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Purpose Enhanced recovery after surgery (ERAS) programs comprise bundles of evidence-based recommendations designed to reduce physiological stress and support early return of function after surgery. In this study, we sought to investigate the barriers and facilitators of successful implementation of ERAS in a major safety-net hospital. Design Our ERAS program has been designed as a quality improvement pilot project in prospective fashion with a real-time feedback loop. The program is designed to address established culture of safety-net hospitals. Methods An extensive multidisciplinary team investigated the barriers to success for three different levels of program stakeholders: providers, patients, and the facility. After a systematic review of these barriers, solutions were offered and implemented in a multidisciplinary care model with special attention to outcomes and continuous feedback. The findings are summarized in a grid format for better understanding and implementation ease. Findings Patients (N = 198) were enrolled in an ERAS program in a nonrandomized fashion during the pilot period of October 2017 to August 2018. ERAS cohort of patients’ outcomes were then compared with those of 20,328 non-ERAS patients. The ERAS group had less complication with shorter length of stay compared with their non-ERAS counterparts. Furthermore, it has cost less to take care of these patients. Interestingly, this decrease was not achieved by a reciprocal increase in subsequent readmission or reoperation rates. Conclusions Unique barriers exist when implementing an ERAS protocol in a safety-net hospital. These barriers can be overcome to improve the quality of care at a decreased cost. We have provided a grid to facilitate the implementation process.

Introduction. Knee osteoarthritis (KOA) is one of the most common degenerative diseases that lead to pain and disability. Oral NSAIDs are effective drugs used to alleviate symptoms in patients with KOA, but they have several important complications, especially in the elderly. In this study, we evaluated the effectiveness of mesotherapy on pain reduction and improvement of functioning in patients with KOA. Methods. Sixty-two patients with KOA, grade 2-3 of the Kellgren–Lawrence scale, were randomized into two groups: the mesotherapy group, in which two injections were applied with piroxicam at a 10-day interval, and the oral group, in which piroxicam was prescribed for 10 days. The patients were evaluated before the treatment and 2, 4, and 8 weeks after it using the Visual Analogue Scale (VAS), Oxford Knee Scare (OKS), and Western Ontario McMaster University Osteoarthritis Index (WOMAC, Persian version). Results. There was no significant difference in demographic characteristics and baseline pain and function scores between the two groups. After 2, 4, and 8 weeks of follow-up, VAS, WOMAC, and OKS scores significantly improved in both groups (in the mesotherapy group: p value p value p value p value p value p value Conclusion. Mesotherapy is an effective and safe treatment modality in patients with mild-to-moderate KOA in the short term. This trial is registered with IRCT2017052434113N1.

Background Based on the anti-inflammatory and anti-oxidant properties of kaempferol and apigenin, we hypothesized that co-injection of these phytochemicals would increase the effectiveness of cell therapy in knee osteoarthritic rats. Methods Anterior cruciate ligament transection (ACLT) was used to induce osteoarthritis (OA). Animals were treated by weekly intra-articular injections of kaempferol (10 or 20 μM) and/or isolated MSCs from synovial membrane (SMMSCs) (3 × 106 cells), a mixture of apigenin (0.1 μM) and kaempferol alone or SMMSCs, hyaluronic acid or PBS (group size n = 6), for three weeks. After three months, the levels of IL-1β, tumor necrosis factor alpha (TNF-α), superoxide dismutase (SOD) and malondialdehyde (MDA) were measured in the cartilage homogenate. Furthermore, relative expressions of collagen II2a1, aggrecan, IL-1β, TNF-α, inducible nitric oxide synthase (iNOS), SOX-9, MMP-3 and MMP-13 were assessed using real-time PCR. Radiological evaluation, before/after treatments, and histopathological assessments were carried out to evaluate the knees. Results Non-toxic concentrations of kaempferol and apigenin determined to be 10, 20 μM and 0.1, 0.3 μM, respectively. In comparison with the OA group, the levels of TNF-α, IL-1β and MDA significantly decreased in OA + MSCs + kaempferol + apigenin group and a significant increase in SOD level was observed. The levels of MMP-13, MMP-3, TNF-α, IL-1β, iNOS were significantly decreased in the groups of OA + MSCs + A0.1 μM + K10 μM and OA + MSCs + K20 μM. Co-treatment of kaempferol and apigenin increased the gene expression levels of collagen IIa1, aggrecan and SOX-9 genes. Conclusion We showed that kaempferol and apigenin potentially increase the efficiency of OA cell therapy in the rat model of ACLT-induced OA.

Self-dual structures, ones that remain unchanged under interchanging electric and magnetic portions of the structure where e r = μ r , except for a 90° rotation around their axis, have been shown [1] to produce perfect zero backscattering to an arbitrarily polarized, normally incident plane wave. This phenomenon can be used to create inherently matched radiating apertures made of point-like elements. In [2] , the radiation characteristics of such elements were presented, showing that the element patterns are quite similar to those of an isolated element in free space, being fairly well-behaved and free of blind spots. In this work, we further elaborate on the feeding and matching of these elements in a waveguiding network, with the radiation taking place into a waveguide simulator environment.

