Search

Background: Significant numbers of patients who undergo major surgery experience postoperative problems, the majority of which are preventable. It has been demonstrated that goal-directed therapy, a method for guiding clinicians in administering fluids, vasopressors, and inotropes, reduces mortality and postoperative complications. However, heart transplant patients were not exclusively investigated. This study focused on patients having heart transplant surgery, which compared the effects of goal-directed versus traditional fluid management. Methods: Goal-directed and standard therapy were examined on 74 patients who had received heart transplantation and were randomly divided into two groups.Using Lidco's CO, CI, SVV, and SVR to track progress toward treatment goals, two groups were compared in terms of fluid repositioning and the use of vasoactive medications.We also compared secondary outcomes like AKI, Cardiac dysrhythmia, CVA, ICU length of stay, and 30-day survival. Results: Both groups had similar baseline characteristics. The goal-directed therapy group had less fluid repositioning. AKI, Cardiac dysrhythmia, CVA, ICU stay, and 30-day survival rates did not differ significantly between the groups; however, Conventional patients spent more time in the ICU. Conclusion: Our data showed that the time spent in the intensive care unit after a heart transplant can be cut in half using GDT. Adverse events occurred in both groups with no statistically significant difference. Preoperative goal-directed therapy needs further well-designed and adequately powered studies.

Familial Mediterranean Fever (FMF) is classified as an autoinflammatory genetic disease inherited by mutations in MEFV. These mutations can affect the dysregulation of inflammatory processes in the human body and lead to fever and pain in the chest and abdomen. Many known missense mutations in MEFV are linked to FMF disease. Mutations in MEFV in most cases are located on the short arm of chromosome 16 and can impair the function of the pyrin protein. In this research, we aimed to examine the entire exons of MEFV for 13 cases (8 females and 5 males) with FMF diagnosis from Southwest Iran. Hence, we amplified and sequenced the exons of MEFV and then, in-silico analysis of detected changes was applied to estimate the probability of pathogenicity for the identified variants. Finally, we found five single nucleotide substitutions, including M694V (c.2080A>G), R202Q (c.605G>A), E447G (c.1430A>G), E148Q (c.442G>C), and V726A (c.2177T>C), in the under-represented patients. The most frequent mutations in our study were R202Q (38.46%) within exon 2 and M694V (30.7%) within exon 10. Other mutations accounted for a further 23% of the alleles, including E477G (7.6%), E148Q (7.6%), and V726A (7.6%). According to the in-silico analyses, including variation pathogenicity, protein structure, and allele frequency assessments, we concluded that all these variants could be considered in FMF molecular profiling in southwest Iran.

Consider a matching problem, in which agents arrive to a marketplace over time and leave after some time periods. Agents can only be matched while present in the marketplace. Each pair of agents can yield a different match value, and a social planner seeks to maximize the total value from matches over a finite time horizon. First we study the case in which vertices arrive in an adversarial order. For the case when agents depart in the order of arrival, we provide a randomized [Formula: see text]-competitive algorithm. When departure times are drawn independently from a distribution with nondecreasing hazard rate, we establish a [Formula: see text]-competitive algorithm. When the arrival order is chosen uniformly at random and agents leave after a fixed number of time periods, a batching algorithm, which computes a maximum-weighted matching periodically, is shown to be 0.279-competitive.

In this paper, the novel Schiff base ligand containing quinoline moiety and its novel copper chelate complexes were successfully prepared. The catalytic activity of the final complex in the organic reaction such as synthesis of chiral benzimidazoles and anti-HIV-1 activity of Schiff base ligand and the products of this reaction were investigated. In addition, green chemistry reactions using microwaves, powerful catalyst synthesis, green recovery and reusability, and separation of products with economic, safe, and clean methods (green chemistry) are among the advantages of this protocol. The potency of these compounds as anti-HIV-1 agents was investigated using molecular docking into integrase (IN) enzyme with code 1QS4 and the GROMACS software for molecular dynamics simulation. The final steps were evaluated in case of RMSD, RMSF, and Rg. The results revealed that the compound VII exhibit a good binding affinity to integrase ( Δ g = −10.99 kcal/mol) during 100 ns simulation time, and the analysis of RMSD suggested that compound VII was stable in the binding site of integrase.

