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Sepsis-associated acute kidney injury (AKI) is highlighted by high incidence of mortality and morbidity. Scutellarin is a flavone extracted from certain medicinal plants with anti-inflammatory and anti-oxidative properties. This research study was done to investigate the beneficial effect of scutellarin on lipopolysaccharide (LPS) murine model of AKI.Five groups of mice were used including control (without LPS injection), LPS group (LPS injection, 10 mg/kg), and LPS + Scutellarin25, 50, and/or 100 groups (receiving scutellarin orally at different doses of 25, 50, or 100 mg/kg before LPS injection).Scutellarin pretreatment effectively lowered kidney function markers (BUN, creatinine, and cystatin C), improved superoxide dismutase (SOD) besides enhancement of level, and/or gene expression for nuclear factor (erythroid-derived 2)-like 2 (Nrf2) and heme oxygenase 1 (HO-1) and also reduced oxidative stress factors including reactive oxygen species (ROS) and malondialdehyde (MDA). In addition, scutellarin reduced tissue level and/or gene expression of inflammatory markers comprising toll-like receptor 4 (TLR4), nuclear factor-kappaB (NF-κB), and tumor necrosis factor α (TNF-α) and properly raised anti-inflammatory factor IL-10. Moreover, scutellarin enhanced mitochondrial membrane potential (MMP) and attenuated histopathological changes in renal tissue subsequent to LPS challenge. Beneficial effects of scutellarin was associated with improvement of gene expression regarding peroxisome proliferator-activated receptor gamma (PPARγ) and its coactivator PGC-1α as specific markers of mitochondrial biogenesis.These results indicate that scutellarin could protect against LPS-provoked AKI through restraining inflammation and oxidative stress and maintenance of mitochondrial health and biogenesis which is partly mediated through its regulation of Nrf2/PPAR-γ/PGC-1α/NF-kB/TLR4.

Proton irradiations are highly sensitive to spatial variations, mainly due to their high linear energy transfer (LET) and densely ionizing nature. In realistic clinical applications, the targets of ionizing radiation are inhomogeneous in terms of geometry and chemical composition (i.e., organs in the human body). One of the main methods for proton range monitoring is to utilize the production of proton induced positron emitting radionuclides; these could be measured precisely with positron emission tomography (PET) systems. One main positron emitting radionuclide that could be used for proton range monitoring and verification was found to be 13N that produces a peak close to the Bragg peak. In the present work, we have employed the Monte Carlo method and Spectral Analysis (SA) technique to investigate the feasibility of utilizing the 13N peak for proton range monitoring and verification in inhomogeneous targets. Two different phantom types, namely, (1) ordinary slab and (2) MIRD anthropomorphic phantoms, were used. We have found that the generated 13N peak in such highly inhomogeneous targets (ordinary slab and human phantom) is close to the actual Bragg peak, when irradiated by incident proton beam. The feasibility of using the SA technique to estimate the distribution of positron emitter was also investigated. The current findings and the developed tools in the present work would be helpful in proton range monitoring and verification in realistic clinical radiation therapy using proton beams.

The Preeclampsia (PE) molecular mechanisms are not fully revealed and different biological processes are involved in the pathogenesis of PE. We aimed to evaluate adenosine and hypoxia-related signaling molecules in PE patients in the current study.Decidua tissue and peripheral blood samples were taken from 25 healthy pregnant and 25 PE women at delivery time. CD39, CD73, and Hypoxia-inducible factor-alpha (HIF-α) were evaluated in mRNA and protein level using real-time PCR and western blotting techniques, respectively. Also, miR-30a, miR-206, and miR-18a expression were evaluated by real-time PCR. At last, secretion levels of IGF and TGF-β in the taken serum of blood samples were measured by ELISA.Our results revealed that Expression of CD39 is decreased in PE cases versus healthy controls at mRNA and protein levels (p = 0.0003 for both). CD73 and HIF-α showed an increased level of expression in PE patients at RNA and protein status (p = 0.0157 and p 0.0001 for protein evaluation of CD73 and HIF-α, respectively). The miRNA-30a (p = 0.0037) and miR-206 (p = 0.0113) showed elevated expression in the decidua of the PE group. The concentration of secreted IGF-1 (p = 0.0002) and TGF-β (p = 0.0101) in serum samples of PE cases compared to the healthy group were decreased.In conclusion, our results showed that aberrant expression of molecules that are involved in ATP catabolism and the hypoxic conditions is observed in PE cases and involved in their hypertension and inflammation could be served as PE prognosis by more confirming in comprehensive future studies. miR-206 and miR-30a play a role by regulating CD39 and CD73 as molecules that are involved in ATP catabolism as well as regulating the production of IGF-1 in the process of hypertension, which is the main feature in patients with preeclampsia. On the other hand, decreased level of miR-18a lead to upregulation of HIF-1a, and the consequence condition of hypoxia increases hypertension and inflammation in these patients.

Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): EU-HORIZON 2020-International Training Network H2020-MSCA-ITN-2017. Background Continuous ambulatory AV-optimization for Cardiac Resynchronization Therapy (CRT) is mainly performed by electrical means. Objective Develop an estimation model of cardiac function that uses feedback from a piezoelectric transducer embedded in an internal pulse generator to guide CRT optimization. Methods During implantation procedures measurements were performed of left ventricular pressure (LVP) and heart sound waveforms, the latter using the piezoelectric alarm transducer of the device in 22 CRT patients at atrioventricular (AV)-delays of 60-330 ms. Post-hoc, machine learning (ML) was employed to produce models that use heart-sound based features to estimate cardiac function in terms of maximum LVP (LVPmax) and the maximum positive derivative of LVP (LVdP/dtmax). Polynomial curve fitting was used to compare estimated and measured AV-delays with highest LVPmax and LVdP/dtmax. Results The figure displays the concept of the study and an example of the measured and estimated optimization curve. With a dataset of ~30,000 beats, ML provided three most suitable features. Using LVPmax, ML-based estimated optimal AV-delays were not significantly different from measured ones (-5.6 ± 17.1ms for LVPmax and +5.1 ± 46.7ms for LVdP/dtmax). The difference in function between the estimated and measured optimal AV-delays was small and not statically significant (1 ± 3mmHg for LVPmax and 9 ± 57mmHg/s for LVdP/dtmax). Conclusion Heart sound sensors in devices in combination with ML provide a reliable assessment of absolute LVPmax and LVdP/dtmax and may be used for continuous optimization of AV-delays in CRT patients.

Background: People with multiple sclerosis ‎(MS) and their physicians recognize cognitive retention as an important desired outcome of disease-modifying Iranian MS experts regarding the treatment approach toward clinical cases with different physical and cognitive conditions. Methods: Opinions of 20 MS specialists regarding the best approach to 6 case scenarios (with different clinical, cognitive, and imaging characteristics) were gathered via a form. Results: The estimated kappa of 0.16 [95% confidence interval (CI): 0.159-0.163; P < 0.001] suggested a poor degree of agreement on the treatment choice among the professionals. Conclusion: Although most specialists agreed with treatment escalation in cases with cognitive impairment, there was no general agreement. Furthermore, there was not enough clinical evidence in the literature to develop consensus guidelines on the matter.

Lung allocation in the US changed nearly 15 years ago from time accrued on the waiting list to disease severity and likelihood of posttransplant survival, represented by the lung allocation score (LAS). Notably, the risk of death within a year plays a stronger role on the score calculation than posttransplant survival. While this change was associated with the intended decrease in waitlist mortality (most recently reported at 14.6%), it was predictable that transplant teams would have to care for increasingly older and complex candidates and recipients. This urgency-based allocation also led centers to routinely consider transplanting patients with higher acuity, often hospitalized and, not infrequently, in the intensive care unit (ICU). According to the Scientific Registry for Transplant Recipients, from 2009 to 2019, the proportion of lung recipients hospitalized and those admitted to the ICU at the time of transplant increased from 18.9% to 26.8% and from 9.2% to 16.5%, respectively..

