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Context: There are several neoadjuvant treatment strategies for HER2-positive breast cancer (BC). Studies have investigated different aspects of these strategies and presented different findings. Objectives: This study aimed at collecting and interpreting economic evaluation studies related to neoadjuvant treatment strategies for HER2-positive BC. Methods: In this systematic review, PubMed, Web of Science (WOS), ScienceDirect, and Scopus databases were searched without a time limit between May and October 2023. Google Scholar search engine was also used to complete the search process. Two authors independently determined the eligibility of the study. To assess the quality of the studies, the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines were used. Disagreements were resolved by discussion or consultation with a third researcher. As this review is descriptive, numerical data were not extracted for statistical analysis. Results: Out of 234 studies found in the first stage, 21 studies from 14 countries were included. The strategies that have been approved by studies include THP (taxol, trastuzumab, pertuzumab), PTD (Pertuzumab in combination with trastuzumab and docetaxel), TH (docetaxel and trastuzumab), T-DMl (trastuzumab emtansine), and HP (trastuzumab plus pertuzumab). Conclusions: The findings of this systematic review show that the reported strategies in the treatment of HER2-positive BC patients are cost-effective in different settings. While the findings of this review provide largely positive results, the characteristics of each strategy should be considered. [ABSTRACT FROM AUTHOR]

Context: The Balance Error Scoring System (BESS), originally designed to diagnose and assess athletes with concussion syndrome, is now widely used to evaluate postural stability. To inteipret balance status, a normative database can be a reliable source. However, different anthropometric characteristics and sociocultural backgrounds across populations hinder the application of previously developed databases in different populations. Objective: The present study was designed to develop a normative data set for the general population of healthy Iranian adults according to their age groups and to study the correlation between BESS scores and the participants' sex, height, weight, and body mass index. Design: A cross-sectional study. Participants: A total of 1051 community-dwelling adults aged 20-69 years not suffering from balance disorders, dizziness, or other neurological or musculoskeletal diseases were recruited and stratified into 5 different age groups by decade. Main Outcome Measures: The BESS tests were composed of single-leg, double-leg, and tandem stances, each on a rigid surface and a foam pad. The individuals maintained each position for 20 seconds with eyes closed. The assessor recorded the total number of errors as the individuals' BESS score (range: 0-60). Results: Significant but weak correlations were found between BESS score and height (r = -.13, P<.001) and between BESS score and body mass index (r=.11, P<.001), and the difference between sexes in BESS score was statistically significant in the 50- to 59-year-old (P = .021) and 60- to 69-year-old (P<.001) groups. The BESS scores were significantly different between all age groups (P < .05), except between the 20- to 29-year-old and 30- to 39-year-old groups (P - 1.000) and between the 40- to 49-year-old and 50- to 59-year-old groups (P = .086). Conclusions: This study provided a normative database for different age groups of asymptomatic Iranian adults. The BESS score had weak correlations with height and body mass index and no correlation with weight, and significant differences were found between sexes in 50- to 69-year-old individuals. This study emphasizes the importance of obtaining specific normative data for different populations. [ABSTRACT FROM AUTHOR]

Incidence of Malignant Melanoma has become the 5th in the UK. To date, the major anticancer therapeutics include cell therapy, immunotherapy, gene therapy and nanotechnology‐based strategies. Recently, extracellular vesicles, especially exosomes, have been highlighted for their therapeutic benefits in numerous chronic diseases. Exosomes display multifunctional properties, including inhibition of cancer cell proliferation and initiation of apoptosis. In the present in vitro study, the antitumour effect of cord blood stem cell (CBSC)‐derived exosomes was confirmed by the CCK‐8 assay (p < 0.05) on CHL‐1 melanoma cells and improve the repair mechanism on lymphocytes from melanoma patients. Importantly, no significant effect was observed in healthy lymphocytes when treated with the exosome concentrations at 24, 48 and 72 h. Comet assay results (OTM and %Tail DNA) demonstrated that the optimal exosome concentration showed a significant impact (p < 0.05) in lymphocytes from melanoma patients whilst causing no significant DNA damage in lymphocytes of healthy volunteers was 300 μg/ml. Similarly, the Comet assay results depicted significant DNA damage in a melanoma cell line (CHL‐1 cells) treated with CBSC‐derived exosomes, both the cytotoxicity of CHL‐1 cells treated with CBSC‐derived exosomes exhibited a significant time‐dependent decrease in cell survival. Sequencing analysis of CBSC exosomes showed the presence of the let‐7 family of miRNAs, including let‐7a‐5p, let‐7b‐5p, let‐7c‐5p, let‐7d‐3p, let‐7d‐5p and two novel miRNAs. The potency of CBSC exosomes in inhibiting cancer progression in lymphocytes from melanoma patients and CHL‐1 cells whilst causing no harm to the healthy lymphocytes makes it a potential candidate as an anticancer therapy. [ABSTRACT FROM AUTHOR]