In the last few years, using chemical insecticides to control the malaria vector has caused environmental pollution and resistance to chemical insecticides. This study aimed to investigate the chemical analysis of essential oils of Thymus carmanicus Jalas by gas chromatography and mass spectrometry (GC-MS) and toxicity activity against the major Iranian malaria vector, Anopheles stephensi. The essential oil of Thymus carmanicus Jalas was prepared from dried leaves using the hydro-distillation method. Gaschromatography-mass spectrometer (GC-MS) was used to analyze and identify thyme essential oil compounds. Bioassay was performed using World Health Organization (WHO) standard test. The T. Carmanicus Jalas essential oil consisted of 15 compounds, with Carvacrol (61%), Thymol (6%), and β-caryophyllene (5%) being the major components by volume. The LC50 and LC90 of thyme oil were 20.37 and 41.38 ppm at 24h after application, respectively. At 24h after application, significant differences were observed between the toxicity of 5%, 20%, 25%, 40%, 50%, and 80% concentrations of Thyme essential oil (P

Background: Septal reduction therapy (SRT) in patients with intractable symptoms from obstructive hypertrophic cardiomyopathy (oHCM) is associated with variable morbidity and mortality. The VALOR-HCM trial (A Study to Evaluate Mavacamten in Adults with Symptomatic Obstructive Hypertrophic Cardiomyopathy Who Are Eligible for Septal Reduction Therapy) examined the effect of mavacamten on the need for SRT through week 32 in oHCM. Methods: A double-blind randomized placebo-controlled multicenter trial at 19 US sites included patients with oHCM on maximal tolerated medical therapy referred for SRT with left ventricular outflow tract gradient ≥50 mm Hg at rest or provocation (enrollment, July 2020–October 2021). The group initially randomized to mavacamten continued the drug for 32 weeks, and the placebo group crossed over to dose-blinded mavacamten from week 16 to week 32. Dose titrations were based on investigator-blinded echocardiographic assessment of left ventricular outflow tract gradient and left ventricular ejection fraction. The principal end point was the proportion of patients proceeding with SRT or remaining guideline eligible at 32 weeks in both treatment groups. Results: From the 112 randomized patients with oHCM, 108 (mean age, 60.3 years; 50% men; 94% in New York Heart Association class III/IV) qualified for week 32 evaluation (56 in the original mavacamten group and 52 in the placebo cross-over group). After 32 weeks, 6 of 56 patients (10.7%) in the original mavacamten group and 7 of 52 patients (13.5%) in the placebo cross-over group met SRT guideline criteria or elected to undergo SRT. After 32 weeks, a sustained reduction in resting left ventricular outflow tract gradient (−33.0 mm Hg [95% CI, −41.1 to −24.9]) and Valsalva left ventricular outflow tract gradient (−43.0 mm Hg [95% CI, −52.1 to −33.9]) was observed in the original mavacamten group. A similar reduction in resting (−33.7 mm Hg [95% CI, −42.2 to −25.2]) and Valsalva (−52.9 mm Hg [95% CI, −63.2 to −42.6]) gradients was quantified in the cross-over group after 16 weeks of mavacamten. After 32 weeks, improvement by ≥1 New York Heart Association class was observed in 48 of 53 patients (90.6%) in the original mavacamten group and 35 of 50 patients (70%) after 16 weeks in the cross-over group. Conclusions: In severely symptomatic patients with oHCM, 32 weeks of mavacamten treatment showed sustained reduction in the proportion proceeding to SRT or remaining guideline eligible, with similar effects observed in patients who crossed over from placebo after 16 weeks. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04349072.

Objective: Considerable variation in primary spontaneous pneumothorax (PSP) management exists in the pediatric population. This study aims to compare nationwide outcomes of children with PSP. Methods: The Nationwide Readmissions Database (2016 to 2018) was used to identify patients 1 to 18 years old with PSP. Trauma, secondary pneumothoraces, and elective admissions were excluded. Demographics and complications were compared among patients undergoing initial nonoperative management (NOM; observation or percutaneous drainage) or operative resection using standard statistical tests. Results: A total of 3,890 patients were identified with PSP (median age, 16 [interquartile range 14 to 17] years). Most (78%) underwent NOM, of which 17% failed requiring operative resection. Of the intent-to-treat cohort, 28% failed NOM during index admission or required repeat percutaneous drainage or operative resection on readmission. Patients treated by NOM had higher 30-day and overall readmission rates compared with operative resection (all P < 0.001). Ipsilateral recurrent pneumothorax was higher in those receiving NOM (13% vs 3%, P < 0.001). Patients from the lowest median household income quartile more frequently received NOM compared with the highest income quartile (82% vs 76%) with more readmissions. Conclusions: Patients with PSP who underwent initial NOM experienced higher readmission rates than those receiving operative resection. Furthermore, socioeconomic status was associated with the utilization of nonoperative versus operative management.