A novel fuzzy cellular automata is proposed to simulate bone degradation during osteoporosis. The initial three-dimensional (3D) bone microstructure is obtained from computed tomography (CT) images. Cellular automata algorithm is implemented to the 3D lattice and a Sugeno Fuzzy inference system is designed with nine sets of fuzzy rules to simulate the degradation process. A distance vector parameter is defined to describe the number of neighborhood cells that each cell can have a connection with. It is shown that by increasing the value of this distance vector, the results converge toward a quasi-constant degraded microstructure. The obtained microstructure is considered to be the final result and compared to prediction of bone degradation of the literature based on phase exchange calculated from mechanical strain energy. It is shown that the fuzzy cellular automata model predicts a more realistic bone degradation and microstructure distribution than the phase exchange method while having a model significantly simpler.

Objective: The purpose of this article was to systematically review the existing articles on entrepreneurial marketing and organizational entrepreneurship of small and medium enterprises. Research Design & Methods: For this purpose, English research related to the keywords entrepreneurial marketing, impact, organizational entrepreneurship and small and medium enterprises were searched in Elsevier, Emerald and Springer databases for the period 2018-2021. In the meantime, 12 related articles were extracted and studied. Findings: The results of this study showed that the dimensions of entrepreneurial marketing improve organizational entrepreneurship indicators in small and medium enterprises. Implications & Recommendations: Entrepreneurial marketing is one of the marketing strategies of small and medium enterprises that helps them grow through entrepreneurship. In fact, entrepreneurial marketing translates important aspects of marketing and entrepreneurship into a comprehensive conceptualization in which marketing becomes the method that firms use to do entrepreneurship. Contribution & Value Added: This article reviewed 12 most recent published articles in terms of entrepreneurial marketing and organizational entrepreneurship to pave the way of finding latest information in this regard.

One of the most key areas of dentistry is dental implant surgery. The use of digital equipment and software in dentistry has developed considerably in recent years compared to other fields of medicine. Since examining the advantages and disadvantages of each approach, along with case studies, can help physicians make informed decisions, this review study aims to raise the awareness of dentists to make easier decisions about using guided or free-hand surgery. When planning for a dental implant, one of the most challenging questions that doctors face is which method to use (guided surgery or free-hand). Choosing the right method, such as other clinical considerations, will depend on the individual circumstances of each patient and the preference of the treating physician. Free-hand surgery is a cost-effective method in which the flap is reflected, and, according to the doctor's diagnostic information, an implant is placed, which in many cases is a useful method. Guided surgery has the highest level of accuracy and control, in which osteotomy is designed and printed through a digital surgery guide, and depending on the complexity of the case and the patient's anatomy, it has a higher level of value than free surgery. The surgical guide helps the surgeon make the implant surgery more accurate, safer, simpler, at a lower cost, and in less time. In fact, there are patterns that convey information about the position of the tooth to the dentist before the implant is placed.

The Miandoab Plain has the largest water reserve in the province of West Azerbaijan, northwest Iran. Groundwater resources along with surface-water meet the needs of urban, industrial, and agricultural sectors, and therefore, their quality should be examined. Water quality indices are useful tools for aquifer management. In this research, the groundwater quality of the Miandoab Plain for agricultural purposes was investigated. For this purpose, the concentrations of the ions Mg2+, Ca2+, Na+, Hco3-, So42-, Cl- and the pH level were measured. The indices effective salinity and potential salinity as well as sodium adsorption ratio and electrical conductivity were analyzed to evaluate the salinity. The geostatistical analysis was performed using the GS+ software, and the zoning maps of salinity hazard were prepared using ArcGIS. To prepare the maps, EC, ES, PS, and SAR as well as Mg2+, Ca2+, Na+, Hco3-, So42, and Cl- were selected based on the semi-variogram values ​​and cross-validation technique. The Cl- map was considered as the basis for preparing the groundwater quality maps of the region. The results showed that the groundwater quality in the east of the plain is suitable, in the central part can be recommended under constant supervision, and in the west is unsuitable for agriculture. In other words, according to the geography of the plain, the recharge area is the low-risk part of the plain and the salinity hazard increases toward the discharge area. The results can pave the way for the relevant organizations to plan for the agricultural and environmental sectors.