Gastric cancer is the third-leading cause of cancer-related mortality and the fifth most common cancer globally. Polyunsaturated fatty acids (PUFAs) are considered as functional ingredients that improve the efficacy of chemotherapeutic drugs. The aim of this study is to investigate the effect of PUFAs administration on matrix metalloproteinases (MMPs).This study was designed as a randomized, double-blind trial. Thirty-four newly diagnosed patients with gastric cancer were randomly divided into two groups: control group (n = 17) and case group (n =17). Both groups received the same dose (75 mg/mThe relative gene expression of MMP-1 and MMP-9 was significantly lower in case group than control. The protein expression of MMP-1 and MMP-9 was significantly lower in case group than control.According to the results of this study, PUFAs reduced the expression of MMPs in gastric cancer cells. It seems that PUFAs may have an inhibitory effect on invasion and metastasis of gastric cancer cells.

Introduction: Gastric cancer is a rather common malignancy worldwide and a major healthcare system issue. Lately, the importance of biomarkers such as macrophage migration inhibitory factor (MIF) has been demonstrated in the diagnosis of various gastrointestinal (GI) malignancies. The present study aimed to evaluate the diagnostic value of MIF, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA 19-9) in gastric cancer. Methods: In this descriptive-analytical study, 84 patients with gastric cancer referred to the gastroenterology clinic of Tabriz University of Medical Sciences, Tabriz, Iran, for diagnostic and therapeutic procedures, and 80 healthy individuals were enrolled. Serum levels of MIF, CEA, and CA 19-9 were measured in both groups. Further, the grade and stage of the cancer were determined in in the patient group. Results: Serum levels of all three MIF, CEA, and CA 19-9 biomarkers in patients with gastric cancer were significantly higher than those of the control group (P = 0.001). However, no statistically significant correlations were found between the studied biomarkers with the tumor grade and stage. The MIF cut-off point for the diagnosis of gastric cancer was found to be 7.05 pg/ml and its sensitivity and specificity were 85.7% and 73.8%, respectively. Conclusion: MIF biomarker may involve in the pathogenesis and development of gastric cancer and it is a potential diagnostic and therapeutic marker in this malignancy.

We theoretically characterize a compact optical polarizer consisting of two cascaded metasurfaces. The relative movement of the metasurfaces is tailored to create an artificial birefringence effect which is utilized to design optical waveplates.

The ability of phase-change materials to reversibly and rapidly switch between two stable phases has driven their use in a number of applications such as data storage and optical modulators. Incorporating such materials into metasurfaces enables new approaches to the control of optical fields. In this article we present the design of novel switchable metasurfaces that enable the control of the nonclassical two-photon quantum interference. These structures require no static power consumption, operate at room temperature, and have high switching speed. For the first adaptive metasurface presented in this article, tunable nonclassical two-photon interference from −97.7% (anti-coalescence) to 75.48% (coalescence) is predicted. For the second adaptive geometry, the quantum interference switches from −59.42% (anti-coalescence) to 86.09% (coalescence) upon a thermally driven crystallographic phase transition. The development of compact and rapidly controllable quantum devices is opening up promising paths to brand-new quantum applications as well as the possibility of improving free space quantum logic gates, linear-optics bell experiments, and quantum phase estimation systems.

This study set out to evaluate the influence of carbon black (CB) on the rheological properties and activation energy of asphalt binder at high service temperatures. The rheological performance of virgin and modified asphalt binders are investigated using three evaluation approaches: (1) Superpave specification parameter (G*/sinδ), (2) multiple stress creep recovery (MSCR) test, and (3) interaction model for computing zero shear viscosity (ZSV). Moreover, the Arrhenius model was used to quantify the activation energy (Ef) of virgin and CB-modified asphalt binders. The result of this study reveals that modifying asphalt binder with up to 10% of CB, by weight of the total asphalt binder, enhances the elastic behavior (R%) and decreases the non-recoverable creep compliance (Jnr) of asphalt binder at high temperatures. Moreover, according to this study, the ZSV index can describe successfully rutting resistance of asphalt binder when compared with MSCR and Superpave rutting specification parameter. Besides, it was indicated that CB-modified asphalt binder has a high fluid resistance as more thermal energy was required for overcoming intermolecular force between molecules.

Confining and controlling electromagnetic energy typically involves a highly resonant phenomenon, especially when subwavelength confinement is desired. Here, we present a class of nonresonant, self-dual planar metastructures capable of protected energy transmission from one side to the other, through arbitrarily narrow apertures. It is shown that the transmission is in the form of matched propagating modes and is independent of the thickness and specific composition of the surface. We analytically prove that the self-dual condition is sufficient to guarantee 100% transmission that is robust to the presence of discontinuities along the propagation path. The results are confirmed numerically through study of various scenarios. The operation is broadband and subject only to the bandwidth of the constituent materials. The polarization of the internal field can also be independently controlled with respect to the incident one. Our structures are promising for applications in sensing, particle trapping, near-field imaging, and wide scan antenna arrays.

Tunable quantum interference is enabled by a design incorporating phase-change materials into metasurfaces. Via controlled joule heating, these structures can switch rapidly between phases of constructive and destructive quantum interferences.

