealed a significant association between food insecurity and distance (OR: 1.16; 95% CI: 1.01, 1.33; P=0.04, significant individually in India and South Africa) and near (OR: 1.12; 95% CI: 1.02, 1.22; P=0.01, significant individually in South Africa) vision impairment, and a between-country heterogeneity of 46.30% and 25.99%, respectively.

CONCLUSION

Food insecurity was associated with both distance and near vision impairment in adults aged 50 years or older across six LMIC. Food policies and intervention programs targeted at decreasing food insecurity in vulnerable households are essential.

Effects of Calorie Restricted Diet on Oxidative/Antioxidative Status Biomarkers and Serum Fibroblast Growth Factor 21 Levels in Nonalcoholic Fatty Liver Disease Patients: A Randomized, Controlled Clinical Trial

Oxidative stress plays a fundamental role in the development and progression of nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the effects of a calorie-restricted (CR) diet on oxidative/anti-oxidative status in patients with NAFLD and the potential mediating role of fibroblast growth factor 21 (FGF-21) in this regard. This randomized, controlled clinical trial was carried out on sixty patients with NAFLD aged 20 to 60 years with body mass index (BMI) ranging from 25 to 35 kg/m2. Participants were randomly assigned to either the CR diet group (received a prescribed low-calorie diet for twelve weeks, n = 30) or the control group (n = 30). Fasting blood samples, anthropometric measurements, dietary intake, and physical activity data were collected for all participants at baseline and at the end of the trial. Significant reductions in weight, BMI, waist circumference, and serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were observed in the CR diet group compared to the control group (all p < 0.05). Liver steatosis grade, serum levels of malondialdehyde (MDA), total antioxidant capacity (TAC), and FGF-21, as well as erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities did not show significant changes in the CR group when compared to the controls at the end of the study (p > 0.05). CR diet with moderate weight loss has some favorable effects on NAFLD but was not able to modify oxidative/anti-oxidative status in these patients. Future studies are warranted to target the effects of long-term interventions with a greater weight loss in this patient population.

Lovastatin attenuates glyoxal-induced toxicity on rat liver mitochondria

Alpha-dicarbonyls such as glyoxal (GO) trigger mitochondrial dysfunction resulting in the development of different diabetic complications. The present study investigated the effects of lovastatin against GO-induced toxicity on rat liver mitochondria. The rat liver mitochondria (0.5 mg protein/mL) were treated with various concentrations of lovastatin (1, 5, 10 µM) at 37°C for 30 min and then exposed to GO (3 mM) at 37°C for 30 min. Oxidative stress markers including MDA, reactive oxygen species (ROS), glutathione (GSH) and protein carbonylation (PC) level were measured. Mitochondrial complex II activity and mitochondrial membrane potential (MMP) were assessed for evaluating mitochondrial function. Glyoxal significantly increased the level of ROS, PC and MDA. This effect was associated with the reduction of MMP, complex II activity and GSH content. Pre-treatment with lovastatin potentially reversed GO-induced mitochondrial toxicity. These results suggest that lovastatin have a protective effect against GO-induced toxicity in isolated rat liver mitochondria.

Porous nanoparticles with engineered shells release their drug cargo in cancer cells

Highly porous nanoscale metal-organic frameworks (nanoMOFs) attract growing interest as drug nanocarriers. However, engineering "stealth" nanoMOFs with poly(ethylene glycol) (PEG) coatings remains a main challenge. Here we address the goal of coating nanoMOFs with biodegradable shells using novel cyclodextrin (CD)-based oligomers with a bulky structure to avoid their penetration inside the open nanoMOF porosity. The PEG chains were grafted by click chemistry onto the CDs which were further crosslinked by citric acid. Advantageously, the oligomers' free citrate units allowed their spontaneous anchoring onto the nanoMOFs by complexation with the iron sites in the top layers. Up to 31 wt% oligomers could be firmly attached by simple incubation with the nanoMOFs in an aqueous medium. Moreover, the anticancer drug doxorubicin (DOX) was successfully entrapped in the core-shell nanoMOFs with loadings up to 41 wt%. High resolution STEM (HR-STEM) showed that the organized crystalline structures were preserved. Remarkably, at the highest loadings, DOX was poorly released out of the nanoMOFs at pH 7.4 (<2% in 2 days). In contrast, around 80% of DOX was released out at pH 4.5 of artificial lysosomal fluid in 24 h. Confocal microscopy investigations showed that the DOX-loaded nanoMOFs penetrated inside Hela cancer cell together with their PEG shells. There, they released the DOX cargo which further diffused inside the nucleus to eradicate the cancer cells.

