All-optical control of skyrmion configuration in CrI 3 monolayer

The potential for manipulating characteristics of skyrmions in a CrI3 monolayer using circularly polarised light is explored. The effective skyrmion-light interaction is mediated by bright excitons whose magnetization is selectively influenced by the polarization of photons. The light-induced skyrmion dynamics is illustrated by the dependencies of the skyrmion size and the skyrmion lifetime on the intensity and polarization of the incident light pulse. Two-dimensional magnets hosting excitons thus represent a promising platform for the control of topological magnetic structures by light.

Comparing ChatGPT and Bing, in response to the Home Blood Pressure Monitoring (HBPM) knowledge checklist

High blood pressure is one of the major public health problems that is prevalent worldwide. Due to the rapid increase in the number of users of artificial intelligence tools such as ChatGPT and Bing, it is expected that patients will use these tools as a source of information to obtain information about high blood pressure. The purpose of this study is to check the accuracy, completeness, and reproducibility of answers provided by ChatGPT and Bing to the knowledge questionnaire of blood pressure control at home. In this study, ChatGPT and Bing's responses to the HBPM 10-question knowledge checklist on blood pressure measurement were independently reviewed by three cardiologists. The mean accuracy rating of ChatGPT was 5.96 (SD = 0.17) indicating the responses were highly accurate overall, with the vast majority receiving the top score. The mean accuracy and completeness of ChatGPT were 5.96 (SD = 0.17) and 2.93 (SD = 0.25) and in Bing were 5.31 (SD = 0.67), and 2.13 (SD = 0.53) Respectively. Due to the expansion of artificial intelligence applications, patients can use new tools such as ChatGPT and Bing to search for information and at the same time can trust the information obtained. we found that the answers obtained from ChatGPT are reliable and valuable for patients, while Bing is also considered a powerful tool, it has more limitations than ChatGPT, and the answers should be interpreted with caution.

The predictive role of the dietary phytochemical index in relation to the clinical and psychological traits of migraine headaches

We investigated the relationship between dietary phytochemical index (DPI) and migraine headaches in Iranian patients, analyzing both clinical and psychological traits. A cross-sectional study was conducted using non-obese adults aged 20-50 years who were diagnosed with migraine. The study used a validated 168-item food frequency questionnaire to assess the usual dietary intake of participants. The DPI was calculated using the following formula: [daily energy derived from phytochemical-rich foods (in kJ)/total daily energy intake (in kJ)] × 100. Clinical outcomes of migraine including frequency, duration, and severity of headaches, as well as migraine-related disability were obtained using relevant questionnaires. Moreover, the mental health profile of patients including depression, anxiety, and stress, as well as serum levels of nitric oxide (NO) were measured. A Poisson regression was used for headache frequency. Linear regression analyzed migraine-related outcomes including duration, severity, migraine-related disability, and serum NO levels. In addition, psychological traits were analyzed via logistic regression. A total of 262 individuals (85.5% females) with a mean age of 36.1 years were included in the analysis. The frequency of migraine attacks was lower in patients in the last DPI tertile compared to those in the first DPI tertile both in the crude [incidence rate ratio (IRR) = 0.70, 95% confidence interval (CI) 0.63, 0.78, Ptrend < 0.001] and fully-adjusted models (IRR = 0.84, 95% CI 0.74, 0.96, Ptrend = 0.009). After controlling for potential confounders, an inverse relationship was observed between higher adherence to DPI and migraine-related disability (β = - 2.48, 95% CI - 4.86, - 0.10, P trend = 0.046). After controlling for potential confounders, no significant relationship was observed between DPI and depression (OR = 0.79, 95% CI 0.42, 1.47, Ptrend = 0.480), anxiety (OR = 1.14, 95% CI 0.61, 2.14, Ptrend = 0.655), and stress (OR = 1.04, 95% CI 0.57, 1.90, Ptrend = 0.876). Higher intakes of phytochemical-rich foods may be associated with lower migraine frequency and improved daily activities among patients. Further studies should confirm our observations and delineate the biological pathways linking phytochemicals and migraine headaches.

Surface decoration of low molecular weight polyethylenimine (LMW PEI) by phthalated dextrin for improved delivery of interleukin-12 plasmid

In this investigation, low molecular weight polyethyleneimine (LMW PEI; 1.8 kDa branched PEI) was conjugated to phathalated dextrin. The aim of this chemical modification was to decorate PEI molecules with a hydrophilic layer to improve its biophysical properties while the phthalic moiety may improve the hydrophilic-hydrophobic balance of the final structure. The polymers were prepared at various conjugation degrees ranging from 6.5% to 16.5% and characterized in terms of biophysical characteristics as well as their gene transfer ability and cell-induced toxicity. The results showed that dextrin-phthalated-PEI (DPHPEI) polymer was able to form nanoparticles with the size range of around 118-170 nm, with the zeta potential of 6.2-9.5 mV. DPHPEI polymers could increase the level of desired protein expression in the cells by up to three folds compared with unmodified LMW PEI while the cell viability of the modified polymers was around 80%. The result of this study shows a promising approach to improve the transfection efficiency of LMW PEI while maintaining its low toxic effects.

"Normal vulva" based on the first national Labiagram design in adult Iranian women not seeking female genital cosmetic surgery: a pilot study

Background

Several studies have been published to present normal values of female genitalia in different age and racial groups.

Aim

The primary objective of our study was to measure the parameters of the external genitalia in adult Iranian women, record the data using the Labiagram system (the first national Labiagram design in Iran), and establish a preliminary database.

Methods

A descriptive study was conducted from March 2022 to December 2022, involving 220 nonpregnant adult women who presented to the gynecology clinic. Women who met the inclusion criteria for the study underwent a comprehensive examination of the external genitalia. The data collected during the examinations were recorded in electronic files and the Labiagram system.

Outcomes

The data showed the diversity of external genital parameters of nonpregnant adult Iranian women.

Results

In this descriptive study, the mean ± SD age of the participants was 51.5 ± 13.44 years, ranging from 15 to 84 years. A total of 192 women (87.3%) had a history of vaginal delivery. There was no statistically significant difference observed in the average measurements of the vulva among the 4 age groups (P < .05). The Pearson correlation coefficient test indicated a statistically weak correlation between body mass index and perineum length (r = 0.174, P = .010). Additionally, a weak correlation was found between body mass index and the width of the labia minora at the left-lower point (r = 0.143, P = .030) and the right-middle point (r = 0.146, P = .031). Furthermore, the results demonstrated that women with a history of vaginal delivery had a significantly longer introitus (49.3 vs 44.3 mm, P = .037), longer labia majora (91.3 vs 87.3 mm, P = .046), and longer labia minora (56.8 vs 50.9 mm, P = .008) when compared with women without prior labor experience.

Clinical Implications

The data will be used as a basis for future studies.

Strengths and Limitations

The use of simple tools for the measuring, data recording, and digital drawing of female external genital anatomy, along with privacy protection, is one of the strengths of this research. The weakness is the small sample size, which is the reason for piloting the Labiagram chart for more extensive studies.

Conclusion

Increasing age and the number of births had no statistically significant effect on the size of external genital parameters among Iranian women. Despite the considerable diversity in these parameters, it has not resulted in a significant demand among Iranian women for female cosmetic surgery.

Assessment of manometric results following posterior pericervical repair or level I to III surgical procedures

Constipation and obstructive bowel disorders are the most common symptoms of prolapse and posterior defects. Prolapse and obstructive defecation disorders are treated using various surgical techniques to repair posterior defects. This study aimed to evaluate the manometry results of patients before and after reconstructive surgery of the posterior compartment. This retrospective cohort study included 40 women with defecation disorders referred to the Imam Khomeini Hospital Complex, an academic center affiliated with Tehran University of Medical Sciences, Tehran, Iran, from 2020 to 2021. Data were collected through medical records and a checklist developed by the researcher before and after surgery. All analyses were performed using SPSS software (version 26), with significance at p<0.05. Forty women with a mean age of 49.47±9.66 years participated in this study. The manometry results showed significant differences in patients before and after surgery in parameters such as maximum resting pressure, push test, constipation, straining during defecation, finger support necessity, sensation of incomplete defecation, dyspareunia, and husband's sexual satisfaction (p<0.001). In addition, all patients had a grade 2 or higher posterior compartment prolapse, which improved in all cases after surgery (p<0.0001). Patients' symptoms significantly improved during the 12-month follow-up after DeLancey level 3 to 1 surgery. This type of surgery proved to be an effective surgical intervention without significant complications in the short-term follow-up.

Genotyping and antibiotic susceptibility of Campylobacter species isolated from raw milk samples in Qazvin, Iran

OBJECTIVE

Campylobacter species are major causes of foodborne illnesses, with unpasteurized milk being a significant carrier of these bacteria, posing a public health risk. One of the challenges in managing Campylobacter infections is the emergence and spread of antibiotic resistance. We conducted a study in Qazvin, Iran, testing 84 raw cow's milk samples to determine the frequency of C. jejuni and C. coli using culture-based and multiplex PCR methods. Additionally, the disk diffusion and RAPD-PCR approaches were utilized to evaluate the phenotypic antibiotic resistance profile and genetic diversity of Campylobacter strains.

