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This article investigates a particular version of the cutting angle method for finding the global minimizer of sub-topical (increasing and plus sub-homogeneous) functions over a simplex. The algorithm is based on the abstract convexity of sub-topical functions. Furthermore, we discuss the proof of convergence of the algorithm and provide results from numerical experiments. [ABSTRACT FROM AUTHOR]

Background: The choroid, a highly vascular structure within the eye, is significantly influenced by various systemic conditions. The advent of enhanced depth optical coherence tomography has improved our ability to evaluate choroidal pathophysiology. The choroidal vascularity index (CVI), a noninvasive and reliable tool, serves as an effective means of assessing the choroidal vascular structure. Recent studies have increasingly focused on exploring CVI alterations under different systemic conditions. This study aims to provide a comprehensive summary of the latest research findings in this area., Methods: A systematic literature review was conducted on October 1, 2023, using two databases, MEDLINE (via PubMed) and Scopus. Search terms were tailored specifically for each database to ensure a thorough exploration of relevant literature. The studies identified were qualitatively assessed, with particular emphasis on outcomes related to CVI and choroidal thickness., Results: A total of 48 studies were included in the review, encompassing a diverse range of systemic conditions such as diabetes, central nervous system disorders, cardiovascular diseases, autoimmune disorders, and infectious diseases. Notable reductions in CVI were observed in diabetic retinopathy, autoimmune diseases, and neurodegenerative disorders. Additionally, the review highlighted variations in CVI values related to the severity of systemic diseases, indicating its potential use as a biomarker for disease progression., Conclusion: This review highlights the significant correlation between variations in the choroidal vascularity index and diverse systemic conditions affecting hemodynamics. An enhanced understanding of CVI provides deeper insights into the pathophysiological mechanisms underlying these disorders and positions CVI as a promising biomarker for early detection and monitoring. Nevertheless, its clinical utility warrants careful assessment. Future research should address the potential limitations of CVI to fully capitalize on its diagnostic and prognostic potential., Competing Interests: Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Low survival rates of breast cancer in developing countries are mainly due to the lack of early detection plans and adequate diagnosis and treatment facilities., Objectives: This study aimed to apply machine learning techniques to recognize the most important breast cancer risk factors., Methods: This case-control study included women aged 17-75 years who were referred to medical centers affiliated with Mashhad University of Medical Science between March 21, 2015, and March 19, 2016. The study had two datasets: one with 516 samples (258 cases and 258 controls) and another with 606 samples (303 cases and 303 controls). Written informed consent has been observed. Decision Tree (DT), Random Forest (RF), Logistic Regression (LR), and Principal Component Analysis (PCA) were applied using R studio software., Results: Regarding the DT and RF, the most important features that impact breast cancer were family cancer, individual history of breast cancer, biopsy sampling, rarely consumption of a dairy, fruit, and vegetable meal, while in PCA and LR these features including family cancer, pregnancy number, pregnancy tendency, abortion, first menstruation, the age of first childbirth and childbirth number., Conclusions: Machine learning algorithms can be used to extract the most important factors in the diagnosis of breast cancer in developing countries such as Iran., Competing Interests: The authors declare that they have no conflicting interests., (©2024 Pacini Editore SRL, Pisa, Italy.)

This research investigates the future dynamics of water yield services in the Gorgan River Basin in the North of Iran by analyzing land cover changes from 1990 to 2020, using Landsat images and predicting up to 2040 with the Land Change Modeler and InVEST model under three scenarios: continuation, conservation, and mitigation. The results indicate significant shifts in agricultural land impacted water yields, which fluctuated from 324.7 million cubic meters (MCM) in 1990 to 279.7 MCM in 2010, before rising to 320.1 MCM by 2020. The study uniquely assesses the effects of land use changes on water yields, projecting a 13.6 % increase in water yield by 2040 under the continuation scenario, a 3.9 % increase under conservation, and a 1.6 % decrease under mitigation, which limits changes on steep slopes to prevent soil erosion and floods. This underscores the interplay between land use, vegetation cover, and water yield, emphasizing strategic land management for water resource preservation and effective watershed management in the GRB., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Hesham El-Askary reports financial support was provided by US Department of Education. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Due to the many applications of manganese oxides in water treatment, this research aimed to synthesize α-Mn 2 O 3 nanoparticles through a green method and investigate the dye adsorption capacity of them. The α-Mn 2 O 3 nanoparticles were successfully synthesized using KMnO 4 and aqueous extract of Pyracantha angustofolia fruits under hydrothermal conditions and calcination. The products were identified using Fourier transform infrared (FTIR), X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET), and scanning electron microscopy (SEM) analyses. The adsorption capacity of methyl orange (MO) and Congo red (CR) dyes were evaluated at different concentrations (25, 50, and 75 ppm) using α-Mn 2 O 3 nanoparticles. Results revealed the spherical and porous structure of α-Mn 2 O 3 nanoparticles with a specific surface area of 21.7 m 2 .g -1 . Dye removal significantly increased with pH decrement. The adsorption capacity for MO and CR was 73.07 and 70.70 mg.g -1 , respectively. The adsorption data of both dyes followed a pseudo-second-order kinetic model. The best fitted models for MO and CR adsorption were the Langmuir isotherm and the Dubinin-Radushkevich, respectively. In addition, a possible adsorption mechanism was proposed for both dyes. The findings showed that α-Mn 2 O 3 nanoparticles are very efficient adsorbents for removing anionic dyes., (© 2024. The Author(s).)

Background: The aim of this study was to assess the anthelmintic activity of Lannea kerstingii and Ficus thonningii , on a nematode model, to promote their use in the Cameroonian pharmacopoeia for the treatment of helminthiases. Methods: One nematode was used, Heligmosomoides polygyrus . First, the effect of the extracts on the eggs and larval stages (L1, L2, and L3) of H. polygyrus was evaluated, 100  μ L of extract and 100  μ L of parasite suspension (containing 50 eggs) were mixed in a 96-well microplate. The 96-well microplate was incubated for 20 h at 25°C in the WMicroTracker which measures the motility of the worms at various concentrations. Finally, docking studies were conducted by using the Glide module in Schrodinger Maestro. Results: The ethanolic extract of L. kerstingii with the half maximal inhibitory concentration (IC 50 ) of 0.1371 mg/mL produced a higher ovicidal effect than the effect produced by other extracts of these plants. However, with an IC 50 of 0.31 mg/mL, the aqueous extract of F. thonningii showed the greatest effect on the L2 stage. The aqueous and ethanolic extracts of L. kerstingii and F. thonningii inhibited the development of the L3 larvae of H. polygyrus with a better effect for the ethanolic extracts. Conclusion: The use of L. kerstingii and F. thonningii for the treatment of helminthiasis has been proved in vitro and in silico by this research. However, more research is required, especially on the acute toxicity and in vivo anthelmintic efficacy to validate this scientific investigation., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Ndjinkeu Ntcheuzing Serena et al.)