We show how a metasurface incorporating a thermally controlled phase-change material (i.e. GeTe) can enable tunable quantum interference, switching between coalescence and anti-coalescence.

Metasurfaces, or phase-engineered quasi-2D interfaces, enable a large degree of control over the reflection, refraction, and transmission of light. Here we demonstrate the design and realization of a visible light gradient metasurface tailored for highly efficient back reflection based on the Huygens-Fresnel principle. The metasurface emulates the functionality of a Littrow grating, capable of efficiently channeling light into the first negative Floquet order over a broad angular range and bandwidth at visible frequencies. Our theoretical results predict unitary efficiency for extremely low profiles and an optical response that is robust against discretization and design modifications. The experimentally realized metasurface is comprised of high-index TiOx nanowires over a protected Ag mirror, enabling back reflection with efficiency above 85% in the visible range, close to the reflectivity of the bare silver mirror. The presented analytical design methodology and the resulting low-profile device are advantageous compared to conventional gratings, while offering broadband efficiencies over a range of incidence angles.

Introduction: Bacterial infections are common causes of mortality and morbidity among chronic kidney disease (CKD) patients under hemodialysis. Objectives: In this study the diagnostic value of serum procalcitonin for diagnosis of bacterial infections in patients with CKD under hemodialysis was assessed. Patients and Methods: In this cross-sectional comparative investigation, 47 patients with CKD under hemodialysis were enrolled to the study. We studied the relationship of serum procalcitonin (PTC) and C-reactive protein (CRP) levels (before and after dialysis) with "positive bacterial culture" and "systemic inflammatory response syndrome (SIRS)" results. Sensitivity and specificity were determined by ROC test. Results: Serum PTC before and after dialysis as well as the CRP before dialysis had no significant association with positive bacterial culture (P=0.492, P=0.1 and P=0.268 respectively), however after-dialysis CRP had a significant association with positive bacterial culture (P=0.032). Conclusion: According to the obtained results, it may be concluded that the diagnostic value of serum PTC for diagnosis of positive culture bacterial infections in hemodialysis patients is not satisfactory since the serum CRP level especially after dialysis is more useful.

Self-dual balanced structures, comprising finite electric and magnetic regions, are invariant to 90 degrees rotation if electric and magnetic regions are interchanged with the rotation. Such structures will produce no backscattering when subject to plane wave illumination along the axis of rotation provided that the Weston balanced condition ∊ r = μ r is obeyed. When higher order spatial harmonics are suppressed, e.g. in a periodic structure whose unit cell is smaller than the wavelength, the entire incident power is forced to be transmitted through the structure. With proper design, this phenomenon can be exploited to produce absorbers over a wide range of frequencies, provided that the constitutive parameters adhere to the Weston condition throughout this range.

A necessary, but not sufficient, condition for parity-time ($P\phantom{\rule{0}{0ex}}T$) symmetry to hold in an optical system is that spatially separated gain and loss must be exactly balanced. This study introduces generalized $P\phantom{\rule{0}{0ex}}T$-symmetric optical structures that can have asymmetric and unbalanced gain-loss profiles, yet offer similar scattering properties and phase transitions as traditional $P\phantom{\rule{0}{0ex}}T$-symmetric ones. The concept of general $P\phantom{\rule{0}{0ex}}T$ symmetry may help to reduce the threshold gain in recently discovered $P\phantom{\rule{0}{0ex}}T$-enabled applications, such as the coherent-perfect-absorber laser and exceptional-point dynamics, and will facilitate optical and photonic devices by offering greater design freedom.

The unique matching properties of self-dual structures provide a rich platform to engineer and control the distribution of the power inside such structures. For instance, narrow gaps embedded inside a self-dual structure can be designed to predominantly carry the incident energy into the outbound interface of the structure. This phenomenon can be used to create quasi-matched radiating apertures made of point-like radiating elements. These elements possess patterns that are quite similar to those of an isolated element in free space, being fairly well-behaved and free of blind spots. These characteristics are envisioned to be of great interest for highly demanding applications of phased arrays.

Self-dual structures, whose electric and magnetic parameters can be interchanged without causing any change to the structure, are shown to be inherently matched to free space. With proper design, in such structures, the normally incident energy is funneled through arbitrarily thin air gaps that support TEM or quasi- TEM modes. A finite-length self-dual waveguide, as suggested herein, is inherently matched at both input and output interfaces, even though the field within the waveguide may be substantially complex and have its own characteristic polarization. This structure looks promising for several applications, as detailed below.

In this work, we experimentally demonstrate metasurface-enhanced photoresponse in organic photodetectors. We have designed and integrated a metasurface with broadband functionality into an organic photodetector, with the goal of significantly increasing the absorption of light and generated photocurrent from 560 up to 690 nm. We discuss how the metasurface can be integrated with the fabrication of an organic photodiode. Our results show large gains in responsivity from 1.5× to 2× between 560 and 690 nm.

An approach to realize Mach-Zehnder type modulators in free-space is presented. Modulation is based on the relative distance between two parallel gradient metasurfaces. We numerically study the device performance and discuss its potential applications.

