Search

Purpose: To investigate the possibility to be able to offer left sided breast cancer patients, not suitable for DIBH, an organ at risk saving treatment. Materials and Methods: Twenty patients receiving radiotherapy for left breast cancer in DIBH were enrolled in the study. Planning CT scans were acquired in the same supine treatment position in FB and DIBH. 3DCRT_DIBH plans were designed and optimized using two parallel opposed tangent beams (with some additional segments) for the breast and chest wall and anterior-posterior fields for regional lymph nodes irradiation. Additionally, FB helical tomotherapy plans were optimized to minimize heart and lung dose. All forty plans were optimized with at least 95% of the total CTV covered by the 95% of prescribed dose of 50 Gy in 25 fractions. Results: HT_FB plans showed significantly better dose homogeneity and conformity compared to the 3DCRT_DIBH specially for regional nodal irradiation. The heart mean dose was almost comparable in 3DCRT_DIBH and HT_FB while the volume (%) of the heart receiving 25 Gy had a statistically significant reduction from 7.90 ± 3.33 in 3DCRT_DIBH to 0.88 ± 0.66 in HT_FB. HT_FB was also more effective in left descending artery (LAD) mean dose reduction about 100% from 30.83 ± 9.2 Gy to 9.7 ± 3.1. The ipsilateral lung volume receiving 20 Gy has a further reduction of 43 % in HT_FB compared with 3DCRT_DIBH. For low dose comparison, 3DCRT_DIBH was superior for contralateral organ sparing compared to the HT_FB due to the limited angle for dose delivery. Conclusion: For patients who cannot be a candidate for DIBH for any reason, HT in free breathing may be a good alternative and provides heart and ipsilateral lung dose sparing, however with the cost of increased dose to contralateral breast and lung.

Background: The Nordic Safety Climate Questionnaire-50 (NOSACQ-50) was developed by a team of Nordic occupational safety researchers based on safety climate and psychological theories. The aim of this study was to develop and validate the Persian version of NOSACQ-50 and assess the score of safety climate on a group of workers in a steel company in Iran. Methods: The Persian version of NOSACQ-50 was distributed among 661 employees of a steel company in Qazvin Province (Iran). Exploratory factor analysis (EFA) and confirmatory factor analysis were used to determine the dimensions of the questionnaire. The reliability of the questionnaire was assessed using Cronbach α coefficient. Pearson correlation test was applied to investigate the correlation between different dimensions. Results: The results of EFA showed that the Persian version of NOSACQ-50 consisted of six dimensions. The Cronbach α coefficient of the questionnaire was 0.94. The mean score of safety climate in all dimensions was 2.89 (standard deviation 0.60). Conclusion: The Persian version of NOSACQ-50 had a satisfactory validity for measuring safety climate in the studied Iranian population.

Background: Traumatic brain injury (TBI) is a global concern, and many people suffer from TBI annually. Determining the outcome of patients with brain injury has a valuable clinical impact and results in better management of patients. In this study, we aimed to investigate the predictive value of magnetic resonance spectrometry (MRS) in patients with diffuse axonal injury (DAI). Method: This is a prospective cohort study on patients with DAI in 6 months at a tertiary medical center. According to the eligibility criteria, the patients were enrolled in the study. The MRS scan was conducted on days 3 and 30, and the correlation of metabolites of MRS according to the GCS score of patients on days 3 and 30 was investigated to determine the prognostic impact of MRS in patients with DAI. Results: A total of 50 patients with DAI, including 39 males and 11 females, were recruited. MRS of patients on day 3 and 30 was conducted and showed that the level phosphocreatine (r = -0.56, P

An ultra-sensitive immunosensor was designed for the accurate determination of Carcinoembryonic Antigen (CEA). To enhance the performance of immunosensor, an MWCNT/Ni(OH)2 nanocomposite was utilized as the electrochemical interface and modifier of the electrode surface. The simple preparation procedures for MWCNT/Ni(OH)2 composite were provided. Its characteristics and properties were investigated by HRTEM, FESEM, XRD, and FTIR techniques. Leveraging the unique electrochemical characteristics shown by the MWCNT/Ni(OH)2 nanocomposite and its correlation with CEA, high accuracy in CEA detection was achieved. Experimental findings provide evidence that the proposed immunosensor has the ability to detect CEA in laboratory samples. This research contributes towards achieving precise and rapid CEA detection in cancer diagnosis and prognosis. Across a wide concentration range of CEA, the designed immunosensor demonstrated a linear response from 0.0001 ng/mL to 2 ng/mL, and its limit of detection (LOD) was just 0.076 pg/mL. To evaluate the practical applicability of the electrochemical immunosensor, blood serum samples were examined, revealing the immunosensor's remarkable specificity and longevity. Its high accuracy and stability make it a valuable tool in clinical settings and biomedical research, paving the way for improved cancer management and patient outcomes.