RESULTS

The findings indicated that Campylobacter spp. was present in 19.05% of the samples, with C. coli being the predominant isolate. We tested eight antibiotic agents, and the resistance levels of the isolates were as follows: erythromycin 100%, tetracycline 75%, doxycycline 56.25%, ceftriaxone 43.75%, chloramphenicol 37.5%, amoxicillin-clavulanic acid 25%, nalidixic acid 12.5%, and azithromycin 6.25%. Genetic diversity analysis categorized Campylobacter isolates into 39 clusters, indicating a wide diversity among strains. However, no significant correlation was observed between antibiotic resistance and cluster patterns. These findings underscore the role of raw milk as a reservoir for Campylobacter spp. and highlight the substantial antibiotic resistance and genetic diversity within the species population.

Long-term outcomes and quality of life after Manchester procedure for pelvic reconstructive surgery in women with cervical elongation

OBJECTIVE

Native-tissue techniques for Pelvic Organ Prolapse (POP) repairs, such as the Manchester Procedure (MP), have recently been revitalized. However, there are conflicting opinions regarding correcting cervical elongation support by the MP, and the risk of possible poor outcomes and postoperative complications. Therefore, this study aimed to investigate anatomical and patient-reported outcomes during one year after MP.

DESIGN

Prospective cohort study.

SETTING

This study was conducted on women who underwent the MP for cervical elongation between 2010 and 2020.

PATIENTS

Women with apical compartment prolapse up to stage 3 due to cervical elongation.

INTERVENTIONS

Manchester Procedure.

MEASUREMENTS

Pre and postoperative evaluations by POP Quantification (POP-Q) system were performed, and patients filled out the quality-of-life questionnaires including Pelvic Floor Distress Inventory Short Form 20 (PFDI-20), and POP/Urinary Incontinence Sexual Questionnaire (PISQ-12) before and 12 months after the procedure. Anatomical outcomes were measured by POP-Q and the changes in POP-related symptoms were evaluated and reported.

MAIN RESULTS

33 participants were recruited in the study. Significant anatomical improvements were obtained in all compartments after the surgery. After 12 months in POP-Q examination, the mean (±SD) of Ba was changed from +1.82 (±1.71) to -1.18 (±1.50), C was changed from -1.25 (±2.81) to -6 (±1.82), and D from -6.30 (±1.42) to -7.1 (±1.25) respectively (P < 0.001). POP-Q stage 0-1 was obtained inof7% in the apical compartment (C <  -1), but only in 45.4% in the anterior compartment (Ba <  -1). A significant reduction in symptom scores was obtained for PFDI-20 (P < 0.01) and PISQ-12 (P = 0.011).

CONCLUSIONS

Our findings suggest that the MP provides adequate apical support with improvement in anatomic and subjective findings for patients with cervical elongation.

Associations between diet quality and migraine headaches: a cross-sectional study

AIMS

We evaluated associations between diet quality and migraine outcomes.

METHODS

The current work represented a cross-sectional study on 262 patients with migraine (20-50 y). Diet quality was assessed using the standard healthy eating index 2015 (HEI-2015) and alternative healthy eating index 2010 (AHEI-2010). A validated 168-item food frequency questionnaire was used to assess dietary intake. Migraine outcomes included clinical factors (severity, duration, frequency, and disability related to migraine) and serum nitric oxide (NO). Associations between diet quality indices and migraine outcomes were evaluated using linear regressions, and β and 95% corresponding confidence interval (CI) were reported.

RESULTS

HEI-2015 was inversely associated with migraine frequency (β = -4.75, 95% CI: -6.73, -2.76) in patients with the highest HEI scores (third tertile) vs. those with the lowest scores (first tertile) after adjusting for relevant confounders. AHEI-2010 was inversely associated with migraine frequency (β = -3.67, 95% CI: -5.65, -1.69) and migraine-related disability (β = -2.74, 95% CI: -4.79, -0.68) in adjusted models. Also, AHEI-2010 was inversely associated with migraine severity in patients in the second vs. first tertile (β = -0.56; 95% CI: -1.08, -0.05). We detected no associations between diet quality and NO levels (All P > 0.14).

CONCLUSIONS

Improved diet quality may be associated with favorable migraine outcomes (lower headache frequency, severity, and migraine-related disability). Future studies are required to confirm and delineate the causal mechanisms of our observations.

Effects of pistachios on glycaemic control: a systematic review and meta-analysis of randomised controlled trials

To evaluate the effects of pistachio consumption on the glucoregulatory status in individuals with a high risk of CVD, a systematic review and meta-analysis of randomised controlled trials (RCT) were conducted. Online databases including PubMed, Scopus, Web of Science and Cochrane Library were searched from inception until June 2019. Human trials that reported data for fasting blood sugar (FBS), fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were included. Data were pooled using the random effect models and expressed as weighted mean difference (WMD) with 95 % CI. Eight RCTs were included in the analyses. Pistachio consumption, exchanged isocalorically for other foods, decreased FBS (WMD: -5·32 mg/dl, 95 % CI (-7·80, -2·64), P < 0·001) and insulin (WMD: -1·86 µIU/ml, 95 % CI (-3·13, -0·59), P < 0·01) concentrations in individuals with a high risk of CVD. However, no changes were observed in the levels of HOMA-IR between the groups (WMD: -0·66, 95 % CI (-1·89, 0·58), P = 0·30). Pistachio consumption may improve glucoregulatory status in individuals at risk for CVD, as evidenced by reduced FBS and insulin concentrations. However, due to the limited availability of studies with diabetic cases and relatively small sample sizes of available studies, well-designed trials with adequate sample sizes aimed at diabetic populations are recommended.

Waveguide-integrated silicon T centres

The performance of modular, networked quantum technologies will be strongly dependent upon the quality of their quantum light-matter interconnects. Solid-state colour centres, and in particular T centres in silicon, offer competitive technological and commercial advantages as the basis for quantum networking technologies and distributed quantum computing. These newly rediscovered silicon defects offer direct telecommunications-band photonic emission, long-lived electron and nuclear spin qubits, and proven native integration into industry-standard, CMOS-compatible, silicon-on-insulator (SOI) photonic chips at scale. Here we demonstrate further levels of integration by characterizing T centre spin ensembles in single-mode waveguides in SOI. In addition to measuring long spin T₁ times, we report on the integrated centres' optical properties. We find that the narrow homogeneous linewidth of these waveguide-integrated emitters is already sufficiently low to predict the future success of remote spin-entangling protocols with only modest cavity Purcell enhancements. We show that further improvements may still be possible by measuring nearly lifetime-limited homogeneous linewidths in isotopically pure bulk crystals. In each case the measured linewidths are more than an order of magnitude lower than previously reported and further support the view that high-performance, large-scale distributed quantum technologies based upon T centres in silicon may be attainable in the near term.

Food insecurity is associated with the sleep quality and quantity in adults: a systematic review and meta-analysis

OBJECTIVE

We evaluated associations between food insecurity (FI) and the quality and quantity of sleep in adults (≥18 years).

DESIGN

The current study represented a systematic review and meta-analysis of observational studies.

SETTING

Databases of PubMed, Scopus, Embase and Web of Science were searched from inception until 6 June 2022. Meta-analyses were conducted using random-effects models, and effect sizes were reported as OR and 95 % CI.

PARTICIPANTS

Data from ten eligible observational studies, including 83 764 participants, were included.

RESULTS

FI was associated with an increased risk of poor sleep quality (OR = 1·45; 95 % CI (1·24, 1·70), I2 = 95, P < 0·001, n 7). Besides, subgroup analysis showed increased risk of poor sleep quality corresponding to the severity of FI across mild (OR = 1·31; 95 % CI (1·16, 1·48), I2 = 0 %, P < 0·001, n 5), moderate (OR = 1·49; 95 % CI (1·32, 1·68), I2 = 0 %, P < 0·001, n 5) and severe (OR = 1·89; 95 % CI (1·63, 2·20), I2 = 0 %, P < 0·001, n 5) levels. Similarly, subgroup analysis by sleep problems showed that FI was associated with an increased the risk of trouble falling asleep (OR = 1·39; 95 % CI (1·05, 1·83), I2 = 91 %, P = 0·002, n 3) and trouble staying asleep (OR = 1·91; 95 % CI (1·37, 2·67), I2 = 89 %, P < 0·001, n 3). Moreover, FI was associated with the odds of shorter (OR = 1·14; 95 % CI (1·07, 1·21), I2 = 0 %, P < 0·001, n 4) and longer sleep duration (OR = 1·14; 95 % CI (1·03, 1·26), I2 = 0 %, P = 0·010, n 4).

CONCLUSIONS

Collective evidence supports that FI is associated with poor sleep quality and quantity in adults. Preventative and management strategies that address FI may provide health benefits beyond improving nutritional status per se.

A systematic review on the management of idiopathic avascular necrosis of the scaphoid (Preiser's disease)

BACKGROUND

Treatment options for patients with Preiser's disease are challenging and varied. This article thus provides a systematic review of existing studies on the outcomes of the treatments for patients suffering from Preiser's disease in order to investigate the most appropriate management of Preiser's in each stage of the disease.

METHODS

We followed PRISMA guidelines while performing the study, and reviewed 107 papers in all languages from 1981 till November 2020 and included 42 studies that met the eligibility criterion. Studies investigating the outcome of one or more treatment options for Preiser's disease were eligible. Besides, quantitative analysis on 130 individuals (135 wrists) of the included studies was performed.

RESULTS

The results show that in stages II and III, pain score reduces more in surgical approach than in conservative treatment. In stage II of the Preiser's, Vascularized Bone Grafting (VBG) was more effective in pain alleviation and improvement in wrist range of motion (ROM) and Mayo Modified Wrist Score (MMWS) than immobilization. Proximal Row Carpectomy (PRC) in stage III causes more pain relief and ROM improvement than VBG and conservative treatments like prescribing NSAIDs. Inconsistent evidence was found in case studies of stage IV; however, they generally favour PRC and SILASTIC implants. Surgical studies of stage I are not yet enough for making a conclusive assessment.

