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Abstract Background Multisystem inflammatory syndrome in children (MIS-C), a complication of COVID-19, is frequently associated with cardiac involvement. Although most affected children recover, the extent and duration of myocardial abnormalities remain uncertain. This study evaluates mid-term cardiac function in MIS-C patients, with and without cardiac involvement, using transthoracic echocardiography (TTE) and speckle-tracking echocardiography (STE). Methods This case–control study (2022–2023) included 90 children: 30 with MIS-C and cardiac involvement, 30 with MIS-C without cardiac involvement, and 30 healthy controls. TTE and STE were used to assess left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) at diagnosis and at three months, comparing outcomes across groups. Results The cardiac involvement group exhibited significantly elevated ferritin and C-reactive protein levels (P = 0.006 and P = 0.017, respectively) and a higher prevalence of troponin positivity (56.67% vs. 20%, P = 0.009). At baseline, these patients had markedly reduced LVEF (56.5 ± 4.3) and GLS (-21.6 ± 3.21) compared to healthy controls (LVEF: 68.2 ± 5.21; GLS: -24.8 ± 1.48; both P

Abstract The relationship between lifestyle choices and health outcomes has received significant scholarly attention. Research indicates that factors such as obesity, insufficient physical activity, tobacco use, and poor dietary habits may elevate the odds of developing metabolic disorders. This study aimed to investigate the association between the combined healthy lifestyle score (HLS) and the odds of metabolic syndrome (MetS) and its associated components in a population of apparently healthy adults. This cross-sectional study utilized data from the Dena PERSIAN cohort, which comprised 2,971 healthy adults. Participants’ combined HLS were evaluated using validated questionnaires that assessed body mass index (BMI), physical activity level (PAL), smoking status, and dietary quality. The evaluation of dietary nutritional quality was conducted using the most recent version of the Healthy Eating Index (HEI), known as HEI-2020. The combined HLS was measured on a scale ranging from zero, indicating an unhealthy lifestyle, to four, representing the healthiest lifestyle. Individuals with the highest combined HLS score had 81% lower odds of having MetS compared to those with the lowest score (OR: 0.19; 95% CI: 0.11–0.33). Higher combined HLS scores were significantly associated with decreased odds of abdominal adiposity (OR: 0.11; 95% CI: 0.07–0.18), abnormal glucose homeostasis (OR: 0.55; 95% CI: 0.35–0.86), elevated serum triglycerides (OR: 0.41; 95% CI: 0.26–0.67), and low high-density lipoprotein cholesterol (HDL-C) levels (OR: 0.39; 95% CI: 0.24–0.65) after adjusting for sex, age, education level, and marital status (P

Abstract This research presents an innovative design for a non-isolated DC-DC converter, which utilizes a single switch in a high step-up configuration. The key element of this design is a three-winding coupled inductor (TWCI), which plays a crucial role in achieving a substantial voltage increase. By utilizing a low duty cycle, the converter minimizes conduction losses in the power switch, resulting in enhanced efficiency. The converter offers several benefits, including reduced voltage stress on both power switches and diodes, a common ground, high efficiency, a simple structure and control mechanism, and fewer components. The study thoroughly examines the converter’s operational modes and provides a comparison with other types of converters to highlight its distinctive characteristics. To validate the converter’s performance, a 400 W prototype was developed and tested in the lab, operating with a 20 V input, a 260 V output, and a switching frequency of 50 kHz.

Abstract Background The incidence of diabetes mellitus (DM) is increasing worldwide, and there is growing interest in the potential use of natural compounds as an alternative treatment for managing DM. Several research studies have investigated the impact of saffron consumption on managing and improving metabolic profiles in patients with DM, and they have shown promising results. Object The study aims to systematically review and perform a meta-analysis to evaluate the potential effects of saffron and its extract on cardiometabolic indicators in diabetic and prediabetic overweight patients. Methods We conducted a comprehensive systematic review and meta-analysis, searching PubMed, Scopus, Web of Science, Embase, and Google Scholar for all relevant studies published before April 20, 2024. We extracted weighted (WMD) or standardized (SMD) mean differences (before-after) and 95% confidence intervals (95%CI) of the outcomes and conducted meta-analyses using R. The study protocol was registered in PROSPERO (CRD42024538380). Results Out of the studies screened, 15 RCTs were selected for inclusion in the systematic review and meta-analysis. These studies collectively involved 869 participants, 438 in the intervention group and 431 in the control group. Notably, our results showed that saffron supplementation led to significant changes in FBS (MD: − 8.75 mg/dL, 95% CI [− 14.75; − 2.76], P

Abstract This paper proposes a new control method for loss reduction of two series buck converters. The proposed method can be applied to each series of buck converters with two power switches. To enhance the efficiency of the converter compared to other structures, a method based on determining operating cycles for loss reduction is employed, leading to increased output efficiency of the converter. Additionally, to demonstrate the efficiency improvement using the proposed method compared to the conventional approach, the efficiency of converter is calculated through theoretical computations under real conditions, and the output results are compared for both losses and efficiency. In addition, the proposed high‐buck converter in this paper benefits from a common ground advantage and exhibits a suitable conversion ratio. The high‐buck converters are used in numerous applications for situations with low voltage and low power. The most important applications for these converters are the power supply for mobile phones, tablets, and other portable electronic devices, battery chargers, and LED drivers. Here, in order to demonstrate the validity of the proposed method, the MATLAB‐Simulink results are provided. Moreover, in order to show the feasibility of the high‐buck converter, a 100‐W prototype has been implemented and the experimental results are provided.

Abstract The DC–DC conversion stage of a three‐stage solid‐state transformer is the most challenging due to the combination of high power, medium voltage, and medium frequency. This combination also causes most of the losses in the DC–DC stage. To address this issue, a new asymmetrical quadruple active bridge series resonant DC–DC converter (AQAB‐SRC) has been proposed as a building block for solid‐state transformers. The converter achieves soft switching of all switches throughout the operating range by extending and using the half‐cycle continuous conduction mode control strategy. It also has fewer high‐frequency transformers compared to other converters, as more bridges are connected to the same multi‐winding transformer. The optimal design of AQAB‐SRC has been analyzed theoretically, and simulation and lab‐scale experimental results have been obtained to validate the feasibility and validity of the proposed topology.

