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In supply chain (SC) systems, channel coordination can be achieved by incentive alignment contracts. The contracting mechanisms reported in the literature are usually “short-term-based” and the respective decisions are assumed to be static. However, real world supply chains (SCs) operate in the long term and decisions may evolve when time passes. As a result, this paper analytically explores the instability of the short-term coordination strategies and examines the evolutionary behaviors of SC members towards SC coordination. Moreover, it incorporates the effects of SC members’ evolutionary strategy adoption into profit surplus distribution among them. To be specific, an evolutionary game theory-based model, namely the “profit surplus distribution (PSD) mechanism for supply chain coordination”, is proposed to investigate how long-term behaviors of SC members will affect the coordination decisions (i.e., choosing to collaborate) and their share of coordination profit surplus. Based on a real case in consumer electronics, we analytically investigate a two-level SC consisting of a retailer investing in sales-effort and a population of manufacturers investing in innovation effort. Using the evolutionary game theory, we examine the relationship between the evolutionary strategies of SC members towards channel coordination and the profit surplus distribution among them. The results reveal that the coordination strategy is preferred by a great percentage of manufacturers in the long term and their share of coordination profit surplus plays a critical role in affecting their evolutionary preference (and vice versa).

Concomitant vitamin D deficiency (VDD) is speculated to aggravate diabetic macular edema (DME). We aimed to determine the effect of hypovitaminosis D correction on the outcome of treatment with intravitreal bevacizumab (IVB) in DME eyes.In this randomized clinical trial, 83 eyes of 83 patients with DME were recruited and divided into three groups: normal vitamin D levels + IVB administration (Group 1), vitamin D insufficient/deficient + IVB administration (Group 2), and vitamin D insufficient/deficient + IVB administration + oral vitamin D supplementation (Group 3). Participants were followed for 6 months after the intervention. Visual (corrected distance visual acuity, CDVA) and anatomical (central macular thickness, CMT) outcomes of intervention were evaluated 1, 3, and 6 months after three monthly loading doses of IVB were given. Serum vitamin D levels were measured 1 and 6 months after the third IVB administration.A total of 29, 26, and 28 eyes were enrolled in groups 1, 2, and 3, respectively. In months 1, 3, and 6, after the three basic loading doses of IVB, visual acuity and CMT improved in all three groups, but improvements (both functional and anatomical) in groups 1 and 3 in month 6 were more significant than in group 2 (mean CDVA LogMAR changes: - 0.18 ± 0.03, - 0.14 ± 0.05, and - 0.2 ± 0.06; mean CMT reductions: - 82.24 ± 11.43, - 66.62 ± 14.34, and - 86.14 ± 18.36, in groups 1, 2, and 3, respectively; p 0.001). The mean number of IVB injections during follow-up was 5.33 (range 4-7), which did not differ between the groups.Correction of vitamin D deficiency in DME patients with type 2 diabetes and vitamin D deficiency, in addition to IVB injections, may play a role in improving CDVA and CMT. However, this beneficial effect seems to be delayed by several months.Iranian Registry of Clinical Trials (IRCT), IRCT20200407046978N1, registered on April 11, 2020, retrospectively registered ( https://en.irct.ir/trial/46999 ).

A novel zero voltage switching (ZVS) interleaved high step-up converter with for renewable energy systems is proposed in this paper. By applying a switched capacitor mixed with coupled inductor and built-in transformer, the proposed converter achieves high voltage gain and minimized voltage stress across power switches. Both of the voltage gain and the voltage stress, can be adjusted by the turns ratio of the coupled inductor and built-in transformer which gives an extra degree of freedom for the converter design. Hence operating at high duty cycles is avoided and low voltage rated semiconductors can be adopted which reduce conduction losses and improve the circuit performance. Furthermore, active clamp scheme is utilized to guarantee ZVS turn ON for the power MOSFETs and the leakage inductances of the magnetic means help to provide zero current switching (ZCS) of the diodes. In such a case, switching losses are minimized and the reverse current recovery is alleviated. Accordingly, the proposed converter with reduced counterparts is a suitable candidate for high step-up and high power applications. Finally, a 600W prototype with 24V-480V voltage conversion is built to demonstrate the performance of the proposed converter.

