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Ivermectin (IVM) is an antiparasitic drug that primarily works by the activation of GABA

Background Meningitis is known as a meningeal inflammation accompanied by pleocytosis in the cerebrospinal fluid (CSF), and can be classified into acute, subacute, and chronic meningitis based on symptoms duration of ≤ 5 days, ≥ 5 days and ≥ 4 weeks, respectively. Subacute and chronic meningitis are caused mainly by indolent infectious agents and noninfectious causes such as autoimmune, and neoplastic. In this study, we investigated the characteristics, diagnosis, and treatment of subacute and chronic meningitis. Methods We extracted the medical records of patients with chronic and subacute meningitis who were referred to three tertiary centers from Jun 2011 to Jun 2021. Initially, 2050 cases of meningitis were screened, and then 79 patients were included in the study. Results Headache (87.3%), nausea and vomiting (74.7%), fever (56.4%), and visual impairments (55.7%) were the most prevalent symptoms. The most common signs were nuchal rigidity (45.3%), altered mental status (26.9%), and papillary edema (37.5%). Brain computed tomography (CT) was normal in 68.6% of the patients while 22.9% of the cases had hydrocephalus. Brain magnetic resonance imaging (MRI) was normal in 60.0% of the patients. The most common abnormal MRI findings were leptomeningeal enhancement (16.0%) and hydrocephalus (16.0%). We had a 44.3% definite diagnosis with bacterial (n:25, 31.6%) and neoplastic (n:8, 10.1%) being the most prevalent etiologies. Mycobacterium tuberculosis (60%) and Brucella spp. (12%) were the most prevalent bacterial pathogens. Conclusions The most common etiologies include infectious, neoplastic, and immunologic. Due to insidious presentation and uncommon etiologies, establishing a proper diagnosis, and providing timely targeted treatment for patients with subacute and chronic meningitis remains a challenge for clinicians.

In the present study, the molecular dynamics method is used to probe the aggregation phenomenon of hybrid nanoparticle within platinum microchannel with pyramidal barriers. In molecular dynamics simulations, argon atoms are described as base fluid particles and for the interaction between these atoms, we use Lennard-Jones potential, while the platinum–platinum and Al2O3 nanoparticles interactions are simulated applying the embedded atom method force field. To analyze the achieved simulation results, some physical parameters such as potential energy, temperature, and distance of nanoparticles center of mass are calculated. The results show external magnetic field decrease the aggregation phenomenon in nanoparticles. Numerically, by adding external magnetic field to simulation box, the COM distance of nanoparticles reaches to 2.7 A and the aggregation time of nanoparticles changes from 1.7 to 2.3 ns. These appropriate effects of external magnetic field from our computational study can be used in the design of heat transfer applications.

Similarities and differences of a large-scale flapping-wing robot with fixed-wing UAVs in equations of motion, trim curves, and aerodynamic forces in forward flight are discussed in this paper and a simplified model for flapping flight is presented. Due to the high Wing to Total Weight (WTW) ratio of large-scale ornithopters, simple rigid body dynamics is not accurate enough for flight dynamics modeling. On the other hand, the multi-body dynamics associated with flapping gives little insight into the behavior of the resulting model due to complexity of equations. It is also difficult to design proper controllers for such complicated models. In this paper, the effects of different terms of multi-body equations of ornithopter on the estimated aerodynamic forces are studied via experimental flight data. A simpler but yet accurate set of equations is obtained by removing less effective terms from original relations. The presented model is in the form of normal aircraft equations plus some additional terms which can be used in different control and estimation processes. In addition, trim conditions of forward flight are extracted using several flight tests, and corresponding periodic behavior of states and forces are studied. These studies are applicable for identifying time-periodic models.