Abstract In the field of Brain Machine Interface (BMI), the process of translating motor intention into a machine command is denoted as decoding. However, despite recent advancements, decoding remains a formidable challenge within BMI. The utilization of current decoding algorithms in the field of BMI often involves computational complexity and requires the use of computers. This is primarily due to the reliance on mathematical models to address the decoding issue and perform subsequent output calculations. Unfortunately, computers are not feasible for implantable BMI systems due to their size and power consumption. To address this predicament, this study proposes a pioneering approach inspired by hyperdimensional computing. This approach first involves identifying the pattern of each stimulus by considering the normal firing rate distribution of each neuron. Subsequently, the newly observed firing pattern for each input is compared with the patterns detected at each moment for each neuron. The algorithm, which shares similarities with hyperdimensional computing, identifies the most similar pattern as the final output. This approach reduces the dependence on mathematical models. The efficacy of this method is assessed through the utilization of an authentic dataset acquired from the Frontal Eye Field (FEF) of two male rhesus monkeys. The output space encompasses eight possible angles. The results demonstrate an accuracy rate of 51.5% while exhibiting significantly low computational complexity, involving a mere 2050 adder operators. Furthermore, the proposed algorithm is implemented on a field-programmable gate array (FPGA) and as an ASIC designe in a standard CMOS 180 nm technology, underscoring its suitability for real-time implantable BMI applications. The implementation required only 2.3 Kbytes of RAM, occupied an area of 2.2 mm2, and consumed 9.32 µW at a 1.8 V power supply. Consequently, the proposed solution represents an accurate, low computational complexity, hardware-friendly, and real-time approach.

Abstract Background The extensively drug-resistant (XDR) strains of Acinetobacter baumannii have become a major cause of nosocomial infections, increasing morbidity and mortality worldwide. Many different treatments, including phage therapy, are attractive ways to overcome the challenges of antibiotic resistance. Methods This study investigates the biofilm formation ability of 30 XDR A. baumannii isolates and the efficacy of a cocktail of four tempetate bacteriophages (SA1, Eve, Ftm, and Gln) and different antibiotics (ampicillin/sulbactam, meropenem, and colistin) in inhibiting and degrading the biofilms of these strains. Results The majority (83.3%) of the strains exhibited strong biofilm formation. The bacteriophage cocktail showed varying degrees of effectiveness against A. baumannii biofilms, with higher concentrations generally leading to more significant inhibition and degradation rates. The antibiotics-bacteriophage cocktail combinations also enhanced the inhibition and degradation of biofilms. Conclusion The findings suggested that the bacteriophage cocktail is an effective tool in combating A. baumannii biofilms, with its efficacy depending on the concentration. Combining antibiotics with the bacteriophage cocktail improved the inhibition and removal of biofilms, indicating a promising strategy for managing A. baumannii infections. These results contribute to our understanding of biofilm dynamics and the potential of bacteriophage cocktails as a novel therapeutic approach to combat antibiotic-resistant bacteria.

Abstract This paper introduces a novel high-voltage gain topology for a solid-state transformer, integrating a DC-DC converter and dual active bridge converters. The proposed design features three DC links operating at different voltage levels. The first DC link connects to a single-switch high step-up DC-DC converter, while the second DC link interfaces with an AC source via a rectifier, allowing the use of both DC and AC inputs. A high-frequency transformer ensures galvanic isolation between the sources and the third DC link. The DC-DC converter employs coupled inductors and voltage multiplier cells, offering distinct advantages such as a high voltage gain, reduced voltage stress on semiconductors, and minimized current ripple. These features make the topology highly suitable for transferring power from renewable energy sources, such as photovoltaic panels, to a high-voltage DC link in microgrid or nanogrid applications. The novelty lies in the combination of multiple voltage levels, high-frequency isolation, and the ability to handle both DC and AC inputs efficiently. An experimental prototype, delivering 620 W with a 25 V DC input and 110 V AC input, is built, and the results validate the converter’s effectiveness.

A compelling body of evidence suggests that EFL students have problem with logical connectors' appropriate use in writing. This study explored Iranian EFL students' adversative connectors use in their essay writing course. To this end, a Learner Corpus of 60393 words consisting of 156 essays was compiled. LOCNESS was chosen as the criterion corpus. AntConc, a freeware concordance program, was used to analyze the data. The findings revealed that, in general, learners underused adversative connectors; both native and non-native students used "but" the most; "on the other hand," and "while" were overused and "despite," "yet," and "instead" were underused by the learners suggesting that the top five most overused adversative connectors make up around 72% of learners' adversative connector use indicating that learners tend to use the same adversative connectors at the cost of underusing the other ones. Analysis of concordance line also illustrated that the learners tended to misuse the subordinating conjunction whereas and though in the initial position. It seems that learners need to be taught how to distinguish between different types of adversative connectors and how to use a wider variety of adversative connectors to reach a better coherence and cohesion in their writings.

This research seeks to develop a sustainable and effective approach to the synthesis of the α-halocarboxylic acid ester derivatives. Using Amberlyst-15, as a heterogeneous acid catalyst, the reaction between various alcohols and chloroacetic acid has been successfully facilitated. In contrast to common optimization procedures, the response surface methodology (RSM) was employed to optimize the reaction conditions, ensuring maximum yield and selectivity. First, several factors including temperature, time, catalyst loading, and acid-to-alcohol ratio were identified to establish the required minimum number of experiments, followed by their execution in the laboratory. Finally, RSM was applied to investigate and optimize the system based on the experimental data. Notably, all materials utilized in this study are widely accessible, which renders this approach highly practical and scalable. The environmentally friendly and sustainable nature of the suggested method, coupled with optimized reaction conditions, renders it a desirable option for producing ester derivatives.