Objective Infertility had an increasing trend between couples in Iran. Several factors such as lifestyle, physical activity, unhealthy dietary habits and stress are associated with production of ROS in seminal fluid. The aim of this study was to identify the role of dietary antioxidants and vitamins intake on semen quality parameters, among Iranian infertile men. Methods This cross-sectional study was performed on 400 newly diagnosed infertile men in Yazd Reproductive sciences Institute from July 2019 to December 2019. The presence of infertility was confirmed by an expert andrologist, based on WHO criteria. Dietary antioxidants and vitamins intake were assessed using a 168 items semi-quantitative food frequency questionnaire (FFQ). Results We found an association between semen volume and Alpha Carotene dietary intake, total motility and Beta Cryptoxanthin dietary intake, and sperm count with riboflavin intake (P = 0.03). Conclusions We concluded that dietary intake of Alpha Carotene, Beta Cryptoxanthin, and Riboflavin are related to sperm count, semen volume and total motility in Iranian infertile men, respectively. Our data suggest that that adhering to a diet that is rich in sources of antioxidant and vitamin can have a positive effect on men’s sexual health. However, more research is needed to confirm these relations and provide the evidence needed to exert these findings into clinical practice.

Semantic segmentation of ground-based all-sky images (ASIs) can provide high-resolution cloud coverage information of distinct cloud types, applicable for meteorology-, climatology- and solar-energy-related applications. Since the shape and appearance of clouds is variable, and there is high similarity between cloud types, a clear classification is difficult. Therefore, most state-of-the-art methods focus on the distinction between cloudy and cloud-free pixels without taking into account the cloud type. On the other hand, cloud classification is typically determined separately at the image level, neglecting the cloud's position and only considering the prevailing cloud type. Deep neural networks have proven to be very effective and robust for segmentation tasks; however they require large training datasets to learn complex visual features. In this work, we present a self-supervised learning approach to exploit many more data than in purely supervised training and thus increase the model's performance. In the first step, we use about 300 000 ASIs in two different pretext tasks for pretraining. One of them pursues an image reconstruction approach. The other one is based on the DeepCluster model, an iterative procedure of clustering and classifying the neural network output. In the second step, our model is fine-tuned on a small labeled dataset of 770 ASIs, of which 616 are used for training and 154 for validation. For each of them, a ground truth mask was created that classifies each pixel into clear sky or a low-layer, mid-layer or high-layer cloud. To analyze the effectiveness of self-supervised pretraining, we compare our approach to randomly initialized and pretrained ImageNet weights using the same training and validation sets. Achieving 85.8 % pixel accuracy on average, our best self-supervised model outperforms the conventional approaches of random (78.3 %) and pretrained ImageNet initialization (82.1 %). The benefits become even more evident when regarding precision, recall and intersection over union (IoU) of the respective cloud classes, where the improvement is between 5 and 20 percentage points. Furthermore, we compare the performance of our best model with regards to binary segmentation with a clear-sky library (CSL) from the literature. Our model outperforms the CSL by over 7 percentage points, reaching a pixel accuracy of 95 %.

This paper considers the problem of an unmanned aerial vehicle (UAV)-enabled cloud network under partial computation offloading scenario, where multiple UAV-mounted aerial base stations are employed to serve a group of remote Internet of Things ground-based smart devices (ISDs). The main objective of this work is to maximize energy efficiency by minimizing the number of needed drones while minimizing the cost associated with serving the ISDs under some realistic quality of service constraints. To that end, we aim to jointly optimize the three-dimensional (3D) UAV placements, transmit power, and cloud resources. This represents a challenging, non-convex and NP-hard optimization problem. In this work, we decompose the optimization problem into three separate subproblems namely, two-dimensional (2D) UAV positioning, UAV altitude optimization, and UAV-cloud resource association. These subproblems are solved using a modified global K-means, successive convex approximation, and successive linear programming techniques. A comprehensive simulation study and comparative evaluation against the state-of-the-art (SOTA) algorithms are conducted to demonstrate the utility of the proposed approach and its benefits in applications of interest.

In today’s competitive business environment, companies are striving to reduce costs and workload of call centers while improving customer satisfaction. In this study, a framework is presented that predicts and encourages taking proactive actions to solve customer problems before they lead to a call to the call center. Machine learning techniques are implemented and models are trained with a dataset which is collected from an internet service provider’s systems in order to detect internet connection problems of the customers proactively. Firstly, two classification techniques which are multi perceptron neural networks and radial basis neural networks are applied as supervised techniques to classify whether the internet connection of customers is problematic or not. Then, by using unsupervised techniques, namely Kohonnen’s neural networks and Adaptive Resonance Theory neural networks, the same data set is clustered and the clusters are used for the customer problem prediction. The methods are then integrated with an ensemble technique bagging. Each method is implemented with bagging in order to obtain improvement on the estimation error and variation of the accuracy. Finally, the results of the methods applied for classification and clustering with and without bagging are evaluated with performance measures such as recall, accuracy and Davies-Bouldin index, respectively.