Background: Parasitic infection remains a serious health trade for humans and livestock. The purpose of this study was to present scientific proof of the anthelmintic properties of Khaya grandifoliola , which the native population uses to cure helminthiasis., Method: Fresh Heligmosomoides polygyrus eggs were isolated from faecal samples of experimentally infected mice. The faecal material was cultured, and L1 and L2 larval stages were recovered after 48 and 120 hours, respectively. Using the worm microtracker, the anthelminthic efficacy of the extracts against H. polygyrus was assessed. Two different extracts (aqueous and ethanol extracts) were prepared. For the ovicidal and larvicidal activities, 100  µ L of various concentrations of plant extracts, levamisole and 1.5% dimethyl sulfoxide (DMSO), were introduced into a 96-well microplate titer followed by the addition of 100  µ L of embryonated eggs (60 eggs) for the ovicidal activity and 100  µ L of L 1 or L 2 larvae (50 larvae) for the larvicidal activity. The movement of the worm was monitored for 24 hours in the worm microtracker at 27°C. The Glide module of the Schrodinger Maestro software was used to perform docking studies., Results: For the aqueous extracts, the highest percentage of inhibition of hatching was 42.77 ± 12% at 7.5 mg/mL. The IC 50 values for the ethanol (0.36 mg/mL) extract showed that the ethanol extract had a good inhibitory effect on the ability of parasites to hatch from eggs. The inhibition percentage of L1 larvae motility at 7.5 mg/mL was 98.0 ± 1.66% and 83.33 ± 1.66% for ethanol and aqueous extracts, respectively. The negative controls, distilled water and 1.5% DMSO, had no inhibitory impact on larvae. On L1-larvae, the drug of choice levamisole (positive control) had the highest percentage effect (100.0%). Six compounds had the highest docking score and their interactions with the receptor as well. Grandiamide A interacts most with tyrosine, glycine, phenylalanine, asparagine, and serine, and its benzene ring and oxygens inhibit these receptors. Carbonyl and hydroxyl (OH) groups connect grandiamide D to asparagine, isoleucine, and phenylalanine, respectively. By donating hydrogen to the receptor through OH groups, D-glucopyranose-6-phosphate also forms relatively strong hydrogen bonds with its oxygen-bound phosphorus and the receptor. 1-O-deacetylkhayanolide E interacts most with serine and glutamic acid. The carbamic acid benzyl ester of carbamic acid [(1S)-1-phenyl-2-[(4-methylphenyl) sulfinyl] ethyl] interacts most with the receptor with carbonyl groups and with asparagine and serine. With its abundant hydroxide, D-mannitol acts as a hydrogen donor and acceptor and interacts most strongly with amino acids such as glycine, asparagine, aspartic acid, alanine, and glutamic acid., Conclusions: K. grandifoliola extracts possess anthelminthic properties. However, in vivo studies are still necessary to demonstrate the effectiveness of this plant for the treatment of helminthiasis., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Noumedem Anangmo Christelle Nadia et al.)

Background: Helminthiasis is endemic in Chad and constitutes a public health problem, particularly among school-age children. The aim of this study was to evaluate the anthelmintic activity of extracts of Khaya anthotheca and Faidherbia albida used in Chad by traditional healers for the treatment of helminthiasis., Methods: The anthelmintic activity was assessed against Heligmosomoides polygyrus and Caenorhabditis elegans larvae using the Worm Microtracker. Embryonated eggs, L1, L2, and L3 larvae of H. polygyrus were obtained after 24 h, 48 h, and 7 days of coproculture and L4 larvae of C. elegans culture using standard procedures. One hundred microliters of extracts at various concentrations, with albendazole and distilled water were, put in contact with 100  µ L of H. polygyrus suspension (containing 50 parasites at various developmental stages) in a microplate and incubated for 20 h at 25°C in the Worm Microtracker. The same procedure was adopted for C. elegans , but with 180  µ L of OP50. 19  µ L of C. elegans suspension (containing 50 larvae) was put in contact with 1  µ L of extract at various concentrations and incubated in the Worm Microtracker. Docking studies were carried out using the Schrodinger Maestro software's Glide module. The score function in the software was used to rank and group distinct possible adduct structures generated by molecular docking., Results: The aqueous and ethanolic extracts of F. albida at a concentration of 2.5 mg/mL showed the same activity as albendazole (100 ± 0.00) on hatching. The IC50s of the aqueous extracts of the two plants (IC 50 : 0.6212 mg/mL and 0.71 mg/mL, respectively) were comparable on egg hatching of H. polygyrus with no significant difference ( p ≥ 0.05) with respect to the ethanol extracts (IC 50 : 0.70 mg/mL and 0.81 mg/mL, respectively). There was no significant difference between the percentage inhibition of extracts and albendazole on the L1 larvae of H. polygyrus ( p ≥ 0.05). The aqueous extracts acted more effectively than the ethanol extracts on the L1 larvae of H. polygyrus with an IC 50 of 0.5588 and ∼9.858 e  - 005 mg/ml, respectively, for K. anthotheca and F. albida . The aqueous extracts of K. anthotheca and F. albida on L3 larvae of H. polygyrus had inhibitory percentages of 92.6 ± 0.62 and 91.37 ± 0.8 at 2.5 mg/mL which were lower than albendazole (100 ± 0.00). The aqueous extracts of K. anthotheca and F. albida on C. elegance showed IC 50 of 0.2775  µ g/mL and 0.5115  µ g/mL, respectively, and were more effective than the ethanol extracts. Examining K. anthotheca and F. albida through the interaction with the protein receptor and its results also confirmed our assumption that the compound used has hydroxyl and carbonyl groups as well as aromatic rings and is exposed to phenolic and flavonoid groups in a more specific way, and it shows a better inhibitory effect., Conclusions: This study scientifically validates the use of extracts of the two plants in the traditional treatment of helminthiasis. However, it will be necessary to evaluate the in vivo anthelmintic activity and toxicity. Examining the ADME properties of these compounds also supports the potential of these ligands to be transformed into pharmaceutical forms., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Baigomen Christalin et al.)

In this research, cerium oxide nanoparticles were synthesized using orange peel extract via a hydrothermal method. An equal ratio of orange peel extract to cerium nitrate salt led to the formation of cerium hydroxide carbonate, whereas a 1 : 10 ratio formed cerium oxide. The hydrothermal treatment was conducted for durations of 5 and 25 hours. Scanning electron microscopy (SEM) images revealed that the hydrothermal samples treated for 5 hours exhibited significant agglomeration in both extract to salt ratios after heat treatment. X-ray diffraction patterns confirmed that all samples were converted into cerium oxide after heating at 500 °C for 3 hours. Based on XRD and SEM results, three cerium oxide samples, including those synthesized through the 25 hours hydrothermal process with a 1 : 10 ratio and the 25 hours hydrothermal process with both ratios and subsequent heat treatment, were selected for further investigation. Fourier transform infrared (FT-IR) analysis revealed more adsorption of the functional groups of orange peel extract on the surface of the as-synthesized sample. Moreover, the heat-treated sample with a 1 : 10 ratio, initially cerium oxide, displayed a higher amount of surface functional groups than the one with a 1 : 1 ratio which was initially cerium hydroxide carbonate. The antibacterial activities of the samples were determined using the colony count method. Activities of all samples against Gram-negative bacteria are in the range of 91.5-93.2% with a negligible difference, whereas the as-synthesized sample exhibited a superior activity of 96.6 ± 1.8% against Gram-positive bacteria compared to the other two heat-treated samples. The 87.3% antioxidant activity of the as-synthesized sample significantly surpassed that of the other two samples, as evaluated by the DPPH radical scavenging method., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

