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Abstract Artificial intelligence computing adapted from biology is a suitable platform for the development of intelligent machines by imitating the functional mechanisms of the nervous system in creating high-level activities such as learning, decision making and cognition in today's systems. Here, the concentration is on improvement the cognitive potential of artificial intelligence network with a bio-inspired structure. In this regard, four spiking pattern recognition platforms for recognizing digits and letters of EMNIST, patterns of YALE, and ORL datasets are proposed. All networks are developed based on a similar structure in the input image coding, model of neurons (pyramidal neurons and interneurons) and synapses (excitatory AMPA and inhibitory GABA currents), and learning procedure. Networks 1–4 are trained on Digits, Letters, faces of YALE and ORL, respectively, with the proposed un-supervised, spatial–temporal, and sparse spike-based learning mechanism based on the biological observation of the brain learning. When the networks have reached the highest recognition accuracy in the relevant patterns, the main goal of the article, which is to achieve high-performance pattern recognition system with higher cognitive ability, is followed. The pattern recognition network that is able to detect the combination of multiple patterns which called intertwined patterns has not been discussed yet. Therefore, by integrating four trained spiking pattern recognition platforms in one system configuration, we are able to recognize intertwined patterns. These results are presented for the first time and could be the pioneer of a new generation of pattern recognition networks with a significant ability in smart machines.

Background: Patients with chronic liver failure (CLF) faced serious medical conditions including the oral cavity. Objective: To investigate the prevalence of oral mucosal lesions, saliva flow rate, and dental complications in candidates of liver transplant surgery. Methods: In this cross-sectional study, oral and dental health of 77 patients with CLF and 77 healthy individuals were assessed for oral mucosal lesions, salivation rate, DMFT (decayed, missing, filled teeth) index, and bone level. To carefully determine the indices and examine the patients thoroughly, a panoramic radiography was also taken from each participant. Results: The frequency of oral mucosal lesions in patients was significantly (p<0.001) higher than the comparison group. The most frequent lesion identified was angular cheilitis followed by candidiasis. The mean saliva flow rate in the patients (0.85 g/min) was also significantly (p<0.001) lesser than that in healthy individuals (1.58 g/min). The DMFT index and bone level were not significantly different between the two groups. Nor was a correlation between the MELD score and each of DMFT index, bone loss, or oral mucosal lesions. Conclusion: Mucosal lesions, especially fungal-related lesions, are more prevalent in the oral cavity of patients with CLF. The saliva production rate is reduced due to various medications used in this group. Patients with CLF are prone to oral infections and a thorough oro-dental examination is crucial in this group of patients. Vigorous oral hygiene instructions should be offered to liver cirrhosis individuals. [ABSTRACT FROM AUTHOR]

Purpose: Utilizing Electroencephalogram (EEG) is more than at any time in history, therefore we have introduced an open-source MATLAB function to provide simulated EEG which is as equivalent as viable to empirical EEG in a user-friendly way with ground truth that is not accessible in real EEG records. This function should be versatile due to the requirements such as the number and orientation of sources, various noises, mode of activation function, and different anatomical structures. Materials and Methods: We indicate all phases, modes, and formulas which constitute EEGg, EEG generator. This function supports selecting main sources locations and orientation, choosing SNR with white Gaussian noise, electrode numbers, and mode of activation functions. Also, users have the option to use automatic or partly automatic, or fully automatic EEG construction in EEGg. This function is ready to use at https://github.com/Avayekta/EEG. Results: EEGg is designed with several parameters that users have chosen. Hence, users can choose different variables to inspect the time and frequency aspects of synthetic EEG. Conclusion: EEGg is a multi-purpose and comprehensive function to mimic EEG but with ground-truth EEG data and adjustable parameters.

Background:Pseudomonas aeruginosa is the most common microorganism found in the sputum culture of Cystic fibrosis (CF) patients causing the pulmonary destruction. Aminoglycosides have a low diffuse rate from lipid membranes, and respiratory system secretions. Regarding the burden of pulmonary exacerbation caused by the pseudomonas aeruginosa in cystic fibrosis patients in the long term and the limited number of clinical trials focused on appropriate treatment strategies, the present study evaluated the concurrent inhaled and intravenous aminoglycoside antibiotics for pulmonary exacerbation caused by the pseudomonas aeruginosa as a safe and effective treatment in children.Method: This study was a blinded, randomized clinical trial phase conducted in a tertiary referral pediatric teaching hospital from May 2021 to May 2022. The patients were randomly allocated to receive intravenously administered ceftazidime and Amikacin alone or with inhaled Amikacin. Forced expiratory volume (FEV1), Amikacin via the level, kidney function tests, audiometry, inflammatory markers (erythrocyte sedimentation rate and C-reactive protein), hospital stay, and bacterial eradication rate were compared in two therapy groups.Results: the average FEV1 has increased by 47% in Neb + group compared to Neb− group following treatment. Hospital stay was lower in Neb + group. No renal toxicity or ototoxicity was observed in both therapy groups. Pseudomonas aeruginosa eradication rate Neb− and Neb + groups were 44% and 69%, respectively (p-value = 0.15).Conclusion: Concurrent inhaled and intravenous Amikacin is safe and effective to treat Pseudomonas aeruginosa exacerbation in CF patients. Moreover, co-delivery antibiotics’ route treatment increased the eradication rate. Although not statistically significant, never the less, it is clinically relevant. The intervention reduced the length of hospitalization in this group.Clinical Trial Registration:clinicaltrials.gov, identifier [IRCT20120415009475N10].