Active Learning (AL) represents a transformative instructional approach that departs from traditional methods by immersing students in experiential learning activities such as problem-solving, discussions, role-plays, interactive engagement, and case studies. Despite its widely recognized potential, the effects of AL on psycho-affective constructs in English as a Foreign Language (EFL) contexts remain underexplored. Hence, this study explored the impact of AL on EFL learners' motivation, attitudes, and anxiety in Iran. A sample of 110 pre-intermediate EFL learners from the Iran Language Institute in Borujerd City was recruited through random sampling. Following participant homogenization via the Oxford Quick Placement Test and outlier exclusion, 51 learners were randomly assigned to an experimental group (EG, n = 26) receiving AL-based instruction, and a control group (CG, n = 25) exposed to traditional lecture-based instruction. Over 18 one-hour sessions, conducted twice weekly, the groups underwent distinct interventions. The outcomes of independent samples t-tests revealed that AL-based instruction significantly enhanced the EFL learners' motivation, fostered more positive attitudes toward English language learning, and effectively reduced anxiety in the EG compared to the CG. The study's findings approved the pedagogical value of AL, specifically its capacity to create an engaging and emotionally supportive classroom environment that promotes learner confidence, sustained motivation, and a positive disposition toward English learning. Different stakeholders in EFL education are encouraged to integrate AL strategies into EFL curricula to improve psycho-affective outcomes.

ABSTRACT Introduction An uncommon and diverse class of cancers originating from mesenchymal tissues is designated as soft tissue sarcoma (STS). To develop effective preventive and treatment strategies for STS, it is essential to gain a deeper understanding of the epidemiological trends associated with the disease. This research will analyze the 4‐year age‐standardized incidence rate (ASIR) and geographical distribution of STS in Iran in great detail. Methods The study population comprised 4968 cases of STS recorded in the Cancer Registry System between 2014 and 2017. The demographic data examined included gender, place of residence, and year of diagnosis. The age‐standardized rate (ASR) of STS incidence was calculated for each location using the World Standard Population. The data were examined using the program ArcMap10.5. The geographic distribution of STS was investigated using the Moran test. Results The ASRs for STS in Iran from 2014 to 2017 were recorded as 1.25 (ASR in male: 1.47, ASR in female: 1.06), 1.36 (ASR in male: 1.46, ASR in female: 1.29), 1.37 (ASR in male: 1.52, ASR in female: 1.21), and 1.78 (ASR in male: 1.58, ASR in female: 1.98), respectively. In 2014 and 2015, age‐standardized incidence at the national level showed a statistically significant regional dispersion that appeared as a clustering pattern, according to Moran's test. However, in 2016 and 2017, this dispersion failed to become statistically significant. Interestingly, men had a greater rate of STS incidence than females. As age grows, ASIR shows a steadily rising trend. The most important gains are shown in the 55–59 age group, which peaked at 4.535 in 2017, and the 80–84 age group, which peaked at 10.848 in the same year. Conclusion The incidence of STS in Iran is lower than the global average. The discrepancies in gender disparities, regional distribution, and incidence rates underscore the complexity of STSs. The findings of this study may assist healthcare professionals and policymakers in the development of region‐specific plans for the treatment, early detection, and prevention of STSs.

Abstract DC microgrids are integral to smart grids, enhancing grid reliability, power quality, and energy efficiency while enabling individual grid independence. They combine distributed and renewable energy sources, reducing overall energy consumption. High-gain DC–DC converters are crucial for elevating voltages from low-voltage DC sources like solar panels and wind turbines in DC microgrids. This paper introduces a non-isolated DC–DC converter designed to achieve ultra-high step-up (UHSU) voltage conversion utilizing a two-winding coupled inductor (CI). The propounded UHSU configuration achieves a substantial voltage increase by employing low duty cycles and a decreased turn ratio for the CI, resulting in a smaller core size. Moreover, this UHSU circuit incorporates soft-switching capabilities for both power switches and diodes, enhancing its efficiency. By keeping the voltage stress on the switches low, the design minimizes losses and improves overall efficiency. The operational modes are thoroughly analyzed, and comparisons with other topologies are presented to demonstrate the effectiveness of the proffered UHSU circuit. Finally, the performance of the UHSU circuit is validated through the construction and testing of a 150-W laboratory prototype operating at a switching frequency of 50 kHz, with Vin = 20 V and Vout = 300 V.

Abstract This paper presents the design and analysis of a high voltage gain converter utilizing a coupled inductor with reduced voltage stress, specifically for photovoltaic energy-based systems. The proposed converter employs a two-winding coupled inductor and voltage multiplier cells to achieve an increase in output voltage while mitigating voltage stress across semiconductor components. Additionally, the voltage multiplier cells function as voltage clamps for the power switch, further enhancing the converter's performance. The converter features a single switch design, which simplifies control, reduces cost, and improves reliability. Key advantages of the converter include a low component count, a common ground between input and output ports, and high efficiency. The converter's performance is thoroughly investigated through mode analysis and steady-state analysis. Comparative evaluations with similar converters are conducted to highlight the benefits and performance of the proposed design. To validate the theoretical analysis, a 125 W prototype with 26 V input and 200 V output voltages operating at a 50 kHz switching frequency is developed, and experimental results are presented, demonstrating the effectiveness and practicality of the proposed high voltage gain converter.

Abstract Objective The non-invasive and inexpensive predictive indicators seem to be essential for the evaluation of coronavirus disease-19 (COVID-19) prognosis. Uric acid to high-density lipoprotein-cholesterol ratio (UHR) have been known as inflammatory and metabolic biomarker in some disorders. This study aimed to evaluate the usefulness of serum uric acid (UA) and UHR values on admission as prognostic indicators for the severity and mortality of COVID-19. Regression models were accomplished to assess the association between UA and UHR with the severity and mortality of COVID-19. Results This study was performed with 424 confirmed COVID-19 patients. The mean UA and UHR values of the severe group and deceased group were statistically higher than those mild group and survivor group, respectively (P

Abstract Background Emergency departments (EDs) are often the front door for urgent mental health care, especially when demand exceeds capacity. Long waits in EDs exert strain on hospital resources and worsen distress for individuals experiencing a mental health crisis. We used as a test case the Australian Capital Territory (ACT), with a population surge of over 27% across 2011–2021 and a lagging increase in mental health care capacity, to evaluate population-based approaches to reduce mental health-related ED presentations. Methods We developed a system dynamics model for the ACT region using a participatory approach involving local stakeholders, including health planners, health providers and young people with lived experience of mental health disorders. Outcomes were projected over 2023–2032 for youth (aged 15–24) and for the general population. Results Improving the overall mental health care system through strategies such as doubling the annual capacity growth rate of mental health services or leveraging digital technologies for triage and care coordination is projected to decrease youth mental health-related ED visits by 4.3% and 4.8% respectively. Implementation of mobile crisis response teams (consisting of a mental health nurse accompanying police or ambulance officers) is projected to reduce youth mental health-related ED visits by 10.2% by de-escalating some emergency situations and directly transferring selected individuals to community mental health centres. Other effective interventions include limiting re-presentations to ED by screening for suicide risk and following up with calls post-discharge (6.4% reduction), and limiting presentations of frequent users of ED by providing psychosocial education to families of people with schizophrenia (5.1% reduction). Finally, combining these five approaches is projected to reduce youth mental health-related ED presentations by 26.6% by the end of 2032. Conclusions Policies to decrease youth mental health-related ED presentations should not be limited to increasing mental health care capacity, but also include structural reforms.