A facile method for preparing superhydrophobic brass mesh is proposed based on electrochemical etching and surface modification. The impact of processing time and the electric potential of the electrochemical etching were studied on the contact angle (CA) of the mesh. The samples were examined using scanning electron microscopy, Energy-dispersive X-ray spectroscopy analysis, X-ray diffraction, and Fourier-transform infrared spectroscopy. The electrochemical etching process caused the decrement of wires' thickness and imposed roughness. Results showed more dissolution of zinc than copper under 3 V of the electric potential and the processing times of 3 and 6 min. The optimum condition of electrochemical etching was obtained under the electric voltage of 3 V for a processing time of 6 min, which led to a CA of 155.5 ± 3.2°. The thickness of the mesh wires decreased by 17.7% due to electrochemical etching in this sample. This sample also showed low adhesion for a water drop. The efficiency of oil/water separation was above 95 for the xylene and ethyl acetate in a batch system. The effect of the flow rate of the oil-water mixture on separation efficiency was also examined. The optimum flow rate was 0.8 ml s -1 with a high separation efficiency of 96.8% for xylene/oil separation., (© 2024. The Author(s).)

Diabetic foot ulcer is one of the most devastating complications of uncontrolled diabetes. Although there have been advances in the management of diabetic foot ulcers, still diabetic foot ulcers are a major cause of many amputations in diabetic patients. Teucrium polium ( T. polium ) is widely used by folk medicine practitioners in Iran for the treatment of diabetic ulcers.The present study was designed to evaluate the safety and efficacy of topical T. polium ointment besides the standard treatment in diabetic foot ulcers.A total of 70 diabetic patients with foot ulcers grade 1 or 2 according to Wagner's scale were enrolled in this study. Patients were randomly divided into two groups. Patients in both groups received standard treatment for diabetic foot ulcers. In addition, group 1 received topical T. polium ointment, and group 2 received topical placebo ointment for 4 weeks. The T. polium and placebo ointments were rubbed twice daily two hours before the conventional dressing. The ulcer size, healing time, and laboratory tests were measured in both groups at baseline and end of the study after 4 weeks.Twenty-nine patients remained in the T. polium group and 26 in the placebo group until the end of the study. The mean surface area of ulcers was 3.52 ± 1.47 and 3.21 ± 1.67 cm 2 in T. polium group and placebo group respectively at baseline which decrease to .717 ± .19 and 1.63 ± .72 cm 2 respectively at the endpoint. The mean ulcer surface area was significantly lower in T. polium compared with the placebo group ( p  < .0001) at end of the study. Also, the number of patients that completely recovered in the T. polium group was significantly higher than the placebo group ( p  < .001) at the end of the study.The addition of topical T. polium ointment to standard treatment significantly improves the healing time of diabetic non-infected foot ulcers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Adaptive laboratory evolution (ALE) can be used to make bacteria less susceptible to oxidative stress. An alternative to large batch scale ALE cultures is to use microfluidic platforms, which are often more economical and more efficient. Microfluidic ALE platforms have shown promise, but many have suffered from subpar cell passaging mechanisms and poor spatial definition. A new approach is presented using a microfluidic Evolution on a Chip (EVoc) design which progressively drives microbial cells from areas of lower H 2 O 2 concentration to areas of higher concentration. Prolonged exposure, up to 72 h, revealed the survival of adaptive strains of Lacticaseibacillus rhamnosus GG, a beneficial probiotic often included in food products. After performing ALE on this microfluidic platform, the bacteria persisted under high H 2 O 2 concentrations in repeated trials. After two progressive exposures, the ability of L. rhamnosus to grow in the presence of H 2 O 2 increased from 1 mm H 2 O 2 after a lag time of 31 h to 1 mm after 21 h, 2 mm after 28 h, and 3 mm after 42 h. The adaptive strains have different morphology, and gene expression compared to wild type, and genome sequencing revealed a potentially meaningful single nucleotide mutation in the protein omega-amidase., (© 2024 Wiley‐VCH GmbH.)

Metagenomics has revolutionized access to genomic information of microorganisms inhabiting the gut of herbivorous animals, circumventing the need for their isolation and cultivation. Exploring these microorganisms for novel hydrolytic enzymes becomes unattainable without utilizing metagenome sequencing. In this study, we harnessed a suite of bioinformatic analyses to discover a novel cellulase-degrading enzyme from the camel rumen metagenome. Among the protein-coding sequences containing cellulase-encoding domains, we identified and subsequently cloned and purified a promising candidate cellulase enzyme, Celcm05-2, to a state of homogeneity. The enzyme belonged to GH5 subfamily 4 and exhibited robust enzymatic activity under acidic pH conditions. It maintained hydrolytic activity under various environmental conditions, including the presence of metal ions, non-ionic surfactant Triton X-100, organic solvents, and varying temperatures. With an optimal temperature of 40 °C, Celcm05-2 showcased remarkable efficiency when deployed on crystalline cellulose (> 3.6 IU/mL), specifically Avicel, thereby positioning it as an attractive candidate for a myriad of biotechnological applications spanning biofuel production, paper and pulp processing, and textile manufacturing. Efficient biodegradation of waste paper pulp residues and the evidence of biopolishing suggested that Celcm05-2 can be used in the bioprocessing of cellulosic craft fabrics in the textile industry. Our findings suggest that the camel rumen microbiome can be mined for novel cellulase enzymes that can find potential applications across diverse biotechnological processes., (© 2024. The Author(s).)

Oxygen pressure plays an integral role in regulating various aspects of cellular biology. Cell metabolism, proliferation, morphology, senescence, metastasis, and angiogenesis are some instances that are affected by different tensions of oxygen. Hyperoxia or high oxygen concentration, enforces the production of reactive oxygen species (ROS) that disturbs physiological homeostasis, and consequently, in the absence of antioxidants, cells and tissues are directed to an undesired fate. On the other side, hypoxia or low oxygen concentration, impacts cell metabolism and fate strongly through inducing changes in the expression level of specific genes. Thus, understanding the precise mechanism and the extent of the implication of oxygen tension and ROS in biological events is crucial to maintaining the desired cell and tissue function for application in regenerative medicine strategies. Herein, a comprehensive literature review has been performed to find out the impacts of oxygen tensions on the various behaviors of cells or tissues., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

To understand the impact of sperm speed as they swim against the flow on fertilization rates, we created conditions similar to the female reproductive tract (FRT) on a microfluidic platform for sperm selection. Selected sperm were evaluated based on early development of fertilized embryos. Bovine and human spermatozoa were selected at various fluid flow rates within the device. We found that the speed of bovine spermatozoa increases as the flow rate increases and that the amount of DNA fragmentation index is lowered by increasing the flow rate. Bovine spermatozoa selected by our platform at low (150 μL h -1 , shear rate 3 s -1 ), medium (250 μL h -1 , shear rate 5 s -1 ), and high flow rates (350 μL h -1 , shear rate 7 s -1 ) were used for fertilization and compared to sperm sorted by centrifugation. The samples collected at the highest flow rate resulted in the formation of 23% more blastocysts compared to the control. While selecting for higher quality sperm by increasing the flow rate does result in lower sperm yield, quality improvement and yield may be balanced by better embryonic development.