Background: The bidirectional brain-machine interfaces algorithms are machines that decode neural response in order to control the external device and encode position of artificial limb to proper electrical stimulation, so that the interface between brain and machine closes. Most BMI researchers typically consider four basic elements: recording technology to extract brain activity, decoding algorithm to translate brain activity to the predicted movement of the external device, external device (prosthetic limb such as a robotic arm), and encoding interface to convert the motion of the external machine to set of the electrical stimulation of the brain. New method: In this paper, we develop a novel approach for bidirectional brain-machine interface (BMI). First, we propose a neural network model for sensory cortex (S1) connected to the neural network model of motor cortex (M1) considering the topographic mapping between S1 and M1. We use 4-box model in S1 and 4-box in M1 so that each box contains 500 neurons. Individual boxes include inhibitory and excitatory neurons and synapses. Next, we develop a new BMI algorithm based on neural activity. The main concept of this BMI algorithm is to close the loop between brain and mechaical external device. Results: The sensory interface as encoding algorithm convert the location of the external device (artificial limb) into the electrical stimulation which excite the S1 model. The motor interface as decoding algorithm convert neural recordings from the M1 model into a force which causes the movement of the external device. We present the simulation results for the on line BMI which means that there is a real time information exchange between 9 boxes and 4 boxes of S1-M1 network model and the external device. Also, off line information exchange between brain of five anesthetized rats and externnal device was performed. The proposed BMI algorithm has succeeded in controlling the movement of the mechanical arm towards the target area on simulation and experimental data, so that the BMI algorithm shows acceptable WTPE and the average number of iterations of the algorithm in reaching artificial limb to the target region.Comparison with existing methods and Conclusions: In order to confirm the simulation results the 9-box model of S1-M1 network was developed and the valid “spike train” algorithm, which has good results on real data, is used to compare the performance accuracy of the proposed BMI algorithm versus “spike train” algorithm on simulation and off line experimental data of anesthetized rats. Quantitative and qualitative results confirm the proper performance of the proposed algorithm compared to algorithm “spike train” on simulations and experimental data.

Purpose: A new code based on Helmholtz decomposition is presented to separate longitudinal (pressure) and transverse (shear) components of a mixed wave field. This algorithm will help isolate shear or pressure components of an elastic wave to further concentrate on each specific wave and its physical characteristics, particularly in medical imaging instrument development and image processing techniques. Materials and Methods: Using the combination of Fourier transform and Helmholtz decomposition, first, the mathematical basis of the work is prepared. After reaching a usable formula, this basis is embedded in the Code written in MATLAB program. Then, various test data containing shear and pressure waves were created and fed to the Code to evaluate its ability to decompose the displacements into the shear and pressure waves. Results: This new algorithm successfully isolated the transverse and longitudinal wavefront of the mixed wavefield. The Code demonstrated 100% accuracy for separating the shear wave and more than 99% for the pressure wave. Moreover, the background noise was kept under 0.03% in every step. Conclusion: The results show that using Helmholtz decomposition in Fourier space on 3D data can help decompose a displacement field into its irrotational and solenoidal components with high accuracy. A weak dependency on wave thickness and contrast was observed, but the algorithm's accuracy never fell below 99%.

Background and Importance: Fracture-dislocation of the thoracic or lumbar spine (traumatic spondyloptosis) occurs in less than 5% of all spinal injuries mainly affecting the ventral direction. Case Presentation: A paraplegic young man was admitted to Shahid Kamyab Hospital in Mashhad City, Iran due to a motor vehicle accident. Computerized tomography (CT) showed a complete posterior dislocation of the T10 vertebral body on T9, with the superior articular processes of T9 bilaterally locked in the inferior endplate of T10 and complete fractures of the posterior elements. Conclusion: The spinal dislocation was re-aligned by a combination of Harrington fixation and pedicular screws leading to spinal fusion. Six months after surgery, the patient was still paraplegic but the sensory symptoms in the lower extremities and clean intermittent catheterization improved.

Elastography is an imaging technique with the ability to determine low quantities of some of the mechanical properties of tissues. The aim of our research is to design a new 3D algorithm using the Shifted Fourier Transform (SFT) to perform a quasi-static elastography. Our innovative idea is implementation of a 3D convolution instead of using three 2D convulsions. At first, we collected the raw data from Abaqus engineering software in the form of breast tissue with a coefficient of elasticity of healthy tissue and tumor tissue with a coefficient of elasticity of tumor tissue. The primary raw data consists of a number of points with x, y and z specified for tumor and healthy breast tissue. At this step, we simulated the displacements in directions of x, y and z at each point of the prescribed tissues for 15 ​mm displacement of probe in –Y direction then we collected 1831 points for tumor and 4186 points for breast before and after pressure. After applying a novel reconstruction algorithm, we convolved all images with the 3D Gabor filters to obtain phases, represented displacements of the breast and tumor images for before and after pressure. To reach this goal, we designed a Gabor filter bank based on the dimensions of the input images in different scales, directions, and deviations. Using the 3D SFT, we calculated the displacements of the breast and tumor tissues followed by 3D elastogram representation of the images. Finally, we implemented a 2D analysis of SFT in order to investigate validation of the 3D SFT. In 2D algorithm, we used three two-dimensional convulsions in XY, YZ and XZ planes. The results obtained from the small displacements marked by circles, confirmed the accuracy of the 3D SFT algorithm. These areas of interest are the tumor areas in the 2D analysis.

PurposeVentilator-Associated Pneumonia (VAP) is one of the most common nosocomial infections in the Pediatric Intensive Care Unit (PICU). Using new strategies to prevent nosocomial infections is crucial to avoid antibiotic resistance. One of these strategies is the utilization of probiotics. This study aims to investigate the efficacy of probiotic prophylaxis in preventing VAP in mechanically ventilated children.MethodThis study was a randomized, double-blind clinical trial. The study included 72 children under 12 years of age under mechanical ventilation for more than 48 h in the Mofid Children's Hospital. Patients were randomly divided into Limosilactobacillus reuteri DSM 17938 probiotic recipients (n = 38) and placebo groups (n = 34). In addition to the standard treatment, both groups received a sachet containing probiotics or a placebo twice a day. Children were screened for VAP based on clinical and laboratory evidence.ResultsThe mean age of children in the intervention and placebo groups was 4.60 ± 4.84 and 3.38 ± 3.49 years, respectively. After adjusting the other variables, it was observed that chance of VAP among probiotics compared to the placebo group was significantly decreased (OR adjusted = 0.29; 95% CI: 0.09–0.95). Also, probiotic was associated with a significantly lower chance of diarrhea than the placebo group (OR adjusted = 0.09; 95% CI: 0.01–0.96).ConclusionProbiotic utilization is effective in preventing the incidence of VAP and diarrhea in children under mechanical ventilation in the PICU.