Transient cavities generated from unsteady leading-edge cavitation may undergo aggressive collapses which are responsible for cavitation erosion. In this paper, we studied the hydrodynamic mechanisms of these events in the leading edge cavitation formed over a modified NACA0009 hydrofoil using experimental and numerical methods. In the experimental investigation, high-speed visualization (HSV) and paint test are employed to study the behavior of the cavitating flow at sigma = 1.25, beta = 5 degrees, U-infinity = 20 m/s. In the numerical part, the same cavitating flow is simulated using an inviscid density-based compressible solver with a barotropic cavitation model. The numerical results are first compared with the experimental HSV to show that the simulation is able to reproduce the main features of the cavitating flow. Then, as the compressible solver is capable of capturing the shock wave upon the collapse of cavities, the location of collapse events with high erosion potential are determined. The location of these collapse events are compared with the paint test results with a qualitatively good agreement. It is clearly observed, in both the experiments and the numerical simulation, that there exists four distinct regions along the hydrofoil with higher risks of erosion: (1) A very narrow strip at the leading edge, (2) an area of accumulated collapses at around 60 percent of the sheet cavity maximum length, (3) an area around the closure line of the sheet cavity with the highest erosion damage, and (4) a wide area close to the trailing edge with dispersed collapse events. A combined analysis of the experimental and numerical results reveals that the small-scale structures generated by secondary shedding are more aggressive than the large-scale cloud cavities (primary shedding). It is also observed that the high risk of cavitation erosion in regions 2 and 3 is mainly due to the collapses of the small cavity structures that are formed around the sheet cavity closure line or the rolling cloud cavity.

This study focuses on energy harvesting from vehicle suspension by employing a regenerative rotational shock absorber. Designing, manufacturing and testing of a prototype device is done step by step to provide a useful manual for researchers. The prototype damper was especially designed for low frequency applications. A rack-pinion mechanism was proposed to transform linear motion to rotational one. Unidirectional motion was realized by using a new combination of bearings and gear chain mechanism. This mechanical rectifier was coupled to light weight gear box with high reduction factor. Experimental studies were conducted in laboratory by utilizing a damper testing device. Excitation vibration motion on prototype was in constant amplitude (25 mm) and at variable low frequencies (0.16, 0.32 and 0.48 Hz). Additionally, different resistances were tested as an external load for electric generator (0.66 ∼ 10.4 Ω). Generated voltage and power in different case studies were presented. The maximum power was found to be 35 W and the maximum performance achieved was 34.36%. The range of calculated damping coefficient is in between 4800 Ns/m and 16000 Ns/m that is convenient for passenger and commercial vehicles.

Epilepsy has garnered increased public health focus because patients who suffer from epilepsy experience pronounced and persistent health and socioeconomic disparities despite treatment and care advances. The epidemiology of epilepsy is diverse in different countries and regions. This nationwide population-based cross-sectional study was conducted to determine the life time prevalence and health related factors of epilepsy for the first time in Iran through a two-phase door-to-door survey method. In phase I, a screening for epilepsy was performed on 68,035 people. Then in phase II, after the neurological evaluation of participants and reviewing medical records, 1130 subjects with epilepsy was confirmed. The life time prevalence of epilepsy was achieved to be 16.6 per 1000 people (95% CI 15.4–17.8) with the average age onset 19.1 ± 21.1 (active prevalence 9.5 per 1000 people). Focal seizure (59.3%), generalized epilepsy (38%) and unknown types of epilepsy (2.7%) were detected among participants. The overall life time prevalence of febrile convulsion was 4.1 per 1000 people. The frequency of attacks per year and per month were 3.0 ± 1.6 and 0.5 ± 0.1, respectively. Age-specific life time prevalence was highest among the age group of 15–19 years old [32.7 per 1000 persons (95% CI 29.1–36.8)] and it was higher in male (53.8%) than female (46.2%) participants. Our results showed that the life time prevalence of epilepsy in Iran is higher than worldwide average.