Background Vestibular schwannoma is an extra-axial, benign tumor that is mostly located in the cerebellopontine angle. The goal of vestibular schwannoma surgery is gross total resection of the tumor along with preservation of the cranial nerves’ function. Intraoperative nerve monitoring is mainly rewarding in VS surgery. Method This study was observed prospectively from 2011–2021. Patients were divided into two groups; group one 19 patients underwent resection of the tumor with intraoperative neuromonitoring and group two without neuromonitoring based on patients’ ability to economically afford neuromonitoring. In the neuromonitoring group, SSEP is evaluated and recorded throughout the whole surgery. MEP is recorded at regular intervals as well. In this study, we benefit from the cooperation of a trained neurophysiologist. We compare tumor size, hemorrhage volume during surgery, length of surgery, and facial nerve preservation (HB score), with the follow-up of 1* year (0, 2, 6 months, 1y). Result FN anatomical preservation rate in the neuromonitoring group was 100% and in the control group was 75%. The rate of GTR in patients operated on using neuromonitoring was 78.9%. The rate of STR and PR in procedures without neuromonitoring was 50.0% and 12.5% respectively. In 100% of patients with intraoperative neuromonitoring, the HB level was evaluated as good. 68.8% of patients without neuromonitoring had poor HB. Conclusion IONM in VS surgery helps increase anatomical nerve preservation rate and facial nerve outcome. The value of coordination of an anatomically trained neurophysiologist along with real-time video-assisted nerve monitoring is to avoid and lower any delay in nerve recognition.

Introduction: Accompaniment of meningioma with other tumors especially cerebral tumors is quite rare. In some institutes, cases of simultaneous meningioma and glioma are seen and reported previously. Case Presentation: We reported a meningioma with the accompaniment of scalp basal cell carcinoma (BCC) with no signs and symptoms of Gorlin syndrome and no history of radiation. Conclusions: Expression of some adjacent cancerous lesions might have a local cancerous induction effect.

Conventional muscle-machine interfaces like Electromyography (EMG), have significant drawbacks, such as crosstalk, a non-linear relationship between the signal and the corresponding motion, and increased signal processing requirements. In this work, we introduce a new muscle-machine interfacing technique called lightmyography (LMG), that can be used to efficiently decode human hand gestures, motion, and forces from the detected contractions of the human muscles. LMG utilizes light propagation through elastic media and human tissue, measuring changes in light luminosity to detect muscle movement. Similar to forcemyography, LMG infers muscular contractions through tissue deformation and skin displacements. In this study, we look at how different characteristics of the light source and silicone medium affect the performance of LMG and we compare LMG and EMG based gesture decoding using various machine learning techniques. To do that, we design an armband equipped with five LMG modules, and we use it to collect the required LMG data. Three different machine learning methods are employed: Random Forests, Convolutional Neural Networks, and Temporal Multi-Channel Vision Transformers. The system has also been efficiently used in decoding the forces exerted during power grasping. The results demonstrate that LMG outperforms EMG for most methods and subjects.

Crown fractures are a common type of traumatic dental injury. Various factors may affect the outcome of crown fractures. This study aimed to evaluate the treatment outcomes of immature teeth with a crown fracture.This retrospective cohort study included patients who presented to a dental trauma center from 2008-2018 with a history of a crown fracture of immature teeth and at least 6 months of follow-up. Outcomes of primary endodontic or restorative interventions as well as reinterventions were evaluated. Kaplan-Meier curves were used to compare the unadjusted differences in survival time. Logistic and Cox regression analyses were performed to identify potential predictors for complication and survival time, respectively.The success rates of the primary interventions for 99 teeth (72 patients) after a median follow-up of 22 months were as follows: cervical pulpotomy (90.4%), partial pulpotomy (85.2%), mineral trioxide aggregate apical barrier (80.0%), root canal treatment (66.6%), and only restoration (47.2%). Teeth that received vital pulp therapy were less prone to complications (adjusted hazard ratio = 0.21; 95% confidence interval, 0.09-0.53; P .05), whereas those with concomitant luxation injuries were more susceptible to complications (adjusted odds ratio = 2.90; 95% confidence interval, 1.01-8.29; P .05).Crown fractures had a relatively high favorable prognosis. Vital pulp therapy (partial or cervical pulpotomy) had the highest success rate, whereas cases that received only restoration had the lowest success rate. Teeth with concomitant luxation injuries had more odds and hazards of complications.