Oral health status can be affected by some factors including drug abuse, systemic conditions and environmental pollutants. The present study was designed to investigate the most important and prevalent dental and oral conditions in adult population of Rafsanjan with the age of 35–70 years. Dental and oral health cohort center as part of the Rafsanjan Cohort Study (RCS) included in the prospective epidemiological research studies in IrAN was established in 2015. Of 9991 subjects enrolled in the RCS, 8682 people participated in the Oral Health Branch of Rafsanjan Cohort Study (OHBRCS).The OHBRCS included 4021 men and 4661 women with the mean age of 49.94 ± 9.51. The most prevalent of oral lesion in total population was candidiasis and the least was aphthous lesion. The prevalence of candidiasis, white and red lesions, periodontal pocket, dental calculus, CAL and the mean of DMFT were higher in the male group than that of female group (p

Ovarian cancer is the most lethal gynecologic cancer. The high grade serous epithelial (HGSE) subtype is the most aggressive and it often presents at advanced stages, while screening programs have not proven beneficial. Management of the advanced stages (FIGO III and IV), which constitute the majority of diagnoses, usually consists of platinum-based chemotherapy and cytoreductive surgery (primary or interval) followed by maintenance therapy. Currently, the standard-of-care for advanced newly diagnosed HGSE ovarian cancer, as per international medical societies, starts with upfront cytoreductive surgery, followed by platinum-based chemotherapy (mostly carboplatin and paclitaxel) and/or anti-angiogenic agent bevacizumab, then maintenance therapy with a poly(ADP-ribose) polymerase (PARP) inhibitor with/without/or bevacizumab (continued). PARP inhibitor use depends on the patient’s genetic signature, mainly the breast cancer gene (BRCA) mutation and the homologous recombination deficiency (HRD) status. Therefore, genetic testing is recommended at diagnosis to inform treatment and prognosis.In line with the evolving standard-of-care for ovarian cancer, a panel of experts in treating advanced ovarian cancer convened to lay down practical recommendations on the management of advanced ovarian cancer in Lebanon; since the currently applicable guidelines by the Lebanese Ministry of Public Health for cancer treatment have not been updated yet to reflect the treatment paradigm shift brought upon by the development and approval of PARP inhibitors. The current work reviews the leading clinical trials on PARP inhibitors (as maintenance for newly diagnosed advanced and platinum-sensitive relapsed ovarian cancer), presents international recommendations, and proposes treatment algorithms for optimal local practice.

In this research, vacuum transient liquid phase bonding of Inconel 939 superalloy was performed using an amorphous Ni–Cr–Fe–Si–B filler alloy at different temperatures from 1060 °C to 1180 °C, and the microstructure and mechanical properties of the joints were investigated. The results showed that the bonding region can be categorized into three athermal solidification, isothermal solidification, and diffusion affected zones. The ASZ region consisted of a eutectic phase while the ISZ region included a Ni-rich gamma single-phase solid solution. Also, the DAZ involved cubic-shaped, needle-like and grain boundary-shaped borides. The width of DAZ increased with increasing the bonding temperatures, and it also led to a decrease in the ASZ/joint ratio. The ASZ was disappeared at 1180 °C. The highest hardness value was obtained for the DAZ region of the sample bonded at 1180 ᵒC, and a direct relationship was detected between the bonding temperature and ISZ hardness. The addition of bonding temperature also led to the improvement of the shear strength and joint efficiency. It was also found that an inverse relationship can be detected between the shear strength and the ASZ/joint ratio. A joint efficiency of ∼79% was obtained for the bonding temperature of 1180 °C.