Effective delivery of the bioactive protein, lactoferrin (LF), remains a challenge as it is sensitive to environmental changes and easily denatured during heating, restricting its application in functional food products. To overcome these challenges, we formulated novel polyelectrolyte ternary complexes of LF with gelatin (G) and negatively charged polysaccharides, to improve the thermal stability of LF with retained antibacterial activity. Linear, highly charged polysaccharides were able to form interpolymeric complexes with LF and G, while coacervates were formed with branched polysaccharides. A unique multiphase coacervate was observed in the gum Arabic GA-LF-G complex, where a special coacervate-in-coacervate structure was found. The ternary complexes made with GA, soy soluble polysaccharide (SSP), or high methoxyl pectin (HMP) preserved the protein structures and demonstrated enhanced thermal stability of LF. The GA-LF-G complex was especially stable with >90% retention of the native LF after treatment at 90 °C for 2 min in a water bath or at 145 °C for 30 s, while the LF control had only ~ 7% undenatured LF under both conditions. In comparison to untreated LF, LF in ternary complex retained significant antibacterial activity on both Gram-positive and Gram-negative bacteria, even after heat treatment. These ternary complexes of LF maintain the desired functionality of LF, thermal stability and antibacterial activity, in the final products. The ternary complex structure, particularly the multiphase coacervate, may serve as a template for the encapsulation and stabilization of other bioactives and peptides., Competing Interests: Conflicts of interest All the authors declare no conflict of interest.

Both computed tomography enterography (CTE) and video capsule endoscopy (VCE) are used in identifying small intestinal pathology in patients with suspected small bowel bleeding (SSBB) following normal upper gastrointestinal endoscopy and colonoscopy. Evidence of the comparative accuracy of these two modalities is crucial for clinical and healthcare decision-making. Comprehensive electronic searches were performed for studies on CTE and/or VCE with reference standard(s). Study selection, data extraction and quality assessment were completed by two authors independently. The QUADAS-2 and QUADAS-C tools were used to assess risk of bias, and applicability. Meta-analysis was performed using a bivariate model to obtain summary estimates of sensitivity, specificity, positive and negative likelihood ratios. Twenty-five studies involving 1986 patients with SSBB were included. Four of these were head-to-head comparison of CTE and VCE. Overall, VCE provided significantly higher sensitivity of 0.74 (95% CI: 0.61-0.83) versus 0.47 (95% CI: 0.32-0.62) for CTE, while CTE showed significantly higher specificity of 0.94 (95% CI: 0.64-0.99) versus 0.53 (95% CI: .36-0.69) for VCE. The positive likelihood ratio of CTE was 7.36 (95% CI: 0.97-56.01) versus 1.58 (95% CI: 1.15-2.15) for VCE and the negative likelihood ratio was 0.49 (95% CI: 0.33-0.72) for VCE versus 0.56 (0.40-0.79) for CTE. A secondary analysis of only head-to-head comparative studies gave results that were similar to the main analysis. Certainty of evidence was moderate. Neither VCE nor CTE is a perfect test for identifying etiology of SSBB in small intestine. VCE was more sensitive while CTE was more specific. Clinicians should choose the appropriate modality depending on whether better sensitivity or specificity is required in each clinical scenario., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Healthcare-associated infections are a major cause of mortality worldwide, especially in intensive care units where severely ill patients have limited physical space., Aims: To investigate the incidence, microbial aetiology, antimicrobial resistance profile, and mortality rate of healthcare-associated infections in intensive care units in the Islamic Republic of Iran., Methods: This observational study retrospectively reviewed the medical records of 1722 intensive care units patients with confirmed healthcare-associated infections at hospitals affiliated with Mashhad University of Medical Sciences in 2017-2019. Data was analysed using SPSS for Windows version 11. Categorical variables were described using frequency and percentage, whereas continuous variables were defined using mean (standard deviation) with 95% confidence interval (CI) for precision. Logistic regression analysis was used to estimate crude odds ratio (OR) and adjusted OR (AOR) with 95% CI, and to identify univariate and multivariate predictors of healthcare-associated infection mortality., Results: In total, 4077 pathogens were isolated, yielding a healthcare-associated infection incidence rate of 22.1%. The most common microorganisms were Acinetobacter spp. (25.0%), Klebsiella spp. (15.1%), Staphylococcus spp. (14.0%), and Candida spp. (12.3%). Ventilator-associated events (39.5%), urinary tract infections (22.7%), and bloodstream infections (14.8%) were the main types of infection. Comorbidities, skin and soft tissue infections, and infections with Acinetobacter spp., Klebsiella spp., Pseudomonas spp., and Candida spp. were significantly associated with higher mortality among intensive care unit patients. Gram-positive bacteria were most resistant to ciprofloxacin (49.2%), clindamycin (38.0%), and erythromycin (37.1%). Gram-negative bacteria were most resistant to ceftazidime (71.0%), ciprofloxacin (65.2%), and cefotaxime (60.5%). The overall mortality rate was 45.2%., Conclusion: Healthcare-associated infections in nearly half of intensive care unit patients were fatal, especially when caused by Acinetobacter spp., Klebsiella spp., Pseudomonas spp., or Candida spp. Therefore, effective strategies must be implemented to combat antibiotic-resistant bacteria, along with stricter adherence to infection control programmes., (Copyright © Authors 2023; Licensee: World Health Organization. EMHJ is an open access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Background: Severe and critically-ill COVID-19 patients are characterized by a severe inflammatory response. Pharmacologic inhibition of acute-phase inflammatory pathways such as IL-6 receptor inhibitor, Tocilizumab (TCZ) may improve patient outcomes in these cases. Consequently, the therapeutic benefit of TCZ was evaluated in this study., Methods: We evaluated intravenous tocilizumab in severe and critically ill adult COVID-19 patients who met pre-defined stringent CRS criteria. A single-center, prospective, observational cohort study was carried out among consecutive adult (≥18 years of age) in-patients with COVID-19 between March 20, 2020 and March 20, 2021. In total, 354 patients were included in our study. Mortality and time to hospital discharge were compared between patients who received tocilizumab treatment (n = 177) and those who did not (n = 177)., Results: A total of 354 patients were analyzed whereas 177 patients were included in each group. In those receiving TCZ, all-cause mortality was significantly reduced, corresponding to an adjusted hazard ratio (HR) of 0.57, (95% confidence interval (CI): 0.43-0.76; P < 0.001). Furthermore, time to discharge was significantly improved in the TCZ group (HR: 1.66; 95%CI: 1.17-2.36, P = 0.004). Invasive mechanical ventilation was not statistically different among the study groups after adjusting for confounding variables (HR: 1.38; 95%CI: 0.89-2.14; P = 0.139). Dosing frequency was independent of survival status ( P = 0.676)., Conclusion: The use of TCZ in ICU-hospitalized patients resulted in improved patient survival and reduced duration of hospitalization. Further studies are needed to confirm the efficacy of TCZ in severe and critical COVID-19 cases., Competing Interests: The authors declare that they have no competing interests., (© 2023 Iran University of Medical Sciences.)