SN38 loaded nanostructured lipid carriers (NLCs); preparation and in vitro evaluations against glioblastoma

SN38 is the active metabolite of irinotecan with 1000-fold greater cytotoxicity compared to the parent drug. Despite the potential, its application as a drug is still seriously limited due to its stability concerns and low solubility in acceptable pharmaceutical solvents. To address these drawbacks here nanostructured lipid carrier (NLC) containing SN38 was prepared and its cytotoxicity against U87MG glioblastoma cell line was investigated. The formulations were prepared using hot ultrasonication and solvent evaporation/emulsification methods. NLCs with a mean size of 140 nm and particle size distribution (PDI) of 0.25 were obtained. The average loading efficiency was 9.5% and its entrapment efficiency was 81%. In order to obtain an accurate determination of released amount of SN38 a novel medium and extraction method was designed, which lead to an appropriate in vitro release profile of the drug from the prepared NLCs. The MTT test results revealed the significant higher cytotoxicity of NLCs on U87MG human glioblastoma cell line compared with the free drug. The confocal microscopy images confirmed the proper penetration of the nanostructures into the cells within the first 4 h. Consequently, the results indicated promising potentials of the prepared NLCs as a novel treatment for glioblastoma.

Effect of hatching time on time to first feed intake, organ development, enzymatic activity and growth in broiler chicks hatched on-farm

The conventional commercial hatcheries used today do not allow the newly hatched chicks to consume feed or water. Combined with natural variation in hatching time, this can lead to early hatched chicks being feed-deprived for up to 72 h before being unloaded at the rearing site. This study investigated the effects of hatching time on time to first feed intake and development of organs, digestive enzymes and productivity in terms of growth and feed conversion ratio in chicks hatched on-farm. Chicks were divided into three hatching groups (early, mid-term and late), and assessed over a full production cycle of 34 days. The results revealed that chicks remain inactive for a considerable amount of time before engaging in eating-related activities. Eating activity of 5% (i.e. when 5% of birds in each hatching group were eating or standing close to the feeder) was recorded at an average biological age (BA) of 25.4 h and a proportion of 50% birds with full crop was reached at an average BA of 30.6 h. Considering that the hatching window was 35 h in this study, the average chick probably did not benefit from access to feed and water immediately post-hatch in this case. At hatch, mid-term hatchlings had a heavier small intestine (30.1 g/kg bw) than both early (26.4 g/kg bw) and late (26.0 g/kg bw) hatchlings. Relative length of the small intestine was shorter in late hatchlings (735 cm/kg bw) than in mid-term (849 cm/kg bw) and early (831 cm/kg bw) hatchlings. However, the relative weight of the bursa fabricii was greater in mid-term (1.30 g/kg bw) than in early hatchlings (1.01 g/kg bw). At hatch, late hatchlings were heavier than early and mid-term hatchlings (P < 0.05), but by 3 days of age early hatchlings were heavier than mid-term and late hatchlings (P < 0.01). The only effect persisting throughout the study was a difference in the relative weight of the small intestine, where late hatchlings had heavier intestines than early hatchlings (P < 0.05). Thus, while there were differences between hatching groups, this study showed that the hatchlings seemed capable of compensating for these as they grew.