CONCLUSION

Surgical treatment outcomes seem more satisfactory in all Preiser's disease stages. Specifically, VBG for patients of stage II provided they have no scaphoid degenerative changes, and PRC seems more satisfactory for stage III.

LEVEL OF EVIDENCE

IV; systematic review of case reports and case series on Preiser's disease.

Comparison of dietary and physical activity behaviors in women with and without polycystic ovary syndrome: a systematic review and meta-analysis of 39 471 women

BACKGROUND

Lifestyle (dietary and/or physical activity [PA]) modification is recommended as first-line therapy to manage polycystic ovary syndrome (PCOS). Current recommendations are based on healthy lifestyle practices for the general public since evidence for unique lifestyle approaches in PCOS is limited and low quality.

OBJECTIVE AND RATIONALE

We aimed to synthesize evidence on dietary and PA behaviors between women with PCOS and those without PCOS. Primary outcomes were overall diet quality, total energy intake and total PA, and secondary outcomes included macronutrients, micronutrients, food groups, foods, glycemic indices, sedentary time and sitting levels. We conducted this work to identify any unique lifestyle behaviors in women with PCOS that could underlie the propensity of weight gain and obesity in PCOS and be targeted for precision nutrition and PA interventions. These findings could be used to inform future practice recommendations and research that more effectively address complications (weight gain, obesity, diabetes, infertility, cardiovascular disease and mental health) in this high-risk population.

SEARCH METHODS

Databases of MEDLINE, Web of Science, Scopus and CINAHL were searched until 15 February 2022 to identify observational studies documenting dietary and PA behaviors between women with PCOS and without PCOS (Controls). Studies on children, adolescents (<18 years), pregnant or menopausal-aged women (>50 years) were excluded. Data were pooled by random-effects models and expressed as (standardized) mean differences (MD) and 95% CIs. The risk of bias was assessed by the Newcastle-Ottawa scale (NOS).

OUTCOMES

Fifty-four studies (N = 39 471 participants; [n = 8736 PCOS; 30 735 Controls]) were eligible (96%; [52/54] NOS scores ≥ 7). Women with PCOS had higher cholesterol (MD: 12.78, 95% CI: 1.48 to 24.08 mg/day; P = 0.03; I2 = 19%), lower magnesium (MD: -21.46, 95% CI: -41.03 to -1.91 mg/day; P = 0.03; I2 = 76%), and a tendency for lower zinc (MD: -1.08, 95% CI: -2.19 to -0.03 mg/day; P = 0.05; I2 = 96%) intake, despite lower alcohol consumption (MD: -0.95, 95% CI: -1.67 to 0.22 g/day; P = 0.02; I2 = 0%) versus Controls. Also, women with PCOS had lower total PA (standardized mean difference: -0.38, 95% CI: -0.72 to 0.03; P = 0.03; I2 = 98%). Conversely, energy, macronutrients (carbohydrate, fat, protein, fiber), micronutrients (folic acid, iron, calcium, sodium), glycemic index and glycemic load were similar (all: P ≥ 0.06). Most eligible studies reported lower total adherence to healthy eating patterns or poorer consumption of major food groups (grains, fruits, vegetables, proteins, seeds, nuts, dairy) in women with PCOS, as described narratively since variable study methodology did not permit meta-analyses.

WIDER IMPLICATIONS

Collective evidence supports that women with PCOS have a lower overall diet quality, poorer dietary intakes (higher cholesterol, lower magnesium and zinc) and lower total PA, despite lower alcohol consumption versus those without PCOS. Considerable heterogeneity among studies reinforces the need for research to address any relative contributions of other factors (e.g. genetic, metabolic or sociodemographic) to the observed differences. These clarifications may contribute to future evidence-based guideline recommendations on monitoring and managing PCOS in the era of precision lifestyle medicine.

Targeted co‐delivery of paclitaxel and anti P‐gp shRNA by low molecular weight PEI decorated with L‐3,4‐dihydroxyphenylalanine

Co-delivery of small chemotherapeutic molecules and nucleic acid materials via targeted carriers has attracted great attention for treatment of resistant tumors and reducing adverse effects. In this study, a targeted carrier for co-delivery was prepared based on low-molecular weight polyethylenimine (LMW PEI). Paclitaxel (PTX) was covalently conjugated onto PEI via a succinate linker. The PEI conjugate was decorated with L-DOPA in order to target large neutral amino acid transporter-1 (LAT-1) that is over-expressed on various cancer cells. This PEI conjugate was complexed with human ABCB1 shRNA plasmid to down-regulate the expression of P-glycoprotein, as one of the major efflux pumps inducing resistance against chemotherapeutics. The formation of PEI conjugate enhanced the solubility of PTX and resulted in the condensation and protection of plasmid DNA in nanosized polyplexes. The results of targeted delivery into the cells demonstrated that PEI conjugate transferred the payloads to the cells over-expressing LAT-1 transporter, while the biological effects on the cells lacking the transporter was negligible. Also, shRNA-mediated down-regulation of P-gp led to the increase of toxic effects on the cells over-expressing P-gp. This study suggests a promising approach for co-delivery of small molecules and nucleic acid materials in a targeted manner for cancer therapy.

Evaluation of Stress and Cognition Indicators in a Puzzle Game: Neuropsychological, Biochemical and Electrophysiological Approaches

Video games have significant and diverse effects on stress and cognitive systems based on the game style. The effect of this media on the central nervous system is significant because of its repetition. Nowadays, video games have become an important part of human life at different ages, and therefore, assessing their effects (good and bad) on stress factors, cognition, and behavior can be an important help in understanding the nature of these games and managing their impact on humans. Consequently, this study aimed to investigate the effect of a puzzle game on the player's stress and cognitive indicators in neuropsychological, biochemical, and electrophysiological approaches. A total of 44 participants were entered into the study and randomly assigned to control and experimental groups. Our interventions were watching (control group) and playing (experimental group) the game. Salivary biomarkers (cortisol and alpha-amylase) were measured using the enzyme-linked immunosorbent assay method. Electrophysiological assessment of attention and stress was performed using electroencephalography. Neuropsychological assessments for the evaluation of mental health, mental fatigue, sustained attention, and reaction time were conducted using paced auditory serial addition test. All tests were administered before and after the interventions. The findings revealed that the salivary cortisol and alpha-amylase significantly reduced after playing the game. There were significantly higher levels of attention after playing the game. Mental health and sustained attention significantly increased after game playing. It can conclude that puzzle-style computer games can strengthen and empower the perceptual-cognitive system and suppress the stress system of players. Therefore, they can be used purposefully as a positive cognitive therapy approach.

Assessing sex differential in COVID-19 mortality rate by age and polymerase chain reaction test results: an Iranian multi-center study

BACKGROUND

The aim of this study is to evaluate the sex differential effect in the COVID-19 mortality by different age groups and polymerase chain reaction (PCR) test results.

RESEARCH DESIGN

In a multicenter cross-sectional study from 55 hospitals in Tehran, Iran, patients were categorized as positive, negative, and suspected cases.

RESULTS

A total of 25,481 cases (14,791 males) were included in the study with a mortality rate of 12.0%. The mortality rates in positive, negative, and suspected cases were 20.55%, 9.97%, and 7.31%, respectively. Using a Cox regression model, sex had a significant effect on the hazard of death due to COVID-19 in adult and senior male patients having positive and suspected PCR test results. However, sex was not found as significant factor for mortality in patients with a negative PCR test in different age groups.

CONCLUSIONS

Regardless of other risk factors, we found that the effect of sex on COVID-19 mortality varied significantly in different age groups. Therefore, appropriate strategies should be designed to protect adult and senior males from this deadly infectious disease. Furthermore, owing to the considerable death rate of COVID-19 patients with negative test results, new policies should be launched to increase the accuracy of diagnosis tests.

Preparation and Characterization of Nanoliposome Containing Isolated VP1 Protein of Foot and Mouth Disease Virus as a Model of Vaccine

Foot-and-mouth disease (FMD) is an acute and highly contagious disease in livestock, such as cattle, sheep, and pigs, leading to a lot of economic losses. The current FMD vaccines formulated by inactivated whole-virus and adjuvant successfully reduce disease outbreaks in many regions of the world. Immunological studies on FMD viruses revealed that the dominant epitope in arising neutral antibody response is amino acid residues constructing the G-H loop, constituting a surface loop of the structural protein, termed VP1. Liposomes as one of the most well-known vehicles are considered an important carrier in vaccine development, and their function is used to encapsulate purified VP1 protein based on their size, charge, and lipid content. Accordingly, the VP1 protein was isolated from the FMD virus. This study aimed to compare four methods of VP1 protein encapsulation in the liposome and the extruding effect, as follows: 1) VP1 protein was dissolved in dimethyl sulfoxide and added to the lipid film hydrated by ethanol, 2) the lipid film was hydrated by VP1 protein with 7M urea, 3) the lipid film was hydrated by VP1 protein and freeze-thawed, and 4) the lipid film was hydrated by VP1 protein. The highest encapsulation efficiency was 91% in the second method which purified protein-containing urea. The VP1 protein in the prepared liposome (1, 2-dimyristoyl-sn-glycero-3-phosphocholine: 1, 2-dimyristoyl-sn-glycero-3-phosphocholine: cholesterol) released more than 90% of protein content after 240 h.