Introduction: Chronic hepatitis is specified as inflammatory disease of the liver lasting for more than six months. Role of noninvasive fibrosis markers as prognostication factors of the presence or absence of significant fibrosis on liver biopsy of patients with chronic hepatitis is the aim of this study. Methods: Two hundred twenty-one patients with chronic hepatitis involved in the study between 2011 and 2013. Routine biochemical indices and serum fibrosis markers such as aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), AST to platelet ratio index (APRI) and Fibrosis 4 score (FIB-4) were evaluated, and the histological grade and stage of the liver biopsy specimens were scored according to the Ishak scoring system. Diagnostic accuracies of these markers for prediction of significant fibrosis were assessed by Receiver Operating Characteristic (ROC) curve analysis. Results: Contemporaneous laboratory indices for imputing AAR, APRI, and FIB-4 were identified with liver biopsies. From all, 135 males (61.1%) and 86 females (38.9%), with mean age of 39.6±14.4 were studied. Significant correlation between stages of fibrosis and FIB-4, APRI and AAR were detected, with a correlation coefficient higher than that of other markers in the patients with Hepatitis B (r = 0.46), C (r = 0.58) and autoimmune hepatitis (r = 0.28). FIB-4 (AUROC = 0.84) and APRI (AUROC = 0.78) were superior to AAR at distinguishing severe fibrosis from mild-to-moderate fibrosis and gave the highest diagnostic accuracy. Conclusion: Application of these markers was good at distinguishing significant fibrosis and decreased the need for staging liver biopsy specimens among patients with chronic hepatitis.

The ability to manipulate electromagnetic waves on scales much smaller than the wavelength is of great interest for various applications in device miniaturization, sensing, and nonlinear wave generation. Surface plasmon polaritons provide a natural solution to this problem through localized resonances. Here, we introduce an alternative novel platform to create deeply sub-wavelength hot-spots in periodic arrangements. The localized power is shown to be guided within narrow hollow channels across electro-magnetically thick surfaces composed of complementary low/high impedance electric and magnetic dielectrics. We will discuss physical intuitions on the observed localization phenomenon along with some numerical examples.

Atomically thin lateral heterostructures based on transition metal dichalcogenides have recently been demonstrated. In monolayer transition metal dichalcogenides, exciton energy transfer is typically limited to a short range (~1 μm), and additional losses may be incurred at the interfacial regions of a lateral heterostructure. To overcome these challenges, here we experimentally implement a planar metal-oxide-semiconductor structure by placing a WS2/MoS2 monolayer heterostructure on top of an Al2O3-capped Ag single-crystalline plate. We find that the exciton energy transfer range can be extended to tens of microns in the hybrid structure mediated by an exciton-surface plasmon polariton–exciton conversion mechanism, allowing cascaded exciton energy transfer from one transition metal dichalcogenides region supporting high-energy exciton resonance to a different transition metal dichalcogenides region in the lateral heterostructure with low-energy exciton resonance. The realized planar hybrid structure combines two-dimensional light-emitting materials with planar plasmonic waveguides and offers great potential for developing integrated photonic and plasmonic devices., Exciton energy transfer in monolayer transition metal dichalcogenides is limited to short distances. Here, Shi et al. fabricate a planar metal-oxide-semiconductor structure and show that exciton energy transfer can be extended to tens of microns, mediated by an exciton-surface-plasmon-polariton–exciton conversion mechanism.

We have been investigating light-matter interaction in extreme-parameter structures. We have found that metastructures with unconventional material parameters provide us with unique platforms exhibiting unprecedented classical and quantum metaphotonic features with various potential applications.

Objective: Helicobacter pylori is a main etiological parameter in chronic active gastritis, gastric duodenal ulcers and gastric malignancy. Particular polyunsaturated fatty acids (PUFA) play roles in inhibitory effect on bacterial propagation. Therefore, this study investigated the protective effects of PUFAs against oxidative stress in patient infected with H. pylori with dyspeptic symptom.Methods: This study is a double blind clinical trial whose target population was 34 patients infected with H. pylori with dyspeptic symptom. Patients were divided into two groups. The first group was treated with standard therapy without supplement (control), and the second group was treated with Standard Therapy and PUFAs supplement, ω-3, ω-6 and ω-9 (case group) for 2 weeks. Two biopsies from Antrum and body of stomach of all patients were collected before and after the treatment. The biopsy samples were used for quick urease test and measurement of Superoxide Dismutase, Glutathione Peroxidase, and total antioxidant capacity.Results: In gastric mucosa mean levels of total capacity antioxidant were significantly increased in case group comparing with control group. Also, the mean of superoxide dismutase enzyme activity and glutathione peroxidase activity increased significantly in case group compared with control group (p value

Using atomically smooth epitaxial silver films, new optical permittivity highlighting significant loss reduction in the visible frequency range is extracted. Largely enhanced propagation distances of surface plasmon polaritons are measured, confirming the low intrinsic loss in silver. The new permittivity is free of extrinsic spectral features associated with grain boundaries and localized plasmons inevitably present in thermally deposited films.