Effective land use and land cover (LULC) change assessment requires tools to measure past, current, and based on them to create a future scenario. LULC changes are unavoidable in the world, particularly in developing countries. Since LULC are too dynamic and complicated without the identification of appropriate methods and approaches the future perdition will be less accurate. Therefore, the integrated Cellular Automata Markov chain (CA-Markov) model is known as a capable estimator. In this study, LULC changes in Zarriné-Rūd River Basin (ZRB) in Iran was analyzed based on different images and data extracted from satellite data in 1989 and 2019 to create the LULC scenario in 2049. The model was validated using actual and projected to 2019. The overall agreement on two extracted maps was 97.85% in 1989 and 96.55% in 2019. The more detailed analysis of validation of calibration based on the kappa showed the highest data reliability of 0.98 in 1989 and 0.95 in 2019, respectively. According to the transition matrix of probabilities, the most significant changes in the ZRB based on the past scenario (1989–2019) is in rainfed and built up land classes of LULC in 2049. Concurrently, the other classes continue to decline except irrigated agriculture and water bodies. The results obtained showed that the pasture and mountain LULC class had continued to reduce more than other classes. Furthermore, water resources and the amount of the precipitation in past and future are important to spatial and temporal expansion on LULC classes.

Magnesium (Mg)-based composites have recently been studied as biodegradable material for the fabrication of orthopedic implants. Nevertheless, in physiological environments, proper mechanical properties and sufficient degradation rate are needed. In this paper, zinc (Zn) was uniformly distributed in the magnesium matrix using a ball milling process, and then the composite of Mg-3Zn/xfCNTs (x = 0, 0.2, 0.4, and 0.8 wt%) was successfully fabricated using a combination of semi-powder metallurgy, sintering and extrusion processes for use as a biodegradable load-bearing implant. The influence of functionalized carbon nanotubes (fCNTs) content on compressive strength, corrosion behavior and in vitro bioactivity (apatite formation ability and cytocompatibility) of the composite was investigated. The key toughening mechanisms that resist crack propagation include fCNTs pull-out, grain bridging by fCNTs, Crack branching and crack deflection. Furthermore, electrochemical and in-vitro immersion studies demonstrated that the corrosion behavior of Mg-3Zn composite under high concertation encapsulation was slightly reversed by fCNTs. Furthermore, cell culture investigations revealed that MG-63 cells present high level of cell viability and proliferate, implying that Mg-3Zn/0.4fCNTs composites are cytocompatible. All the findings suggest that the Mg-3Zn/0.4fCNTs composite with outstanding mechanical properties and appropriate corrosion resistance and biocompatibility may be a potential candidate for biodegradable implant application.

Nanotechnologies present a promising application in the production of water to obtain potable water from natural sources by treatment. Clinoptilolite is an abundant and low-cost natural zeolite, which has adsorbent properties. Moreover, this study introduces a simple method for non-harmful natural adsorbent preparation and modification using different acids and bases with convenient and accessible desorption. The characterization methods used in this study are X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Response Surface Method (RSM) has been utilized to reflect the influence of operations variables in Design Expert 7.0. Other Variables, including the Effect of Modifications, contact time, the percentage of the dosage of adsorbent to the beginning (initial) pollutants concentration (D/C), and pH on total iron, were researched during the research procedure. The characterization results indicated that clinoptilolite nanoparticles were well prepared, and the preparation method was effective. Best modification Performance was shown in Z10(0.1 M Hydrochloric Acid dried by Air) at 24 h Setting time. The achieved results from Design Expert showed that at D/C and pH equal to 81.53 and 6.5, respectively, the optimal percentage of the iron removal is obtained with a value equal to 97.97%. In addition, Freundlich isothermal model best described the total iron adsorption process, and it has been observed that the maximum adsorption capacity is 50 mg/g for the total iron removal.

The novel COVID-19 pandemic has caused upheaval around the world and has led to drastic changes in our daily routines. Long-established routines such as commuting to workplace and in-store shopping are being replaced by telecommuting and online shopping. Many of these shifts were already underway for a long time, but the pandemic has accelerated them remarkably. This research is an effort to investigate how and to what extent people's mobility-styles and habitual travel behaviors have changed during the COVID-19 pandemic and to explore whether these changes will persist afterward or will bounce back to the pre-pandemic situation. To do so, a stated preference-revealed preference (SP-RP) survey is designed and implemented in the Chicago metropolitan area. The survey incorporates a comprehensive set of questions associated with individuals' travel behaviors, habits, and perceptions before and during the pandemic, as well as their expectations about the future. Analysis of the collected data reveals significant changes in various aspects of people's travel behavior. We also provide several insights for policymakers to be able to proactively plan for more equitable, sustainable, and resilient cities.