Metastatic carcinomas are more prevalent in the vertebrae and epidural spaces than in the intradural and intramedullary spinal cord. Although thyroid carcinomas seldom induce intramedullary spinal cord metastases, no evidence has been presented to prove that pure follicular thyroid carcinomas can generate these metastases. In this case, a man in his late 30s who had undergone lymphadenectomy, thyroidectomy, and radioactive iodine therapy developed spastic paraparesis and urine retention. Owing to the patient's aggressive clinical presentation with intramedullary metastasis, an initial tumor biopsy was performed to determine the histology of the tumor. Following an unexpectedly negative first biopsy, the patient underwent thorough tumor excision, the histopathology of which revealed a metastatic pure thyroid follicular carcinoma. Hence, it is imperative that all patients with pure follicular thyroid cancer who have developed acute neurological symptoms, regardless of how long they have been in remission, be immediately evaluated for intramedullary spinal cord metastases.

The proto-diastolic third heart sound (S3) is observed in various hemodynamic conditions in both normal and diseased hearts. We propose a novel, one-degree of freedom mathematical model of mechanical vibrations of heart and blood that generates the third heart sound, implemented in a real-time model of the cardiovascular system (CircAdapt). To examine model functionality, S3 simulations were performed for conditions mimicking the normal heart as well as heart failure with preserved ejection fraction (HFpEF), atrioventricular valve regurgitation (AVR), atrioventricular valve stenosis (AVS) and septal shunts (SS). Simulated S3 showed both qualitative and quantitative agreements with measured S3 in terms of morphology, frequency, and timing. It was shown that ventricular mass, ventricular viscoelastic properties as well as inflow momentum play a key role in the generation of S3. The model indicated that irrespective of cardiac conditions, S3 vibrations are always generated, in both the left and right sides of the heart, albeit at different levels of audibility. S3 intensities increased in HFpEF, AVR and SS, but the changes of acoustic S3 features in AVS were not significant, as compared with the reference simulation. S3 loudness in all simulated conditions was proportional to the level of cardiac output and severity of cardiac conditions. In conclusion, our hemodynamics-driven mathematical model provides a fast and realistic simulation of S3 under various conditions which may be helpful to find new indicators for diagnosis and prognosis of cardiac diseases.

In the present study, Fe(II)-based MOF (Fe-BTC, BTC = 1,3,5-benzentricarboxylate) was synthesised via a chemical method and then synthesised hybrid polyorthoaminophenol (POAP)/Fe-BTC films by elect...

This paper presents an analytical solution for free-vibration and stability analyses of hybrid-composite toroidal shells. The considered hybrid material incorporates the composition of fibers and n...

BackgroundAcute exacerbations of interstitial lung diseases (AE-ILD) have a high mortality rate with no effective medical therapies. Lung transplantation is a potentially life-saving option for patients with AE-ILD, but its role is not well established. The aim of this study is to determine if this therapy during AE-ILD significantly affects post-transplant outcomes in comparison to those transplanted with stable disease.MethodsWe conducted a retrospective study of consecutive patients with AE-ILD admitted to our institution from 2015 to 2018. The comparison group included patients with stable ILD listed for lung transplant during the same period. The primary end-points were in-hospital mortality for patients admitted with AE-ILD and 1-year survival for the transplanted patients.ResultsOf 53 patients admitted for AE-ILD, 28 were treated with medical therapy alone and 25 underwent transplantation. All patients with AE-ILD who underwent transplantation survived to hospital discharge, whereas only 43% of the AE-ILD medically treated did. During the same period, 67 patients with stable ILD underwent transplantation. Survival at 1 year for the transplanted patients was not different for the AE-ILD group versus stable ILD group (96% vs 92.5%). The rates of primary graft dysfunction, post-transplant hospital length-of-stay and acute cellular rejection were similar between the groups.ConclusionPatients with ILD transplanted during AE-ILD had no meaningful difference in overall survival, rate of primary graft dysfunction or acute rejection compared with those transplanted with stable disease. Our results suggest that lung transplantation can be considered as a therapeutic option for selected patients with AE-ILD.