Comprehensive evaluation of disparities in cardiometabolic and reproductive risk between Hispanic and White women with polycystic ovary syndrome in the United States: a systematic review and meta-analysis

OBJECTIVE

We conducted a systematic review and meta-analysis to comprehensively compare cardiometabolic and reproductive health risk between Hispanic and White women with polycystic ovary syndrome in the United States in response to the call by the international guideline for polycystic ovary syndrome to delineate health disparities.

DATA SOURCES

Databases of MEDLINE, Web of Science, and Scopus were initially searched through October 25, 2020, and confirmed on February 1, 2021.

STUDY ELIGIBILITY CRITERIA

Observational studies comparing glucoregulatory, lipid profile, anthropometric, blood pressure, androgen, ovarian morphology, oligoanovulation, and infertility status between Hispanic and White women with polycystic ovary syndrome were included. The primary outcome was metabolic syndrome risk. Furthermore, major cardiovascular events (stroke, coronary heart disease, and heart failure) and mortality rate (cardiovascular death and total mortality) data were evaluated. Studies on adolescents (<2 years after menarche), pregnant, or menopausal-aged women (>50 years) were excluded.

METHODS

Data were pooled by random-effects models and expressed as mean differences and 95% confidence intervals. Risk of bias was assessed by the Newcastle-Ottawa Scale.

RESULTS

A total of 11 studies (n=2267; 589 Hispanic and 1678 White women) were eligible. All studies, including both White and Hispanic women, had high-quality assessment (Newcastle-Ottawa Scale score of ≥8). Hispanic women exhibited comparable metabolic syndrome prevalence (7% [95% confidence interval, -1 to 14]; P=.06; I2=0%); however, Hispanic women exhibited higher modified Ferriman-Gallwey score (0.60 [95% confidence interval, -0.01 to 1.21]; P=.05; I2=0%), fasting insulin (5.48 μIU/mL [95% confidence interval, 3.11-7.85]; P≤.01; I2=40.0%), and homeostatic model assessment of insulin resistance (1.20 [95% confidence interval, 0.50-1.89]; P≤.01; I2=43.0%) than White women. The 2 groups had comparable glucose, lipid profile, waist circumference, blood pressure, and androgen status (all P≥.08). Findings about group differences in certain reproductive outcomes (ie, ovarian dysmorphology and infertility) were contradictory and described only narratively as inclusion in the meta-analyses was not possible. No study reported on cardiovascular events or mortality.

CONCLUSION

Hispanic women with polycystic ovary syndrome exhibited greater impairments in glucoregulatory status than White women. Disparities in reproductive risks could not be concluded. The degree to which glucoregulatory aberrations translate into patient-pressing diseases (diabetes mellitus and infertility) remains a major roadblock given the paucity of available evidence. Our observations have supported the consideration of these disparities in the diagnostic, monitoring, and management practices for polycystic ovary syndrome and reinforced the need to elucidate mechanisms that account for the observed disparities to foster equity in polycystic ovary syndrome care.

Improvement of Cognitive Indicators in Male Monkeys Exposed to Extremely Low-Frequency Electromagnetic Fields

Today, the production of extremely low-frequency electromagnetic fields (ELF-EMFs) has significantly increased. This study aimed to investigate the effect of the ELF-EMFs on the structure and function of the brain in male rhesus monkeys in terms of visual learning (VL), visual memory (VM), and visual working memory (VWM). To conduct the study, four monkeys were selected, of whom two monkeys were irradiated by 12-Hz ELF-EMFs with a magnitude of 0.7 microtesla, and two monkeys were tested without irradiation (control group). A blood sample was taken in three stages, namely pre- and post-irradiated and the recovery phases. Changes in the plasma levels of sodium, potassium, and adrenocorticotropic hormone (ACTH) were evaluated. Moreover, gene expression of N-methyl-D-aspartate (NMDA) receptors was assessed. The anatomical change of the brain's prefrontal area was measured by magnetic resonance imaging and Digital Imaging and Communications in Medicine LiteBox file. The abilities of VL, VM, and VWM significantly improved after the irradiation. Furthermore, the expression of the NMDA receptors gene and the plasma levels of sodium, potassium, and ACTH significantly enhanced after the irradiation. However, the prefrontal area was not significantly affected by the irradiation. No significant differences were observed in any of the studied factors in the control group. Our findings suggested that ELF-EMFs irradiation at 12 Hz positively affected VL and VWM. Consequently, 12-Hz ELF-EMFs irradiations can be widely applied to improve cognitive abilities in monkeys.

Diagnostic accuracy of first and early second trimester multiple biomarkers for prediction of gestational diabetes mellitus: a multivariate longitudinal approach

BACKGROUND

Gestational Diabetes Mellitus (GDM) is an underlying cause of maternal and newborn morbidity and mortality all around the world. Timely diagnosis of GDM plays an important role in reducing its adverse consequences and burden. This study aimed to determine diagnostic accuracy of multiple indicators in complete blood count (CBC) test for early prediction of GDM.

METHODS

In this prospective cohort study, the data from 600 pregnant women was analyzed. In the study sample, the two-step approach was utilized for the diagnosis of GDM at 24-28 weeks of gestation. We also used the repeated measures of hemoglobin (Hb), hematocrit (Hct), fasting blood sugar (FBS) and red blood cell count (RBC) in the first and early second trimesters of pregnancy as the longitudinal multiple indicators for early diagnosis of GDM. The classification of pregnant women to GDM and non-GDM groups was performed using a statistical technique based on the random-effects modeling framework.

RESULTS

Among the sample, 49 women (8.2%) were diagnosed with GDM. In the first and early second trimester of pregnancy, the mean HcT, Hb and FBS of women with GDM was significantly higher than non-GDMs (P < 0.001). The concurrent use of multiple longitudinal data from HcT, Hb, RBC and FBS in the first and early second trimester of pregnancy resulted in a sensitivity, specificity and area under the curve (AUC) of 87%, 70% and 83%, respectively, for early prediction of GDM.

CONCLUSIONS

In general, our findings showed that the concurrent use of repeated measures data on Hct, Hb, FBS and RBC in the first and early second trimester of pregnancy might be utilized as an acceptable tool to predict GDM earlier in pregnancy.

Consumption of pistachio nuts positively affects lipid profiles: A systematic review and meta-analysis of randomized controlled trials

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of consuming pistachio nuts on lipid profiles (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglyceride [TG]). Databases of PubMed, Scopus, ISI Web of Science, and Cochrane Library were searched from inception to June 2019 to identify RCTs documenting the effects of consuming pistachio nuts on blood lipid profiles in adults. Effect sizes were reported as weighted mean difference (WMD) and 95% confidence interval (CI) using the random-effects models (DerSimonian-Laird method). Twelve eligible RCTs were included. Consumption of pistachio nuts decreased TC (WMD: -7.48 mg/dL; 95% CI, -12.62 to -2.34), LDL-C (WMD: -3.82 mg/dL; 95% CI, -5.49 to -2.16) and TG (WMD: -11.19 mg/dL; 95% CI, -14.21 to -8.17) levels. However, HDL-cholesterol levels (WMD: 2.45 mg/dL; 95% CI, -2.44 to 7.33) did not change following pistachio consumption. Consuming pistachio nuts may improve lipid profiles (TC, LDL-C, TG) in adults and may be protective against cardiometabolic diseases. However, further studies with larger sample sizes are required to confirm these results.

The relationship between demographic features, anthropometric parameters, sleep duration, and physical activity with ECG parameters in Fasa Persian cohort study

Backgrounds

Cardiovascular Diseases (CVDs) are the first leading cause of death worldwide. The present study aimed to investigate the relationship between demographics, anthropometrics, sleep duration, physical activity, and ECG parameters in the Fasa Persian cohort study.

Methods

In this cross-sectional study, the basic information of 10,000 participants aged 35–70 years in the Fasa cohort study was used. The data used in this study included demographic data, main Electrocardiogram (ECG) parameters, anthropometric data, sleep duration, and physical activity. Data analysis was performed using t-test, chi-square, and linear regression model.

Results

Based on multivariate linear regression analysis results, increased age was significantly associated with all study parameters. Nevertheless, gender and body mass index showed no significant relationship with SV3 and PR. Wrist circumference, hip circumference and waist circumference significantly increased the mean values of the ECG parameters. However, sleep duration was not significantly associated with the ECG parameters. In addition, hypertension was major comorbidity, which was shown to increase the mean values of the ECG parameters.

Conclusion

Several factors affected the ECG parameters. Thus, to interpret ECGs, in addition to age and gender, anthropometric indices, physical activity, and previous history of comorbidities, such as hypertension and ischemic heart disease, should be taken into consideration.