Background: Hospitalized infants and children are usually treated with many medications in the hospital. Concurrent use of multiple drugs, known as polypharmacy, is inevitable in critically ill patients. This study aims to investigate the possible interactions as well as their type and number, and their effect on the treatment process plus the duration of hospital stay of patients. Methods: In this descriptive study, the medical records of 189 patients admitted to the ICU ward of Mofid Children's Educational Hospital in Tehran were prospectively studied over six months. The collected data included disease diagnosis, patient medication information, age and gender, and treatment interventions. Interactions between drugs were identified using Up-to-date database, with the results analyzed by SPSS software. Results: The results revealed that hospitalization increased with an increasing number of drugs. The findings also indicated a direct relationship between the number of drug interactions and the duration of hospital stay. After examining the relationship between intensive care unit (ICU) outcome and the number of drug items as well as the number of drug interactions, it was found that there is a direct relationship between the two. There was also a direct relationship between Class D plus X interactions and mortality rate along with duration of stay. Conclusion: This study showed a direct relationship between drug interactions and the duration of hospitalization. In other words, as drug interactions increased, so did the duration of hospital stay.

Background: Brain source imaging based on electroencephalogram (EEG) data aims to recover the neuron populations’ activity producing the scalp potentials. This procedure is known as the EEG inverse problem. Recently, beamformers have gained a lot of consideration in the EEG inverse problem. Objective: Beamformers lack acceptable performance in the case of correlated brain sources. These sources happen when some regions of the brain have simultaneous or correlated activities such as auditory stimulation or moving left and right extremities of the body at the same time. In this paper, we have developed a multichannel beamformer robust to correlated sources. Material and Methods: In this simulation study, we have looked at the problem of brain source imaging and beamforming from a blind source separation point of view. We focused on the spatially constraint independent component analysis (scICA) algorithm, which generally benefits from the pre-known partial information of mixing matrix, and modified the steps of the algorithm in a way that makes it more robust to correlated sources. We called the modified scICA algorithm Multichannel ICA based EEG Beamformer (MIEB). Results: We evaluated the proposed algorithm on simulated EEG data and compared its performance quantitatively with three algorithms: scICA, linearly-constrained minimum-variance (LCMV) and Dual-Core beamformers; it is considered that the latter is specially designed to reconstruct correlated sources. Conclusion: The MIEB algorithm has much better performance in terms of normalized mean squared error in recovering the correlated/uncorrelated sources both in noise free and noisy synthetic EEG signals. Therefore, it could be used as a robust beamformer in recovering correlated brain sources.

Background and Aim: Music can regulate the activity of brain structures that play a significant role in emotions. The perceived emotion techniques such as dichotic listening clarify the relationships between auditory emotional stimuli and hemispheric asymmetries in the auditory modality. We examined the impact of pleasantness/unpleasantness of music by Acceptable Noise Level (ANL) as a subjective measure of listeners’ willingness to accept background noise. Methods: In this study, 32 participants rated their pleasantness with about ten songs; then, we considered the effect of preferred pleasant and unpleasant music on dichotic music listening and acceptable background noise. There were six forced attention conditions to calculate ANL, followed by measuring the most comfortable level and background noise level for each condition. Results: The pairwise comparison analyses revealed significantly higher ANL in forced attention to pleasant music than to speech (p

The use of transcranial Electrical Stimulation (tES) in the modulation of cognitive brain functions to improve neuropsychiatric conditions has extensively increased over the decades. tES techniques have also raised new challenges associated with study design, stimulation protocol, functional specificity, and dose-response relationship. In this paper, we addressed challenges through the emerging methodology to investigate the dose-response relationship of High Definition-transcranial Direct Current Stimulation (HD tDCS), identifying the role of negative valence in tinnitus perception. In light of the neurofunctional testable framework and tES application, hypotheses were formulated to measure clinical and surrogate endpoints. We posited that conscious pairing adequately pleasant stimuli with tinnitus perception results in correction of the loudness misperception and would be reinforced by concurrent active HD-tDCS on the left Dorsolateral Prefrontal Cortex (dlPFC). The dose-response relationship between HD-tDCS specificity and the loudness perception is also modeled. We conducted a double-blind, randomized crossover pilot study with six recruited tinnitus patients. Accrued data was utilized to design a well-controlled adaptive seamless Bayesian dose-response study. The sample size (n = 47, for 90% power and 95% confidence) and optimum interims were anticipated for adaptive decision-making about efficacy, safety, and single session dose parameters. Furthermore, preliminary pilot study results were sufficient to show a significant difference (90% power, 99% confidence) within the longitudinally detected self-report tinnitus loudness between before and under positive emotion induction. This study demonstrated a research methodology used to improve emotion regulation in tinnitus patients. In the projected method, positive emotion induction is essential for promoting functional targeting under HD-tDCS anatomical specificity to indicate the efficacy and facilitate the dose-finding process. The continuous updating of prior knowledge about efficacy and dose during the exploratory stage adapts the anticipated dose-response model. Consequently, the effective dose range to make superiority neuromodulation in correcting loudness misperception of tinnitus will be redefined. Highly effective dose adapts the study to a standard randomized trial and transforms it into the confirmatory stage in which active HD-tDCS protocol is compared with a sham trial (placebo-like). Establishing the HD-tDCS intervention protocols relying on this novel method provides reliable evidence for regulatory agencies to approve or reject the efficacy and safety. Furthermore, this paper supports a technical report for designing multimodality data-driven complementary investigations in emotion regulation, including EEG-driven neuro markers, Stroop-driven attention biases, and neuroimaging-driven brain network dynamics.

This study is designed to present an agent-based model (ABM) to simulate the interactions between tumor cells and the immune system in the melanoma model. The Myeloid-derived Suppressor Cells (MDSCs) and dendritic cells (DCs) are considered in this model as immunosuppressive and antigen-presenting agents respectively. The animal experiment was performed on 68 B16F10 melanoma tumor-bearing C57BL/6 female mice to collect dynamic data for ABM implementation and validation. Animals were divided into 4 groups; group 1 was control (no treatment) while groups 2 and 3 were treated with DC vaccine and low-dose 5- fluorouracil (5-FU) respectively and group 4 was treated with both DC Vaccine and low-dose of 5-FU. The tumor growth rate, number of MDSC, and presence of CD8+/CD107a+ T cells in the tumor microenvironment were evaluated in each group. Firstly, the tumor cells, the effector immune cells, DCs, and the MDSCs have been considered as the agents of the ABM model and their interaction methods have been extracted from the literature and implemented in the model. Then, the model parameters were estimated by the dynamic data collected from animal experiments. To validate the ABM model, the simulation results were compared with the real data. The results show that the dynamics of the model agents can mimic the relations among considered immune system components to an emergent outcome compatible with real data. The simplicity of the proposed model can help to understand the results of the combinational therapy and make this model a useful tool for studying different scenarios and assessing the combinational results. Determining the role of each component helps to find critical times during tumor progression and change the tumor and immune system balance in favor of the immune system.