Introduction: Spinal cord injury (SCI) is characterized by serious both motor and sensory disability of the limbs below the injured segment. It is the most traumatic disorder among central nervous system (CNS) conditions which not only leads to psychological and physical harm to patients but also results in a dramatic loss in the life quality. Many efforts have been developed to find a therapeutic approach for SCI; however, an effective treatment has not yet been found. The lack of effective treatment approach and rehabilitation of SCI underscores the need to identify novel approaches. Tissue engineering associated with stem cells has been recently introduced as an effective treatment approaches for traumatic SCI. Although, low survival rates, immune rejection, cell dedifferentiation, and tumorigenicity have been addressed for tissue engineering. Regenerative medicine is an interdisciplinary field developing and applying tissue engineering, stem cell (SC) therapy, and SC-derived extracellular vesicle therapy that aims to provide reliable and safe ways to replace injured tissues and organs. The application of mesenchymal stem cells-derived extracellular vesicles (MSC-EVs) has recently attracted attention to improve central nervous system dysfunction such as SCI, mainly by promoting neurogenesis and angiogenesis., Methods: In this review article the latest information of SCI improvement using stem cell-derived extracellular vesicles published data in the Web of Science, Scopus, Science Direct and Pub Med databases were collected., Results: The data collected show that MSC-EVs, including exosomes, alone or in combination with scaffolds can can regenerate the injured nerve in SCI., Conclusion: This study summarizes the efficacy of MSC-EVs, including exosomes, alone or in combination with scaffolds in the treatment of SCI and then discusses the therapeutic outcomes observed in SCI experimental models following treatment with MSC-EVs alone or loaded on scaffolds in particular collagen-based scaffolds., Highlights: The pathological process of SCI being very complex.A complete effective strategy has yet to be found for treatment of SCI in human.Exosomes derived-stem cells alone have great potential for the treatment of SCI.Various biocompatible scaffolds are good drug carriers for SCI treatment.Various biocompatible scaffolds are good carriers for exosomes., Plain Language Summary: Human with spinal cord injury (SCI) show serious motor and sensory disability of the limbs. Since there is no an effective treatment for SCI, researchers are trying to develop and find a new therapeutic approach for SCI. CNS tissue engineering with various stem cells sources as well as their derived extracellular vesicle has been extensively attracted for providing reliable and safe approach for SCI treatment. Extracellular vesicles are lipid bilayer membrane-enclosed organelles containing various biomolecules involved in a variety of complex intercellular communication systems. They are released from all cell types into their surrounding environment and are important vehicles for paracrine The application of stem cells-derived extracellular vesicles (MSC-EVs) has recently attracted attention to improve central nervous system dysfunction such as SCI, mainly by promoting neurogenesis and angiogenesis., Competing Interests: All authors declared no conflict of interest., (Copyright© 2023 Iranian Neuroscience Society.)

Chimonanthus grammatus is used as Hakka traditional herb to treat cold, flu, etc. So far, the phytochemistry and antimicrobial compounds have not been well investigated. In this study, the orbitrap-ion trap MS was used to characterize its metabolites, combined with a computer-assisted structure elucidation method, and the antimicrobial activities were assessed by a broth dilution method against 21 human pathogens, as well as the bioassay-guided purification work to clarify its main antimicrobial compounds. A total of 83 compounds were identified with their fragmentation patterns, including terpenoids, coumarins, flavonoids, organic acids, alkaloids, and others. The plant extracts can strongly inhibit the growth of three Gram-positive and four Gram-negative bacteria, and nine active compounds were bioassay-guided isolated, including homalomenol C, jasmonic acid, isofraxidin, quercitrin, stigmasta-7,22-diene-3 β ,5 α ,6 α -triol, quercetin, 4-hydroxy-1,10-secocadin-5-ene-1,10-dione, kaempferol, and E -4-(4,8-dimethylnona-3,7-dienyl)furan-2(5H)-one. Among them, isofraxidin, kaempferol, and quercitrin showed significant activity against planktonic Staphylococcus aureus (IC 50 = 13.51, 18.08 and 15.86 µg/ml). Moreover, their antibiofilm activities of S. aureus (BIC 50 = 15.43, 17.31, 18.86 µg/ml; BEC 50 = 45.86, ≥62.50, and 57.62 µg/ml) are higher than ciprofloxacin. The results demonstrated that the isolated antimicrobial compounds played the key role of this herb in combating microbes and provided benefits for its development and quality control, and the computer-assisted structure elucidation method was a powerful tool for chemical analysis, especially for distinguishing isomers with similar structures, which can be used for other complex samples., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hu, Tekin, Hu, Yaghoobi, Khan, Ghosh, Panda, Huang and Luyten.)

Rational: The rationale of this study was to evaluate the visual and anatomical outcomes of pars plana lensectomy and iris-claw Artisan intraocular lens (IOL) implantation in patients with subluxated crystalline lenses secondary to Marfan syndrome., Materials and Methods: In this retrospective case series, we evaluate the records of 21 eyes of 15 patients with Marfan syndrome and moderate-to-severe crystalline lens subluxation who underwent pars plana lensectomy/anterior vitrectomy and implantation of iris-claw Artisan IOL at referral hospital from September 2015 to October 2019., Results: Twenty-one eyes of 15 patients (10 males and five females) with a mean age of 24.47 ± 19.14 years were included. Mean best-corrected visual acuity was improved from 1.17 ± 0.55 logMAR to 0.64 ± 0.71 logMAR at the final follow-up visit ( P < 0.001). The mean intraocular pressure did not change significantly ( P = 0.971). The final refraction showed a mean sphere of 0.54 ± 2.46 D and a mean cylinder of 0.81 ± 1.03 at the mean axis of 57.92 ± 58.33 degrees. One eye developed rhegmatogenous retinal detachment 2 months after surgery., Conclusions: Pars plana lensectomy and iris-claw Artisan IOL implantation seem to be a useful, impressive, and safe procedure with a low rate of complications in Marfan patients with moderate-to-severe crystalline lens subluxation. Visual acuity was significantly improved with acceptable anatomical and refractive outcomes., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Oman Ophthalmic Society.)