Abstract This paper proposes a new soft‐switching bidirectional multiport DC/DC converter for PV/EV applications. The proposed topology is capable of using several different sources simultaneously. Also, it has some benefits including high voltage gain, bidirectional, soft‐switching technique, and multi‐input multi‐output (MIMO) topology. In addition, all inputs of the proposed converter are separate from each other and it causes control of the outputs to be simple in the wake of the common ground of the inputs and outputs. The proposed converter can work on zero current switching (ZCS) conditions on some power semiconductors (power diode/switch) and decreases the switching and conduction losses. It also makes use of semiconductors with lower resistance on‐state (Rds‐on). Using coupled inductor techniques and working of semiconductors under ZCS conditions eliminates the total loss affected by reverse recovery of the power diodes, and a passive clamp circuit can recover the leakage energy released by the leakage inductance of the used coupled inductor. The proposed topology is built and tested in the laboratory. To confirm the accurate operation of the proposed topology, it is tested by Typhoon HIL‐404 emulator at 12 V–12 V–12 V inputs/270 W with 50 kHz switching frequency.

Background: Emergency medical services (EMS) play a crucial role as the first line of defense during emergencies and disasters. Given the current impact of climate change, EMS will need to employ innovative strategies to cope with changing conditions. This scoping review investigates how EMS can adapt to climate change in pre-hospital emergencies. Materials and Methods: In this study, peer-reviewed studies and texts on adaptive strategies of pre-hospital emergency systems published in 2023 were reviewed. Accordingly, online databases, including Web of Science, PubMed, Scopus, and Google Scholar as a search engine were searched. The selected keywords were as follows: “Medical technician,” “paramedic,” “ambulance,” “climate change,” “global warming,” “adaptation,” “mitigation,” and “resiliency” (and synonyms). Conclusion: No wide-ranging study has been conducted on the adaptation strategies of EMS against climate change and this is the first study in this field. In this study, elements and adaptation strategies against climate change were investigated. Extracting these cases and using them to improve the readiness and resilience of the pre-hospital emergency system will be effective against this phenomenon.

In this research, the effect of protease enzyme type (pepsin and pancreatin) and hydrolysis time (40-200 minutes) on the degree of hydrolysis and antioxidant properties (DPPH radical scavenging activity, Fe chelating activity, Fe reducing power and total antioxidant capacity) of flaxseed meal protein hydrolysates was investigated. The results showed that increasing the hydrolysis time increased the degree of hydrolysis, and the samples obtained from pancreatin had a higher degree of hydrolysis than pepsin. The highest activity of Fe2+ chelating (53.71 ± 0.45%) and Fe3+ reduction (1.32 ± 0.02, absorbance at 700 nm) was achieved by pancreatin after 200 minutes of hydrolysis. Pancreatin samples were more capable of inhibiting DPPH free radicals than pepsin, and their activity increased with increasing time up to 160 minutes. The highest total antioxidant capacity (1.36 ± 0.08 absorbance at 695 nm) among the samples was obtained after 160 minutes of hydrolysis with pancreatin. The antioxidant capacity of flax seed protein hydrolysates in inhibiting DPPH radical, Fe chelating activity, and total antioxidant capacity was lower than the antioxidant capacity of vitamin C at a concentration of 50 (mg/ml), but it had more Fe reducing power than vitamin C. Therefore, it can be concluded that compared to pepsin, pancreatin had a greater ability to produce flaxseed protein hydrolysates with significant antioxidant properties. According to the results, flaxseed protein hydrolysates from pancreatin enzyme and a hydrolysis time of 160 minutes have the ability to be used in food formulations to produce functional products.

Abstract This paper presents a novel topology for Z-source inverters (ZSI). The new Z-Source network is based on the coupled-inductors and active switched boost. Features of the topology include high voltage boost ability, single magnetic-core, low voltage stress on the active switch, and capacitors. The principles of operation, analysis, voltage and current equations of each component, and the converter voltage gain in the steady-state are presented. A comparison with other topologies has also been performed to determine the advantages and disadvantages of the proposed ZSI. Finally, experimental results of the laboratory prototype are presented to confirm the performance of the proposed topology.

Abstract Background Cancers of the genitourinary system, particularly prostate, bladder, and kidney cancer, exhibit a high prevalence. Consequently, predicting the morbidity and mortality of genitourinary cancers holds great significance for future planning and implementation. This study aimed to examine the crude and age-standardized rates of mortality and the trend of genitourinary cancers over nine years in northern Iran. Methods This cross-sectional study used data on the number of deaths attributed to genitourinary cancers recorded in Babol City between 2013 and 2021 through the cause of death registration and classification system. Population estimates were derived from the latest census reports. Subsequently, crude and age-standardized rates, as well as trends for genitourinary cancers, were calculated. Results A total of 307 deaths occurred, with an average age of 75.6 ± 14.3 years due to genitourinary cancers. The crude and age-standardized rates of genitourinary cancers increased from 2.7 and 1.9 per hundred thousand people in 2013 to 7.7 and 5.9 per hundred thousand people in 2021, respectively. Over the study period, death rates significantly rose for men (P

Abstract Multi‐level inverters (MLIs) have a wide range of applications that try to minimize power electronics such as switches, diodes, and DC sources. Switched‐capacitor inverters are offered with reduced sources that reduce the number of sources and switches. This paper presents a switched capacitor‐based MLI with fewer components for grid‐connected applications. The basic topology can inherently charge and stabilize the capacitor voltage without additional circuits, sensors, or initial charges. This topology is generalized as a cascaded structure and produces higher voltage levels. The proposed cascaded topology is improved regarding the number of switches and components and the voltage stress on switches. This topology is compared with several similar topologies to evaluate the advantage of the proposed topology. For this purpose, a comprehensive comparison is performed by defining the cost function. The proposed topology under dynamic operating conditions is examined and validated. The phase‐shifted pulse width modulation is used to perform the switching of the proposed topology. Grid‐connected results for the proposed basic topology are also presented. The simulation results in MATLAB software and the laboratory results from a prototype made in the laboratory demonstrate the correctness and capability of the proposed converter.