White adipose tissue browning in critical illness: A review of the evidence, mechanisms and future perspectives

Observational studies suggest better clinical outcomes following critical illness in patients with overweight and obesity (obesity paradox). An understanding of the morphologic, physiologic and metabolic changes in adipose tissue in critical illness may provide an explanation. Recent studies have demonstrated the transformation of white to brown-like adipocytes due to the "browning process," which has been of interest as a potential novel therapy in obesity during the last decade. The characteristics of the browning of white adipose tissue (WAT) include the appearance of smaller, multilocular adipocytes, increased UCP1 mRNA expression, mitochondrial density and respiratory capacity. These changes have been identified in some critical illnesses, which specifically refers to burns, sepsis and cancer cachexia in this study. The pathophysiological nature of WAT browning, underlying mechanisms, main regulators and potential benefits and harms of this process are interesting new areas that warrants further investigations. In this review, we discuss emerging scientific discipline of adipose tissue physiology in metabolic stress, available data, gaps of knowledge and future perspectives. Future investigations in this field may provide insights into the underlying mechanisms and clinical aspects of browning that may further our understanding of the proposed obesity paradox following critical illness, which may in turn open up opportunities for novel therapies to save lives and improve recovery.

Demographics, laboratory parameters and outcomes of 1061 patients with coronavirus disease 2019: a report from Tehran, Iran

We aimed to determine the characteristics of coronavirus disease 2019 (COVID-2019) among the Iranian population. In this study, we collected and analysed the demographics, laboratory findings and outcomes of patients with COVID-19 who were admitted to Masih Daneshvari Hospital in Tehran, Iran between 20 February 2020 and 2 April 2020. Among 1061 patients, 692 (65.2%) were male and the median age was 55 years (interquartile range (IQR), 44–66 years). Totally, 129 (12.2%) patients died during hospitalization in the ward or intensive care unit. From the remaining 932 individuals, 46 (5.0%) were admitted to the intensive care unit and 886 (95.0%) were hospitalized in the ward. Those patients who died were significantly older than those hospitalized in the ward (p < 0.001). The median absolute number of lymphocytes was 1.2 × 10³/μL (IQR 0.9 × 10³ to 1.6 × 10³/μL) and 708 (66.7%) patients had lymphopenia (absolute lymphocyte count <1500/μL). Among the laboratory tests, D-dimer, serum ferritin and albumin had the strongest correlations with mortality (r = 0.455, r = 0.412, r = –0.406, respectively; p < 0.001 for each one). In conclusion, laboratory findings could provide useful information with regard to the management of individuals with COVID-19.

Design Evaluation in Novel Orthoses for Patients with Medial Knee Osteoarthritis

Osteoarthritis of the knee is a debilitating condition affecting increasing numbers of individuals each year. One option for treatment is orthotic knee braces, but a little independent reviews have taken place to date on their relative outcomes for users. This study therefore evaluates the efficacy of different types of knee orthoses (braces) with regard to key aspects of use, including gait parameters, mobility and levels of comfort and compliance in subjects presenting with osteoarthritis (OA) of the knee. The collated data is presented with relevant supporting literature and appropriate descriptions in relation to each knee orthosis type that was identified, within appropriate subsections with advantages and disadvantages appropriately allocated. An analysis of each brace as presented by the corresponding article is then described further in terms of the design and structure, user outcomes and assessment summaries. According to the study carried out in this paper, it is presented and proved that applying the use of knee braces can reduce the knee adduction moment (KAM), but the amount of reduction afforded varies between designs. All of the studies reported significant pain reduction and functional improvement with the use of a knee brace, although their effect on the knee joint range of motion vary. Knee braces long-term use depends upon high levels of comfort and patient compliance, and further studies need to be conducted on larger numbers of subjects over greater time periods to reflect the long-term outcomes accurately

Foraging behavior of Aphidius matricariae (Hymenoptera: Braconidae) on tobacco aphid, Myzus persicae nicotianae (Hemiptera: Aphididae)