Immunity Evaluation of an Experimental Designed Nanoliposomal Vaccine Containing FMDV Immunodominant Peptides

Foot-and-mouth disease (FMD) is a highly contagious viral disease affecting cloven-hoofed animals. The particular virus causing FMD disease is called FMD virus and is a member of the Aphthovirus genus in the Picornaviridae family. The FMD virus has an 8500 nt long single strain positive RNA genome with one open reading frame (ORF) trapped in an icosahedral capsid protein. This virus genome doesn't have proofreading property which leads to high mutagenesis. It has seven serotypes, including O, A, ASIA, SAT1, SAT2, and C serotypes, as well as many subtypes. Iran is an endemic region for foot-and-mouth disease. Vaccination of susceptible animals with an inactivated whole-virus vaccine is the only way to control the epidemic in many developing countries. Today, conventionally attenuated and killed virus vaccines are being used worldwide. In Iran, animals have been vaccinated every 105 days with an inactivated FMD vaccine. Although commercially available FMD vaccines are effective, they provide short-term immunity requiring regular boosters. A new FMD vaccine is needed to improve immunization, safety, and long-term immune responses. A synthetic peptide vaccine is one of the safe and important vaccines. Peptide vaccine has low immunogenicity, requiring strong adjuvants. Nanoliposomes can be used as new adjuvants to improve immune response. In the current study, nanoliposomal carriers were selected using Dimyristoylphosphatidylcholine (DMPC), dimyristoyl phosphoglycerol (DMPG), and Cholesterol (Chol) as an adjuvant containing two immunodominant synthetic FMDV peptides. The liposomal formulations were characterized by various physicochemical properties. The size, zeta potential, and encapsulation efficiency were optimized, and the obtained nanoliposome was suitable as a vaccine. The efficacy of vaccines has been evaluated in guinea pigs as animal models. Indirect ELISA was used to detect FMDV-specific IgG. The obtained results indicated that although antibody titer was observed, the amount was lower compared to the groups that received inactivated virus-containing liposomes. In addition, the results showed that liposome was an appropriate adjuvant, compared to other adjuvants, such as Alum and Freund, and can act as a depot and induce an immune response.

The Fasa Registry on Systolic Heart Failure (FaRSH): Feasibility Study and the First 5-year Reports

BACKGROUND

The literature on patients with heart failure (HF) from the Middle East, besides a few existing registries, is scarce. We report, for the first time in our country, a hospital-based registry for systolic HF.

MATERIALS AND METHODS

This was a web-based registry on HF, conducted in Vali-Asr Hospital affiliated with Fasa University of Medical Sciences, Fasa, Iran. The goal of this registry was to define overall baseline clinical characteristics and natural history of hospitalized patients with systolic HF, to evaluate current management schema and implementation of practice guidelines, and to determine the correlation between genetic predisposition environmental effects, individuals' characteristics of health, lifestyle, morbidity, and mortality in relation with the effects of medication.

RESULTS

To date, 2378 individuals with a mean of age 67.08±13.07 years have been registered. Among which, 1381 (58.07%) patients were diagnosed with denovo HF. Most of the patients (60.1%) were male, and 8.9% had admissions during the past 30 days. The most common causes of HF were ischemic heart disease (86.5%) and hypertension (5.3%). Most patients had NYHA class one (44.3%) and three (20.4%). Overall, near 30% had diabetes and more than 38% had hyperlipidemia. Most individuals have been not a history of cigarette smoking (68.7%) or water-pipe smoking (96.9%). Also, 22.2% were current opium users, and 3.2% were previous opium users.

CONCLUSION

The findings of this registry could make a realistic view of HF as a chronic disease with a burden. Therefore, policymakers can design programs and guidelines to prevent disease and better survival and quality of life.

Obesity, but not hyperandrogenism or insulin resistance, predicts skeletal muscle mass in reproductive-aged women with polycystic ovary syndrome: A systematic review and meta-analysis of 45 observational studies

Women with polycystic ovary syndrome (PCOS) exhibit reduced muscle insulin-mediated glucose uptake, potentially attributed to altered muscle mass; however, this is inconclusive. Altered muscle mass may aggravate PCOS complications. Our systematic review and meta-analysis evaluated whether PCOS alters muscle mass and function. Databases (MEDLINE, Web of Science, Scopus) were searched through September 2, 2020, for studies documenting skeletal muscle mass (lean tissue mass) and function (strength) in PCOS and control groups. The primary outcome was total lean body mass (LBM) or fat-free mass (FFM). Data were pooled by random-effects models and expressed as mean differences and 95% confidence intervals. Forty-five studies (n = 3676 participants) were eligible. Women with PCOS had increased total (0.83 [0.08,1.58] kg; p = 0.03; I²  = 72.0%) yet comparable trunk (0.84 [-0.37,2.05] kg; p = 0.15; I²  = 73.0%) LBM or FFM versus controls. Results of meta-regression analyses showed no associations between mean differences between groups in total testosterone or homeostatic model assessment of insulin resistance and total or trunk LBM or FFM (All: p ≥ 0.75). Mean differences in body mass index (BMI) were associated with total (0.65 [0.23,1.06] kg; p < 0.01; I²  = 56.9%) and trunk (0.56 [0.11,1.01] kg; p = 0.02; I²  = 42.8%) LBM or FFM. The PCOS subgroup with BMI ≥ 25 kg/m² had greater total LBM or FFM versus controls (1.58 [0.82,2.34] kg; p < 0.01; I²  = 64.0%) unlike the PCOS subgroup with BMI < 25 kg/m² (-0.45 [-1.94,1.05] kg; p = 0.53; I²  = 69.5%). Appendicular lean mass and muscle strength data were contradictory and described narratively, as meta-analyses were impossible. Women with PCOS have higher total and trunk lean tissue mass attributed to overweight/obesity, unlike hyperandrogenism or insulin resistance.

Impact of Obesity on Anti-Mullerian Hormone (AMH) Levels in Women of Reproductive Age

Obesity negatively impacts reproductive health, including ovarian function. Obesity has been posited to alter Anti-Müllerian hormone (AMH) production. Understanding biological factors that could impact AMH levels is necessary given the increasing use of AMH for predicting reproductive health outcomes in response to controlled ovarian stimulation, diagnosing ovulatory disorders, onset of menopause, and natural conception. In this narrative review, we evaluated the impact of obesity on AMH levels in healthy, regularly cycling reproductive-age women (18-48 years). Thirteen studies (n = 1214 women; (811, non-obese (body mass index; BMI < 30 kg/m2); 403, obese (BMI > 30 kg/m2))) were included, of which five reported decreased AMH levels with obesity, whereas eight showed comparable AMH levels between groups. Inclusion of women with higher obesity classes (Class 3 versus Class 1) may have been a factor in studies reporting lower AMH levels. Together, studies reporting AMH levels in otherwise healthy women remain limited by small sample sizes, cross-sectional designs, and lack of representation across the entire adiposity spectrum. Ultimately, the degree to which obesity may negatively impact AMH levels, and possibly ovarian reserve, in otherwise healthy women with regular menstrual cycles should be deemed uncertain at this time. This conclusion is prudent considering that the biological basis for an impact of obesity on AMH production is unknown.

Use of Bentofeed and Persian Melon Peel Biochar in the Decolorization of Water Contaminated with Methylene Blue and their Effects on In vitro Ruminal Fermentation

This study conducted two experiments to evaluate the effects of two cheap adsorbents, including bentofeed (a commercial name of bentonite) and Persian melon peel biochar (PMPB) on the decolorization of water contaminated by methylene blue (MB) and ruminal fermentation pattern. The decolorization efficiency of bentofeed and PMPB at three levels of 0, 4, and 8 mg per 10 ml of 0, 3, 6, and 9 mg/L MB solutions mg/L after 3 and 24 h of incubation was evaluated by its absorbance at 660 nm. At all dye concentrations, PMPB, and bentofeed showed high potential in removing MB from water with an efficiency of 60%-99.5%. In both incubation times, the addition of 8 mg bentofeed had the highest effect on the removal efficiency when the dye concentration was 6 or 9 mg/L. However, the removal efficiency was declined with increasing MB concentration (p &amp;lt;0.05). Experiment two evaluated the effects of various levels (same as experiment one) of MB, bentofeed, and PMPB on in vitro gas production (GP) and volatile fatty acids (VFA) in two individual 4&amp;times;3 factorial experiments. The potential GP (b), rate constant of gas production (c), metabolizable energy, organic matter digestibility, and total VFA were significantly decreased with increasing MB in the medium (p &amp;lt;0.05), while all parameters were increased when bentofeed or PMPB was added to the medium containing MB (p &amp;lt;0.05). The amounts of acetic, propionic, and butyric acids were not affected by PMPB; however, they changed when bentofeed was added to the medium (p &amp;lt;0.05). The NH3-N concentration was decreased significantly following the increase of MB; moreover, it was increased when PMPB and bentofeed were added to the medium. MB, as a water contaminant agent, had negative effects on ruminal fermentation parameters. Both adsorbents (i.e., PMPB and specially bentofeed) were efficiently able to remove MB from the water. The negative effects of MB on fermentation parameters were also alleviated as a result of using bentofeed or PMPB. It seems that bentofeed has the higher adsorption property of MB, compared to that of the PMPB.

Trend analysis of disability adjusted life years due to cardiovascular diseases: results from the global burden of disease study 2019

BACKGROUND

Cardiovascular diseases (CVDs) are the number one cause of global mortality representing about one third of all deaths across the world. The objective of the present study was to model the global trend in disability-adjusted life years (DALY) and its components due to CVD over the past three decades. We also aimed to evaluate the longitudinal relationship between CVD DALY and Human Development Index (HDI) in this period of time.

METHODS

The age-standardized rates of years lost due to disability (YLD), years of life lost (YLL) and DALY were extracted for cardiovascular diseases from the Global Burden of Disease (GBD) Study 2019 in years 1990 to 2019. Additionally, the United Nations Development Programme (UNDP) database was used to retrieve HDI values for all world countries at the same period time. The trend analysis was performed using the joinpoint regression model.

RESULTS

The obtained revealed a significant downward trend for DALY and its components with the average annual percent change of - 1.0, - 0.3 and - 1.1 per 100,000 population, respectively for DALY, YLD and YLL. We also found that countries with high/very high levels of HDI have remarkably experienced steeper declining slope of trend than those in lower levels of HDI over the study period.

CONCLUSIONS

Although the observed decreasing trend of CVD burden is a hopeful message for all world countries, the considerable gap in slope of trend between richer and poorer parts of the world is a serious alarm for health policy makers. Regarding this, there is an urgent need to put more efforts on implementing preventive programs, improving the level of patients' care and providing efficient treatment, especially in regions with lower levels of HDI.