Deep ocean passages are advantageous sites for long-term monitoring of deep transport and other physical properties relevant to climate. Rotating hydraulic theory provides potential for simplifying monitoring strategy by reducing the number of quantities that need to be measured. However, the applicability of these theories has been limited by idealizations such as restriction to zero or uniform potential vorticity (pv) and to channels with rectangular cross sections. Here the relationship between the flow characteristics in a canonical sea strait and its upstream condition is studied using uniform pv rotating hydraulic theory and a reduced-gravity shallow-water numerical model that allows for variation in pv. The paper is focused mainly on the sensitivity of the hydraulic solution to the strait geometry. We study the dynamics of channels with continuously varying (parabolic) cross sections to account for the rounded nature of sea-strait topographies and potentially improve monitoring strategies for realistic channel geometries. The results show that far enough from the channel entrance, the hydraulically controlled flow in the strait is insensitive to the basin circulation regardless of parabolic curvature. The controlled transport relation is derived for the case of uniform pv theory. Comparing the model to theory, we find that the measurement of the wetted edges of the interface height at the critical section can be used to estimate the volume flux. Based on this finding, we suggest three monitoring strategies for transport estimation and compare the estimates with the observed values at the Faroe Bank Channel. The results showed that the estimated transports are within the range of observed values. Significance Statement The paper investigates the relationship between the flow characteristics in an idealized sea strait and its upstream condition using rotating hydraulic theory and numerical modeling. We study the dynamics of channels with continuously varying (parabolic) cross sections to account for the rounded nature of sea-strait topographies and potentially improve monitoring strategies for realistic channel geometries. We suggest three monitoring strategies for transport estimation and apply the methods to the Faroe Bank Channel. Our estimates of dense water transport are within the range of observed values. This is significant, because the suggested monitoring strategies only require 1–3 measurements to estimate the transport at a given passage and can be used to guide observing systems.

Background: Considering the effect of heart disease and its post-surgical complications on the patient's quality of life, identifying risk predictors for complications after surgery and the patient's clinical course can help us to improve the quality of primary care after surgery, reduce complications and improve the patient's recovery after surgery. This study aims to determine postoperative complication prevalence and related risk predictors. Material and methods: In this cross-sectional study, the clinical course after cardiac reoperation of patients in the cardiac operating room of Imam Khomeini Hospital during the years 2014-2021was studied. Patients who have had a stroke in the past six months, heart failure, and EF less than 25% were excluded from the study. This study investigates the relationship between preoperative and intraoperative conditions of patients (age, sex, hemoglobin, serum creatinine, blood product transfusion, and pump time) and postoperative complications (death, AKI, bleeding, CVA, and pulmonary complication. Results: This study examined 461 cardiac reoperation patients with a mean age (44.54±18.35). The most common complications were bleeding (8.24%), death (8.2%), and AKI (19.65$), respectively. In this study, there was a significant difference in terms of age, hemoglobin level, creatinine level, pump time, and blood product transfusion in patients faced with death and AKI compared to uncomplicated patients. Patients with postoperative bleeding received more blood products and had a longer pump time than uncomplicated patients, which was statistically significant. Conclusion: In this study, there was a significant difference between deceased and uncomplicated patients after cardiac reoperation in terms of age, anemia, pre operative renal failure, and receiving more blood products during surgery. This difference, however, does not necessarily create a causal relationship; but suggests some risk predictors for redo cardiac surgery.