The aim of this study was to investigate the foraging behavior of Aphidius matricariae (Haliday) (Hymenoptera: Braconidae) as a biological control agent of Myzus persicae nicotianae Blackman (Hemiptera: Aphididae), a key and cosmopolitan pest of tobacco fields. To achieve a strategy for the control of this pest and a mass-rearing program of the parasitoid, host stage preference, switching, functional response, and mutual interference of A. matricariae were investigated at 25 ± 1°C, 70 ± 5% RH and 16:8 h L:D photoperiod. The parasitoid showed a preference for third- and fourth-instar nymphs of tobacco aphid in both choice and no-choice experiments. Using the Murdach's model, switching behavior was observed in A. matricariae between different density proportions of third- and fourth-instar nymphs. Further, the parasitoid exhibited a type II functional response when it was offered to third-instar nymphs of M. persicae nicotianae at six densities (2, 4, 8, 16, 32, and 64). Based on the linear regression analysis, there was a significance difference between the logarithm of per capita searching efficiency and the logarithm of parasitoid density. As the wasp density increased, per capita searching efficiency decreased. The result of this study revealed that A. matricariae is an effective agent in the integrated management of M. persicae nicotianae. In addition, application of these results can be important in mass-rearing program of A. matricariae.

HBs antigen and mannose loading on the surface of iron oxide nanoparticles in order to immuno-targeting: fabrication, characterization, cellular and humoral immunoassay

Mannosylation of nanovaccine is an appropriate strategy for targeting the mannose receptors on DCs. Here, HBsAg and mannose loaded on the surface of iron oxide nanoparticles to increases HBsAg vaccine potency. Nanoparticles are made by co-precipitation method and bonded to the HBsAg and mannose by chemical bonding. The physicochemical properties of nano-vaccines, their toxicity and antigenicity were determined. The synthesized nano-vaccine showed spherical shape with a mean particle size of 60 nm, a zeta potential of -44 mV, an antigen-binding efficiency of around 100% and for mannose 78%. In vitro release of nanoparticles exhibited about 30% at the first day and about 60% until the third day. SDSPAGE analysis confirmed structural integrity of HBsAg loaded on nanoparticles. The HBsAg-loaded LCMNP and MLCMNP nanoparticles had no toxic effects on HEK293 cell line. The quantification of the intracellular Fe by ICP-OES as a criterion of nano-vaccine uptake revealed mannose intensify uptake of MLCMNP. In addition, mannose in the structure of MLCMNP improved IL-6, TNF-α and IFN-γ (>16 fold) cytokines genes expression by macrophage/dendritic cells after exposure in 12 h. Immunization of experimental mice (subcutaneously, two times with 2-week intervals) with 5 µg of HBsAg loaded on MLCMNP nanoparticles increased specific total IgG and IgG2a/IgG1 ratio. In addition, TNF-α, IL-12, IL-2 and IL-4 cytokines in mannosylated nano-vaccine increased versus nano-vaccine group while lymphocyte proliferation and IFN-γ responses in the targeted nano-vaccine group show a tiny increase versus the nano-vaccine group. The results show that mannosylated nano-vaccine promotes higher level of cellular and humoural immune responses against HBsAg nano-vaccine.

Evaluating pre- and post-operation plasma miRNAs of papillary thyroid carcinoma (PTC) patients in comparison to benign nodules

Background

Thyroid cancer is the most common endocrinology cancer that its incidence has increased in recent decades. miRNAs are new biomarkers in recent studies in the diagnosis and follow-up of these patients.

Methods

Blood and thyroid tissue samples were obtained from two groups of included patients (PTC and benign nodules), pre- and post-operation. miRNAs were extracted from these plasma samples and were measured quantitatively. After cDNA synthesis, qPCR was carried out. Then tissue samples were investigated, and their relation to miR expression was studied. These results were analyzed by paired- and independent samples t-test, and non-parametric tests.

Results

miR-222 and miR-181a declined in PTC patients before and after surgery, significantly (P < 0.001 for both groups), with no significant difference in control group before and after surgery (P = 0.61 for miR-222 and P = 0.06 for miR-181a). The difference between the two groups, pre-and post-operation, was statistically significant (P = 0.01 for miR-222 and P < 0.001 for miR-181a). Comparing case and control groups, pre- and post-operatively, yielded no significant difference, in miR-155-5p levels (P = 0.61 and P = 0.53, respectively). Comparing PTC and control groups before surgery showed a significant difference (P = 0.01), while no significant difference was observed comparing them after surgery, in miR146-a (P = 0.27). Our results depicted a higher miR-155-5p and miR-146a expression before surgery than after it (P < 0.001 in both groups, for both miRs). We found a significant relationship between miR-222 and BRAFV600E mutation and significantly higher levels of miR-181a with increasing tumor size in PTC patients.