Purpose: For over three decades, various researchers have aimed to construct a model of breast cancer. Most of them have used an infrared thermal model to stimulate breast cancer, but in this study, a novel estimation methodology is presented to detect the breast cancer tumor using the surface measurement obtained by Passive Acoustic Thermometer (PAT). PAT is a safe method for internal temperature estimation that works based on acoustic radiation of materials with a specific temperature. Materials and Methods: This article uses a simulation framework for breast tissue simulation and tumor detection using the PAT methodologies in different scenarios. This framework supports the generation of acoustic radiation, tissue modelling, signal processing, parameter estimation, and temperature reconstruction processes. The proposed framework estimates the temperature in the frequency domain and uses the frequency spectrum of the acquired ultrasound signals captured by a single transducer. Using the proposed framework, PAT has been evaluated in breast cancer detection. Results: According to the results, obtained from the temperature estimation in scenario 3, the sub-band estimation method, which is utilized in practical experiments in this field, shows different errors in each sub-band, making it difficult to select the true estimation. Therefore, a novel formulation is proposed that provides only one estimated temperature for breast tissue with a reasonable error (1.28 degrees) for tumor detection. Conclusion: The results show that it is possible to use this framework to evaluate the PAT in different scenarios for tumor detection. In fact, this method enhances the possibility of examination of different conditions and algorithms. It also reduces the cost of practical experiments.

This article summarizes the first and second Iranian brain–computer interface competitions held in 2017 and 2018 by the National Brain Mapping Lab. Two 64-channel electroencephalography (EEG) datasets were contributed, including motor imagery as well as motor execution by three limbs. The competitors were asked to classify the type of motor imagination or execution based on EEG signals in the first competition and the type of executed motion as well as the movement onset in the second competition. Here, we provide an overview of the datasets, the tasks, the evaluation criteria, and the methods proposed by the top-ranked teams. We also report the results achieved with the submitted algorithms and discuss the organizational strategies for future campaigns.

Abstract Background In Photoacoustic imaging (PAI), the most prevalent beamforming algorithm is delay-and-sum (DAS) due to its simple implementation. However, it results in a low quality image affected by the high level of sidelobes. Coherence factor (CF) can be used to address the sidelobes in the reconstructed images by DAS, but the resolution improvement is not good enough, compared to the high resolution beamformers such as minimum variance (MV). In this paper, it is proposed to use high-resolution-CF (HRCF) weighting technique in which MV is used instead of the existing DAS in the formula of the conventional CF. Results The higher performance of HRCF is proved numerically and experimentally. The quantitative results obtained with the simulations show that at the depth of 40 mm, in comparison with DAS+CF and MV+CF, HRCF improves the full-width-half-maximum of about 91% and 15% and the signal-to-noise ratio about 40% and 14%, respectively. Conclusion Proposed method provides a high resolution along with a low level of sidelobes for PAI.

Objective: Pharmacokinetic and clinical studies recommend applying loading dose of colistin for the treatment of severe infections in the critically ill adults. Pharmacokinetic studies of colistin in children also highlight the need for a loading dose. However, there are no clinical studies evaluating the effectiveness of colistin loading dose in children. Methods: In a randomized trial, children with ventilator-associated pneumonia or central line-associated bloodstream infection (CLABSI) for whom colistin was initiated, were enrolled. Patients were randomized into two groups; loading dose and conventional dose treatment arms. In the conventional treatment arm, colistimethate sodium was initiated with maintenance dose. In the loading dose group, colistimethate sodium was commenced with a loading dose of 150,000 international unit/kg, then on the maintenance dose. Both treatment arms also received meropenem as combination therapy. Primary outcomes were overall efficacy, clinical improvement and microbiological cure. Secondary outcomes were colistin-induced nephrotoxicity and development of resistance. Findings: Thirty children completed this study. There was a significantly higher overall efficacy in the group received loading dose (42.9 vs. 6.3%, P = 0.031). There weren't any significant differences in the clinical and microbiological endpoints. In the subgroup of children with CLABSI, results illustrated a trend toward (though statistically nonsignificant) better clinical cure for patients receiving loading dose. Conclusion: This preliminary study suggests that colistin loading dose might have some benefits in critically ill children, specifically in children with CLABSI. Further trials are required to elucidate colistin best dosing strategy in critically ill children with severe infections.

Low frequency readiness potential (RP) is elicited in electroencephalograms (EEGs) as one intends to perform an imagery (IMI) or real movement (RMI). While in most brain-computer-interface (BCI) applications the challenge is to classify RPs of different limbs from the given EEG trials, the objective of this study is fast and automatic detection of RPs from the entire single channel EEG signal. The proposed algorithm has two threshold blocks based on the nonlinear Teager-Kaiser energy operator (TEO) in the first block and the morphological properties of the RP waveform as constraints in the second block. The performance is strongly influenced by the abrupt energy changes due to transients and artefacts. As the major contribution, the proposed nonlinear convex optimization algorithm enables separation of transients from low frequency components by providing a fast thresholding mechanism. Application of the proposed method to Physionet RMI dataset, BCI competitionIV-1 IMI dataset and our own left hand movement datasets of healthy subjects led to true positive rates (TPRs) of 76.5±8.27%, 83.85±11.4%, and 81.1±5.23%, number of FPs/min of 2.4±1.07, 1.4±0.7, and 1.6±0.69 and accuracy rates of 85.4±3.83%, 90±3.56%, and 91.2±2.04%. Movement onset detection latency from our automatic RP detector was -384.9±296.5 ms.As a conclusion, the proposed method outperforms state-of-the-art techniques using as low as single channel EEG making it suitable for real-time neuro-rehabilitation of paralyzed subjects suffering from stroke.

Brain shift is an important obstacle to the application of image guidance during neurosurgical interventions. There has been a growing interest in intra-operative imaging to update the image-guided surgery systems. However, due to the innate limitations of the current imaging modalities, accurate brain shift compensation continues to be a challenging task. In this study, the application of intra-operative photoacoustic imaging and registration of the intra-operative photoacoustic with pre-operative MR images are proposed to compensate for brain deformation. Finding a satisfactory registration method is challenging due to the unpredictable nature of brain deformation. In this study, the co-sparse analysis model is proposed for photoacoustic-MR image registration, which can capture the interdependency of the two modalities. The proposed algorithm works based on the minimization of mapping transform via a pair of analysis operators that are learned by the alternating direction method of multipliers. The method was evaluated using an experimental phantom and ex vivo data obtained from a mouse brain. The results of the phantom data show about 63% improvement in target registration error in comparison with the commonly used normalized mutual information method. The results proved that intra-operative photoacoustic images could become a promising tool when the brain shift invalidates pre-operative MRI.