A high step-up dc–dc converter with multiple magnetic devices and switched-capacitor voltage multiplier cell (SC VMC) is proposed in this article. By simultaneous implementation of a coupled inductor (CI) and a built-in transformer (BIT), the voltage gain is flexibly increased with an additional degree of freedom in comparison with the converters with only BIT or CI. To further increase the voltage gain, the secondary winding of the CI is inserted in series with the primary winding of the BIT. This new architecture leads to multiplication of the turns ratios of the CI and BIT in the voltage gain expression, as well. The SC VMC not only extends the voltage gain but also reduces the voltage stress across the MOSFETs. To have a better device utilization, the blocking capacitor is participated in voltage gain improvement. Moreover, through active clamp circuit, the leakage energy of the magnetic devices is recycled and zero voltage switching (ZVS) performance is obtained for the main and auxiliary MOSFETs. In such a case, the switching frequency can be increased to reduce the volume of the converter. Finally, a 400-W laboratory prototype with 25– 400 V voltage conversion is fabricated to demonstrate the effectiveness of the proposed converter.

Background & Aim The appropriate meal consumption affects the children's and adolescents' health. Few studies have shown an association between the socioeconomic inequality and the eating behavior among children and adolescents. Therefore, the aim of this study was to assess the socioeconomic inequality in meal skipping patterns among children and adolescents. Materials & Methods The data were accessible through the fifth round of a school‐based program in Iran in 2015. In this cross‐sectional nationwide study, 14,286 students aged 7–18 years were selected via the multistage cluster sampling from 30 provinces of Iran. The Global School‐based Health Survey validated questionnaire was used to assess the socioeconomic variables and meal consumption patterns among children and adolescents. Socioeconomic status (SES) was computed using principle component analysis method. Multivariate logistic regression analysis was used to assess the socioeconomic inequality in meal skipping patterns. Results The frequency of breakfast, lunch, and dinner skipping were 13.8% (95% CI: 13.3–14.5), 6.8% (95% CI: 6.4–7.2), and 7.5% (95% CI: 7.1–7.9), respectively. In multivariate model, living in a two‐parent family compared to living in a single‐parent family decreased the odds of breakfast skipping (OR: 0.53, 95% CI: 0.42–0.67)). Low SES level was associated with higher odds of skipping breakfast (OR: 1.79, 95% CI: 1.50–2.14) and dinner (OR: 1.80, 95% CI: 1.42–2.28). Moreover, maternal illiteracy and unemployment were associated with skipping breakfast, lunch, and dinner (all p values

Purpose Boarding is a common problem in the emergency department (ED) and is associated with poor health care and outcome. Imam Khomeini Hospital is the main healthcare center in Urmia, a metropolis in the northwest of Iran. Due to the overcrowding and high patient load, we aim to characterize the rate, cause and consequence of boarding in the ED of this center. Methods All medical records of patients who presented to the ED of Imam Khomeini Hospital from August 1, 2017 to August 1, 2018 were retrospectively analyzed. Patients with uncompleted records were excluded. Boarding was defined as the inability to transfer the admitted ED patients to a downstream ward in ≥2 h after the admission order. Demographic data, boarding rate, mortality and triage levels (1–5) assessed by emergency severity index were collected and analyzed. The first present time of patients was classified into 4 ranges as 0:00–5:59, 6:00–11:59, 12:00–17:59 and 18:00–23:59. Descriptive, parametric and non-parametric statistical tests were performed and the risk of boarding was determined by Pearson Chi-square test. Results Demographic data analysis showed that 941 (58.5%) male and 667 (41.5%) female, altogether 1608 patients were included in this study. Five patients (0.3%) died. The distribution of patients with the triage levels 1–5 was respectively 79 (4.9%), 1150 (71.5%), 374 (23.3%), 4 (0.2%) and 0 (0%). Most patients were of level 2. Only 75 (4.7%) patients required intensive care. The majority of patients (84.2%) were presented at weekdays. The maximum patient load was observed between 12:00–17:59. Of the 1608 patients, 340 (21.1%) experienced boarding within a mean admission time of 13.70 h. Among the 340-boarded patients, 20.1% belonged to surgery, 12.1% to orthopedics, 10.9% to neurosurgery and 10.3% to neurology. The boarding rate was higher in females, patients requiring intensive care and those with low triage levels. Compared with the non-boarded, the boarded patients had a higher mean age. Conclusion The boarding rate is higher in the older and female patients. Moreover, boarding is dependent on the downstream ward sections: patients requiring surgical management experience the maximum boarding rate.