Conclusion

miR-222 showed overexpression in all PTC cases, which is indicative of a relation between miRNA and PTC. Also, comparing miR-181 and miR-146a showed a significant difference between cancerous and benign cases. miR-155-5p as an inflammatory factor, showed no significant changes, comparing two groups.

Traumatic urethral rupture, its surgical management with temporary cystostomy and concurrent wound reconstruction in a cat

A 3-month-old male DSH cat was presented with a history of lethargy, anorexia, dysuria, urinary incontinence, dermatitis and swelling in the perineal area following a road traffic trauma. Retrograde positive-contrast urethrography revealed an intra-pelvic urethral rupture which was managed by performing transurethral catheterisation. Due to accidental removal, the case was presented for re-examination following a progressive urine scald dermatitis several days later. So, surgical placement of cystostomy tube was performed. The cat regained his ability to urinate normally a week later and the catheter was withdrawn. The extensive perineal dermatitis due to urine scald necessitated delayed primary closure. Topical and systemic antibiotics were administered for 2 weeks and second intention wound healing was completed after 5 weeks.

Total replacement of corn silage with sorghum silage improves milk fatty acid profile and antioxidant capacity of Holstein dairy cows

Total mixed rations containing corn silage (CS) or forage sorghum silage (SS) were fed to mid-lactation Holstein cows to determine the effects on feed intake, lactation performance, milk composition and fatty acid profile, nutrient digestibility, blood metabolites, rumen microbial N synthesis, and antioxidant status. The experiment was designed as a 2-period change-over (two 28-d periods) trial with 2 diets including CS diet or SS diet and 12 cows. Total replacement of CS with SS had no significant influence on dry matter intake. Substituting CS with SS had no effect on milk production, feed efficiency, and milk concentrations of fat, protein, lactose, and solids-not-fat, whereas yields of milk fat, protein, and lactose were greater for cows fed the CS diet. Blood parameters including glucose, albumin, cholesterol, triglyceride, total protein, urea N, and fatty acids were not affected by the dietary treatments. Apparent digestibility coefficients of dry matter, organic matter, crude protein, ether extract, neutral detergent fiber, and acid detergent fiber were not significantly influenced by the diets. Replacing CS with SS had no effect on total saturated fatty acids and total monounsaturated fatty acids, whereas total polyunsaturated fatty acid percentage was greater with the SS diet. Proportions of C20:0, C18:3n-3, and C18:3n-6 were affected by feeding SS. Cows fed CS had a greater amount of urinary purine derivatives. Feeding SS had a positive effect on total antioxidant capacity of blood and milk. In conclusion, SS can be fed to lactating Holstein cows as a total replacement for CS without undesirable effects on animal performance, but with positive effects on antioxidant capacity and polyunsaturated fatty acids of milk. This forage can be an excellent choice for dairy farms in areas where cultivation of corn is difficult due to water shortage.

Antibacterial effect of tramadol against Staphylococcus aureus and Pseudomonas aeruginosa: an in vivo study

Some important adverse effects of local and regional anaesthesia including injection-site infection, epidural abscess and meningitis, are usually caused by bacteria such as Staphylococcus aureus and Pseudomonas aeruginosa. These infections can even cause the patient's death in severe cases. In the present study, the antimicrobial activity of tramadol was investigated on S. aureus and P. aeruginosa in BALB/c-sensitive mice. This experimental multigroup research study evaluated the effect of two different concentrations of injectable tramadol (12.5 and 25 mg/mL) on local infections caused by S. aureus and P. aeruginosa in BALB/c mice within 24 and 48 hours. The results showed that tramadol injection in the specified doses did not have a significant impact on the diameter of lesions caused by local infections due to these organisms. However, the diameter of inflammation resulting from local infection with P. aeruginosa had statistically increased in the two doses after 48 hours (p 0.019). Subcutaneous injection of tramadol reduced the growth of S. aureus through enhancing phagocytes and tissue inflammation; however, it did not help eliminate P. aeruginosa, and at a dose of 25 mg/mL it also increased the growth and spread of the bacteria. It seems that the observed difference was due to the different characteristics of these two bacteria.