Background: A better understanding of the spatial pattern of stomach cancer can be helpful in the implementation of preventive strategies. This study is one of the first studies to establish a study unit based on the smallest possible size for cluster analysis. This study includes a novel evaluation of spatial differences in different geographical areas of Arak. The present study seeks to discover the spatial clusters of stomach cancer from 2009 to 2014 in Arak. Methods: All of the addresses of the stomach cancer cases were geocoded. After that, the number of stomach cancer cases in each census block was calculated to be entered in the SaTScan software. A discrete Poisson-based probability model was used to analyze this cluster. Results: In Arak, there are 5502 census blocks with a population of about 526,182. The number of identified and registered stomach cancer cases with an acceptable residence address was 392. Totally, 11 stomach cancer clusters were established in the area of Arak, from these; two clusters were detected statistically significant. Relative risks of the first and second clusters were 1.75 (P = 0.01) and 17.60 (P = 0.04) and those are located within the radius of 1.73 and 0.085 km, respectively. Conclusions: Our results have confirmed that two areas are at a higher risk than others. However, based on the results of this study, community-based interventions in certain geographical areas can be designed to reduce and control the incidence of stomach cancer. [ABSTRACT FROM AUTHOR]

Enhanced external counterpulsation (EECP) is believed to be a non-invasive treatment for coronary artery disease and angina. The aim of this study was to determine the safety and effectiveness of EECP in refractory angina patients through a systematic reviews and meta-analysis. We conducted a comprehensive search of the literature published on PubMed, Cochrane library, Scopus, Science Direct, Trip Database and Google Scholar databases using appropriate keywords and specific strategy with no time limit. Having selected and screened the studies based on the defined inclusion and exclusion criteria and evaluating their quality based on the Cochrane checklist. For the meta-analysis, the Mantel-Haenszel method or the generic Inverse Variance was used. Analyses were done with Review Manager 5.2 software. A number of 299 studies were initially reviewed and finally, seventeen studies were included in the meta-analysis based on the inclusion and exclusion criteria. Also, thirteen outcomes were analyzed and the results of meta-analysis in twelve outcomes including (Systolic Blood Pressure (7 studies), Diastolic Blood Pressure (7 studies), Pulse Pressure (4 studies), Mean Arterial Pressures (4 studies), Heart Rate (6 studies), Angina episodes (7 studies), Walking distance (2 studies), Canadian Cardiovascular Society classification (6 studies), Flow-Mediated Dilation (3 studies), Daily Nitrate Usage (4 studies), Exercise Treadmill Test-Time (2 studies), ST-segment depression (2 studies) demonstrated a significant clinical advantage in the EECP treatment effectiveness in patients with angina. No significant difference was observed regarding EECP usefulness (P = 0.18) in the outcome of brachial artery diameter (2 studies).Based on the meta-analysis, the results indicate the safety and effectiveness of EECP in patients with angina pectoris and indicate the usefulness of this treatment in these patients. In general, the authors believe that the general conclusion in this regard requires some studies with a large sample size and a control group assignment. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to introduce a new and economical method for reduction of nitrate content in canned apples and pears. Methods: The nitrate content was determined before and after treatment with CaHPO4 ranging from 0.01% to 0.1% using spectroscopic method in 2015 in Pharmaceutical Sciences Research Center, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran-Iran. The effect of treatment time at three different time points (30, 60, 90 min) was determined. Sensory evaluation was performed using five-point hedonic scales. Results: Nitrate content in fresh fruit is significantly (P<0.05) lower than canned products; this may be explained by the effect of water for washing fruits during processing. The mean value of nitrate in canned apples were significantly (P<0.05) higher compared to the canned pears; this may be related to the type of fruits and its texture and composition. Nitrate content of canned apples and pears were decreased from 233.24±24.90 to 128.80±0.423 and 195.11±20.32 to 118.804±0.634 mg/kg, respectively. Different concentration of CaHPO4 did not influence sensory attributes of canned apples while overall acceptance of canned pears decreased only in 0.1% CaHPO4 (P<0.05). The most efficient time for treating by CaHPO4 was 90 min, but the most practical one is recommended 30 min. Addition of CaHPO4 did not change pH of canned samples. Conclusion: Application of CaHPO4 is suggested as a novel, safe and economical method for removal of nitrate in canned products. [ABSTRACT FROM AUTHOR]