COVID-19; SARS-CoV-2 infection; Heart failure COVID-19; Infección por SARS-CoV-2; Insuficiencia cardiaca COVID-19; Infecció per SARS-CoV-2; Insuficiència cardíaca Aims To describe the natural history of SARS-CoV-2 infection in patients with hypertrophic cardiomyopathy (HCM) compared with a control group and to identify predictors of adverse events. Methods and results Three hundred and five patients [age 56.6 ± 16.9 years old, 191 (62.6%) male patients] with HCM and SARS-Cov-2 infection were enrolled. The control group consisted of 91 131 infected individuals. Endpoints were (i) SARS-CoV-2 related mortality and (ii) severe clinical course [death or intensive care unit (ICU) admission]. New onset of atrial fibrillation, ventricular arrhythmias, shock, stroke, and cardiac arrest were also recorded. Sixty-nine (22.9%) HCM patients were hospitalized for non-ICU level care, and 21 (7.0%) required ICU care. Seventeen (5.6%) died: eight (2.6%) of respiratory failure, four (1.3%) of heart failure, two (0.7%) suddenly, and three (1.0%) due to other SARS-CoV-2-related complications. Covariates associated with mortality in the multivariable were age {odds ratio (OR) per 10 year increase 2.25 [95% confidence interval (CI): 1.12–4.51], P = 0.0229}, baseline New York Heart Association class [OR per one-unit increase 4.01 (95%CI: 1.75–9.20), P = 0.0011], presence of left ventricular outflow tract obstruction [OR 5.59 (95%CI: 1.16–26.92), P = 0.0317], and left ventricular systolic impairment [OR 7.72 (95%CI: 1.20–49.79), P = 0.0316]. Controlling for age and sex and comparing HCM patients with a community-based SARS-CoV-2 cohort, the presence of HCM was associated with a borderline significant increased risk of mortality OR 1.70 (95%CI: 0.98–2.91, P = 0.0600). Conclusions Over one-fourth of HCM patients infected with SARS-Cov-2 required hospitalization, including 6% in an ICU setting. Age and cardiac features related to HCM, including baseline functional class, left ventricular outflow tract obstruction, and systolic impairment, conveyed increased risk of mortality. The project was funded by a grant from the Instituto de Salud Carlos III (ICSIII, COV20 00420). We should state that the SHaRe registry has been supported by an unrestricted grant from MyoKardia/Bristol Myers Squibb.

In the EXPLORER-HCM trial, mavacamten improved exercise capacity and symptoms in patients with obstructive hypertrophic cardiomyopathy (oHCM). Mavacamten effects on the primary endpoint, a composite of peak oxygen consumption (VOSubgroup analyses by beta-blocker use were performed in patients with oHCM from the EXPLORER-HCM and mavacamten long-term extension (MAVA-LTE) studies. In EXPLORER-HCM, 189 patients (75.3%) were receiving beta-blockers, and 62 (24.7%) were receiving non-dihydropyridine calcium-channel blockers or no background HCM medication; 170 patients (90.4%) receiving beta-blockers had chronotropic incompetence. Improvements in peak VOMavacamten improved measures of functional capacity, LVOT obstruction, symptom burden and biomarkers in patients with HCM regardless of beta-blocker use. Beta-blocker use was often associated with chronotropic incompetence, affecting peak VO

Due to the COVID-19 pandemic, numerous institutions converted medical education didactics to electronic formats including both live teleconference didactics and recorded faculty lectures. This study aims to compare the effect of recorded versus live teleconference didactic lectures on medical student examination scores during the surgery clerkship.Medical students completing the Surgery Clerkship received a weekly series of didactic lectures taught by faculty via a teleconference (2020-2021 academic year) or recorded format (2021-2022 academic year). Performance outcomes included weekly quizzes, National Board of Medical Examiners (NBME) Surgery Shelf Exam, and clerkship Objective Structured Clinical Examination (OSCE) scores.University of Miami Miller School of Medicine.All second- (MS2) and third-year (MS3) medical students completing the Surgery Clerkship over two academic years (n = 312).Students who received live teleconference lectures (n = 156) demonstrated higher average scores on weekly quizzes (89%) and the NBME shelf exam (76%) compared to those receiving recorded lectures (n = 156; 71% quiz, 70% shelf exam), both p0.001. There was a significant association with performance in the highest quartile (Q1) of weekly quiz scores and receiving live lectures (40% vs. recorded lectures 1%, p0.001). Comparing only MS3 students, mean weekly quiz scores and Q1 achievement were significantly higher (both p0.001) in the teleconference cohort with no significant difference in NBME shelf exam performance (p = 0.971). No difference in OSCE performance was observed between groups.These results suggest that synchronous teleconferences may be more effective than recorded lectures for achieving institutional learning objectives on the surgery clerkship without any negative impact on NBME shelf exam or clinical evaluation parameters. This information should be used to inform future institutional clerkship design and educational initiatives.