Associations between exposure to heavy metals and the risk of chronic kidney disease: a systematic review and meta-analysis

We performed a systematic review and meta-analysis to examine the relationship between heavy metals (HMs) exposure and the risk of chronic kidney disease (CKD). Databases of Web of Science, Embase, MEDLINE, and Scopus were searched through June 2020 to identify studies assessing the relationships between exposure to HMs (i.e. cadmium, lead, arsenic, mercury) and the risk of CKD, evaluated by decreased estimated glomerular filtration rate (eGFR) and/or increased proteinuria risks in adults (≥18 years). Data were pooled by random-effects models and expressed as weighted mean differences and 95% confidence intervals. The risk of bias was assessed by the Newcastle-Ottawa scale (NOS). Twenty-eight eligible articles (n = 107,539 participants) were included. Unlike eGFR risk (p = 0.10), Cadmium exposure was associated with an increased proteinuria risk (OR = 1.35; 95% CI: 1.13, 1.61; p < 0.001; I² = 79.7%). Lead exposure was associated with decreased eGFR (OR = 1.12; 95%CI: 1.03, 1.22; p = 0.008; I² = 87.8%) and increased proteinuria (OR = 1.25; 95% CI: 1.04, 1.49; p = 0.02; I² = 79.6) risks. Further, arsenic exposure was linked to a decreased eGFR risk (OR = 1.55; 95% CI: 1.05, 2.28; p = 0.03; I² = 89.1%) in contrast to mercury exposure (p = 0.89). Only two studies reported the link between arsenic exposure and proteinuria risk, while no study reported the link between mercury exposure and proteinuria risk. Exposure to cadmium, lead, and arsenic may increase CKD risk in adults, albeit studies were heterogeneous, warranting further investigations. Our observations support the consideration of these associations for preventative, diagnostic, monitoring, and management practices of CKD.

Ethnic Disparities in Cardio-Metabolic and Reproductive Profiles in Women With Polycystic Ovary Syndrome per the New International Guideline: A United-States Based Multi-Center Study

The magnitude and direction to which cardio-metabolic and reproductive aberrations may disproportionately impact diverse populations of women with PCOS are relevant yet unclear. The uncertainty stems, in part, from heterogeneity in PCOS diagnostic criteria used and technical challenges in the reliable assessment of this clinical population. We evaluated whether cardio-metabolic (abdominal adiposity, hypertension, impaired glucoregulatory status) and reproductive (hyperandrogenism, polycystic ovarian morphology [PCOM], menstrual irregularity) outcomes were different in PCOS (n = 120, 18-36 yrs.) across 4 groups: (1) Non-Hispanic White (n = 76); (2) Non-Hispanic Black (n = 14); (3) Non-Hispanic Asian (n = 15); and, (4) Hispanic White (n = 15). Women were prospectively recruited across 3 academic medical centers in New York State and were matched for age and body mass index. PCOS was defined by the Rotterdam criteria using the recommended thresholds of the 2018 International Evidence-based Guideline for the Assessment and Management of PCOS. Concerning abdominal adiposity, the Asian group (mean ± standard deviation; 0.78 ± 0.06) had a lower waist to hip ratio (WHR) compared to the White group (0.85 ± 0.09; P = 0.01). Also, the Asian group had a higher sex hormone binding globulin (SHBG, 65.9 ± 23.4 nmol/L) compared to all other groups (White [40.5 ± 22.3]; Black [43.8 ± 21.9]; Hispanic [36.8 ± 18.8] nmol/L; All: P &lt; 0.04). In contrast, the White group were most hyperandrogenic, evidenced by their higher modified Ferriman-Gallwey (mFG) scores (10 ± 4) compared to other groups (Black [4 ± 0]; Asian [2 ± 0]; Hispanic [4 ± 1]; All: P ≤ 0.001). Consistently, the White group (1.0 ± 0.5 ng/dL) exhibited increased free testosterone (FT) compared to other groups (Black [0.5 ± 0]; Asian [0.4 ± 0]; Hispanic [0.6 ± 0.1] ng/dL; All: P ≤ 0.001), unlike total testosterone (P = 0.12). Regarding PCOM, the White group exhibited higher follicle numbers per ovary (FNPO 2-9 mm, 48 ± 22) compared to other groups (Black [30 ± 16]; Asian [26 ± 5]; Hispanic [22 ± 17]; All: P ≤ 0.05). Unlike Black (12.4 ± 1.3 mm; P = 0.05) and Hispanic (13.5 ± 1.1 mm; P = 0.89) groups, the White group (13.9 ± 2.1 mm) also exhibited larger ovarian volume (OV) compared to Asian group (12.4 ± 1.5 mm; P = 0.03). Women had comparable blood pressure (systolic, diastolic), fasting glucose, homeostatic model assessment of insulin resistance, or intermenstrual interval length (All: P ≥ 0.09). Overall, Asian women in the US likely exhibit the mildest PCOS metabolic (decreased WHR, increased SHBG) phenotype, whereas White women show the most severe reproductive (increased mFG, FT, FNPO, OV) phenotype. If confirmed by larger studies, our observations warrant additional population-specific diagnostic considerations to prevent and manage PCOS cardio-metabolic (e.g., metabolic syndrome risk) and reproductive (e.g., hirsutism, PCOM) complications across ethnicities.

Skeletal Muscle Health in Polycystic Ovary Syndrome: Protective Effect of Hyperandrogenism or Detrimental Effect of Insulin Resistance? A Systematic Review and Meta-Analysis

Women with polycystic ovary syndrome (PCOS) exhibit reduced skeletal muscle insulin-mediated glucose uptake. Altered muscle mass may affect insulin resistance (IR) and inflammation, thereby potentially aggravating reproductive status including ovulatory cyclicity and fertility potential. However, the relationship between PCOS and skeletal muscle mass is elusive given conflicting reports on protective or detrimental influence of PCOS endocrine derangements (hyperandrogenism, IR) on muscle. We evaluated whether muscle mass and function are affected by PCOS in response to a call to elucidate musculoskeletal alterations in the International Evidence-based Guideline for the Assessment and Management of PCOS. Databases of MEDLINE, Web of Science, and Scopus were searched (January 1990 to September 2020) to identify observational studies on skeletal muscle mass (lean tissue mass) and function (strength) in PCOS and control groups. The primary outcome was total lean body mass (LBM) or fat-free mass (FFM). Data were pooled by random-effects models and expressed as weighted mean differences and 95% confidence intervals. Forty-five studies (n = 3,676 [1,854, PCOS; 1,822, controls]) were eligible. Forty-one evaluated lean tissue mass and five strength. PCOS groups had increased total (0.83 [0.08, 1.58] kg; P=0.03; I² = 72.0%) yet comparable trunk (0.84 [-0.37, 2.05] kg; P = 0.15; I² = 73.0%) LBM/FFM. There were no associations between mean differences of groups in total testosterone (TT) or homeostatic model assessment of IR (HOMA-IR) and total/trunk LBM/FFM (All: P ≥ 0.75) by meta-regressions. However, mean differences of groups in body mass index (BMI) were associated with total (0.65 [0.23, 1.06] kg; P < 0.01; I² = 56.9%) and trunk (0.56 [0.11, 1.01] kg; P = 0.02; I² = 42.8%) LBM/FFM. Accordingly, PCOS sub-group with overweight/obesity (BMI ≥ 25 kg/m²) exhibited greater total LBM/FFM than controls (1.58 [0.82, 2.34] kg; P < 0.01; I² = 64.0%) unlike a lean (BMI < 25 kg/m²) sub-group (-0.45 [-1.94, 1.05] kg; P = 0.53; I² = 69.5%). Some study results were contradictory (i.e., increased appendicular mass or strength in PCOS group or comparable findings between groups) and study methodology varied; thus, inclusion in meta-analyses was not possible. PCOS cohorts have a tendency for increased total and trunk lean tissue mass likely attributed to obesity. However, most critically, whether PCOS influences other lean tissue areas (appendicular), morphology, and function is unclear. Our observations do not support any protective/detrimental influence of hyperandrogenism (TT) or IR (HOMA-IR) on lean mass. Heterogeneity among studies warrants research to address any contributions of lifestyle, healthcare, and biological factors to observed differences for future guideline recommendations to improve PCOS musculoskeletal and reproductive health (www.crd.york.ac.uk/PROSPERO ID, CRD42020203490).