Background: To date, no specific exercises have been designed to selectively strengthen the vastus medialis muscle. Therefore, the purpose of this research is to provide a clear answer to the question: Is it truly impossible to strengthen the vastus medialis independently of the entire quadriceps muscle group? Methods: Thirty-three females with lateral patellar compression syndrome were randomly divided into 2 groups: one focused on selective strengthening of the vastus medialis (n = 16) and the other on general strengthening of the quadriceps (n = 17). The intervention lasted 8 weeks. Muscles cross-sectional area and electrical activity were assessed using ultrasound and electromyography, respectively. Data analysis was done using independent and dependent t-tests. Results: In the selective strengthening group, significant increases were observed in the activity and cross-sectional area of the vastus medialis, as well as in the ratios of vastus medialis/vastus lateralis activity and cross-section from pre-to post-intervention (P

The present numerical study explores the performance of fluid-structure interaction (FSI) in a microchannel with an oscillating elastic wall. A two-dimensional (2D) Computational Fluid Dynamics (CFD) simulation was performed to investigate the influence of the elastic wall's frequency and amplitude on fluid flow behavior, pressure drop, and heat transfer enhancement. The FSI governing equations were solved using the Arbitrary Lagrangian-Eulerian (ALE) method. The results indicated that the Nusselt number (Nu) decreases as oscillation frequency increases. In contrast, the Nu increased linearly with the oscillation amplitude. Additionally, the Prandtl number (Pr) showed an insignificant influence on the Nu number for the studied operating range. An optimal operating condition was identified for the microchannel with an oscillating wall, achieving a spatial average Nu number of 16.796 compared to 14.577 for a simple microchannel channel, representing a 15.23 %% enhancement in heat transfer. A correlation is derived for the spatial average Nu number as a function of the Reynolds number (Re), Strouhal number (St), Pr, and vibration amplitude ratio, providing a valuable tool for designing and optimizing microchannel systems with FSI. Finally, the Maxwell boundary conditions are incorporated into the simulation of a microchannel with a vibrating upper wall to evaluate the slip conditions.

Objectives: Nitric oxide is the most important mediator of penile erection after the onset of sexual excitement. It activates cyclic guanosine monophosphate (cGMP), increasing penile blood flow. Most pharmaceutical medications prevent enzyme phosphodiesterase type 5 (PDE-5) from breaking down cGMP, thus keeping its level high. However, due to the adverse effects of pharmacological therapies, herbal drugs that improve sexual function have gained attention recently. This study aimed to investigate the combined effects of ginseng, Tribulus terrestris, and L-arginine amino acid on the sexual performance of individuals with erectile dysfunction (ED) using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Methods: Over three months, 98 men with erectile dysfunction were randomly assigned to receive either 500 mg of herbal supplements or placebo pills. Each herbal tablet contained 100 mg of protodioscin, 35 mg of ginsenosides, and 250 mg of L-arginine. Results: The results showed that the changes in the average scores of ILEF-5 within each group before and after the intervention indicated that all parameters related to the improvement of sexual function in patients with erectile dysfunction improved in the herbal treatment group (p < 0.001). The herbal group significantly improved IIEF-5 scores in non-diabetics (p < 0.05). However, there was no significant difference in the changes of IIEF-5 scores between the two intervention and control groups in diabetic patients. Conclusion: In conclusion, ginseng, Tribulus terrestris, and L-arginine have properties that increase energy and strengthen sexual function, making them suitable for patients with sexual disorders.

Euler deconvolution system is a well-known approach to estimate the depth of underground sources in potential field geophysics. Over-determined Euler linear equations are usually solved independently and separately for the gravity and magnetic data, and each result is an estimate for the depth of the potential sources. This technique is widely utilized to analyze individually the depth variations of magnetic and gravity sources. However, depth estimation of each of the mentioned potential fields may return specific and exclusive results regarding the complex nature of the subsurface structures, and the gravity and magnetic separate depth estimation solutions may be discordant in many aspects. In cases of low resolution for gravity and magnetic data sets, this study indicates that independently solved Euler depth estimation systems cannot yield reliable and accurate solutions of potential field sources. Combining the gravity and magnetic data and simultaneously solving the Euler equations for gravity and magnetic potential fields, this research presents a novel approach called the joint Euler method with a proper capability to return more accurate and improved depth estimations for boundary and body of potential field sources. The presented method was solved and examined over homogeneous and non-homogeneous synthetic scenarios with reduced resolution, and the depth solutions were also compared with the separate approach. After obtaining the desired results from the synthetic models, the joint Euler technique was applied to the gravity and magnetic data of the Kifl oil trap located in Iraq. The results were quite promising rather than the separate depth estimations, proving the sufficiency and applicability of the proposed potential field method in terms of interpretational aspects.

Models intended to describe the time evolution of a gene network must somehow include transcription, the DNA-templated synthesis of RNA, and translation, the RNA-templated synthesis of proteins. In eukaryotes, the DNA template for transcription can be very long, often consisting of tens of thousands of nucleotides, and lengthy pauses may punctuate this process. Accordingly, transcription can last for many minutes, in some cases hours. There is a long history of introducing delays in gene expression models to take the transcription and translation times into account. Here we study a family of detailed transcription models that includes initiation, elongation, and termination reactions. We establish a framework for computing the distribution of transcription times, and work out these distributions for some typical cases. For elongation, a fixed delay is a good model provided elongation is fast compared to initiation and termination, and there are no sites where long pauses occur. The initiation and termination phases of the model then generate a nontrivial delay distribution, and elongation shifts this distribution by an amount corresponding to the elongation delay. When initiation and termination are relatively fast, the distribution of elongation times can be approximated by a Gaussian. A convolution of this Gaussian with the initiation and termination time distributions gives another analytic approximation to the transcription time distribution. If there are long pauses during elongation, because of the modularity of the family of models considered, the elongation phase can be partitioned into reactions generating a simple delay (elongation through regions where there are no long pauses), and reactions whose distribution of waiting times must be considered explicitly (initiation, termination, and motion through regions where long pauses are likely). In these cases, the distribution of transcription times again involves a nontrivial part and a shift due to fast elongation processes.