The in silico identification of potent anti-cancer agents by targeting the ATP binding site of the N-domain of HSP90

To identify new HSP90 inhibitors, the ATP binding site of the N-domain of HSP90 was targeted by molecular docking of a library of 23,129,083 compounds (from the ZINC database) to the ATP binding site of the N-domain of HSP90. Structure-based virtual screen (SBVS) was performed using idock software on the istar web platform. Based on idock binding energies, 40 molecules were considered as HSP90 inhibitors. In the next step, the 40 molecules and the compound AT13387 (Onalespib) were docked to the XJX binding site using AutoDock Vina software. By comparing the binding energies of the 40 molecules selected with compound AT13387, 26 molecules were selected. By applying the rule of five, eight molecules were selected as hit compounds. The interactions of these eight compounds with the XJX binding site were obtained and investigated, and two-dimensional interaction maps were provided for the others. Finally, computing the toxicity of these compounds with the ProTox-II webserver shows that three compounds, namely ZINC89453765, ZINC23918431 and ZINC12414793, can be considered as good HSP90 inhibitors. These compounds are inactive for nuclear receptor signalling and stress response pathways including heat shock response, so do not have the limitations of common HSP90 inhibitors. They are also inactive for hepatotoxicity, carcinogenicity, immunotoxicity, mutagenicity and cytotoxicity.

Design and Synthesis of a Biocompatible 1D Coordination Polymer as Anti-Breast Cancer Drug Carrier, 5-Fu: In Vitro and in Vivo Studies

Designable coordination polymers with suitable chemical diversities and biocompatible structures have been proposed as a promising class of vehicles for drug delivery systems. Here, we hydrothermally synthesized a novel one-dimensional (1D) coordination polymer, [Zn(H₂O)₆K₂(H₂BTC)₂(H₂O)₄](H₂BTC)₂·2H₂O, where H₃BTC = benzene-1,3,5-tricarboxylic acid (trimesic acid), cp.1. As the hydrogen bonds stabilized 1D chains in three dimensions, the cp.1 could be a good candidate for delivering small-molecule chemotherapeutics such as 5-fluorouracil (5-Fu). The synthesized cp.1 showed a remarkable 5-Fu loading of 66% with encapsulation efficiency of 98% and almost complete release process. The 5-Fu-loaded cp.1 displayed a time-dependent cytotoxicity effect against breast cancer cell lines MCF-7 and 4T1. The cellular uptake of cp.1 particles was investigated via confocal laser scanning microscopy using fluorescein isothiocyanate and LysoTracker Red staining. Furthermore, the in vivo antitumor impact of 5-Fu-loaded cp.1 was studied on 4T1 breast cancer BALB/c mice model. The intratumor treatment of 5-Fu-loaded cp.1 demonstrated beneficial antitumor efficacy by postponing tumor growth. These results suggest that the 5-Fu-loaded cp.1 microparticles with a great locoregional delivery can be efficient anticancer drug carriers for further clinical treatments.

Body growth, intestinal morphology and microflora of quail on diets supplemented with micronised wheat fibre

1. Particle size reductions of fibre-rich materials alter structure, functional and digestive properties. To determine the effects of using fibre as an additive in Japanese quail rations on performance and gut physiology, a trial using micronised wheat fibre (MWF) at levels of 0.0, 5, 10 and 15 g/kg in feed was conducted. 2. Growth rate and feed efficiency were significantly improved when diets contained MWF while feed intake was not affected by levels of the fibre. As MWF content increased, the relative weight of gizzard and gastrointestinal tract (GIT) significantly increased whereas liver relative weight significantly decreased. 3. MWF inclusion significantly increased relative length of gut segments, villi height, villus thickness, the villi height to crypt depth proportion in jejunum and ileum and the number of goblet cells in different parts of intestine. 4. Tibia weight, length and ash content were increased linearly with rising MWF inclusion. Litter moisture was affected by MWF inclusions in a quadratic manner. The colony forming unit (CFU/g) of Streptococci spp. in ileal digesta was decreased with increasing MWF inclusion levels in the diet. 5. In conclusion, MWF can be used as a feed additive in quail diets and its inclusion in feed resulted in better performance, beneficial changes in intestinal microbial counts and improvements in small intestine morphology.