Purpose: Internal temperature is a significant factor for medical diagnosis. There are several thermometric methods, including IR, MRI, and active ultrasonic thermometry, which have limitations for clinical applications. The new method in this field called Passive Acoustic Thermometry (PAT), which enhanced some of this limitation. PAT is a safe method for internal temperature estimation that works based on acoustic radiation of materials with a specific temperature. Several experimental studies have been carried out so far in the field of PAT. While, to the best of our knowledge, there is no simulation-based research for nonhomogeneous materials reported yet. In this article (for the first time) we proposed a simulation framework for evaluating the PAT methodologies in nonhomogeneous materials; also we proposed a new formulation for temperature estimation in PAT algorithm. Materials and Methods: This framework supports the generation of acoustic radiation, signal processing, parameter estimation, and temperature reconstruction processes. At the moment the proposed framework estimates the temperature in the frequency domain and uses the frequency spectrum of the acquired ultrasound signals captured by a single transducer. Using the proposed framework, we tried to implement the previously practical experiments and the results of the simulation are consistent with those of the practical experiments. Also, we proposed the formulation that improves the error of temperature estimation. Results: We study 6 scenarios, including 2 environments with a target at 3 different temperatures. The average error of the proposed formulation in two different nonhomogeneous materials for three different temperatures is less than 0.25°C. Conclusion: The results show that the proposed formulation is the best estimation in the formula that has been introduced until now and compare with the previous study the accuracy is enhanced 54% (from 0.79 to 0.36 deg.). Therefore, the proposed formula enhanced PAT accuracy for temperature estimation. Also, the results show that it is possible to use this framework to evaluate the PAT in different scenarios. Therefore, this method enhances the possibility of examination of different conditions and algorithms. It also reduces the cost of practical experiment.

Acoustic thermometry is one of non-invasive methods to measure the temperature inside tissue area. especially when using the thermal therapy techniques such as High Intensity Focused Ultrasound (HIFU) and other thermal based methods, thermal assessment of heated area seems to be necessary. Some of acoustic properties of medium are temperature dependent, therefore, evaluation of temperature dependent parameters will be an indirect and non-invasive approach in thermometry. In this paper some of thermometry methods based on changes in acoustic properties of medium has been reviewed. The published methods are classified in two main categories: passive and active thermometry. In the passive thermometry, the thermal measurement probes, induced no acoustic signals to the medium, but they receive the radiated signals from the heated medium. In active method, the thermometry probe transmits a signal into the heated region and receive the echoes, then the received RF signals are processed in order to measure the temperature.

Abstract Background: Postoperative nausea and vomiting (PONV) is one of the most common complications in the patients undergoing strabismus surgery. The aim of current study was comparing supplemental 80% and 40% oxygen on reducing postoperative nausea and vomiting in the pediatrics undergoing strabismus surgery. Materials and Methods: In this clinical trial study, 100 pediatric patients scheduled for strabismus surgery under general anesthesia were allocated randomly into two parallel supplemental 80% and 40% oxygen groups during surgery. PONV in patients was compared until 24hrs after operation. Results: In the first 6hrs postoperatively, PONV in the supplemental 40% and 80% oxygen groups were 48.8% and 30.6% respectively, also were 20.8% and 12.2% in the 6 to 24hrs postoperatively. Therefore, there were no significant differences between both groups in regarding of PONV in 6hrs and 6 to 24hrs postoperatively (p values were 0.18 and 0.25, respectively). Conclusion: According to our results, there is no any difference between 40% and 80% oxygen postoperatively in the pediatrics undergoing strabismus surgery.

Purpose: Passive Acoustic Thermometer (PAT) is a safe method for internal temperature estimation that works based on acoustic radiation of materials with a specific temperature. Several experimental studies have been carried out so far in the field of PAT. While, to the best of our knowledge, there is no simulation-based research reported yet. Materials and Methods: In this article (for the first time) we proposed a simulation framework for evaluating the PAT methodologies. This framework supports the generation of acoustic radiation, signal processing, parameter estimation, and temperature reconstruction processes. At the moment, the proposed framework estimates the temperature in the frequency domain and uses the frequency spectrum of the acquired ultrasound signals captured by a single transducer. Results: Using the proposed framework, we tried to implement previously practical experiments and the results of the simulation are consistent with those of the practical experiment. The mean error of temperature estimation was below 0.45 °C. The results show that it is possible to use this framework to evaluate the PAT in different scenarios. Conclusion: Therefore, this method enhances the possibility of examination of different conditions and algorithms. It also reduces the cost of practical experiment.

Purpose: Event-Related Potentials (ERPs) have been used in addiction studies to evaluate cognitive performance and craving in individuals with Substance Use Dependence (SUD). This paper reviews studies that used ERPs to investigate cue reactivity, inhibitory control and error processing in SUDs to integrate new findings. Materials and Methods: Five abused substances are included in the investigation, i.e. alcohol, nicotine, cannabis, cocaine, and methamphetamine. For each substance, the main recent findings related to the ERPs are specifically discussed, according to the latency of ERPs. Results: Individuals with SUD allocate more attention resources to the cognitive processing of substance related cues, indexed by increased amplitude of middle and late latency ERPs. Laboratory observations also show amplitude enlargement for early latency ERPs. Individuals with SUD reveal a deficiency in the inhibitory control and conscious error processing, indexed by attenuated N2 and Pe amplitude. Conclusion: This study expands the findings of previous related reviews implying that substance abusers allocate more attention resources to drug cues indexed by enlarged P3 and LPP amplitude. Regarding P3 elicited in inhibitory control tasks, there is not still convergent results, while N2 and Pe become attenuated as reported in previous reviews. The cognitive and motor inhibitory component (P3) changes show a controversial result.