Abstract This paper proposes, a novel soft‐switching bidirectional direct current to direct current (DC–DC) converter based on switched‐capacitor and coupled‐inductor. The proposed converter has a simple structure and utilizes four switches and a three‐winding coupled inductor and can achieve a high voltage conversion ratio in both step‐up/step‐down operations. By employing the switched‐capacitor technique, voltage stress across the power switches is low and therefore low voltage rating switches can be adopted to reduce the losses of their conduction. Soft‐switching characteristic of the proposed converter reduces the switching loss of active power switches and raises the conversion efficiency. This paper presents theoretical analysis for all operating modes of the converter, voltage conversion ratio, voltage and current stresses of all power switches. Finally, to test the validity of theoretical results and demonstrate the performance of the converter, experimental results are provided.

Objective: Anthracycline administration in children is associated with cardiac dysfunction. Speckle-tracking echocardiography (STE) can detect subclinical cardiac damage that may go undetected by conventional two-dimensional (2D) echocardiography. This study aims to investigate medium-term anthracycline cardiotoxicity using STE and determine a safer administrable level of anthracyclines (ACs). Methods: This observational case–control study enrolled 37 healthy controls and 78 pediatric cancer survivors who received chemotherapy. The patients were divided into two groups: cardiotoxic received (CR) and cardiotoxic free (CF). Data on segmental longitudinal strain (LS), global LS (GLS), and 2D echocardiographic parameters were collected after a drug-free period of at least one year. Results: A total of 115 children with a mean age of 108 ± 55 months, of whom 66% were males, were included in the study. Both the groups of cancer survivors exhibited significantly reduced GLS compared to healthy controls (CR vs. controls, P = 0.001; CF vs. controls, P = 0.013), but no significant difference in left ventricular ejection fraction (LVEF) was observed (P = 0.75). Overall, cancer survivors treated with ACs demonstrated a significant reduction in strain in 10 left ventricular segments, particularly in the basal segments (P < 0.05). Among CR patients, those with impaired GLS (n = 43, GLS worse than −21.9) had significantly higher mean age and cumulative anthracycline dose compared to CR patients with normal GLS (age, P = 0.024; anthracycline dosage, P = 0.036). Using an anthracycline cutoff of 223 mg/m2 resulted in a higher detection rate (49% vs. 25%) and fewer missed cases (51% vs. 74%) compared to the 360 mg/m2 anthracycline cutoff. Conclusion: Childhood cancer survivors demonstrate significantly reduced GLS while preserving a normal LVEF, which does not differ significantly from reference values of healthy children. The reduction in strain appears to be associated with higher anthracycline doses and older age. Lowering the anthracycline threshold to 223 mg/m2 may improve the predictability of a decline in cardiac function using strain imaging at medium-term follow-up.

Abstract The integration of synchronous generators (SG) to the grid will present serious problems in some instances. The increase in fault current level is one of the most crucial issues, which causes miscoordination between directional over current relays (DOCRs), in addition to putting excessive pressure on the circuit breakers. This research uses the Fault Current Limiters (FCL) to restore coordination, without changing the settings of DOCRs, by reducing the level of fault current in the grid. The main goal of this research is to find the optimal size, location, and number of FCLs at the minimum cost and with the least operation time for the relays, using Jellyfish Search Optimisation (JSO) algorithm. This can be achieved through three different approaches. The first one is optimizing the location, number, and impedance size of the FCL by minimising a cost function. The second approach involves optimizing the backup relay operation time. A combination of the two previous approaches is used as the third approach. The outstanding feature of this research is that it considers the optimal location of DG and FCL while optimizing the operation times of DOCRs, which is a new framework.

ABSTRACT Objective: This study aimed to assess root volumes of maxillary canines and adjacent lateral incisors in patients with unilateral maxillary canine impaction. Methods: This cross-sectional study was performed on cone-beam computed tomography (CBCT) scans of 100 patients (49 females and 51 males) with unilateral maxillary canine impaction. The images were loaded in Planmeca Romexis Viewer, and root layers between the cementoenamel junction and apex were reconstructed at 600-µm intervals. At each layer, the root boundary was marked, and finally, the root volume was calculated by multiplying the layers’ area by the thickness of 600 µm. The root size of canines and lateral incisors was compared between the impaction and normal eruption sides. Results: Sixty-two patients showed buccal canine impaction, and 38 presented palatal impaction. The mean root volume of canines on the impaction side was significantly greater than that on the normal eruption side; either the tooth was buccally or palatally impacted (p

Introduction: Foreign body aspiration (FBA) is a common, life-threatening pediatric emergency and was shown to be associated with high risk of morbidity and mortality. This systematic review and meta-analysis aimed to investigate the diagnostic value of chest computed tomography (CT) scan for identification of FBA in children. Methods: From inception to May 2024, a systematic search was carried out across multiple databases including Medline, Scopus, and Web of Science, considering published papers in English language. Quality assessment of the included studies was performed using seven domains of Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Results: The systematic literature search yielded 7203 articles. The pooled sensitivity and specificity of chest CT scan for identification of FBA were 0.99 (95% CI: 0.98-0.99) and 0.97 (95% CI: 0.96-0.98), respectively. The pooled positive likelihood ratio was 10.12 (95% CI: 4.59-22.20), and pooled negative likelihood ratio was 0.05 (95% CI: 0.02-0.1). Furthermore, the area under the summarized receiver operating characteristic (SROC) curve was 0.98. Conclusion: Our meta-analysis revealed that despite high heterogeneity, in the diagnostic characteristics of chest CT scan among studies, it has high diagnostic value in identifying FBA in suspected pediatric cases.