Background: Studies on the use of fecal immunochemical test (FIT) in colorectal screening have long assumed perfect accuracy for colonoscopy. No study to date has directly compared the diagnostic accuracy of colonoscopy and FIT to detect advanced neoplasia (AN) in a head-to-head diagnostic accuracy meta-analysis. Methods: A comprehensive electronic search was performed for a head-to-head comparison of FIT and colonoscopy using a third acceptable reference standard in asymptomatic adults. Cochrane methodology was used to perform a head-to-head diagnostic test accuracy (DTA) meta-analysis. Quality assessment tool for diagnostic accuracy studies-2 (QUADAS-2) was used to assess the risk of bias in included studies. Results: Two studies met the eligibility criteria. Overall sensitivity and specificity were 98.5 (95% CI 96.3-100%) and 100% (99.9-100%) for colonoscopy and 16.4% (10.3-22.6%) and 95.4% (94.3-96.4%) for FIT. Colonoscopy was significantly better than FIT ( P < 0.0001). The positive and negative likelihood ratios (LRs) were 1.75 (1.57-1.96) and 0.03 (0.01-0.08) for colonoscopy and 3.02 (2.01-4.55) and 0.88 (0.82-0.95) for FIT, respectively. Conclusion: Colonoscopy provides significantly better diagnostic accuracy to detect AN compared with FIT (GRADE: ⨁⨁◯◯). Our study provided precise sensitivity and specificity of both colonoscopy and FIT and a revision in screening policies based on an updated cost-effectiveness analysis considering the results of the head-to-head analysis., Competing Interests: Competing Interests The authors declare no conflict of interest related to this work., (© 2023 Middle East Journal of Digestive Diseases.)

Although incredible progress in the field of Janus particles over the last three decades has delivered many promising smart-material prototypes, from cancer-targeting drug delivery vehicles to self-motile nanobots, their real-world applications have been somewhat tempered by concerns over scalability and sustainability. In this study, we adapt a simple, scalable 3D mask method to synthesize Janus particles in bulk using starch as the base material: a natural biopolymer that is safe, biocompatible, biodegradable, cheap, widely available, and versatile. Using this method, starch granules are first embedded on a wax droplet such that half of the starch is covered; then, the uncovered half is treated with octenyl succinic anhydride, after which the wax coating is removed. Janus particles with 49% Janus balance can be produced in this way and were observed to self-assemble into wormlike strings in water due to their hydrophobic/hydrophilic nature. Our Janus starch granules outperform the non-Janus controls as thickening and gelling agents: they exhibit a fourfold increase in water-holding capacity, a 30% lower critical caking concentration, and a viscosity greater by orders of magnitude. They also form gels that are much firmer and more stable. Starch Janus particles with these functional properties can be used as novel, lower-calorie, highly efficient, plant-based super-thickeners in the food industry, potentially reducing starch use in food by 55%.

Background : Fecal immunoglobulin test (FIT) has been advocated as the first line of screening for colorectal cancer (CRC) in several jurisdictions. Most studies have focused on CRC as the outcome of interest. Our goal was to quantify the diagnostic accuracy of different thresholds of FIT as compared with colonoscopy for detection of advanced colonic neoplasia and potential modifiers using proper Cochrane methodology. Methods : A comprehensive electronic search was performed for studies on FIT using colonoscopy as the reference standard to detect advanced neoplasia. Cochrane methodology was used to perform a diagnostic test accuracy (DTA) meta-analysis. Diagnostic accuracy of different cut-offs of FIT, including 25, 50, 75, 100, 150, and 200 ng/mL, were calculated separately. Meta-regression analysis was also performed to detect potential a priori modifiers, including age, location of the tumor, and time from FIT to colonoscopy. Results : Twenty-four studies were included with no evidence of publication bias. The sensitivity of FIT did not decrease with lowering the cut-off, although specificity increased in higher cut-offs. Commonly used cut-offs of 50 ng/mL, 75 ng/mL, and 100 ng/mL for FIT provided sensitivity of 39%, 36%, 27% and specificity of 92%, 94%, 96%, respectively. Diagnostic accuracy of FIT did not significantly differ in proximal versus distal lesions or in individuals below or over the age of 50 years. The results remained robust in a meta-regression of the location of the study, time from FIT to colonoscopy, and methodological quality. Conclusion : The sensitivity of FIT might have been overestimated in previous studies focusing on CRC, and it seems to be independent of age, location of neoplasia, or cut-offs, contrary to some previous studies. Lowering the cut-off will reduce the diagnostic odds ratio (DOR) by increasing specificity but without any effect on sensitivity., Competing Interests: Conflict of Interest The authors declare no conflict of interest related to this work., (© 2022 Middle East Journal of Digestive Diseases.)

Physicochemical conditions play a key role in the development of biofilm removal strategies. This study presents an integrated, double-layer, high-throughput microfluidic chip for real-time screening of the combined effect of antibiotic concentration and fluid shear stress (FSS) on biofilms. Biofilms of Escherichia coli LF82 and Pseudomonas aeruginosa were tested against gentamicin and streptomycin to examine the time dependent effects of concentration and FSS on the integrity of the biofilm. A MatLab image analysis method was developed to measure the bacterial surface coverage and total fluorescent intensity of the biofilms before and after each treatment. The chip consists of two layers. The top layer contains the concentration gradient generator (CGG) capable of diluting the input drug linearly into four concentrations. The bottom layer contains four expanding FSS chambers imposing three different FSSs on cultured biofilms. As a result, 12 combinatorial states of concentration and FSS can be investigated on the biofilm simultaneously. Our proof-of-concept study revealed that the reduction of E. coli biofilms was directly dependent upon both antibacterial dose and shear intensity, whereas the P. aeruginosa biofilms were not impacted as significantly. This confirmed that the effectiveness of biofilm removal is dependent on bacterial species and the environment. Our experimental system could be used to investigate the physicochemical responses of other biofilms or to assess the effectiveness of biofilm removal methods., Competing Interests: The authors have declared that no competing interests exist.

Background: Objectives were to investigate aspects of the COVID-19 epidemics via testing the individuals who were referred to Aramesh Medical Laboratory in Tehran and to integrate the molecular results with epidemiological data since the beginning of the epidemic. Methods: In this cross-sectional Study 77528 outpatients were referred to Aramesh Medical laboratory by physicians for the diagnosis of SARS-CoV-2 infection between March 2019 and May 2021. Viral acid nucleic extracted from nasal and throat specimens and subsequently amplified using Reverse Transcriptase Real-Time PCR. Laboratory data including Ct values compared with epidemic peaks of COVID-19 countrywide. Statistical Analysis was done by SPSS 21 Software. Results: 14312 (18.46%) tested positive.36.5% of the positive cases were in the 30 to 39 years old age group. The positive result rate was significantly different based on months, ranging from 6% to 28%, compatible with four recognized epidemic peaks encompassing the end of March through the first week of April (first epidemic peak), from June to July 2020 (second epidemic peak), October until mid of November 2020 (third epidemic wave) followed by the end of April to May 2021 (until the end period of study, in the middle of 4th peak). In 37.8% of cases, the Ct value was between 21 and 28. Two separate trends were seen for Ct ≤ 25 and Ct ≤ 20 for the first and fourth epidemic peaks, respectively. There was an association between the number of total monthly positive results and total deaths in the country, especially with the second to third peaks (in the course of summer 2020) and fourth epidemic peak. Conclusion : It might be useful to consider laboratory admission rates as an indicator for changes in the epidemic level in the country to continue the SARS-CoV-2 surveillance in accordance with public decision-makers., (© 2022 Iran University of Medical Sciences.)