PurposePlant-based diets have been related to decreasing morbidity and mortality of many non-communicable diseases. The purpose of this study was to investigate the relationship between plant-based diets and lipid profiles and anthropometric indices.Design/methodology/approachThis cross-sectional study was performed on 236 men and women selected from Shiraz health-care centers. This study used a 168-item food frequency questionnaire to calculate plant-based diet index (PDI), healthy plant-based diet index (hPDI) and unhealthy plant-based diet index (uPDI). Total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol and triglycerides were measured. Furthermore, body mass index, a body shape index and conicity index (CI) were calculated after measuring weight, height and waist circumference.FindingsHigher score of PDI was significantly related to higher triglycerides level (OR = 2.16; 95% CI: 1.04, 4.48;P= 0.03). In the fully adjusted model, there was a significant association between ABSI and hPDI (OR = 4.88; 95% CI: 1.17, 20.24;P= 0.03). A significant inverse association was observed between uPDI and high-density lipoprotein (HDL) (OR = 0.45; 95% CI = 0.21, 0.98;P= 0.03). Also, this study found a decreasing, but insignificant trend in relation of ABSI (OR = 0.72; 95% CI = 0.22, 2.34) and CI (OR = 0.41; 95% CI = 0.06, 0.56) with PDI.Research limitations/implicationsFurther studies are needed to explore the association of PDI with anthropometric indices and lipid profile and also to assess the potential causality of the observed associations. Plant-based diets according to their contents could affect triglycerides, HDL and anthropometric properties.Practical implicationsHence, dietitians should consider the findings of this study such as the inverse effect of unhealthy plant-based diets on HDL and the relation between healthy plant-based diets and WC and abdominal obesity.Originality/valueThis study showed that adherence to a plant-based diet was related to higher triglycerides levels. Also, uPDI was inversely associated with HDL level. Furthermore, participants who adhered more to a healthy plant-based diet had higher abdominal adiposity.

BACKGROUND: Despite the exact etiopathogenesis of psoriasis remains unknown, the increasing or decreasing of some trace elements and oxidative stress status are considered to play a role. In this study, the effect of Lactocare R synbiotic on the serum levels of trace elements including Zn, Cu, Mg, Na, Fe, P, Ca, and K in the patients with mild to moderate psoriasis was investigated. METHODS: Sixty-four patients with mild to moderate psoriasis were included. Patients were randomly divided into treatment (n32) and control (n32) groups. The treatment group received Lactocare R and the control group received a placebo (two times daily for 12 weeks). Eight patients from the intervention group and 18 patients from the control group discontinued the study because of the recent COVID-19 condition. For routine trace element analysis, the blood samples were collected from all patients at the baseline as well as week 12 post-treatment. The serum was then isolated and the serum levels of trace elements including Fe, K, Ca, Mg, P, Zn, Na, and Cu were measured using an automatic electrolyte analyzer. For confirmation of the effect of Lactocare R on the alteration of serum levels of trace elements, intra-group analysis was performed at two interval times: baseline and week 12 post-treatment. RESULTS: The serum levels of K, P, and Ca in the placebo group were significantly higher than that of the treatment group at baseline. Serum levels of Zn and Ca were significantly higher in the treatment group compared to the placebo group at week 12 post-treatment. Moreover, a significantly lower serum level of K, P, and Ca in the treatment group at the baseline compared to the placebo group was compensated on week 12 post-treatment. Intra-group analysis in the treatment group showed that the serum levels of Fe, Ca, Mg, P, Zn, and Na was significantly increased at week 12 post-treatment compared to baseline levels. Whereas, intra-group analysis in the control group showed only Ca has a significant difference between baseline and week 12 post-treatment. CONCLUSION: The serum levels of Fe, Zn, P, Mg, Ca, and Na are increased significantly 12 weeks after oral administration of Lactocare R in psoriatic patients. The serum level of Fe and Cu is affected by sex at pre- and post-treatment. This study supports the concept that Lactocare R exerts beneficial effects in the gastrointestinal tract to improve mineral absorption in psoriatic patients.

Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer in the United States and it is found in 17% of patients thought to have complicated diverticular disease. However, primary adenocarcinoma rarely occur in the colostomy site and the risk of developing malignancy is similar to that of any other colonic segment. Polyps found in CRC screenings can be divided into the following types: hyperplastic polyps, polyps with no malignant potential, adenomatous polyps, polyps with malignant potential, and malignancies. Local complications of the colostomy can appear in the immediate, early, or late postoperative period, with an incidence ranging from 15 to 30%; neoplasia is even less common.

Aims Psychological factors are among the most suspected indicators which may cause atherosclerosis. Coping strategies modifying psychological stress may be significantly associated with health outcomes. However, little is known about the influence of adaptive and maladaptive coping strategies on major adverse cardiovascular disease (CVD) events. The purpose of this study is to examine this idea among a sample of adults. Design: cohort study. Methods and results The Isfahan cohort study (ICS) is a longitudinal population-based, prospective study. Participants (N=6323 individuals aged 35 years or greater at baseline) were selected by multistage random sampling with 6-year intervals (i.e. 2001: 6323 individuals, 2007: 3296 individuals, and 2013: 1706 individuals). Adaptive and maladaptive coping strategies were evaluated by a multicomponent self-administered stress management paper-based questionnaire. All CVD events were confirmed by a blinded panel of experts and a marginal cox regression model was used to model the survival data. Adaptive coping strategies could be protective against CVD events with hazard ratios (95% confidence interval) [0.97 (0.95–0.99)] and maladaptive coping strategies seem to be a risk factor, 1.02 (1.01–1.04) in the whole population. Individuals younger than 60 showed similar results, with 0.96 (0.93–0.98) and 1.04 (1.01–1.07) for adaptive and maladaptive coping strategies, respectively. However, these findings were not replicated among seniors older than age 60. Conclusion Based on our results, coping strategies have an important role in cardiovascular events, particularly among young adults. According to the results, informing patients about adaptive stress management may promote primary prevention of CVD events.

The core objectives of sustainable development are to develop access to renewable, sustainable, reliable, and cost-effective resources. Wind is an essential source of renewable energy, and monopile wind turbines are one method proposed for harnessing wind power. Offshore wind turbines can be vulnerable to earthquakes and liquefaction. This numerical study defined the effects of wind turbine weight on the seismic response of a wind turbine-monopile system located in liquefied multilayered soil with layer thicknesses of 5, 10, 15, and 20 m using four far-field records. OpenSees PL analysis indicated that if the liquefied sand had a lower density or a thickness of more than 10 m, then an increase in the earthquake acceleration beyond 0.4 g caused the pile to float like liquefied soil and to lose its vertical bearing capacity. Moreover, increasing the wind turbine power from 2 to 5 kW had no significant effect on the soil-structure interaction response. As the earthquake acceleration increased, the bending moment of the pile-column also increased as long as liquefaction did not occur and the pile-column deformation remained rotational-spatial in shape. As the acceleration and liquefaction increased and the pile began to float in response to its transverse motion, there was no significant difference in the pile-column displacement along the length, but there was a decrease in the pile-column bending moments. As this phenomenon increased and the pile continued to float, transformation of the pile increased the difference between the displacement of the pile-column along its length and further increased the bending moments. These results were derived from multiple correlation analysis, the bending moment relations, and lateral displacement of the pile-column of the wind turbine.