Background: During the last decade, the rapid expansion of universal neonatal hearing screening (UNHS) has brought into focus questions about the most appropriate screening technology for this indication. Objectives: The main aim of this study was to examine the cost-effectiveness of automated auditory brainstem response (AABR) and otoacoustic emissions (OAE) in universal neonatal hearing screening programs. Methods: This economic study was performed in Iran. A decision tree model was applied for economic evaluation of the AABR and OAE devices used in UNHS. The main inputs of our model included the prevalence of hearing loss in Iran, device sensitivity, specificity and cost per case, as well as definite diagnosis of each newborn. Upon collection, these inputs were analyzed with TreeAge economic analysis software. Sensitivity analysis was conducted upon examining the probability of uncertainty concerning the inputs. Results: For a one-year period and a one-million population of newborns, the UNHS entails a cost of $3,310,700 and detects 4,650 newborns with hearing loss, using the AABR device. However, if the OAE device is used, the cost will be expanded to $3,414,100 and 3,850 newborns with hearing loss will be detected. Consequently, the AABR device costs $103,400 less than the OAE device, and detects 800 more cases than the OAE device. Sensitivity analysis results revealed that the prevalence rate or costs of the gold standard had no effect on displacing the dominant technology. Conclusions: In this study, it was found that the AABR is the cost-effective alternative compared to OAE. AABR dominates OAE, because it has lower expected costs and higher effectiveness. [ABSTRACT FROM AUTHOR]

Background: Due to increasing clinical demand for adipose tissue, a suitable cell for reconstructive adipose tissue constructs is needed. In this study, we investigated the ability of Human Endometrial-derived stem cells (EnSCs) as a new source of mesenchymal stem cells to differentiate into adipocytes. EnSCs are the abundant and easy available source with no immunological response, for cell replacement therapy.Methods: Single-cell suspensions of EnSCs were obtained from endometrial tissues from 10 women experiencing normal menstrual cycles, and were cultured at clonal density (10 cells/cm2) or limiting dilution. Endometrial mesenchymal stem cellmarkers were examined flow cytometry. These cells were treated with adipogenicinducingmedium for 28 days. The adipogenic differentiation of the EnSC was assessed by cellular morphology and further confirmed by Oil Red O staining and RTPCR.The BM-MSC differentiated into adipocytes in the presence of adipogenicstimuli for 3 weeks.Results: The flow cytometric analysis showed that the cells were positive for CD90,CD105, CD146 and were negative for CD31, CD34.We showed that the key adipocytesmarker PPARa was expressed in mRNA level after 28 days post treatment(PT).Conclusion: According to our finding, it can be concluded that EnSCs represent auseful in vitro model for human adipogenesis, and provide opportunities to study the stages prior to commitment to the adipocyte lineage. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive rehabilitation includes a set of programs to train the brain, which leads to the improvement of mental and neuro-psychological functions. This meta-analysis was conducted with the aim of investigating the effectiveness of cognitive rehabilitation in comparison with routine rehabilitation methods in patients with multiple sclerosis (MS)., Methods: The Cochrane Library, ProQuest, PubMed, PsycINFO, and Web of Science databases were searched from inception to August 2022. Google Scholar was used to find relevant sources and complete the search coverage. Two authors independently selected studies based on predefined inclusion criteria. Data analysis was performed using RevMan (version 5.3)., Results: Out of the 578 studies found, 20 studies were finally included in this review. The results of the meta-analysis on four outcomes (Paced Auditory Serial Addition Test (PASAT), Brief Visuospatial Memory Test (BVMT), MS Neuropsychological Screening Questionnaire (MSNQ), and Beck Depression Inventory (BDI)) indicated that the outcome was significant in favor of the cognitive rehabilitation group. However, for five outcomes (Controlled Oral Word Association Test (COWAT), California Verbal Learning Test (CVLT), Everyday Memory Questionnaire (EMQ), Symbol Digit Modalities Test (SDMT), and Expanded Disability Status Scale (EDSS)), the differences between the two groups were not significant., Conclusion: The results of this meta-analysis showed that cognitive rehabilitation has an effect on improving the performance of patients with MS. However, further studies with more accurate methodologies are required to determine which of the outcomes cognitive rehabilitation has a greater effect on., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s), 2024.)