Interferon beta is currently the first line treatment of relapsing-remitting multiple sclerosis (RRMS). Different formulations of interferon beta are available. Avonex and CinnoVex are two interferon beta-1a being prescribed by neurologists in Iran. The aim of this study was to compare the four and half year outcome of Avonex and CinnoVex in patients with RRMS. A total 186 of patients with definite RRMS diagnosis were followed for four and half years. Patients were randomly assigned to receive either Avonex or CinnoVex. Patients were subsequently visited every 6 months, and MRI was also undertaken prior each visit. The efficacy end points were to compare mean scores of expanded disability status scale (EDSS) and the proportion of patients with MRI and clinical activity in follow-up visits between Avonex and CinnoVex. Safety end point was to compare the percentage of adverse events between two groups. One hundred and eighty-two patients completed the study. The population of study experienced a steady increase in EDSS during follow-up with a mean increase of 1.03. Repeated measures ANOVA revealed no statistically significant difference between Avonex and CinnoVex (p = 0.78). The most common adverse events were headache, myalgia, fatigue, fever, flu symptoms, injection site pain, and depression. Direct comparison of each adverse events revealed no meaningful difference between two groups except for only a few adverse events. There was no statistically significant difference in MRI activity and clinical activity between two groups. Avonex and CinnoVex showed similar efficacy and safety outcome in patients with RRMS.

Despite the numerous remedies prescribed so far, tip vortex cavitation (TVC) remains a major issue in design and operation of diverse applications. In this paper, we experimentally investigate the effectiveness of winglets in suppressing TVC. An elliptical hydrofoil is selected as the baseline geometry and various winglets are realized by bending the last 5 or 10% of the span at +/- 45 degrees and +/- 90 degrees dihedral angles. To better focus on the physics of the problem, we have intentionally avoided any optimization on the geometries and our winglets are only smooth non-planar extensions of the original cross-section. Modifying no more than 3.7% of the lifting surface, lift-and-drag force measurements demonstrate that the hydrodynamic performances of the winglet-equipped hydrofoils are not substantially different from the baseline. Nevertheless, cavitation inception-desinence tests reveal that undeniable advantages are achieved by the winglets in TVC alleviation. It is found that the 10%-bent 90 degrees winglets are more effective than the 45 degrees cases, with - 90 degrees (bent down toward the pressure side) performing superior to + 90 degrees. For instance, the 90 degrees-bent-downward winglet reduces the TVC inception index from 2.5 for the baseline down to 0.8 (a reduction of 68%) at 15 m/s freestream velocity and 14 degrees incidence angle. In addition, the study on the bending length effect conducted for the 90 degrees configurations shows that the 5%-bent winglets are not as striking as the 10% ones. Employing Stereo-PIV technique, the influence of winglets on non-cavitating flow structures is examined. For the most effective winglet (10%-bent 90 degrees-downward), we observe that the maximum tangential velocity of the tip vortex falls to almost half of the baseline and the vortex core size increases significantly (by almost 70%). These effects are accompanied by a tangible reduction in the axial velocity at the vortex core leading to further mitigation of TVC.

In this paper, the steady flow of a viscoplastic fluid is modeled in a planar channel equipped with a deformable segment in the middle of an otherwise rigid plate. The fluid is assumed to obey the Herschel-Bulkley model which accounts for both the yield stress and the shear-thinning behavior of physiological fluids such as blood. To accommodate the large deformations of the flexible segment, it is assumed to obey the twoparameter Mooney-Rivlin hyperelastic model. The so-called fluid-structure interaction problem is then solved numerically, under creeping-flow conditions, using the finite element package, COMSOL. It is found that the yield stress leads to a larger wall deformation and a higher pressure drop as compared with Newtonian fluids. This behavior is predicted to intensify if the fluid is shear-thinning. That is, for a given yield stress, the pressure drop and the wall deformation both increase with an increase in the degree of the fluid's shear-thinning behavior.

Telomerase is activated in chronic myeloid leukemia (CML); however, it is not known whether the catalytic telomerase reverse transcriptase subunit (hTERT) is vital in the progression of this disease. This study involved patients with CML in the chronic phase (pretreatment and after treatment), accelerated and blastic phase. Expression of the hTERT gene differed significantly among the four major groups (p0.05). We also compared hTERT expression according to demographic parameter such as age and sex, and found no significant differences (p0.05). Taken together, our findings suggest the importance of hTERT as a valuable molecular marker in the follow-up of patients with CML, which may have clinical implications for the prognosis.

Purpose Artificial neural networks (ANNs) are used to optimize a formulation of poly(lactic acid) (PLA) nanoparticles containing hydrophobic drug molecules through a study of the critical parameters affecting nanoparticle size.