Global spectral graph wavelet signature for surface analysis of carpal bones

Quantitative shape comparison is a fundamental problem in computer vision, geometry processing and medical imaging. In this paper, we present a spectral graph wavelet approach for shape analysis of carpal bones of the human wrist. We employ spectral graph wavelets to represent the cortical surface of a carpal bone via the spectral geometric analysis of the Laplace-Beltrami operator in the discrete domain. We propose global spectral graph wavelet (GSGW) descriptor that is isometric invariant, efficient to compute, and combines the advantages of both low-pass and band-pass filters. We perform experiments on shapes of the carpal bones of ten women and ten men from a publicly-available database of wrist bones. Using one-way multivariate analysis of variance (MANOVA) and permutation testing, we show through extensive experiments that the proposed GSGW framework gives a much better performance compared to the global point signature embedding approach for comparing shapes of the carpal bones across populations.

Comparison of Entonox and Transcutaneous Electrical Nerve Stimulation (TENS) in Labor Pain

One of the concerns among mothers for delivery is labor pain. There are various methods to decrease labor pain, of which epidural anesthesia is an effective one, but not all mothers agree to receive this invasive intervention. Transcutaneous electrical nerve stimulation (TENS) is an inexpensive, safe, and easily applicable method which can be used in patient control mode. To find proper non-invasive methods to pain relief during labor this study was conducted to compare TENS, Entonox and combination of them during the first phase of labor. In this RCT study, 120 pregnant women in the age range of 20-40 years, singleton pregnancy, at 37-42 weeks’ gestation, at cervical dilatation of less than 4 cm in phase one of labor were selected and randomly divided into three groups including TENS, Entonox and combination group. Pain severity was recorded based on VAS at the time of presentation to the maternity unit, cervical dilatations of 4-6cm, 6-8cm, and 8-10cm and demographic characterizations. There were no significant differences regarding to age, parity, and BMI between the three groups. Pain was less severe in combination group compared to other two groups at cervical dilations of 4-6cm and 6-8cm. At cervical dilation of 8-10cm, VAS score was higher in Entonox group than in other two groups, but no significant difference existed between TENS and combination group. Duration of the first phase of labor was longer in TENS group than the other two groups. TENS is a non-invasive, safe, easy applicable and self-administered method with low rate of complications which can be used alone or in combination with other methods in relieving labor pain.Journal of Medical and Biomedical Sciences (2017) 6(2), 11-16

NanoMIL-100(Fe) containing docetaxel for breast cancer therapy

Metal-organic frameworks, such as MIL-100, have been recently introduced as promising drug carriers due to their notable characteristics such as stability, biocompatibility and owning large porosity which may admit a broad range of drugs with different molecular sizes. In this study, we firstly proposed an accessible top-down approach using ultrasound method to prepare nanoMIL-100 and secondly, evaluated its potentials as an anticancer nanocarrier. This is the first report that docetaxel (DTX) as a highly hydrophobic anticancer drug was encapsulated in nanoMIL-100 with the drug payload of 57.2 wt%. Characterizations of the prepared nanoMIL-100 and DTX-loaded nanoMIL-100 were performed by PXRD, FT-IR, N₂ adsorption, DLS and FE-SEM. Moreover, the drug loading and release processes were quantified by HPLC. The in vitro release of DTX from the prepared nanocarrier was investigated in two pH values, 7.4 and 5.5. The toxic effect of DTX-loaded nanoMIL-100 was examined on human breast cancer cell line, MCF-7, and a significant decrease was observed in IC₅₀ value (0.198 μg/mL) at the first 24 h in comparison with the free drug (4.9908 μg/mL). This nanocarrier may, thus offer promising potentials as a novel cytotoxic drug delivery system.