Black Women Have a Worse Cardio-Metabolic Risk Profile Compared to White Women with Polycystic Ovary Syndrome in the United States: A Systematic Review and Meta-Analysis

Health disparities may influence cardio-metabolic risk in women with polycystic ovary syndrome (PCOS). The magnitude and direction of differences in cardio-metabolic risk between Black and White women with PCOS remain uncertain due to inconsistent reports. We conducted a systematic review and meta-analysis to evaluate evidence on cardio-metabolic health disparities between Black and White women with PCOS in the US in response to the call for further delineation of these disparities by the International Evidence-based Guideline for the Assessment and Management of PCOS. Databases of MEDLINE, Web of Science, and Scopus were searched (January 1990 to September 2020) to identify observational studies documenting cardio-metabolic risk profile (glucoregulatory, lipid profile, anthropometric, blood pressure status) in Black and White women with PCOS. The primary outcome was fasting glucose. Further, cardiovascular events (stroke, coronary heart disease, heart failure) and mortality rate (cardiovascular death, total mortality) data were evaluated between groups. Studies on children (< 17 yrs.), pregnant or menopausal-aged (> 50 yrs.) women were excluded. Data were pooled by random-effects models and expressed as weighted mean differences and 95% confidence intervals. Eleven studies (n = 2,821; [626 Black; 2,195 White women]) evaluated cardio-metabolic risk profile, yet none reported on cardiovascular events/mortality rate. Black women had comparable fasting glucose (-0.61 [-1.69, 2.92] mg/dL; I² = 62.5%), yet exhibited increased fasting insulin (6.76 [4.97, 8.56] µIU/mL; I² = 59.0%); homeostatic model assessment of insulin resistance (HOMA-IR; 1.47 [0.86, 2.08]; I² = 83.2%); systolic blood pressure (SBP, 3.32 [0.34, 6.30] mmHg; I² = 52.0%) and decreased triglyceride (-32.56 [-54.69, -10.42] mg/dL; I² = 68.0%) when compared to White women with PCOS (All: P ≤ 0.03). Groups were comparable in total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and diastolic blood pressure (All: P ≥ 0.06). Paucity in the number of studies that evaluated cardiovascular events or mortality limits any conclusions about potential disparities. Overall, Black women with PCOS have a greater tendency for an adverse cardio-metabolic risk profile (increased insulin, HOMA-IR, SBP), despite lower triglyceride levels than White women. Our observations support consideration of these disparities for diagnostic, monitoring, management, and public health practices, and for future guideline recommendations. Heterogeneity among studies warrants future research to address the relative contributions of biological, environmental, socioeconomic, and healthcare factors to the observed disparities. Longitudinal research should address cardiovascular events and mortality rate in Black women with PCOS (www.crd.york.ac.uk/PROSPERO ID, CRD42020183485).

Disparities in cardio metabolic risk between Black and White women with polycystic ovary syndrome: a systematic review and meta-analysis

OBJECTIVE

We conducted a systematic review and meta-analysis to summarize and quantitatively pool evidence on cardiometabolic health disparities between Black and White women with polycystic ovary syndrome in the United States in response to the call for further delineation of these disparities in the international evidence-based guideline for the assessment and management of polycystic ovary syndrome.

DATA SOURCES

Databases of MEDLINE, Web of Science, and Scopus were searched initially through March 05, 2020, and confirmed on September 11, 2020.

STUDY ELIGIBILITY CRITERIA

Observational studies documenting cardiometabolic risk profile (glucoregulatory, lipid profile, anthropometric, and blood pressure status) in Black and White women with polycystic ovary syndrome were included. Studies on children (<17 years old) and pregnant or menopausal-aged women (>50 years) were excluded. The primary outcome was fasting glucose. Furthermore, data on major cardiovascular events (stroke, coronary heart disease, heart failure) and mortality rate (cardiovascular death, total mortality) were evaluated.

METHODS

Data were pooled by random-effects models and expressed as mean differences and 95% confidence intervals. Studies were weighted based on the inverse of the variance. Heterogeneity was evaluated by Cochran Q and I2 statistics. Study methodologic quality was assessed by the Newcastle-Ottawa scale.

RESULTS

A total of 11 studies (N=2851 [652 Black and 2199 White]) evaluated cardiometabolic risk profile and all had high quality (Newcastle-Ottawa scale score of ≥8). No studies reported on cardiovascular events and mortality rate. Black women had comparable fasting glucose (-0.61 [-1.69 to 2.92] mg/dL; I2=62.5%), yet exhibited increased fasting insulin (6.76 [4.97-8.56] μIU/mL; I2=59.0%); homeostatic model assessment of insulin resistance (1.47 [0.86-2.08]; I2=83.2%); systolic blood pressure (3.32 [0.34-6.30] mm Hg; I2=52.0%); and decreased triglyceride (-32.56 [-54.69 to -10.42] mg/dL; I2=68.0%) compared with White women (all, P≤.03). Groups exhibited comparable total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and diastolic blood pressure (all, P≥.06).

CONCLUSIONS

Black women with polycystic ovary syndrome have a greater tendency for an adverse cardiometabolic risk profile (increased insulin, homeostatic model assessment of insulin resistance, and systolic blood pressure) despite lower triglycerides than White women. Our observations support the consideration of these disparities for diagnostic, monitoring, and management practices in Black women and for future guideline recommendations. Given the heterogeneity among studies, future research should address the relative contributions of biologic, environmental, socioeconomic, and healthcare factors to the observed disparities. Furthermore, longitudinal research is required to address patient-pressing complications, including cardiovascular events and mortality rate in Black women with polycystic ovary syndrome as a high-risk yet understudied population.

Effects of select dietary supplements on the prevention and treatment of viral respiratory tract infections: a systematic review of randomized controlled trials

Introduction: Viral respiratory tract infections (RTIs) have been recognized as a global public health burden. Despite current theories about their effectiveness, the true benefits of dietary supplements on the prevention and treatment of viral RTIs remain elusive, due to contradictory reports. Hence, we aimed to evaluate the effectiveness of dietary supplements on the prevention and treatment of viral RTIs.Areas covered: We systematically searched databases of PubMed, Web of Science, Scopus, and Google Scholar through 4 March 2020, to identify randomized controlled trials that evaluated the effects of consuming selected dietary supplements on the prevention or treatment of viral RTIs.Expert opinion: Thirty-nine randomized controlled trials (n = 16,797 participants) were eligible and included. Namely, vitamin D supplementation appeared to improve viral RTIs across cohorts particulate in those with vitamin D deficiency. Among the evaluated dietary supplements, specific lactobacillus strains were used most commonly with selected prebiotics that showed potentially positive effects on the prevention and treatment of viral RTIs. Further, ginseng extract supplementation may effectively prevent viral RTIs as adjuvant therapy. However, longitudinal research is required to confirm these observations and address the optimal dose, duration, and safety of dietary supplements being publicly recommended.

Happiness in marginalized populations: a community-based study in South Central Iran

Background

Happiness has multiple levels and determinants in different communities, cultures, and social groups. The current study aimed to investigate happiness and its main determinants in slums in south central Iran.

Methods

This community-based, cross-sectional study was conducted with the participation of adults at least 18 years of age living in the biggest slum area in Shiraz, south central Iran. To determine levels of happiness, participants were asked to complete the Persian version of the GHQ28 questionnaire and a checklist based on the 2017 World Happiness Report. Data was analyzed using SPSS software version 19. A p-value less than 0.05 was considered significant.

Results

The mean age of the participants was 42.06 ± 16.34 years. Overall, 542 participants (45 %) were females, 257 (21.3 %) were illiterate, 678 (56.3 %) were married, and 495 (41.1 %) were unemployed and lived with their household. The happiness score, according to the Cantril ladder score, was 6.41 ± 2 (out of a total score of 10). Happiness was not correlated with gender (p = 0.37) or immigration (p = 0.06). Lower levels of happiness were seen in older adults (r=− 0.12, p < 0.001), illiterates (p = 0.03), the unemployed (p < 0.001), and people separated from their spouses (p < 0.001). Job satisfaction (p < 0.001, r = 0.47), total general health (p < 0.001, r=-0.36) and hope (p < 0.001, r = 0.41) were significantly correlated with happiness. Social support (< 0.001) and sufficient income and satisfaction (p < 0.001) were related with a higher score of happiness.

Conclusions

Marital status, smoking, employment and job satisfaction, social support and trust, feelings of insecurity in the neighborhood, hope for the future, facing violence, and income satisfaction were the main determinants of happiness in the Sang Siah slum area.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00545-2.

Associations Between Serum Magnesium Concentrations and Polycystic Ovary Syndrome Status: a Systematic Review and Meta-analysis

Magnesium (Mg) is the second most frequent intracellular cation in humans with a critical role in insulin metabolism and glucoregulation. Women with polycystic ovary syndrome (PCOS) often present with insulin resistance and impaired glucoregulatory status; however, their Mg status remains unclear. Therefore, we aimed to conduct a systematic review and meta-analysis to evaluate serum Mg concentration in women with PCOS and compare it with that of controls without PCOS. Online databases of PubMed, Scopus, Cochrane Library, and ISI Web of Science were searched for studies evaluating the relationship between Mg concentrations and PCOS status until October 2019. Pooled weighted mean differences (WMDs) of serum Mg levels were calculated using random effects models. A total of eight studies (10 arms; n = 2026 women) were included. Pooled effect sizes, expressed as WMD and 95% CI, revealed decreased serum Mg concentrations in women with PCOS compared with controls (- 0.09 (- 0.17, - 0.02) mmol/L; P = 0.01). However, significant heterogeneity was detected across the studies (I ² = 98.0%, P < 0.001). Despite the classification of studies based on baseline BMI classes, we did not detect the potential source of the observed heterogeneity. Subgroup analysis showed that overweight and obese women (BMI ≥ 25 kg/m², 0.07 mmol/L (- 0.14, - 0.01); P = 0.02) with PCOS had lower magnesium concentrations than normal women (BMI < 25 kg/m², - 0.11 (- 0.25, 0.04) mmol/L; P = 0.14) compared with the control group. Serum Mg concentrations appear to be declined in overweight or obese women with PCOS, which may warrant screening and management of Mg status in this clinical population. High-quality studies are needed to elucidate the relationship between Mg concentrations and the development of PCOS.