Due to concern regarding the consumption of high amount of sugar in diet and role of diet in combating overweigh and related disease, the aim of present study was to optimize a reduced calorie probiotic chocolate milk formula with suitable physicochemical properties. The formula comprising inulin, stevia (Stevia rebaudiana Bertoni), chia (Salvia hispanica L.) seed gum (CSG), and whey protein concentrate (WPC) which optimized using Box-Behnken design (BBD) and then enriched with an encapsulated probiotic strain Lactobacillus acidophilus (DSM1643). The independent variables included inulin (2–8%), CSG (0.1–0.5 %), stevia (50–100 % replacement of sugar), and WPC (1–3%). The dependent variables were selected as viscosity, average particle size, sedimentation percentage, and general acceptance. Optimization done toward achieving the highest viscosity and general acceptance and the lowest sedimentation percentage and average particle size. The optimal conditions were found to be 7.99 % inulin, 70 % stevia, 0.34 % CSG, and 1 % WPC. Under these conditions, the viscosity, sedimentation percentage, average particle size, and general acceptance of the product were equal to 40.69 mPa s, 2.2 %, 434.221 nm, and 5.1, respectively. Next, the chocolate milk was enriched with at 109 CFU/g probiotic bacteria and evaluated. The probiotic strain was resistant to simulated gastrointestinal conditions and under this condition the free bacterial cells count declined by 8 logCFU/g while the encapsulated cells decreased approximate 3 logCFU/g. The bacteria count did not undergo a significant change until the 5th day of storage. The results showed that the inulin, stevia, CSG, and WPC at optimal concentrations and encapsulated probiotic bacteria could be simultaneously applied to produce a product with good properties. This formula could be considered as a new product with health improving properties, low calorie which is suitable for people suffering from diabetes and obesity.

The combination polymers or copolymers have new and combined properties and increase the efficiency of the new polymer. Biopolymers are biodegradable and can play the role of biocompatible and biodegradable in composite polymers. Therefore, poly ortho–toluidine was grafted on chitosan (Cs-g-POT) by chemical and electrochemical polymerization methods. Cs-g-POT was characterized by FTIR, UV–visible, and 1H NMR spectroscopy techniques. The thermal behaviors of the copolymer were investigated by thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The images of the surface of the copolymer obtained from imaging SEM confirm the successful attachment of POT on chitosan and indicate that the graft polymerization has been successfully performed with both methods. The percentage and efficiency of engraftment were carefully measured and reported. The electrical conductivity of Cs-g-POT was measured by the four-point method and the conductivity was 9.1 × 10−4 S/cm. The copolymer's antibacterial property was studied on Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa as a common bacterium in skin wounds. These studies were investigated using the disk diffusion and minimum inhibitory concentration (MIC) methods. In all tested concentrations the polymer could inhibit the growth of E. coli and P. aeruginosa significantly. However, it inhibited the growth of S. aureus in concentrations above 1 μg. Bacteria are adsorbed on the surface of the polymer by polar-polar and Van Der Waals interactions, where they undergo cell lysis by dopant and electron transfer, and eventually bacterial cell death. Due to its scaffolding properties, this polymer will have a very good use in tissue and bone repair as well as anti-cancer drugs.

Abstract Background and aim This study aims to examine the mortality rate and trend of gastrointestinal cancers, particularly gastric cancer, as the leading cause of death among cancers in northern Iran over a 9-year period. In light of the changing incidence and mortality rates of cancer in Iran and around the world, the importance of these diseases in people’s lives, and the necessity of updating and monitoring the trend of cancer mortality, we have decided to report on the mortality trend of gastrointestinal cancers, based on crude and age-standardized rates. Method This study is a cross-sectional examination of deaths caused by gastrointestinal cancers in Babol city, Iran, between 2013 and 2021. Data was collected from the cause of death registration and classification system of Babol University of Medical Sciences. Population estimation was obtained from the latest census reports. The crude and age-standardized mortality rates and trends of the cancers were calculated. Results Overall, there were 1345 deaths from gastrointestinal cancers with an average age of 69.11 ± 14.25 years. The crude and age-standardized rates of these cancers rose from 24.1 to 20.1 per hundred thousand people in 2012 to 29.5 and 25.5 per hundred thousand people, respectively. This trend became more prevalent significantly with the increase of each decade of age for both men (P-value Trend = 0.002) and women (P-value Trend = 0.012). An analysis of gastrointestinal cancers revealed a decreasing trend for cancers of the small intestine, an increasing trend for cancers of the colon, pancreas, and gallbladder, and a stable trend for the remaining cancers over the study period. Conclusion The age-standardized rate and the number of gastrointestinal cancers is rising, highlighting the importance of preventative measures such as screening, increasing public awareness, and appropriate diagnostic methods.

Abstract In this study, to solve total harmonic distortion (THD) and voltage stress on switches, challenges have been made by presenting a new multi‐level inverter (MLI). The proposed topology can operate with both symmetric and asymmetric sources. The proposed topology in symmetric and asymmetric mode with 18 switches can produce 17 and 49 voltage levels, respectively, with THD values of 4.14% and 1.45%, which passes the IEEE harmonic standard. The main advantage of the proposed topology is reducing the number of circuit devices, which reduces the price, volume, and complexity of the circuit by reducing the number of circuit devices. The proposed topology reduces the THD, the number of power electronics components, and voltage stress by increasing the output levels. The proposed topology is compared with other topologies and the advantage of the proposed topology is shown in terms of the number of switches and drivers. In addition, the proposed topology is compared in terms of the cost function. The power losses based on the thermal model of the proposed topology have been analysed and simulated. Simulation and experimental results are presented for different scenarios such as load type, load changes, and modulation index changes to validate the proposed topology.

Abstract This paper proposes a new transformerless buck‐boost converter with an extended voltage conversion ratio. This converter has semi‐quadratic voltage gain, which provides more gain with lower duty cycles. This converter has a simple structure and easy implementation, which reduces the cost and increases efficiency. The proposed converter operates in continuous conduction mode and provides two operation modes by turning on and off the switches. The suggested converter has continuous input current and low input current ripple, which is important when utilizing renewable energy sources. The calculation of the proposed converter includes ideal and practical voltage gain, current calculations, voltage stresses of the switches and diodes, current stress of the switches, parameter design, efficiency, and a brief analysis of discontinuous conduction mode and boundary conditions. The proposed converter provides efficiency of about 93.1% in boost mode and 92.14% in buck mode at 50 W output power. The suggested converter varies the input voltage from 20 to 48 V in boost mode and changes the input voltage from 20 to 10.4 V in buck mode. Finally, a laboratory prototype has been built to prove and evaluate the simulation results and theoretical analysis of the proposed converter.