Using a suitably designed, ultra-thin graded metasurface, we demonstrate the possibility of hiding an arbitrarily shaped/sized object from an impinging plane wave. The metasurface is tailored to provide an abrupt, inhomogeneous discontinuity to the electromagnetic field that compensates for the unwanted scattering created by the object. The desired field distribution is generated based on the equivalence principle through reconstruction of the electric/magnetic fields at the metasurface location, resembling a flat conducting surface for an external observer. We apply this concept to hide electrically large, cylindrical (two-dimensional, 2-D) and spherical (3-D) domes at optical frequencies and discuss practical cloaking designs for microwave and terahertz regimes. The presented graded metasurface-based cloaks may find interesting applications as low-profile, tunable covers for low observability and noise reduction in wireless commutation systems.

Pemphigus is defined as a group of chronic self-immune vesicular diseases histologically recognized by inter-epidermic vesicles resulting from acantholysis. The aim of this study was to evaluate the precipitant and circulative IgG antibodies in patients with pemphigus vulgaris before and after treating with immunofluorescence. Sixty-two patients (34 females and 28 males) with clinically and pathologically confirmed P.V. were studied prospectively over a one year period of time during which direct and indirect immunofluorescent tests were performed before and after treatment. They had mild or moderate forms of disease. All patients received prednisolon 1-2 mg/kg/day and Azathioprine 2-3 mg/kg/day or methylpredisolon (1 g day(-1) for 4 days) and cyclophosphamide (500 mg/first day) pulse therapy due to general condition. Thirty- four females and 28 males enrolled, the mean age were 39.5 years (SD = 12.7). Before treatment, 10 and 52 cases were positive for skin depositing + or ++) and circulatory IgG (1/20 -1/60), respectively. Two to 3 month later, 37 were IgG positive with titers 1/20 to 1/160. The correlation between circulatory IgG before and after treatment was weakly positive (p = 0.05, r = 0.415). In the present study, treatment methods used for patients suffering from pemphigus vulgaris were not successful in significantly decreasing the circulative autoantibodies levels.

This study was done to investigate the effects of opioid and nitrergic systems on depression in an experimental model of cholestasis in mice, since elevated levels of these substances are seen in cholestatic subjects. Bile duct ligated (BDL) and sham-operated mice were forced to swim individually and the immobility time in the last 4 min of the 6 min test was evaluated to determine the effects of cholestasis on depression. To assess the possible involvement of endogenous opioids and nitric oxide (NO), effective and sub-effective doses of naltrexone an antagonist of opioid receptors, and N-nitro-l-arginine methyl ester (L-NAME) a non-specific NO synthase inhibitor, were administrated acutely and chronically to BDL and Sham-operated mice and then their immobility time was measured in forced swimming test (FST). The immobility time significantly decreased after bile-duct ligation. Naltrexone and L-NAME significantly reversed antidepressant like effect of cholestasis. Co-administration of sub-effective doses of naltrexone and L-NAME also reversed antidepressant effect in FST in chronic administration. But acute drug administration did not reverse the anti-depressant effect of cholestasis. We have shown that elevated levels of endogenous opioids and NO in cholestatic mice induce an anti depressant like effect, causing a reduction in the mice immobility time in FST. And the study also showed the predominant effect of opioid system and NO modulation of that in anti-depressant like effect of cholestasis.

Background and study aims Recent findings introduced APOBEC3G (A3G) as a host factor that blocks viral replication. It induces G to A hypermutations in viral DNA at the step of reverse transcription and in response to interferon. This study aimed to investigate the expression of liver A3G protein in association with both replication of hepatitis B virus (HBV) and frequency of G to A mutations in BCP (basal core promoter)-PC (pre-core) region. Patients and methods Fifty-one liver biopsies of naive chronic hepatitis B (CHB) patients enrolled for the expression of A3G were done by immunohistochemistry (IHC) standard method. The presence of HBV DNA and sequences of BCP-PC region at the time of liver biopsy was investigated in all patients. Results Among 34 patients with detectable HBV DNA, 31 carried 1–5 G to A mutations in the BCP-PC region. IHC results showed that the expression level of A3G in CHB patients’ liver was very low. Of all patients, A3G is expressed in three undetectable HBV DNA subjects and a patient with 2.24 × 10 4 copies ml −1 of HBV DNA. G to A mutated residues were indicated at positions 1727, 1757 and 1896 of the HBV genome of this patient. Conclusion This study indicates that despite very low levels of both A3G in liver and the number of positive subjects, A3G has a potential role to restrict the in vivo replication of HBV.

Relying on abrupt phase discontinuities, metasurfaces characterized by a transversely inhomogeneous surface impedance profile have been recently explored as an ultrathin platform to generate arbitrary wave fronts over subwavelength thicknesses. Here, we outline fundamental limitations of passive gradient metasurfaces in molding the impinging wave and show that local phase compensation is essentially insufficient to realize arbitrary wave manipulation, but full-wave designs should be considered. These findings represent a critical step towards realistic and highly efficient conformal wave manipulation beyond the scope of ray optics, enabling unprecedented nanoscale light molding.