Use of shock waves to temporarily increase the permeability of the cell membrane is a promising approach in drug delivery and gene therapy to allow the translocation of macromolecules and small polar molecules into the cytoplasm. Our understanding of how the characteristics of the pressure profile of shock waves, such as peak pressure and pulse duration, influences membrane properties is limited. Here we study the response of lipid bilayer membranes to shock pulses with different pressure profiles using atomistic molecular dynamics simulations. From our simulation results, we find that the transient deformation/disordering of the membrane depends on both the magnitude and the pulse duration of the pressure profile of the shock pulse. For a low pressure impulse, peak pressure has a dominant effect on membrane structural changes, while for the high pressure impulse, we find that there exists an optimal pulse duration at which membrane deformation/disordering is maximized.

This study aimed to examine the effects of chronic methamphetamine use on the topological organization of whole-brain functional connectivity network (FCN) by reconstruction of neural-activity time series at resting-state. The EEG of 36 individuals with methamphetamine use disorder (IWMUD) and 24 normal controls (NCs) were recorded, pre-processed and source-reconstructed using standardized low-resolution tomography (sLORETA). The brain FCNs of participants were constructed and between-group differences in network topological properties were investigated using graph theoretical analysis. IWMUD showed decreased characteristic path length, increased clustering coefficient and small-world index at delta and gamma frequency bands compared to NCs. Moreover, abnormal changes in inter-regional connectivity and network hubs were observed in all the frequency bands. The results suggest that the IWMUD and NCs have distinct FCNs at all the frequency bands, particularly at the delta and gamma bands, in which deviated small-world brain topology was found in IWMUD.

Background: Using conventional tDCS over the temporo-parietal junction (TPJ) we previously reported that it is possible to manipulate subjective visual vertical (SVV) and postural control. We also demonstrated that high-definition tDCS (HD-tDCS) can achieve substantially greater cortical stimulation focality than conventional tDCS. However, it is critical to establish dose-response effects using well-defined protocols with relevance to clinically meaningful applications.Objective: To conduct three pilot studies investigating polarity and intensity-dependent effects of HD-tDCS over the right TPJ on behavioral and physiological outcome measures in healthy subjects. We additionally aimed to establish the feasibility, safety, and tolerability of this stimulation protocol.Methods: We designed three separate randomized, double-blind, crossover phase I clinical trials in different cohorts of healthy adults using the same stimulation protocol. The primary outcome measure for trial 1 was SVV; trial 2, weight-bearing asymmetry (WBA); and trial 3, electroencephalography power spectral density (EEG-PSD). The HD-tDCS montage comprised a single central, and 3 surround electrodes (HD-tDCS3x1) over the right TPJ. For each study, we tested 3x2 min HD-tDCS3x1 at 1, 2 and 3 mA; with anode center, cathode center, or sham stimulation, in random order across days.Results: We found significant SVV deviation relative to baseline, specific to the cathode center condition, with consistent direction and increasing with stimulation intensity. We further showed significant WBA with direction governed by stimulation polarity (cathode center, left asymmetry; anode center, right asymmetry). EEG-PSD in the gamma band was significantly increased at 3 mA under the cathode.Conclusions: The present series of studies provide converging evidence for focal neuromodulation that can modify physiology and have behavioral consequences with clinical potential.

Implantation failure is a major limiting step for in-vitro fertilisation (IVF). Embryo implantation is the result of the interaction of the embryo with the endometrium. Oxidative stress (OS) can cause defective embryo development and retardation. Genetic polymorphisms of detoxicating enzymes, such as glutathione S-transferases (GSTs), may play an important role in the outcome of embryo implantation. GSTM1 and GSTT1 are known to be highly polymorphic. The aim of this study was to examine the association of GSTM1 and GSTT1 gene polymorphisms with IVF-ET outcome in a population in northern Iran. Blood samples were collected from 120 infertile women who underwent an IVF cycle, and 108 healthy volunteers. Genomic DNA was prepared from peripheral blood leucocytes. Genotype frequencies were determined in patients and healthy controls using polymerase chain reaction (PCR). It was found that 25.8% of the infertile women and 0% of the controls had the GSTM1 null genotype (odds ratio (OR) = 76.37; 95% CI = 4.6-1,265.7; p = 0.0025). On the other hand, 5% of the cases and 0% of the controls had the GSTT1 null genotype (OR = 12.3, 95% CI = 0.68-221/3, p = 0.088). These results suggest that GSTM1 null type might be associated with IVF outcome in a population in northern Iran. [ABSTRACT FROM AUTHOR]

Purpose: The mechanical map of liver tissue like stiffness is as important as its anatomical image for clinical purposes like staging the liver fibrosis. Acoustic radiation force-based shear waves interference patterns elastography is an interesting independent imaging rate technique which can generate shear waves in the liver tissue in any desired depth by means of the high intensity focused, long duration push beams. Because of wave attenuation and absorption process the sound wave energy is dissipated in the tissue and due to energy conservation law is turned into heat thus like any other ultrasound imaging modality, shear waves interference patterns elastography carries the risk of tissue heating and thermal ablation specially at the focal spot. Therefore, particular attention must be paid to the thermal safety assessment to shear waves interference patterns elastography. The aim of the present simulation study is the thermal safety evaluation in the liver tissue. Materials and Methods: The liver tissue has been simulated in the presence of its adjacent tissues like skin, muscle, ribs and intercostal muscles in 3 dimensions during shear waves interference patterns elastography. With 4 seconds exposure time and 2 MPa focal pressure. Results:Temperature at the focal point increases from normal body temperature (37˚C) to 47˚C. Conclusion: Thermal effects appraisal, indicates that the general tissue heating stays within the safe region.

Purpose: Variations in the mechanical properties of soft tissues may be a sign of a disease. Since some disease like fibrosis or cancer change the stiffness of related tissues, we can assess the disease of a soft tissue with its elasticity. The elastic stiffness properties of soft tissues can be estimated using locally induced displacements and shear waves. Materials and Methods: A two-dimensional plane finite element model has been created as soft tissue. The soft tissue has been exposed to two Amplitude Modulated High Intensity Focused Ultrasound transducer (AMHIFU), hence shear wave interference patterns which can be captured by lower frame rate imaging are generated. The acoustic radiation force created by a self-focusing ultrasound transducer has been determined from an ultrasound pressure field simulation. A Gaussian function was fitted to the resulting Acoustic Radiation Force (ARF) field and implemented in the form of a body force in the finite element model. Results: The effect of different excitation parameters for their optimization in the elasticity estimation has been investigated. Conclusion: In the result section, the effect of ARF excitation parameters on shear wave elasticity measurements has been represented. Shear wave interference pattern elastography which does not need high frame rate imaging with optimized parameters can be used as a non-invasive method for measuring the elastic stiffness of soft tissues.