Effect of green coffee bean extract supplementation on liver function and inflammatory biomarkers: A meta-analysis of randomized clinical trials

Inflammation is considered a major contributor to non-alcoholic fatty liver disease (NAFLD) and several chronic diseases such as, cardiovascular disease and type two diabetes. Green coffee bean extract (GCBE) supplementation has been suggested to enhancing antioxidant capacity in people with obesity but results across studies are mixed. We conducted a meta-analysis of randomized controlled trials of GCBE supplementation in overweight/obese with normal liver function and NAFLD adults with ALT, AST, γ-GTP, ALP, LDH, CRP, IL-6, and TNF-α as outcomes by searching PubMed and other databases. Eight studies were included, totaling 330 participants randomized to GCBE supplementation or placebo ranging from 50 mg/day to 1200 mg/day for 8-12 weeks. GCBE supplementation resulted in lower levels of TNF-α (mean difference = 1.37 pg/mL [95% CI = 0.97-1.76]; p < 0.00001). No significant difference was found in the remaining markers. In conclusion, GCBE supplementation attenuated TNF-α, a circulating inflammatory marker mediator which may be linked with lower systemic inflammation. However, potential cellular and molecular mechanisms by which GCBE exerts this positive effect warrants further investigations in human model studies.

Prediction of Hospitalization Length. Quantile Regression Predicts Hospitalization Length and its Related Factors better than Available Methods

BACKGROUND

Length of hospitalization is one of the most important indices in evaluating the efficiency and effectiveness of hospitals and the optimal use of resources. Identifying these indices' associated factors could be useful. This study aimed to investigate effective factors of the length of hospitalization in Zanjan teaching hospitals in 2018 using the Quantile regression model.

METHODS

This cross-sectional study was conducted on 1,031 patients. The study population consisted of patients in orthopaedic, pediatric, internal, surgical and intensive care units. The samples were selected by multistage random sampling. The information was collected by a pre-designed checklist. The Quantile regression model and ordinary regression model were performed on the data.

RESULTS

Of the 1,031 patients admitted to different units, 624 (60.52%) were male. Mean and standard deviation of length of hospitalization for men, women and all patients were 7.25±5.48, 8.09±6.35 and 7.58±5.83 respectively. For 90 percent of patients the length of hospitalization was less than 14 days. Twenty-five percent of patients in pediatric and orthopedic units and ten percent of patients in internal and surgery units were hospitalized less than three days. In all quantiles, patients' length of hospitalization in surgery and orthopedic units, compared to the intensive care unit, and patients hospitalized for injuries and poisonings compared to other causes, had a statistically significant difference. (p<0.05).

CONCLUSION

Due to the heterogeneity (skewness) of the length of hospital stay in different units of the hospital, the quantile regression model predicts the length of hospital stay more precisely than the ordinary regression models.

Efficacy of synbiotic interventions on blood pressure: a systematic review and meta-analysis of clinical trials

PURPOSE

The present systematic review and meta-analysis aimed to evaluate the effect of synbiotic interventions on blood pressure levels in adults.

METHODS

A systematic literature search was conducted in the databases of MEDLINE, Scopus, Web of Science, and Cochrane through March 2020 to identify all randomized control trials (RCTs) investigating the effects of synbiotic interventions on blood pressure parameter, including systolic (SBP) and diastolic blood pressure (DBP). Grading of Recommendations Assessment, Development and Evaluation (GRADE) scale was used to assess the certainty of evaluated outcomes and determine the strength of recommendations.

RESULTS

Eleven RCTs were included in the meta-analysis. Synbiotic interventions significantly reduced SBP (-3.02 mmHg; 95% CI: -4.84, -1.21; I² = 55%) without changing DBP levels (-0.57 mmHg; 95% CI: -1.78, 0.64; I² = 50%). Subgroup analyses revealed that the SBP-lowering effects of synbiotic interventions were more pronounced wherein trials were longer (≥12 weeks), synbiotic interventions were administrated as a supplement, and participants were younger (<50 years old). Also, a significant improvement in both SBP and DBP levels was evident in subgroups with a lower (<30 kg/m²) body mass index.

CONCLUSIONS

Synbiotic interventions may significantly improve SBP levels in adults.

Spent Li-Ion Battery Graphite Turned Into Valuable and Active Catalyst for Electrochemical Oxygen Reduction

Employing Li-ion batteries (LIBs) in portable electronics has become a necessity in the modern world but, due to the short application time for any given battery (1-3 years), the quantity of spent LIBs (SLIBs) waste is becoming substantial. Herein, a novel strategy for recycling SLIB graphite and reforming it as a valuable catalyst material for electrochemical oxygen reduction reaction was proposed. SLIB graphite has been used as a precursor material for graphite oxide, which was thereafter doped with nitrogen to prepare nitrogen-doped graphene (NG-Bat). The prepared NG-Bat was characterized by various physical characterization methods and the electrochemical properties of the resulting catalyst material were investigated in alkaline media. It was found that NG-Bat prepared from SLIB had superior physical and electrochemical properties in comparison to commercial nitrogen-doped graphene. The findings clearly demonstrate the importance of the recycling of SLIB graphite and its great potential to be re-applied for various applications.

Anti-osteoarthritis potential of peppermint and rosemary essential oils in a nanoemulsion form: behavioral, biochemical, and histopathological evidence

BACKGROUND

This study aimed to evaluate the effect of nanoemulsion containing peppermint and rosemary essential oils in rats with osteoarthritis (OA).

METHODS

In this experimental study, we prepared a nanoemulsion containing peppermint and rosemary essential oils by spontaneous emulsification and evaluated the nanoemulsion's dermal irritation and toxicity. Investigating the analgesic effect of the nanoemulsion, we randomly assigned 36 male rats to 6 groups: Control (saline injection into the knee), osteoarthritis (intra-articular injection of 2 mg monosodium iodoacetate), and four groups of OA treated with nanoemulsion gel, nanoemulsion solution, rosemary and peppermint essential oil gel, or diclofenac sodium. Treatments were administered topically at a dose of 1 ml daily. Using behavioral tests, we assessed pain on days 1, 4, 7, and 14 after injection. Finally, we did the histopathological and biochemical evaluation of rats' knee joints.

RESULTS

There were no irritation signs on the animals' skin after receiving the nanoemulsion and no changes in the hematological and biochemical parameters of rats' blood compared to the control group. Receiving nanoemulsion decreased the mechanical (P < 0.001) and thermal allodynia (P < 0.05), thermal hyperalgesia (P < 0.05), and ambulatory-evoked pain in comparison with the OA group. Also, the nanoemulsion receiving rats showed an increase in SOD and GPx activity and a decrease in MDA level. Histopathology of synovial tissues confirmed the results of behavioral and biochemical tests.

CONCLUSION

The nanoemulsion containing essential oils of peppermint and rosemary reduces osteoarthritis pain via increasing antioxidant capacity and improving the histopathological features of the rats' knee joint.

ENRICH: A fast method to improve the quality of flexible macromolecular reconstructions

Cryo-electron microscopy using single particle analysis requires the computational averaging of thousands of projection images captured from identical macromolecules. However, macromolecules usually present some degree of flexibility showing different conformations. Computational approaches are then required to classify heterogeneous single particle images into homogeneous sets corresponding to different structural states. Nonetheless, sometimes the attainable resolution of reconstructions obtained from these smaller homogeneous sets is compromised because of reduced number of particles or lack of images at certain macromolecular orientations. In these situations, the current solution to improve map resolution is returning to the electron microscope and collect more data. In this work, we present a fast approach to partially overcome this limitation for heterogeneous data sets. Our method is based on deforming and then moving particles between different conformations using an optical flow approach. Particles are then merged into a unique conformation obtaining reconstructions with improved resolution, contrast and signal-to-noise ratio. We present experimental results that show clear improvements in the quality of obtained 3D maps, however, there are also limits to this approach, i.e., the method is restricted to small deformations and cannot determine local patterns of flexibility of small elements, such as secondary structures, which we discuss in the manuscript.

Releasing and structural/mechanical properties of nano-particle/Punica granatum (Pomegranate) in poly(lactic-co-glycolic) acid/fibrin as nano-composite scaffold

The effect of poly(lactic‑co‑glycolic acid) (PLGA) on structure, degradation, drug release and mechanical properties of fibrin/pomegranate(F/POM)-based drug‑eluting scaffolds have been studied comprehensively.

METHODS AND MATERIAL

Nanoparticle-fibrin is prepared from thrombin and fibrinogen dissolved in NaOH and HCl. Then pomegranate powder is added to it. Nanoparticles/pom are provided by freeze drying and freeze milling. The 3-D scaffold of poly(lactide-co‑glycolic acid) (PLGA) was prepared via salt‑leaching solvent/casting leaching method and impregnated with nanofibrin-pom. Structural and chemical component of the scaffolds were evaluated by transmission and scanning electron microscopy and furrier transmission infrared spectroscopy, respectively. Moreover, the scaffolds were characterized from the degradation rate and drug releasing rate points of view of human Adipose Derive Stem Cells (hADSCs). Cytotoxicity effects of the scaffold were evaluated on hADSCs via MTT assay.

RESULTS

The results showed that the size of nanoparticles was about 100 nm. The scaffold had a slow degradation rate and it caused a sustained release pattern of pom. MTT assay indicated that nanoparticles had no cytotoxicity and fibrin-pom nanoparticles increased compressive strength of PLGA/scaffolds dramatically and also caused a proper compressive modulus.

CONCLUSIONS

By adding F/POM nanoparticle to PLGA and fabricating a three‑dimensional nanocomposite scaffold (PLGA/F/POM nanoparticle), special physical and mechanical properties also suitable for drug release and cell behavior were achieved, which makes it suitable for cartilage tissue engineering applications (Tab. 1, Fig. 7, Ref. 53) Keywords: hybrid composites, drug delivery, carrier, nanoparticles, scaffold.