This review aims to investigate the effect of stem cell (SC) therapy on the management of neurogenic bladder (NGB) in four neurological diseases, including spinal cord injury (SCI), Parkinson’s disease (PD), multiple sclerosis (MS), and stroke, in the clinical setting. An electronic database search was conducted in the Cochrane Library, EMBASE, Proquest, Clinicaltrial.gov , WHO, Google Scholar, MEDLINE via PubMed, Ovid, Web of Science, Scopus, ongoing trial registers, and conference proceedings in June 2019 and updated by hand searching on 1 February 2021. All randomized controlled trials (RCTs), quasi RCTs, phase I/II clinical trials, case-control, retrospective cohorts, and comprehensive case series that evaluated the regenerative potential of SCs on the management of NGB were included. Cochrane appraisal risk of bias checklist and the standardized critical appraisal instrument from the JBI Meta-Analysis of Statistics, Assessment, and Review Instrument (JBI-MAStARI) were used to appraise the studies. Twenty-six studies among 1282 relevant publications met our inclusion criteria. Only SC therapy was applied for SCI or MS patients. Phase I/II clinical trials (without control arm) were the most conducted studies, and only four were RCTs. Four studies with 153 participants were included in the meta-analysis. The main route of transplantation was via lumbar puncture. There were no serious adverse events. Only nine studies in SCI and one in MS have used urodynamics, and the others have reported improvement based on patient satisfaction. SC therapy did not significantly improve residual urine volume, detrusor pressure, and maximum bladder capacity. Also, the quality of these publications was low or unclear. Although most clinical trials provide evidence of the safety and effectiveness of MSCs on the management of NGB, the meta-analysis results did not show a significant improvement; however, the interpretation of study results is difficult because of the lack of placebo controls.

Background The patient-directed PREPAREforYourCare.org program empowers patients to participate in advance care planning (ACP) discussions with clinicians. Our goal was to determine whether PREPARE could reciprocally increase clinician ACP communication. Methods In a secondary analysis of two trials evaluating the efficacy of PREPARE plus an easy-to-read advance directive (AD) versus an AD alone, patients were included if they were ≥55 years old, English- or Spanish-speaking, and had ≥2 chronic conditions. We audio-recorded postintervention primary care visits and used the validated clinician-patient participation coding scheme to calculate the number of clinician ACP utterances concerning information-giving, recommendations, or supportive talk. We examined differences by study arm using mixed effects negative binomial models, stratifying by language. To assess possible mediation, we adjusted for active patient participation (e.g., asking questions or stating preferences). Results Three hundred ninety-three visits were audio-recorded (177 in PREPARE arm and 216 in AD-only arm). Recordings included 179 clinicians (mean 2.2 [SD 1.9] patients each). Patients' mean age was 66 ± 8 years, 31% had limited health literacy, and 25% were Spanish-speaking. Exactly 67% of recordings included information-giving, 85% recommendations, and 62% supportive talk. PREPARE resulted in 51% more clinician supportive talk versus the AD alone (mean 4.5 [8.9] vs. 2.9 [6.0] utterances; incidence rate ratio 1.51 [95% CI 1.02-2.24]). Effects were most pronounced among Spanish speakers. There were no differences in information-giving or recommendations. After adjusting for active patient participation, no differences in supportive talk remained. Conclusions The patient-directed PREPARE program was associated with greater clinician supportive ACP communication with older adults compared with an AD alone; the effect was most pronounced among Spanish speakers and was mediated by active patient participation. Thus, PREPARE helps patients be more engaged communicators, which in turn encourages clinicians to be more supportive of patients. Enhanced patient-clinician communication represents an important mechanism by which PREPARE may decrease disparities in ACP.

Objectives Postprandial distress syndrome (PDS) is associated with food indigestion. Efficacy of drugs used against PDS is limited whereas dietary modifications were shown to have important beneficial effects. Traditional Persian Medicine (TPM) sages suggested a dietary regimen known as Persian metabolic diet (PMD) for the management of PDS patients. In this study, the efficacy of PMD in alleviating the symptoms of PDS was explored. Methods This single-center, parallel-group, randomized clinical trial included 56 patients whom were randomly allocated to PMD group (29 participants) and Optional diet (OD) group (27 participants). They were instructed to follow the protocol for two weeks. Using a standard validated questionnaire, all outcomes were evaluated at baseline, end of the intervention period, and end of follow-up time. Results At the end of the intervention period, comparing the changes of severity scores between the groups showed a statistically significant difference in week 2 (p-value Conclusions This diet prepared based on Persian medicine seems to be effective in relieving the symptoms of patients with PDS.