fractal analysis of viscous fingering of a reactive miscible flow displacement in homogeneous porous media is investigated and multifractal spectrum, and fractal dimension are introduced as two essential features to characterize the irregularity of finger patterns. The Reaction of the two reactant fluids generates a miscible chemical product C in the contact zone. Considering the similarity between chemical products and coastline, monofractal and multifractal analyzes are performed. In monofractal analysis, the box-counting method is implemented on binary images and in multifractal analysis, due to the image processing; the fractal characteristics of viscous fingering instability are analyzed by means of fractal quantities such as Holder exponent, multifractal spectrum, f (α)-image and fractal dimension dynamics. Fractal analysis shows that the fractal dimension increases with time. Also, by considering five different nonlinear simulations, the results show that in the case both sides of the chemical product C are unstable, the multifractal spectrum curve has the highest peak, which means the more complex finger patterns lead to more values of fractal dimension. In addition, a comparison between different values of Ar is conducted and the results show similar behavior. However, small value of aspect ratio leads to a broader width of the multifractal spectrum curve. Furthermore, f (α)-images of concentration contour were investigated for different precisions and some undetectable finger patterns were observed in these images. It can be concluded that the use of f (α)-image represents more detailed image than concentration contours.

Lean individuals with nonalcoholic fatty liver disease (NAFLD) represent a subset of patients with a distinct risk factor profile. We assessed the association between body mass index (BMI) on waitlist and postliver transplantation (LT) outcomes among these patients. We retrospectively analyzed the United Network for Organ Sharing data, including adult patients with NAFLD listed for LT between February 27, 2002, and June 30, 2020. We first used competing risk analyses to estimate the association of BMI with waitlist removal due to death or clinical deterioration. We then conducted Kaplan-Meier estimates and Cox regression models to determine the impact of weight change during the waiting list on all-cause mortality and graft failure after LT. Patients with normal weight (BMI 18.5-24.9 kg/m

Study aim: The purpose of this study was to investigate the impact of speed-based strategy instruction on motor sequence learning and transfer. Material and methods: Male participants (n = 30, 18 to 24 years old) were assigned to one of the groups based on instruction. Motor sequence learning was examined using the complex dynamic arm movement task. Two sets of speed and control instructions completed ten blocks of 100 trials in the acquisition phase followed by the retention and transfer test after 24 hours. Results: Mixed analysis of variance (2×10 and 2×4) and the independent samples t-test were used to examine the data. The results demonstrated that element response time and error of prediction in both groups were significantly improved in the acquisition phase (P < 0.05), but in the 24-hour retention test, the speed group had a significantly better element response time than the control group (P < 0.05). Furthermore, the findings of the independent samples t-test in the transfer test revealed that element duration and error rate were significantly better in the speed group than the control group (P < 0.05). Conclusions: According to the data, when compared to the conventional technique, in which participants were not given any special instructions, the speed-based instruction resulted in greater acquisition of the acquired motor sequence and better transfer of a new sequence.

We aim to study the association between state child access prevention (CAP) and overall firearm laws with pediatric firearm-related mortality.The Centers for Disease Control and Prevention Web-based Injury Statistics Query and Reporting System was queried for pediatric (aged18 y) all-intent (accidental, suicide, and homicide) firearm-related crude death rates (CDRs) among the 50 states from 1999 to 2019. States were into three groups: Always CAP (throughout the 20-year period), Never CAP, and New CAP (enacted CAP during study period). We used the Giffords Law Center Annual Gun Law Scorecard (A, B, C, D, F) to group states into strict (A, B) and lenient (C, D, F) firearm laws. A scatter plot was constructed to display state CDR based on CAP laws by year. The top 10 states by CDR per year were tabulated based on CAP law status. Wilcoxon rank-sum was used to compare CDR between strict and lenient scorecard states in 2019.There were 12 Always CAP, 21 Never CAP, and 17 New CAP states from 1999 to 2019. No states changed from CAP laws to no CAP laws. Never CAP and New CAP states dominated the high outliers in CDR compared to Always CAP. The top 10 states with the highest CDR per year were most commonly Never CAP. Strict firearm laws states had lower median CDR in 2019 than lenient states (0.79 [0-1.67] versus 2.59 [1.66-3.53], P = 0.007).Stricter overall gun laws are associated with three-fold lower all-intent pediatric firearm-related deaths. For 2 decades, the 10 states with the highest CDR were almost universally those without CAP laws. Our findings support the RAND Gun Policy in America initiative's claims on the importance of CAP laws in reducing suicide, unintentional deaths, and violent crime among children, but more research is needed.