Abstract This paper presents a non‐isolated single‐switch ultra‐high step‐up (UHSU) DC–DC converter with a three‐winding coupled inductor (CI) which is utilized to achieve ultra‐high voltage gain with a small amount of duty cycle leading to low conduction losses of the power switch and higher efficiency. The voltage gain of the suggested UHSU converter is adjusted by two methods: the duty cycle of the power switch and the three‐winding CI turn ratio, therefore enhancing the design flexibility of the suggested converter. Due to the utilization of the passive clamp circuit in the structure of the proposed converter, it is possible to select a power switch with low voltage rated and small ON‐state resistance, further enhancing the converter efficiency. The operation modes are discussed in detail and to clarify the salient features of the proposed converter, a comparison with other configurations is provided. Finally, to accredit the performance of the proposed converter, a 150‐W laboratory archetype with an input and output voltage of 20 and 300 V, respectively, at 50 kHz switching frequency is fabricated.

Abstract In this paper, a new topology is introduced for capacitor-based multi-level inverters. The proposed topology is based on combination of two Cross-Square-Switched T-Type inverters. This structure can be generalized in two modular and cascaded modes. In the cascaded mode, higher voltage levels are produced with low power switches. The main features of the proposed topology include the level generation without the utilization of the H-bridge module, the low number of switching components, a lower number of DC voltage sources, and low total blocking voltage. Besides, in the proposed topology, the number of conducting switches in the current path for each different voltage level is low, which leads to a conduction loss decrement. The loss simulations are performed, and the results are presented. A study provides a detailed comparison of the proposed topology in terms of various parameters. In this paper, the nearest level modulation switching, which is low-frequency switching, is utilized to generate voltage levels. To confirm the performance of the proposed topology, a simulation was performed with MATLAB/Simulink software, and a laboratory sample was implemented. Comparative results, simulation results, and implementation results indicate the appropriate performance of the proposed structure in different steady-state and dynamic conditions.

The protein C-type lectin is secreted by the secondary-stage larve of Toxocara canis (T. canis). Its antigenic characteristics have been the subject of research. The recombinant pET-32a (+) plasmid containing the 660 bp sequence of T. canis C-type lectin gene was successfully synthesized, cloned, and expressed in Escherichia coli (DE3+). Serum samples were collected from 56 pet owners. Forty-four samples were negative and twelve samples were positive which were performed with a commercial ELISA kit. The same samples were also tested using dot blot and Western blot analysis prepared with recombinant CTL antigen (rCTL). The expression was confirmed by Sodium Dodecyl Sulfate (SDS-PAGE) and Western blot. The study results revealed that two samples, which tested negative in the ELISA analysis, were found to be positive when using the recombinant C-type lectin (rCTL) antigen in both dot blot and Western blot analyses. The overall test results showed a high level of agreement between the three methods, with Kappa coefficients of 1 and 0.9 for the comparisons. This indicates the potential of using recombinant CTL antigen, to detect positive samples that may be missed by E-S Antigen. The recombinant rCTL demonstrated higher sensitivity than the excretory-secretory Antigens, indicating its potential for improved serodiagnosis of human toxocariasis. The study proposes that the rCTL could be further evaluated in supplementary studies to improve and develop the diagnostic kits for toxocariasis.

Abstract This article proposes an interleaved high step‐up DC–DC converter topology designed for renewable energy applications, featuring an ultra‐high voltage conversion ratio. The converter employs an interleaved structure, resulting in a low peak‐to‐peak ripple in the input source current, which is particularly advantageous for solar PV sources. To enhance the output voltage, the topology utilizes voltage multiplier cells (VMC) and coupled inductor techniques. Two coupled inductors with three windings are integrated into the proposed topology, with the secondary and tertiary windings combined with VMC. This combination effectively reduces the maximum voltage stress across power switches, enabling the use of low‐rated and cost‐effective power switches for implementation. The article offers comprehensive operation modes and steady‐state analyses to demonstrate the converter's performance. A comparison is made between the suggested structure and other similar converter topologies. To validate the mathematical analysis, a 200‐W prototype is constructed, operating at a frequency of 25 kHz and achieving a voltage conversion range of 20 to 409 V. The experimental results are presented to support the findings.

Abstract Many COVID-19 survivors experience lingering post-COVID-19 symptoms, notably chronic fatigue persisting for months after the acute phase. Despite its prevalence, limited research has explored effective treatments for post-COVID-19 fatigue. This randomized controlled clinical trial assessed the impact of Amantadine on patients with post-COVID-19 fatigue. The intervention group received Amantadine for two weeks, while the control group received no treatment. Fatigue levels were assessed using the Visual Analog Fatigue Scale (VAFS) and Fatigue Severity Scale (FSS) questionnaires before and after the trial. At the study's onset, VAFS mean scores were 7.90 ± 0.60 in the intervention group and 7.34 ± 0.58 in the control group (P-value = 0.087). After two weeks, intervention group scores dropped to 3.37 ± 0.44, significantly lower than the control group's 5.97 ± 0.29 (P-value

Abstract Aim Vitamin D is a prominent modulator of immunity and respiratory function. It plays a vital role in respiratory diseases such as cystic fibrosis (CF). S. However, there is a dearth of information on patients with CF. The purpose of the meta-analysis is to highlight the importance of following the existing guidelines regarding maintenance of Vitamin D serum levels in patients with CF. Methods The systematic search was conducted without utilizing any time or language limitations in original database from the beginning until March 2022. The meta-analysis was performed using a random-effects model. Heterogeneity was determined by I 2 statistics and Cochrane Q test. Results Pooled analysis using the random-effects model of the 8 case–control studies with 13 effect sizes revealed that the serum 25-OH-vitamin D in participants with cystic fibrosis was significantly lower than controls in pediatrics and adolescences (WMD: − 3.41 ng/ml, 95% CI − 5.02, − 1.80, p =