Background: Recent EEG-SSVEP signal based BCI studies have used high frequency square pulse visual stimuli to reduce subjective fatigue. However, the effect of total harmonic distortion (THD) has not been considered. Compared to CRT and LCD monitors, LED screen displays high-frequency wave with better refresh rate. In this study, we present high frequency sine wave simple and rhythmic patterns with low THD rate by LED to analyze SSVEP responses and evaluate subjective fatigue in normal subjects.Materials and Methods: We used patterns of 3-sequence high-frequency sine waves (25, 30, and 35 Hz) to design our visual stimuli. Nine stimuli patterns, 3 simple (repetition of each of above 3 frequencies e.g., P25-25-25) and 6 rhythmic (all of the frequencies in 6 different sequences e.g., P25-30-35) were chosen. A hardware setup with low THD rate ( 90% for CCA and LASSO (for TWs > 1 s). High frequency rhythmic patterns group with low THD rate showed higher accuracy rate (99.24%) than simple patterns group (98.48%). Repeated measure ANOVA showed significant difference between rhythmic pattern features (P < 0.0005). Overall, there was no significant difference between the VAS of rhythmic [3.85 ± 2.13] compared to the simple patterns group [3.96 ± 2.21], (P = 0.63). Rhythmic group had lower within group VAS variation (min = P25-30-35 [2.90 ± 2.45], max = P35-25-30 [4.81 ± 2.65]) as well as least individual pattern VAS (P25-30-35).Discussion and Conclusion: Overall, rhythmic and simple pattern groups had higher and similar accuracy rates. Rhythmic stimuli patterns showed insignificantly lower fatigue rate than simple patterns. We conclude that both rhythmic and simple visual high frequency sine wave stimuli require further research for human subject SSVEP-BCI studies.

Hydroxymethylglutaryl Co-enzyme A reductase inhibitors, also known as statins, are a class of anti-hyperlipidemic agents. These drugs have been employed vastly to reduce the morbidity and mortality of cardiovascular disorders. Soon after their introduction, benefits other than their primary actions were discovered. Along with these pleiotropic properties, a series of mainly favorable effects has been proposed in patients intended to undergo hematopoietic stem cell transplantation. These actions address some complications encountered by this special population such as graft-versus-host disease, efficacy of chemotherapy, infections, etc. This review presents the current evidence surrounding these issues.

Background: Drug utilization studies are helpful in understanding the current practice. We have conducted a retrospective study to evaluate the relevant use of a group of most commonly prescribed antibiotics in a teaching hospital in Iran. The results of this study may be of help for clinicians to improve the patient care. Methods: Patients who received parenteral ceftazidim, vancomycin and amikacin from December2010 to May 2011 were enrolled in this study. Patient’s data including demographic, length of Hospital stay, drug allergy, first and final diagnosis were recorded in a predesigned data collection form. American Hospital Formulary Services (AHFS) book were used as a reference for evaluation of study drug indication and dosing according to diagnosis and microbiological culture. Defined Daily Dose (DDD) of each drug extracted from Anatomic and Therapeutic Chemical classification system (ATC/DDD) and drug usage data evaluated by calculating the ratio of prescribed drug to its DDD.| Results: The ratio of prescribed daily dose to DDD was 0.78, 0.95 and 0.86 for amikacin, ceftazidime and vancomycin respectively. Between amikacin group, 43 patients (86%) received drug empirically, the number of empiric treatments for ceftazidim and vancomycin were 45(90%) and 44 patients (88%). The renal function tests (Blood Urea Nitrogen, Serum Creatinin) were evaluated in 56% of amikacin group, 64% in ceftazidime group and 78% in vancomycin group. Conclusion: The results of this study indicate the need to establish continuing medical education (CME) courses for physicians to familiarize them with standards required to use and monitor these agents.

Mechanics of the bilayer membrane play an important role in many biological and bioengineering problems such as cell–substrate and cell–nanomaterial interactions. In this work, we study the effect of thermal fluctuation and the substrate elasticity on the cell membrane–substrate adhesion. We model the adhesion of a fluctuating membrane on an elastic substrate as a two-step reaction comprised of the out-of-plane membrane fluctuation and the receptor–ligand binding. The equilibrium closed bond ratio as a function of substrate rigidity was computed by developing a coupled Fourier space Brownian dynamics and Monte Carlo method. The simulation results show that there exists a crossover value of the substrate rigidity at which the closed bond ratio is maximal.

Human cytomegalovirus (HCMV) antigens in glioblastoma (GBM) present opportunities for personalised immunotherapy. However, their presence in GBM tissue is still under debate, and evidence of their impact on functional immune responses and prognosis is sparse. Here, we investigated the presence of pp65 (UL83) and immediate early 1 (IE-1) HCMV antigens in a cohort of Norwegian GBM patients (n= 177), using qPCR, immunohistochemistry, and serology. HCMV status was then used to investigate whether viral antigens influenced immune cell phenotype, infiltration, activation and patient survival. Pp65 and IE-1 were detected by qPCR in 23% and 43% of GBM patients, respectively. Furthermore, there was increased seropositivity in GBM patients relative to donors (79%vs. 48%, respectively; Logistic regression, OR = 4.05, 95%CI [1.807-9.114],P= 0.001, also when adjusted for age (OR = 2.84, 95%CI [1.110-7.275],P= 0.029). Tissue IE-1-positivity correlated with increased CD3+CD8+T-cell infiltration (P< 0.0001), where CD8+effector memory T (TEM) cells accounted for the majority of CD8+T cells compared with peripheral blood of HCMV+patients (P< 0.0001), and HCMV+(P< 0.001) and HCMV−(P< 0.001) donors. HLA-A2/B8-restricted HCMV-specific CD8+T cells were more frequent in blood and tumor of HCMV+GBM patients compared with seronegative patients, and donors irrespective of their serostatus. In biopsies, the HCMV-specific CD8+TEMcells highly expressed CTLA-4 and PD-1 immune checkpoint protein markers compared with populations in peripheral blood (P< 0.001 andP< 0.0001), which expressed 3-fold greater levels of CD28 (P< 0.001 andP< 0.0001). These peripheral blood T cells correspondingly secreted higher levels of IFNγ in response to pp65 and IE-1 peptide stimulation (P< 0.001). Thus, despite apparent increased immunogenicity of HCMV compared with tumor antigens, the T cells were tolerised, and HCMV status did not impact patient survival (Log Rank3.53HR = 0.85 95%CI [0.564-1.290],P =0.45). Enhancing immune functionality in the tumor microenvironment thus may improve patient outcome. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is one of the most common cancers known among women. This study aimed to investigate the level of vitamin D receptor gene expression in two tumoral and healthy breast tissues in breast cancer patients and its association with prognostic factors., Methods: This descriptive cross-sectional study was conducted in 2022 on 50 patients with high suspicion of breast cancer who were candidates for mastectomy and lumpectomy in a learning hospital. From the patients, two tissue samples were prepared, and there was a total of 100 samples. The samples were subjected to H/E staining and evaluated by a pathologist. The presence or absence of malignancy in each sample was confirmed by two pathologists, and HER2/ER/PR indices were determined. Descriptive and analytical statistical methods and SPSS version 22 software were used., Results: The average age of the patients was 51.60 ± 11.22 years old, and the average tumor size was 3.17 ± 1.28. Most tumors were grade 2 (48%). The expression of HER2, ER, and PR was positive in 24, 64, and 54%, respectively. The largest number of cases were in stage 2A. The expression level of vitamin D receptor (VDR) gene in healthy tissue (2.08 ± 1.01) was higher than tumoral tissue (0.25 ± 1.38) (P = 0.001). In tumoral and healthy tissue, VDR expression was not significant according to tumor grade, HER2, ER, PR, LVI, LN, disease stage, age, and tumor size., Conclusions: The expression level of VDR in healthy tissue was significantly higher than tumoral tissue. However, there was no significant relationship between VDR and tumor grade, HER2, ER, PR, LVI, LN, disease stage, age, and tumor size., (© 2024. The Author(s).)