The authors opinions in physiology books are different on some issues, and this mixes up the readers. The purpose of this article is to clarify the differences between two examples in renal physiology (the autoregulation and the reabsorption of the materials in the proximal tubule) to help better understand; therefore, this paper is especially beneficial for medical students. The latest editions of several physiology books are used in this study including Brenner and Rector›s "The Kidney", Seldin and Giebisch’s "The Kidney Physiology and Pathophysiology", Koeppen Stanton›s "Renal Physiology", Vander’s "Renal Physiology", Boron’s "Medical Physiology", Ganong’s "Review of Medical Physiology", Rose’s "Clinical Physiology of Acid-Base and Electrolyte Disorders", "Renal Pathophysiology: the Essentials" by Rennke and Denker, "Color Atlas of Physiology", "Renal Physiology: a Clinical Approach", and "Medical Physiology" by Guyton. It is concluded that the two above-said methods, in general, adopt similar approaches. However, there are some differences in terms of details that are explained and clarified in this study.

Background: Idiopathic granulomatous mastitis (IGM) is a rare benign breast disease that mostly occurs in reproductive ages in parous women. Hormonal, autoimmune, and microbial causes have been implicated as causes. We carried out this prospective study to investigate the reproductive factors and underlying disease states in IGM. Methods: This study was conducted in two phases. In the first phase, we evaluated the reproductive factors, anthropometric parameters and past medical histories of participants of an ongoing multicentric clinical trial. In the second phase, we performed an extensive review of the literature for studies that had considered patients with a histologic-proven diagnosis of IGM without date limitations, and extracted the data about parity, breastfeeding, oral contraceptive pill use and past medical histories. We then carried out a meta-analysis. Results: Data of 123 patients were included. The mean age was 35.11±7.07 years, and the mean body mass index was 27.41±4.74. Overall, %93.8, 90.27% and 28.7% of patients were parous, had breastfed, and had used OCP, respectively. Hypothyroidism represented the most common (18.94%) previous medical disease. We included 89 studies in our search. Considering these studies and ours, the pooled prevalence of rates of parity, breastfeeding and oral contraceptive pill consumption were 96%, 89%, and 29%; and the pooled prevalence of hypothyroidism, diabetes and hypertension were 9%, 5% and 5%, respectively. Although not exactly comparable, these rates of hypothyroidism were higher than those reported in women in the general population (4.2% in one large study in Iran). Conclusion: Our study suggests a possible relation between a past history of hypothyroidism and IGM. We propose a study that investigates the occurrence of IGM in some large cohorts of healthy women, and the retrospective assessment of thyroid tests in the primary serum samples.

Mineralogical information is becoming increasingly important for the interpretation and prediction of the long-term leaching behavior of mine waste rock and tailings, yet the collection of quantitative mineralogical data for these materials is complicated by biases introduced during sample preparation. Here, we present experiments with synthetic reference materials, soluble mineral (gypsum) and pulverized weathered waste rock samples to investigate potential artifacts that can be introduced during the preparation of granular sample specimen for quantitative mineralogical analysis. Our results show that, during epoxy-molding, particle segregation due to size is more important than that due to density, both of which can be effectively circumvented by cutting molds perpendicular to the orientation of settling. We also determine that sacrificing sample polish to avoid phase alteration need not impede phase attribution as long as surface roughness and slope are calibrated with sample-internal contrast references. Finally, bootstrapping analysis shows that variability in geometric and mineralogical particle parameters due to unresolved sample heterogeneity is small compared with other biases, even at particle numbers 150 µm. Our results demonstrate the importance of quantifying potential sources of error during sample preparation in quantitative mineralogical studies on mine wastes.