It has been hypothesized that antioxidant and oxidant capacities may be related to the severity of obstructive lung impairment in patients with sulfur mustard (SM)-induced lung injuries. Our study was designed to measure the level of glutathione (GSH) and malondialdehyde (MDA) activities in patients intoxicated with SM and to evaluate the relationship between their activity and the severity of pulmonary dysfunction. A total of 250 patients with a history of exposure to a single high dose of SM gas and also 60 healthy nonsmoking individuals with no history of exposure to SM were selected. All patients underwent spirometry; based on its indices they were divided into two groups: mild (n = 140) and moderate-to-severe (n = 110) pulmonary dysfunction. Also, serum GSH and MDA concentration measurements were performed for all patients and controls. The mean GSH level in controls was 29.85 +/- 3.26 micromol/ml, which was significantly higher than in patients with mild and moderate-to-severe pulmonary dysfunction (19.02 +/- 2.36 and 17.89 +/- 2.16 micromol/ml, respectively). Also, the mean MDA level in controls was 0.69 +/- 0.09 micromol/ml, which was significantly lower than in patients with mild and moderate-to-severe pulmonary dysfunction (0.74 +/- 0.05 and 0.75 +/- 0.05 micromol/ml, respectively). There was a weak linear correlation between GSH level and some of the pulmonary function indices. On the other hand, there was no significant relationship between the MDA level and pulmonary indices. Our study confirmed important alterations in the oxidative-antioxidative system in patients suffering from SM-induced lung injuries, as shown by a decreased serum level of GSH and an increased level of MDA. Individuals with moderate-to-severe SM-induced lung injuries show a greater tendency for a decreased level of GSH and an increased level of MDA than those with mild injuries; however, there is only minimal association between pulmonary function parameters and the serum level of MDA and GSH. These findings encourage us to examine therapeutic measures to correct such imbalances in future studies.

The H-point standard addition method (HPSAM) is applied to kinetic data for the simultaneous determination of ascorbic acid (AA) and L-cysteine (Cys). If present in excess amounts, iron(III) is quantitatively reduced to iron(II) by AA or Cys which in turn, in the presence of phenanthroline (phen), produces a colored iron(II)-phen complex showing maximum absorbance at 510 nm. HPSAM is based on the difference of the reaction rates between AA and Cys with Fe(III). The linear dynamic ranges for the two analytes AA and Cys are 0.50–4.00 ppm and 1.00–8.00 ppm, respectively. The RSD% for 6 replications of AA and Cys at 3.00 ppm is 2.30 and 2.70, respectively. The predictability of the method is checked by determining the two analytes in real samples. The various effects of several similar reducing agents are investigated.

Background and the purpose of the study Existing evidence confirms that no pharmacologic agent ameliorates the decline in the lung function or changes the prognosis of chronic obstructive pulmonary disease (COPD). We tried a critical combination therapy for management of COPD. Methods Current or past smoker (passive or active) COPD patients with moderate to severe COPD who did not respond to primitive therapy (i.e., oral prednisolone (50 mg in the morning) for 5 days; with Beclomethasone Fort (3 puff q12h, totally 1500 micrograms/day), Salmeterol (2 puffs q12h, 50 micrograms/puff) and ipratropium bromide (4 puffs q8h) for two months, enrolled to study. Furthermore they were received N-Acetylcysteine (1200 mg/daily), Azithromycin (tablet 250 mg/every other day) and Theophylline (100 mg BD). Results The study group consisted of 44 men and 4 women, with a mean age and standard deviation of 63.6 ± 12.7 years (range 22–86 years). Thirteen of 48 patients (27.0%) was responder based on 15% increasing in FEV 1 (27.7 ± 7.9) after 6.7 ± 6.1 months (57.9 ± 12.9 year old). There were statistically significant differences in age and smoking between responders and non-responders (P value was 0.05 and 0.04 respectively). There was no difference in emphysema and air trapping between two groups (p = 0.13). Conclusion Interestingly considerable proportion of patients with COPD can be reversible using combination drug therapy and patients will greatly benefit from different and synergic action of the drugs. The treatment was more effective in younger patients who smoke less.