Stroke subtypes, risk factors and mortality rate in northwest of Iran

Background: Stroke is the second most common cause of death and first cause of disability in adults in the world. About 80% of all stroke deaths occur in developing countries. So far, the data on stroke epidemiology have been limited in Iran. Therefore, this study was focused on stroke demographic data, risk factors, types and mortality. Methods: A retrospective study was done in two university tertiary referral hospitals in Tabriz, northwest of Iran, from March 2008 to April 2013. Patients diagnosed with stroke were enrolled in the study. Demographic data, stroke subtypes, duration of hospitalization, stroke risk factors and hospital mortality rate were recorded for all the patients. Results: A total number of 5355 patients were evaluated in the present study. Mean age of the patients was 67.5 ± 13.8 years, and 50.6% were men. Final diagnosis of ischemic stroke was made in 76.5% of the patients, intra-cerebral hemorrhage (ICH) with or without intra-ventricular hemorrhage (IVH) in 14.3% and subarachnoid hemorrhage (SAH) in 9.2%. Stroke risk factors among the patients were hypertension in 68.8% of the patients, diabetes mellitus (DM) in 23.9%, smoking in 12.6% and ischemic heart diseases (IHD) in 17.1%. Mean hospital stay was 17.3 days. Overall, the in-hospital mortality was 20.5%. Conclusion: Compared to other studies, duration of hospital stay was longer and mortality rate was higher in this study. Hypertension was the most common risk factor and cardiac risk factors and DM had relatively lower rate in comparison to other studies. Because of insufficient data on the epidemiology, patterns, and risk factors of stroke in Iran, there is a necessity to develop and implement a national registry system.

Glyoxal toxicity in isolated rat liver mitochondria

Glyoxal is a physiological metabolite formed by lipid peroxidation, ascorbate autoxidation, oxidative degradation of glucose, and degradation of glycated proteins. Glyoxal has been linked to oxidative stress and can cause a number of cellular damages, including covalent modification of amino and thiol groups of proteins to form advanced glycation end products. However, the mechanism of glyoxal toxicity has not been fully understood. In this study, we have focused on glyoxal toxicity in isolated rat liver mitochondria. Isolated mitochondria (0.5 mg protein per milliliter) were prepared from the Wistar rat liver using differential centrifugation and incubated with various concentrations of glyoxal (1, 2.5, 5, 7.5, and 10 mM) for 30 min. The activity of mitochondrial complex II was determined by measurement of MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) conversion. The mitochondrial membrane potential (MMP), lipid peroxidation (MDA), reactive oxygen species (ROS) formation, glutathione (GSH) content, and protein carbonylation were also assessed. After an incubation of isolated liver mitochondria with glyoxal, disrupted electron transport chain, increased mitochondrial ROS formation, lipid peroxidation, mitochondrial membrane damage, GSH oxidation, and protein carbonylation ensued as compared to the control group ( p < 0.05). Glyoxal toxicity in isolated rat liver mitochondria was dose-dependent. In conclusion, glyoxal impaired the electron transport chain, which is the cause of increased ROS and MDA production, depletion of GSH, and disruption of MMP. Mitotoxicity of glyoxal might be related to the pathomechanisms involved in diabetes and its complications.

A 110-nW in-channel sigma-delta converter for large-scale neural recording implants

Advancement in wireless and microsystems technology have ushered in new devices that can directly interface with the central nervous system for stimulating and/or monitoring neural circuitry. In this paper, we present an ultra low-power sigma-delta analog-to-digital converter (ADC) intended for utilization into large-scale multi-channel neural recording implants. This proposed design, which provides a resolution of 9 bits using a one-bit oversampled ADC, presents several desirable features that allow for an in-channel ADC scheme, where one sigma-delta converter is provided for each channel, enabling development of scalable systems that can interface with different types of high-density neural microprobes. The proposed circuit, which have been fabricated in a TSMC 180-nm CMOS process, employs a first order noise shaping topology with a passive integrator and a low-supply voltage of 0.6 V to achieve ultra low-power consumption and small size. The proposed ADC clearly outperforms other designs with a power consumption as low as 110 nW for a precision of 9 bits (11-fJ per conversion), a silicon area of only 82 μm × 84 μm and one of the best reported figure of merit among recently published data converters utilized in similar applications.