Context: The Balance Error Scoring System (BESS), originally designed to diagnose and assess athletes with concussion syndrome, is now widely used to evaluate postural stability. To interpret balance status, a normative database can be a reliable source. However, different anthropometric characteristics and sociocultural backgrounds across populations hinder the application of previously developed databases in different populations., Objective: The present study was designed to develop a normative data set for the general population of healthy Iranian adults according to their age groups and to study the correlation between BESS scores and the participants' sex, height, weight, and body mass index., Design: A cross-sectional study., Participants: A total of 1051 community-dwelling adults aged 20-69 years not suffering from balance disorders, dizziness, or other neurological or musculoskeletal diseases were recruited and stratified into 5 different age groups by decade., Main Outcome Measures: The BESS tests were composed of single-leg, double-leg, and tandem stances, each on a rigid surface and a foam pad. The individuals maintained each position for 20 seconds with eyes closed. The assessor recorded the total number of errors as the individuals' BESS score (range: 0-60)., Results: Significant but weak correlations were found between BESS score and height (r = -.13, P < .001) and between BESS score and body mass index (r = .11, P < .001), and the difference between sexes in BESS score was statistically significant in the 50- to 59-year-old (P = .021) and 60- to 69-year-old (P < .001) groups. The BESS scores were significantly different between all age groups (P < .05), except between the 20- to 29-year-old and 30- to 39-year-old groups (P = 1.000) and between the 40- to 49-year-old and 50- to 59-year-old groups (P = .086)., Conclusions: This study provided a normative database for different age groups of asymptomatic Iranian adults. The BESS score had weak correlations with height and body mass index and no correlation with weight, and significant differences were found between sexes in 50- to 69-year-old individuals. This study emphasizes the importance of obtaining specific normative data for different populations.

Peripheral nerve injuries can lead to lifetime loss of function and permanent disfigurement. Different methods, such as conventional allograft procedures and use of biologic tubes present problems when used for damaged peripheral nerve reconstruction. Designed scaffolds comprised of natural and synthetic materials are now widely used in the reconstruction of damaged tissues. Utilization of absorbable and nonabsorbable synthetic and natural polymers with unique characteristics can be an appropriate solution to repair damaged nerve tissues. Polymeric nanofibrous scaffolds with properties similar to neural structures can be more effective in the reconstruction process. Better cell adhesion and migration, more guiding of axons, and structural features, such as porosity, provide a clearer role for nanofibers in the restoration of neural tissues. In this paper, basic concepts of peripheral nerve injury, types of artificial and natural guides, and methods to improve the performance of tubes, such as orientation, nanotechnology applications for nerve reconstruction, fibers and nanofibers, electrospinning methods, and their application in peripheral nerve reconstruction are reviewed.