The magnetic actuation of ferrofluid droplets offers an inspiring tool in widespread engineering and biological applications. In this study, the dynamics of ferrofluid droplet generation with a Drop-on-Demand feature under a non-uniform magnetic field is investigated by multiscale numerical modeling. Langevin equation is assumed for ferrofluid magnetic susceptibility due to the strong applied magnetic field. Large and small computational domains are considered. In the larger domain, the magnetic field is obtained by solving Maxwell equations. In the smaller domain, a coupling of continuity, Navier Stokes, two-phase flow, and Maxwell equations are solved by utilizing the magnetic field achieved by the larger domain for the boundary condition. The Finite volume method and coupling of level-set and Volume of Fluid methods are used for solving equations. The droplet formation is simulated in a two-dimensional axisymmetric domain. The method of solving fluid and magnetic equations is validated using a benchmark. Then, ferrofluid droplet formation is investigated experimentally, and the numerical results showed good agreement with the experimental data. The effect of 12 dimensionless parameters, including the ratio of magnetic, gravitational, and surface tension forces, the ratio of the nozzle and magnetic coil dimensions, and ferrofluid to continuous-phase properties ratios are studied. The results showed that by increasing the magnetic Bond number, gravitational Bond number, Ohnesorge number, dimensionless saturation magnetization, initial magnetic susceptibility of ferrofluid, the generated droplet diameter reduces, whereas the formation frequency increases. The same results were observed when decreasing the ferrite core diameter to outer nozzle diameter, density, and viscosity ratios., (© 2022. The Author(s).)

Starch, as a staple carbohydrate, is frequently used as a thickener to enhance food texture. As such, there is an increasing interest in studying starch modification to improve its thickening ability. Instead of the conventional mechanism of swelling-based thickening, the present work presents an alternative using starch-based patchy particles as a texturizer prepared through a bottom-up method by physically grafting small amaranth starch granules (∼1 μm) onto corn starch granules (>10 μm). After thermal treatment in aqueous ethanol, starches were partially gelatinized, and the particle stiffness was reduced. The corn starch and amaranth starch were modified to carry a negative charge and a positive charge, respectively. The hydrated swollen starch granules were centrifuged and dehydrated, which stitched particles together, forming a corona-shaped patchy structure with a negatively charged core and positively charged patches. The electrostatic interaction allowed particles to associate, and the pockets created in the flocs were able to trap more water. The enhanced water-holding capacity consequently contributed to a significantly higher storage modulus, loss modulus, and viscosity compared to the native starch and the mixed charged starch with the same blending ratio between amaranth and corn starch. The enhanced viscoelasticity was not affected by cooking and mechanical stress, which could be used as a shear-reversible thickener to modify texture with less raw ingredients, thus helping to reduce the amount of energy-dense starch in diets. This is the first time that the concept of patchy particles has been extended to food-grade ingredients with a facile and scalable method.

The female reproductive tract simultaneously guides and selects high-quality sperm using rheotaxis in mammalian species. Sperm quality, however, is traditionally evaluated only by their movement velocities and concentration using computer-assisted sperm analysis (CASA), which ignores sperm rheotaxis. Here, by mimicking the female reproductive tracts' dimensions and hydrodynamic features, a new method is introduced to quantify sperm rheotaxis ability for evaluating semen quality. The combination of our RHEOtaxis quaLity indEX (RHEOLEX) and motile sperm concentration is able to predict sperm fertility levels in artificial insemination at various shear rates within 5 minutes. This means that RHEOLEX could be a biomarker for determining male in vivo fertility, unlike conventional semen quality parameters which fail to provide statistically significant predictions. In addition, a high RHEOLEX is associated with a low DNA fragmentation index (DFI), showing that this new parameter is able to identify low-DFI samples. Not only does this work highlight the importance of rheotaxis in determining male in vivo fertility, but it also provides a solid benchmark for developing fast microfluidic devices for male fertility prediction as well as DFI. Last, the data imply that the female reproductive tract might use rheotaxis to keep sperm with fragmented DNA from reaching the fertilization site.

Background: Human papilloma virus (HPV) causes the most common sexually-transmitted infection especially among sexually-active individuals. The aim of study was to characterize the molecular characterization of HPV genotypes between 5176 female and male patients., Methods: HPV DNA was extracted from genital swabs of the study participants and amplified by Real Time Polymerase Chain Reaction (PCR). Genotyping was performed for 2525 cases using REALQUALITY RQ-Multi HPV Detection Kit for the identification of 14 high risk (HR) and 2 low risk (LR) HPV genotypes. Demographic figures were analyzed in correlation with virological data statistically., Results: Out of 5176 cases from 7 laboratories, 2727 (53%) were positive for HPV, of which. 2372(87%) women and 355 (13%) men were HPV positive. However, in an intra-gender analysis, positive rate was higher in men (355/637, 55.7%) than in women (2372/4539, 52%; P value 0.007). HPV positive patients were younger than negative individuals. Positive rate was higher among age categories 20-40. Genotyping was performed for 2525 cases. Out of 1219 (48%) patients who contained single genotypes, 566 (22%) and 653 (26%) harboured HR and LR genotypes, respectively. In females and males, 1189 (54%) and 117 (37%) contained multiple genotypes. No substantial associations were found between different age categories and HR/LR and multiple genotypes distribution., Conclusion: The prevalence of HPV infection in both genders was high. However, men had a higher rate of infection. These observations highlighted the necessity for a plan for targeted education to younger population in the society as well as application of infection control measures against HPV infection, especially in terms of general population mass HPV vaccination., (© 2022. The Author(s).)

Cerebral mucormycosis (CM) is a life-threatening manifestation of mucormycosis, an angioinvasive fungal infection caused by Mucorales. We sought to systematically review all available case reports to describe epidemiologic features, clinical manifestations, predisposing factors, and diagnostic and treatment strategies of CM. A systematic search was conducted using a combination of the following keywords: "Mucor", "Zygomycetes", "mucormycosis", "cereb*", "brain", "central nervous system", and "intracranial", separately and in combination until December 31 st 2018. Data sources included PubMed, Scopus, EMBASE, Web of Science, Science Direct, and Proquest without limiting the time of publication. We included 287 articles corresponding to 345 cases of CM. Out of the 345 cases, 206 (60%) were male with a median age of 44 years; 130 (38%) were reported from North America; 87 (25%) from Asia; and 84 (24%) from Europe. The median time from onset of symptoms to presentation was 3-7 days (65/345, 65%). The highest mortality was observed among patients with diabetes mellitus ( P =0.003). Debridement of infected brain tissue was associated with improved survival in CM cases (OR 1.5; 95% CI 01.3-1.8; P <0.0001). The use of liposomal amphotericin B (L-AMB) was significantly associated with patients' recovery (OR 2.09; 95% CI 1.2-3.4; P =0.003). The combination of L-AMB and posaconazole (12.5%) was more effective than the monotherapy treatment of CM cases ( P =0.009). Clinicians should consider DM as an important risk factor for CM. Moreover, surgical debridement and antifungal combination therapy could be an effective approach in the management of CM patients., Competing Interests: OR received a grant from the Research Foundation of Rigshospitalet related, and a grant from A.P. MØLLER FONDEN not related to this work. The authors declare that they have no competing interests.