In this work the design of an ultrathin carpet cloak based on a metasurface with ring resonators is demonstrated. The scattering from a triangular bump of a Gaussian beam is suppressed by manipulating the reflection phase along the edge of the bump. This is achieved by an array of closed ring resonators with varying radii. The object to hide can be placed under the bump on a flat ground plane. The performance of the designed cloak in the near field and far field is numerically analyzed at the operation frequency and the successful concealing of the bump is confirmed. The presented cloak has a thin, lightweight design and can find applications in radar and antenna systems.

Gradient metasurfaces have recently received significant attention for the unique opportunities they offer for advanced wave manipulation. Such metasurfaces are usually discrete implementations of surface impedance profiles, which are analytically derived to yield the desired operation. Several recent numerical and experimental studies have shown that gradient metasurfaces can work very well over large bandwidths, extending to frequencies where the definition of surface impedance is not straightforward. Here, we develop an alternative description of such metasurfaces based on coupled-mode theory and provide an explanation for this intriguing effect. Quite surprisingly, our theory shows that broadband anomalous reflection and transmission, does not necessarily require the use of spatial gradients, but they can be achieved through suitably designed periodic arrays of resonant particles. In addition to their theoretical importance, our results can be important for the design of efficient metasurfaces with specified frequency response.

Suppressing the unwanted scattering from an antenna while maintaining its optimal absorption capabilities is desirable in many practical applications. However, traditional techniques to suppress the scattering of a receiving antenna typically come at the price of significantly lowering the absorbed power, and are thus unfavorable for realistic applications. On the contrary, we prove that the proper interference of multiple scattering modes can decouple the constraints on scattering and absorption of a system, opening a new venue to implement an efficient sensor with minimized scattering signature. Here, we theoretically and experimentally present the design of microwave antennas based on overlapped electric and magnetic dipolar modes, observing over 6-dB scattering suppression without sacrificing absorption. The presented technique is of special interest for non-invasive sensing and radar technology.

Here we present the design and numerical results for an ultrathin unidirectional carpet cloak based on the restoration of the phase of the reflected wave. This ultrathin carpet cloak conceals a triangular surface bump with center height of 4.1 mm and tilt angle of 20 deg. The cloaking metasurface consists of an array of closed ring resonators, which allow an efficient phase manipulation along the edge of the bump. The numerical results at operation frequency f0 = 80 GHz demonstrate a good performance of the designed cloak in both near field and far field. The presented cloak has a thin, lightweight, and easy to fabricate design for radio and THz frequencies and can find applications in radar and antenna systems.

Warm-mix asphalt (WMA) technologies aid in reducing mixing and compaction temperatures for asphalt concrete mixtures, allowing for savings in fuel consumption and extending haul distances and construction season. The reduced temperatures also provide a greener technology as emissions are lowered at the plant and the construction site. Engineering and environmental benefits promoted the rapid implementation of WMA technologies, but concerns remain regarding the difference in mixture performance of WMA versus hot-mix asphalt (HMA) because of the changes in the production process, specifically in terms of moisture susceptibility. This case study evaluates moisture susceptibility through the use of laboratory tests including the wet indirect tensile (IDT) strength test, the tensile strength ratio (TSR), and the Hamburg wheel tracking test (HWTT) analyzed with a novel methodology. The performance of two WMA technologies (Evotherm DAT and foaming) versus a control HMA is analyzed with and without antist...

Objective: To study the effect of erythropoietin (EPO) treatment on renal and lung injury following renal ischemia/reperfusion (I/R). Materials and Methods: Thirty male Wistar rats were assigned to three groups of 10 rats each. The first group was sham-operated, the second was subjected to renal I/R (30 min of ischemia followed by 24 h of reperfusion). The third group was subjected to renal I/R and treated with EPO in two doses: the first dose 1 h prior to ischemia (1,000 U/kg) and the second dose 6 h after ischemia (1,000 U/kg). Results: The renal and lung tissue injury index, tissue serum blood urea nitrogen and creatinine (Cr) were higher in the renal I/R group compared to the renal I/R + EPO group; the difference was statistically significant (p < 0.05). Kidney and lung tissue glutathione peroxidase and superoxide dismutase levels were higher in the renal I/R + EPO group than the renal I/R group; the difference was also statistically significant (p < 0.05). Conclusion: The data showed that EPO pretreatment could be effective in reducing renal and lung injury following renal I/R and could improve the cellular antioxidant defense system. Hence EPO pretreatment may be effective for attenuating renal and lung injury after renal I/R-induced injury during surgical procedures, hypotension, renal transplantation and other conditions inducing renal I/R.

Early diagnosis of Gastric adenocarcinoma could increase survival of the patients and also remarkably reduce treatment costs. This study aimed at evaluating the diagnostic value of serum P35 in comparison with tissue P35 in gastric adenocarcinoma and their relationship with microscopic prognostic factors. In this descriptive analytical study, 35 patients (74.3% male and 25.7% female with mean age of 63.00 +/- 12.75 years with gastric adenocarcinoma were evaluated. Blood samples were taken from all patients before gastrectomy to evaluate serum P35 with ELISA method and after surgery tissue samples were gathered to evaluate tissue P35 with immunohistochemical method. The relation between tissue and serum P35 with severity of the disease and microscopic findings was assessed. Tissue P35 was negative in 57.1%, positive in 22.9% and very positive in 20%. Mean serum P35 was 1.34 +/- 0.43 mg dL(-1). There was no relation between serum P35 and adenocarcinoma type, tumor grade, vascular and neurological invasion and number of lymph node involved. Serum P35 levels significantly increased by increase in tissue P35 positivity (p = 0.004). There was significant correlation between tissue P35 and adenocarcinoma type (p = 0.006), neurological involvement (p = 0.04) and number of involved lymph nodes (p = 0.001). Although serum P35 level was higher in cases with more lymph node involvement and vascular and neural invasion, the marker was not capable to predict the involvement degree of stomach cancer. In comparison with serum P35, tissue P35 plays more significant role in these cases.