Introduction: The efficacy and safety of a single novel electronic pulp sensitivity tester with a transilluminator (PSTT) capable of providing 4 different tests was compared with gold standard (GS) pulp testing methods., Methods: Four hundred eighty teeth, including 3 from each quadrant and their contralateral and opposing teeth, were randomly assessed using the PSTT or GS methods. Seven days later, the same teeth were assessed using the method not used earlier so that all teeth were evaluated using both methods. Sixty previously root canal-treated teeth, serving as negative controls, were assessed identically to the experimental groups. Results were analyzed using IBM SPSS software (IBM Corp, Armonk, NY) (P < .05)., Results: A higher percentage of teeth responded to cold and electricity using GS methods compared with the PSTT (99.4 vs 93.1 and 99.6 vs 97.3, respectively). A lower percentage of teeth responded to heat using the GS method compared with the PSTT (50.0 vs 68.1). Chi-square tests determined differences in the proportion of sensitivity to temperature, and electric testing methods were statistically significant (P < .001 and P = .004, respectively). No difference in the proportion of sensitivity was observed for transillumination. The Wilcoxon signed rank test determined significantly shorter cold testing times using the GS method (P = .024). Shorter testing times were observed using the PSTT for heat (P < .001), electric pulp testing (P = .048), and transillumination (P = .001). The overall PSTT testing time was significantly shorter than the GS testing time (P = .03). Tissue injury was not observed., Conclusions: The PSTT efficiently and safely provided heat and transillumination for pulpal diagnosis. Improvements are needed to enhance the cold and electric stimulus efficacy., (Copyright © 2023 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Background: Stenosis and scar formation after repair of laryngeal tissue defects are serious problems that can significantly influence a patient's quality of life., Objective: In this study, we evaluated the use of magnetic resonance imaging to assess the efficacy of adipose tissue-derived mesenchymal stem cells (ASCs) on cartilaginous regeneration in an experimental rabbit model., Methods: Ten male white Dutch rabbits each had a 5 mm cartilaginous defect created surgically in the right and left thyroid lamina. On the right side, ASCs labeled with iron oxide particles were infused. As a control, the left side was left untreated. Repair of the defects were then evaluated by direct observation, histological evaluation, and magnetic resonance imaging monitoring done on days 1, 7, 14, and 28., Results: Histological examination revealed that compared with control, transplanted ASCs significantly increased cartilage regeneration ( P ˂ 0.001), reduced inflammation ( P ˂ 0.001), and fibrosis ( P  = 0.050). Magnetic resonance imaging tracking showed accurate placement and viability of the infused ASCs, as evidenced by low signal intensity onT2 weighted images at the level of the right thyroid cartilage., Conclusions: Infusion of ASCs improved laryngeal regeneration of surgically induced cartilaginous defects while decreasing fibrous tissue formation in this in vivo rabbit model. Furthermore, magnetic resonance imaging was shown to be a useful, noninvasive method to track correct ASCs placement and viability in cartilage regeneration in this animal model., Competing Interests: The authors have indicated that they have no conflicts of interest regarding the content of this article., (© 2022 The Author(s).)

Introduction: The aims of this study were to investigate aerosolized microorganisms generated during endodontic emergencies and nonsurgical root canal therapy (NSRCT), to assess the spread of airborne microbes, and to verify the spatial distribution of airborne microbial spread., Methods: A total of 45 endodontic procedures were sampled, including full pulpotomy (n = 15), pulpectomy (n = 15), and NSRCT (n = 15). Samples were collected during room resting and after treatment. The passive air sampling technique using settle plates was applied. Agar plates were set at different locations in the operatory. The colony-forming unit (CFU) was counted in brain-heart infusion blood agar plates. A set of agar plates containing selective chromogenic culture media was used for the isolation and presumptive identification of target microorganisms. Fungi were investigated using Sabouraud dextrose agar., Results: Pulpotomy generated the lowest mean CFU count (P < .05). There was no difference between the mean CFU counts found in pulpectomy and NSRCT (P > .05). A higher mean CFU count was found close to the patient's mouth (0.5 m) than at a 2-m distance in pulpectomy and NSRCT (P < .05). There was no difference between the mean CFU count found in front of the patient's mouth versus diagonal in pulpectomy and NSRCT (P > .05). Staphylococcus aureus (22/45, 48.8%) was the most frequent bacteria species. Longer treatment times were associated with higher CFU counts., Conclusions: Our findings indicated that pulpotomy generates less aerosolized microorganisms than pulpectomy and NSRCT. The proximity to the patient's mouth and the treatment duration were implicated in the level of contamination., (Copyright © 2021 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)