Objectives: According to Persian medicine (PM), the uterus is an important organ in women, responsible for purifying the blood and nourishing the fetus. Each organ has a specific temperament distinct from the whole-body temperament based on PM. Dystemperament occurs when body or organ Mizaj (Persian word for temperament) deviates from what is considered normal, resulting in malfunction. Many gynecological disorders described in PM and conventional medicine, including infertility, recurrent miscarriage, oligomenorrhea/amenorrhea, hypermenorrhea, vaginitis, cervicitis, urinary incontinence, and pelvic pain, are considered to be associated with uterine dystemperaments. Hence, proper management of such disorders requires precise diagnosis and treatment of uterine dystemperaments. Accordingly, this review study aimed to collect and categorize these symptoms from PM texts and other relevant articles. Methods: In this study, we reviewed 10 well-known PM references, including Canon in Medicine (Al-Qanun Fi al-Teb), the Great Panacea (Exir-e A’zam), the Treasure of Kharazmshah (Zakhireh Kharazmshahi), the Perfect Book of the Art of Medicine (Kamel alSana’a al-Tebbiya), Akbari’s Medicine (Tebb-E-Akbari), Gharshi’s Commentary on Canon of Medicine (Sharh-e Qarshi bar Qanun), Commentary on Hippocrates’ Aphorisms (Sharh-e Fosul-e Boqraat), Summary of Experiences (Kholasa-tut Tajarob), Description of Signs and Symptoms (Sharh-e Asbab va Alamat), and Aghili’s Treatments (Mo’alejat-e Aghili). Moreover, Scopus, PubMed, Web of Science, SienceDirect, and Google Scholar databases were queried with the keywords ‘mizaj’, ‘temperament’, ‘uterus’, ‘uterine’, ‘cold/hot or warm’, and ‘dry/wet’, while Persian databases of Magiran, Iran Medex, and SID were searched using keywords ‘mizaj’, ‘rahem’, ‘garm’, ‘sard’, ‘tar’, and ‘khoshk’ to extract signs and symptoms associated with uterine temperament and dystemperament. Results: Five indicators were specified in the articles and PM sources for determining the temperament and dystemperament of the uterus as follows: 1) Menstrual blood characteristics (including amount, temperature, color, odor, flow rate, and consistency); 2) Uterine discharge characteristics (including amount, consistency, color, odor, and accompanied symptoms, especially burning and itching); 3) Fertility and pregnancy status (including infertility, abortion, etc.); 4. Other characteristics of the female reproductive system (including pubic hair, menarche age, sexual desire and quality of intercourse, and vaginal and cervical condition on vaginal examination); and 5) General symptoms (including the ten PM indicators of whole-body Mizaj). Conclusions: PM sources have described the characteristics of uterine temperament and dystemperament in detail. These indices can be used for more effective diagnosis, treatment, and even prevention of gynecological diseases, as well as designing and validation of standard tools for determining uterine temperament and dystemperament.

Vinyl acetate (VA) is a volatile compound and the main compound of the carpenter’s glue. VA causes upper respiratory tract irritation, cough, and hoarseness in occupational exposure. As Iran is one of the biggest carpet producers in the world, this study was carried out to determine the inhalational health risk for employees exposed to VA. To the best of our knowledge, this was the first health risk assessment and the first evaluation of the lung functions and respiratory symptoms in employees exposed to VA. In the six finishing shops of carpet manufacturing industry in Kashan city, Iran the cross-sectional studies were conducted in 2022. The subjects comprised of forty male employees exposed to VA and of forty non-exposed employees in the reference group. VA analyses in the workers’ breathing zones were performed based on the National Institute for Occupational Safety and Health (NIOSH) 1453 Method. VA concentrations were measured using Gas Chromatography-Mass Spectrometry (GC–MS). Inhalational risk assessment to VA was performed using the United States Environmental Protection Agency method and the Monte Carlo simulations. Respiratory functions were determined using the spirometry indices. In the exposed employees, considerably higher prevalence rates of pulmonary symptoms were observed in comparison with the control group. Statistical analysis showed a remarkable difference between lung function parameters measured in the case and the control groups. The VA Hazard Quotient (HQ) values for all working posts, except the quality control unit, were > 1 indicating the substantial inhalational non-cancerogenic risk. The sensitivity analysis revealed that the VA concentrations and exposure time had the most significant contribution in the uncertainty assessment. Therefore, it is recommended to decrease exposure to VA concentrations and to reduce the working time of exposed employees.