Background: The influence of Non-Alcoholic Fatty Liver Disease on the outcome of chronic hepatitis B disease, including viral, biochemical and histologic characteristics, in Iranian patients is not yet fully un- derstood. Aim: To evaluate the effect of Non-Alcoholic Fatty Liver Disease (NAFLD) on long-term histology- cal, biochemical and viral outcome of chronic he- pa-tictis B in Iranian patients. Methods: We retro- spec-tively evaluated 94 “e Ag” negative chronic hepatitis B patients (with NAFLD: 44, without NAFLD: 50). Non-Alcoholic Fatty Liver Disease was diagnosed based on liver biopsy according to Kleiner classifica-tion. Liver biopsy was done for all patients. Serologi-cal and biochemical variables were evaluated with repeated measure analysis. Results: Non-Alcoholic Fat- ty Liver Disease (NAFLD) was present in 47% of the patients (44 out of 94 patients). In the NAFLD group, increase in AST, ALT, stage (P = 0.002), grade, and total score of liver biopsy were independently related to non-alcoholic fatty liver disease, while HBV-DNA viral load did not correlate with the presence of a fatty liver. Conclusion: Abnormalities of liver enzymes and liver histopathology are more prevalent in concurrent chronic hepatitis B and Non-Alcoholic Fatty Liver Disease (NAFLD).

Permeable friction courses (PFCs) are popular in Texas, where the current specification for PFC (Item 342) has a maximum aggregate size of 1/2 in. and is typically placed in layer thicknesses of 1.5 to 2 in. In this study fine-graded PFCs composed of a single aggregate fraction are proposed for placement at a nominal thickness of 1 in. Initial laboratory testing found that the target air void content for volumetric design would be around 26% air voids, substantially higher than the current PFC designs, which are between 18% and 22% air voids. To minimize the likelihood of failure, extensive laboratory testing was performed to arrive at the proposed design. Tests included Hamburg wheel-track testing, overlay tester cracking, and Cantabro, draindown, and water flow tests. The proposed fine PFC mix was first placed on a test track in Pecos, Texas. Two designs were placed and subjected to limited traffic loadings, field water flow, noise, and skid measurements. These test sections performed well. The next section was placed on a Texas Department of Transportation project in May 2011 and subjected to extremely intense traffic loading conditions on an exit ramp on US-59 in Lufkin. This ramp has a high frequency of wet-weather accidents. In addition to extreme traffic loads, the surface experienced extreme heat (air temperatures approaching 105°F) and heavy localized rain (a 6-in. rain event within a 24-h period). After 3 months the fine PFC is holding up well.

AIM: To evaluate the impact of combination therapy with Lamivudine and Adefovir for treatment of chronic hepatitis B in Lamivudine-resistant patients. METHODS: Among the 110 adult chronic hepatitis B Iranian patients whom were treated with Lamivudine, for 36 months, nineteen patients (17%) with no any biochemical and viral responses to Lamivudine alone, were selected and enrolled in the study. Due to resistancy, Adefovir was added to Lamivudine, and continued for 30 months. We measured HBV_DNA viral load and serum AST, ALT in 0, 12, 24, 30 and 0, 6, 12, 18, 24, 30 months, respectively. RESULTS: Between biochemical and viral characteristics, Repeated Measure analysis identified just biochemical markers— Aspartate Aminotransferase level (AST) (P = 0.002) and Alanine Aminotransferase level (ALT) (P = 0.007) —as predictors of response to treatment, while, viral marker—HBV DNA load—was not statistically significant (P = 0.128). CONCLUSIONS: Treatment for a long time, such as 21.5 ± 8.8 months, with Lami- vudine and Adefovir, can cause liver enzymes including AST and ALT, decreasing and being normal. But, this finding is not indicative, for HBV-DNA viral load.

Permeable friction course (PFC) mixtures constitute one of the best options for surface paving, since they offer advantages (as compared to dense-graded hot mix asphalt) in terms of safety, economy, and environment. However, mix design and evaluation of PFC mixtures still require improvement and standardization to further promote the reliable use of these mixtures. This paper summarizes an extensive literature review focused on the basic aspects integrated in the mix design and evaluation of PFC mixtures. Although substantial advances related to these topics were reported since implementation of PFC mixtures in the 1990’s, there is still a need for integration of several of these advances in an improved mix design procedure. The paper also identifies areas that require additional research, including the optimization of the balance between mixture functionality and durability and replacement of the indirect assessment of these important aspects.