Background: CCN1 is an extracellular matrix-associated protein thought to be implicated in tumor-stromal interaction in several solid tumors. The aim of our pilot study was to evaluate the correlation between CCN1 expression in stromal cells, pancreatic intraepithelial neoplasia (PanIN) and pancreatic ductal adenocarcinoma cells in resected pancreatic ductal adenocarcinoma (PDAC) specimens, and correlate that clinically. Methods: A total of 42 paraffin-embedded PDAC tumor specimens were stained for CCN1 and evaluated via immunohistochemical (IHC) analysis. Statistical analysis was performed to correlate between CCN1 expression profiles in tumor tissues and clinicopathological parameters of patients. Results: Our results showed CCN1 (CYR61) gene was highly expressed in PDAC tissues relative to other organ specific tumor tissues. Also, moderate and overexpression of CCN1 in PanIN was associated with PanIN grade 3 tissues. A statistically significant association was found between PanIN CCN1 scores on one hand and cancer stage, cancer grade, and CCN1 expression among ductal tumor cells and adjacent stromal cells on the other hand. Discussion: The associations demonstrated suggest that CCN1 might be contributing to a substantial role in the interaction between the pancreatic tumors on one hand and their surrounding microenvironment and their precursors on the other hand; hence, it might serve as a potential therapeutic target for PDAC.

Background: Radical cystectomy (RC) remains the standard of care for muscle-invasive bladder cancer (MIBC). Because of the higher overall risks associated with RC, particularly in the elderly patients with multiple comorbidities, other less invasive bladder preservation strategies have been considered. Methods: This is a retrospective chart review of patients diagnosed with MIBC, pT2–4N0–2M0, at the American University of Beirut Medical Center between 2007 and 2017. Results: 98 patients, 85 (86.7%) males and 13 (13.3%) females, were included. Of the 98 patients, 19 (19.3%) patients were treated with upfront CRT, 35 (35.7%) were treated with upfront RC and 44 (45%) were treated with NAC. 26 (26.5%) patients underwent RC after NAC and 18 (18.4%) received CRT after NAC. The mean overall survival (OS) for the different treatment modalities was 69.4, 60.4, 56.1 and 44.2 months for RC, CRT, RC post-NAC and CRT post-NAC, respectively (p = 0.83). The median disease-free survival (DFS) was 29, 22, 21 and 16 months for RC, CRT, RC post-NAC and CRT post-NAC, respectively (p = 0.49). Patients with pT3/T4 had a higher risk of death by 3.335 folds compared to pT2 (95% CI [1.321–8.422], p

Background Female doctors are increasingly choosing oncology as a career while they are still under-represented in leadership positions globally. The European Society of Medical Oncology has recently surveyed its members regarding gender equality in the work place. Limited data are available from the Middle East. The aim of our study was to survey female oncologists practicing in the Middle East to identify common challenges and suggest areas for improvement.Methods A cross-sectional survey was distributed among female participants attending the annual Lebanese Society of Medical Oncology meeting in March 2018, and in the Pan-Arab annual meeting in April 2018. The questionnaire used included questions assessing sociodemographic characteristics, involvement in leadership and academic positions and the impact of career on family life.Results Overall, 88 questionnaires were collected from women practicing all over the Middle East. 59% reported that a male doctor was responsible for the work team; however, 57% covered a managerial or leadership role within their job. 64% of the female oncologists believed that their gender had at least moderate, significant and even major impact on their career. Participants reported that their careers have a considerable impact on their relationship with friends and social networking (49%) and their family and marriage (44%). 58% report having problems with finding balance between work and family, and 50% find barriers to attend international meetings. Several ways to improve were suggested, 56% voted for offering development and leadership training specifically women, 45% suggested implementing a flexible work schedule.Conclusion In what is considered a male dominant environment, gender equality according to female oncologists working in the Middle East, is very comparable to the world data provided. Several strategies have been identified to continue progress in this domain with the aim to improve academic leadership opportunities and work-life balance for all.