Biological biocides have the potential to reduce plant biotic stresses and boost development, but they tend to be unstable and degrade quickly. BCAs inhibit plant diseases and enhance crop productivity while being eco-friendly. Encapsulation research has increased in recent decades in response to the growing need for BCAs. These formulations can address the difficulties of free-form formulations. They can improve the efficacy of BCAs by prolonging their shelf life and offering the controlled release of biological components. Using a novel approach, they can be a potential platform for controlling biotic stressors, especially plant pathogens. Chitosan and alginate are two important biopolymers with great potential in enclosing BCAs. These can also be used alone for encapsulation, but their application in composite form eliminates the disadvantages of using them alone. However, several other biopolymers have significant roles in formulating BCAs, such as gums, gelatin, starch, and pectin. Given the amazing potential of these new formulations, this comprehensive review highlights more recent developments about encapsulating BCAs based on nano and micro-materials and their appliances in reducing plant biotic stressors. These prospects might provide the foundation for future opportunities to expand the efficacy and application BCAs by formulation technologies to combat plant pathogens.

Gastrostomy tube (GT) placement for enteral access is one of the most common procedures for infants with numerous conditions such as congenital heart disease (CHD). Discrepancies in the literature exist regarding outcomes of newborns with CHD undergoing GT placement. This study sought to characterize postoperative outcomes and readmission complications in this patient population.The Nationwide Readmission Database was queried from 2010 to 2014 for all newborns who underwent GT placement during their index hospitalization. Newborns with or without CHD other than an isolated atrial or ventricular septal defect were compared using standard statistical tests. A propensity score-matched analysis was performed among newborns with or without CHD using100 covariates.Seven thousand seven hundred thirty six patients underwent GT placement. Newborns with CHD (27%) more frequently underwent open GT (59% versus 55%) and less frequently underwent laparoscopic (17% versus 19%) or percutaneous (24% versus 26%) GT placement compared to those without CHD, P = 0.043. GT-related complications on index admission were similar between groups (7% versus 7%, P = 0.770). Newborns with CHD had higher overall readmission rates (39% versus 31%), more GT-related readmission complications (7% versus 3%), and higher readmission costs ($35,787 versus $20,073) compared to newborns without CHD, all P 0.001. Laparoscopic GT was associated with the lowest rate of GT-related complications (0%) and overall readmission rates (27%) compared to open or percutaneous endoscopic gastrostomy (all P 0.001).Compared to newborns without CHD, newborns with CHD had higher rates of overall readmissions, readmission costs, and GT-related complications on readmission. The laparoscopic GT approach was underused despite fewer complications and readmissions.

In this study, A reinforced concrete (RC) reference specimen with compressive strength of 250 kg/cm 2 and the weak RC specimen for seismic rehabilitation with compressive strength of 150 kg/cm2 were examined in two types of structures with 6 and 12-stories. The link beam lengths of 50, 80, and 100 cm have been used in 6 and 12-stories prototypes under the effect of 7 earthquake records. The nonlinear dynamic analyses are performed. Then, The behavior of the link beam depends on its length. For short link beam lengths, shear behavior is serious, then for medium lengths, shear-flexural behavior is important, and finally, long lengths will have flexural behavior for the beam. In eccentrically braced frames, the details of the link beam and the fit of the other members must be done in such a way as to ensure its proper ductility. According to the obtained results, the performance of short link beams is much better than long link beams, and short link beams provide more energy dissipation and, at the same time, more ductility. Therefore, in the design of the link beam, mainly the shear of the link beam is considered as a ductile component. The axial force in the link beam, which is due to the application of lateral load to the structure, reduces both the bending capacity and the inelastic deformation capacity of the link beam, so it can be explained that in steel eccentric braces, the link beam is symmetrical between the two main components of the brace and it can affect the strength of the structure against lateral loads.

'Smart' bandages based on multimodal wearable devices could enable real-time physiological monitoring and active intervention to promote healing of chronic wounds. However, there has been limited development in incorporation of both sensors and stimulators for the current smart bandage technologies. Additionally, while adhesive electrodes are essential for robust signal transduction, detachment of existing adhesive dressings can lead to secondary damage to delicate wound tissues without switchable adhesion. Here we overcome these issues by developing a flexible bioelectronic system consisting of wirelessly powered, closed-loop sensing and stimulation circuits with skin-interfacing hydrogel electrodes capable of on-demand adhesion and detachment. In mice, we demonstrate that our wound care system can continuously monitor skin impedance and temperature and deliver electrical stimulation in response to the wound environment. Across preclinical wound models, the treatment group healed ~25% more rapidly and with ~50% enhancement in dermal remodeling compared with control. Further, we observed activation of proregenerative genes in monocyte and macrophage cell populations, which may enhance tissue regeneration, neovascularization and dermal recovery.