Permeable friction course (PFC) mixtures, or new-generation open-graded friction course mixtures, are one of the safest and quietest available alternatives for surface paving. Advantages to the use of PFC mixtures are improvements in safety, reduction in environmental impact (e.g., cleaner runoff), and economy. These advantages are closely related to their high total air void (AV) content and aggregate gradation, which confers high permeability and noise reduction properties to PFC mixtures. Research was completed at Texas A&M University to improve PFC mix design. Findings included improved determination of the total AV content through the use of a calculation procedure to obtain the mixture theoretical maximum specific gravity, Gmm, and dimensional analysis to determine the mixture bulk specific gravity, Gmb. Water-accessible AV content was proposed as a surrogate of the total AV content for mix design and evaluation. In addition, the water flow value (outflow time) and the expected value of permeability (E[k]) were recommended, respectively, to assess field drainability and to estimate the permeability of both laboratory- and field-compacted (i.e., road cores) mixtures. The Cantabro loss test was suggested for assessing mixture durability. Furthermore, an improved criterion for verification of stone-on-stone contact for mix design and a field-density control during construction were recommended to guarantee adequate stability and durability. Recommendations to improve fabrication of Superpave® gyratory compactor specimens and sampling of field-compacted mixtures (by using road cores) were included. This set of recommendations was integrated in an improved mix design method for PFC mixtures.

Stone-on-stone contact of the coarse-aggregate fraction is one of the main characteristics of permeable friction course (PFC) asphalt mixtures that is required to provide adequate resistance to both raveling and permanent deformation. Currently, stone-on-stone contact is determined by comparing the air voids content in the coarse aggregate (VCA), assessed in both the dry-rodded condition (VCA DRC ) and the compacted PFC mixture (VCA mix ). The underlying assumption is that the coarse aggregate of a compacted PFC mixture with VCA mix equal to VCA DRC would develop a stone-on-stone contact condition equivalent to that existing in the dry-rodded aggregate. This study focused on proposing enhancements for the quantitative determination of stone-on-stone contact of PFC mixtures. The assessment supported on both laboratory testing and application of the discrete element method and image analysis techniques, led to recommendation of a criterion to determine the breaking-sieve size. In addition, verification of stone-on-stone contact using a maximum VCA ratio of 0.9 was recommended to ensure the design and construction of PFC mixtures with fully developed stone-on-stone contact.

Durability of porous or permeable friction courses (PFC) is an important aspect to address when designing this type of hot mix asphalt. At present, several agencies perform the mix design of PFC primarily by determining volumetric mixture properties. This approach ensures adequate mixture functionality, but it does not guarantee mixture durability. This paper evaluates the Cantabro loss test, the Hamburg Wheel-Tracking test (HWTT) and the Overlay test (OT) to determine the one most appropriate for mix design and laboratory performance evaluations. The Cantabro loss test, performed in both dry and wet conditions, is recommended for PFC mix design to corroborate the suitability of the optimum asphalt content defined based on volumetric determinations. The HWTT and the OT are not recommended, since the variability of the test results indicated that these tests may not be suitable for PFC mixtures.

Introduction Hepatic ischemia/reperfusion (I/R) injury leads to free radical generation and acute inflammatory responses that cause liver damage, an important problem for liver transplantation. Pioglitazone is known to protect I/R injury in various tissues; however, the mechanism of cytoprotection is not well understood. This study investigated the effects of pioglitazone administration in a warm hepatic I/R model on tumor necrosis factor (TNF)-α level, tissue injury, and antioxidant enzyme activity. Materials and Methods Eighty wistar strain rats were divided into 4 groups (n = 20): Group 1 sham hosts; Group 2 hepatic I/R; Group 3 hepatic I/R + pioglitazone (10 mg/kg); and Group 4 hepatic I/R + vehicle. Rat livers were subjected to 30 minutes of ischemia followed by 6 hours of reperfusion. After reperfusion rats were humanely killed to obtain liver tissue to study glutathione peroxidase (GPx), superoxide dysmutase (SOD), malondialdehyde (MDA) levels and for histopathologic assessment. TNF-α, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were measured in serum. Results Pioglitazone pretreatment significantly reduced liver enzyme content (ALT, 176.80 ± 13.75 vs 235.28 ± 31.92 and AST, 748.20 ± 79.29 vs 944.85 ± 101.87) and TNF-α level (9:8.60 ± 8.67 vs 138.28 ± 9.99) after I/R compared with the control group. MDA level (3.02 ± 0.37 vs 4.36 ± 0.38) and hepatocytic degeneration were reduced in the pioglitazone-treated group. GPx (2.40 ± 0.25 vs 1.36 ± 0.31) and SOD activity (2.22 ± 0.30 vs 1.40 ± 0.35) were significantly higher in the pioglitazone-treated group compared with the control group. Conclusion The present study showed that pioglitazone administration improved hepatic I/R injury that was associated with enhanced antioxidant enzyme activities and suppression of TNF-α, ALT, and AST levels. Because peroxisome proliferator-activated receptor-γ agonists are widely used to treat diabetic patients, it may be relatively easy to expand their clinical indication. However, further investigations will be required to delineate protective mechanisms by which pioglitazone attenuates hepatic tissue injury after I/R.