Cumulus removal (CR) is a central prerequisite step for many protocols involved in the assisted reproductive technology (ART) such as intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing (PGT). The most prevalent CR technique is based upon laborious manual pipetting, which suffers from inter-operator variability and therefore a lack of standardization. Automating CR procedures would alleviate many of these challenges, improving the odds of a successful ART or PGT outcome. In this study, a chip-scale ultrasonic device consisting of four interdigitated transducers (IDT) on a lithium niobate substrate has been engineered to deliver megahertz (MHz) range ultrasound to perform denudation. The acoustic streaming and acoustic radiation force agitate COCs inside a microwell placed on top of the LiNbO 3 substrate to remove the cumulus cells from the oocytes. This paper demonstrates the capability and safety of the denudation procedure utilizing surface acoustic wave (SAW), achieving automation of this delicate manual procedure and paving the steps toward improved and standardized oocyte manipulation.

Background: Vaccination against HCV is an effective measure in reduction of virus-related public health burden and mortality. However, no prophylactic vaccine is available as of yet. DNA-based immunization is a promising modality to generate cellular and humoral immune responses. The objective of this study is to provide a systematic review of HCV DNA vaccines and investigate and discuss the strategies employed to optimize their efficacies., Methods: MEDLINE (PubMed), Web of Science, Scopus, ScienceDirect, and databases in persian language including the Regional Information Centre for Science & Technology (RICeST), the Scientific Information Database and the Iranian Research Institute for Information Science and Technology (IranDoc) were examined to identify studies pertaining to HCV nucleic acid vaccine development from 2000 to 2020., Results: Twenty-seven articles were included. Studies related to HCV RNA vaccines were yet to be published. A variety of strategies were identified with the potential to optimize HCV DNA vaccines such as incorporating multiple viral proteins and molecular tags such as HBsAg and Immunoglobulin Fc, multi-epitope expression, co-expression plasmid utilization, recombinant subunit immunogens, heterologous prime-boosting, incorporating NS3 mutants in DNA vaccines, utilization of adjuvants, employment of less explored methods such as Gene Electro Transfer, construction of multi- CTL epitopes, utilizing co/post translational modifications and polycistronic genes, among others. The effectiveness of the aforementioned strategies in boosting immune response and improving vaccine potency was assessed., Conclusions: The recent progress on HCV vaccine development was examined in this systematic review to identify candidates with most promising prophylactic and therapeutic potential., (© 2021. The Author(s).)

Background: The first confirmed cases of COVID-19 in Iran were reported in Qom city. Subsequently, the neighboring provinces and gradually all 31 provinces of Iran were involved. This study aimed to investigate the case fatility rate, basic reproductive number in different period of epidemic, projection of daily and cumulative incidence cases and also spatiotemporal mapping of SARS-CoV-2 in Alborz province, Iran., Methods: A confirmed case of COVID-19 infection was defined as a case with a positive result of viral nucleic acid testing in respiratory specimens. Serial interval (SI) was fitted by gamma distribution and considered the likelihood-based R0 using a branching process with Poisson likelihood. Seven days average of cases, deaths, doubling times and CFRs used to draw smooth charts. kernel density tool in Arc GIS (Esri) software has been employed to compute hot spot area of the study site., Results: The maximum-likelihood value of R0 was 2.88 (95%, CI: 2.57-3.23) in the early 14 days of epidemic. The case fatility rate for Alborz province (Iran) on March 10, was 8.33% (95%, CI:6.3-11), and by April 20, it had an increasing trend and reached 12.9% (95%,CI:11.5-14.4). The doubling time has been increasing from about two days and then reached about 97 days on April 20, 2020, which shows the slowdown in the spread rate of the disease. Also, from March 26 to April 2, 2020 the whole Geographical area of Karj city was almost affected by SARS-CoV-2., Conclusions: The R0 of COVID-19 in Alborz province was substantially high at the beginning of the epidemic, but with preventive measures and public education and GIS based monitoring of the cases,it has been reduced to 1.19 within two months. This reduction highpoints the attainment of preventive measures in place, however we must be ready for any second epidemic waves during the next months., (© 2021. The Author(s).)

Epilepsy is a brain disorder disease that affects people's quality of life. Electroencephalography (EEG) signals are used to diagnose epileptic seizures. This paper provides a computer-aided diagnosis system (CADS) for the automatic diagnosis of epileptic seizures in EEG signals. The proposed method consists of three steps, including preprocessing, feature extraction, and classification. In order to perform the simulations, the Bonn and Freiburg datasets are used. Firstly, we used a band-pass filter with 0.5-40 Hz cut-off frequency for removal artifacts of the EEG datasets. Tunable-Q Wavelet Transform (TQWT) is used for EEG signal decomposition. In the second step, various linear and nonlinear features are extracted from TQWT sub-bands. In this step, various statistical, frequency, and nonlinear features are extracted from the sub-bands. The nonlinear features used are based on fractal dimensions (FDs) and entropy theories. In the classification step, different approaches based on conventional machine learning (ML) and deep learning (DL) are discussed. In this step, a CNN-RNN-based DL method with the number of layers proposed is applied. The extracted features have been fed to the input of the proposed CNN-RNN model, and satisfactory results have been reported. In the classification step, the K-fold cross-validation with k = 10 is employed to demonstrate the effectiveness of the proposed CNN-RNN classification procedure. The results revealed that the proposed CNN-RNN method for Bonn and Freiburg datasets achieved an accuracy of 99.71% and 99.13%, respectively.

Cocrystals are important molecular adducts that have many advantages as a means of modifying the physicochemical properties of active pharmaceutical ingredients, including taste masking and improved solubility, bioavailability, and stability. As a result, the discovery of new cocrystals is of great interest to commercial drug discovery programs. Time-consuming manual analysis of the large volumes of data that emerge from large-scale cocrystal screening programs of up to 1000s of preparations poses a challenge. Raman spectroscopy has been shown to discriminate between cocrystals and physical mixtures and is easy to automate, allowing rapid screening of large numbers of potential cocrystals, but the spectral features that encode the information are often subtle (e.g., slight changes in peak positions or intensities). We have employed an automated signal processing routine based on a sparse decomposition algorithm to speed up the data processing steps while maintaining the accuracy of a trained spectroscopist. We used our algorithm to screen 31 potential cocrystal preparations and found that through the use of a computationally generated threshold, we could achieve a clear classification of cocrystals and physical mixtures in less than a minute, compared to several hours manually.