Pregnancy is considered as one of the most important events in every woman's life, which is not a pleasant event for all women, and in cases where the stages are not managed properly, it can cause a lot of stress on the mother and her family. For this reason, the present study was conducted to investigate the effect of phenylephrine on oxytocin-induced hemodynamic changes. This study was conducted on a group of pregnant women referred to Ayatollah Taleghani Hospital in Ilam and those undergoing cesarean section were included in the study. The objectives of the study explained to the women participating in the study, whether the participation was voluntary or not to participate in the intervention, compliance with the Helsinki and Belmont Declaration, and confidentiality of information. The women included in the study were randomly assigned to experimental and control groups. The checklists of the researchers were completed by observing and asking the patients from the time the patient entered the hospital until the end of the surgery. The variables expected by the researchers were evaluated before the intervention and 2, 4, 6, 8, 10 and 12 minutes after the intervention. In the experimental group, 12 (30%) patients had no nausea, 18 (45%) patients had low nausea, 8 (20%) patients had moderate nausea and 2 (5%) patients had severe nausea. While in the control group, 5 (12.5%) patients had no nausea, 13 (32.5%) patients had low nausea, 14 (35%) patients had moderate nausea and 8 (20%) patients had severe nausea. Also, a significant difference was between in the experimental and control groups in terms of nausea (P = 0.02). The study results showed that using phenylephrine can be effective on improving blood pressure, heart rate, nausea and vomiting in patients, which for this reason it is recommended to use this drug to improve the health of women undergoing cesarean section.

In this paper, an interleaved zero voltage switching high step‐up converter based on active clamp, coupled inductor (CI), built‐in transformer (BIT), and switched capacitor (SC) is proposed. The main novelty of the proposed converter is that the secondary winding of the CI is inserted between the primary winding of the CI and the primary winding of the BIT. Therefore, the voltage gain can be achieved in proportionate to the multiplication of the turn ratios of the CIs and BIT. The configuration of the proposed converter not only increases the voltage gain, but also reduces the current and voltage stress of the power switches and restricts the input current ripple, which decreases the conduction losses and increases the lifetime of the input source. Also, zero voltage switching turn‐ON and turn‐OFF conditions for all switches are achieved by employing an active clamp configuration. The voltage across the diodes clamped to the output voltage and the reverse recovery problem is reduced due to the leakage inductors. Finally, a 600 W prototype with 24–400 V voltage conversion is built to verify the performance and theoretical analysis.

Introduction This study aimed to evaluate the sensitivity of the erect chest X-ray for diagnosing subdiaphragmatic free air. Furthermore, we examined the effects of different parameters, including sex, age, size of perforation, and the location of perforation on the sensitivity of the erect CXR. Methods This study included all patients with perforated peptic ulcer (107 cases) referred to the Shahid Rajaei hospital of Tonekabon from April 2015 to August 2020. The perforated peptic ulcer was confirmed by laparotomy, and the erect chest X-ray was performed as a preoperative procedure. The collected checklist was analyzed using the IBM SPSS Statistics V22.0 software. Results Achieved results showed total sensitivity of 86% for the erect chest X-ray. The sensitivity of the erect CXR was calculated, 88.5% and 82.6% at males and females, respectively. However, the sensitivity for different age groups was about 86%. The larger perforations resulted in higher sensitivity. Furthermore, the erect chest X-ray sensitivity for duodenal perforations (92.5%) was significantly greater than the gastric perforations (75%). Conclusion Based on this study, the erect chest X-ray could be utilized as a preoperative procedure with total sensitivity of 86% for gastroduodenal perforations. Patients' age and sex have no significant impact on the sensitivity (P-value > 0.05). However, the size and location of perforation significantly influenced the sensitivity (P-value Implications for practice The erect chest X-ray is used as a routine procedure to detect subdiaphragmatic free air in gastroduodenal perforations. The effects of different factors such as age, sex, size of perforation, and the location of perforation on the sensitivity of the erect chest X-ray are discussed for the first time in this study.

Background Family-centered care has been considered as a philosophy of care. Family presence in intensive care units (ICUs), especially in the acute phase of the disease is controversial. This study has been carried out in order to determine the effect of the family presence on anxiety and agitation in patients undergoing coronary artery bypass grafting (CABG). Materials and methods In a clinical trial, 70 patients were randomly allocated into groups of experimental and control. In the experimental group, during the weaning process from the mechanical ventilation, a family member was present at the bedside. The degree of anxiety and Richmond’s Agitation and Sedation Scale (RASS) were compared in seven consecutive time stages, including the time of entry into the ICU, the first respiratory drive, the family entrance, 20 min and 1 h after the presence of the family member, the time of extubation, and 1 h after extubation. Results There was a significant difference between the two groups in the mean scores of the anxiety scale in the first (P =0.008), second (P=0.002), and third stages (P =0.005). This difference was not significant in the fourth to seventh stages (P>0.05). As the baseline anxiety levels were different, a covariate adjustment was used for comparisons between treatments, adjusting the main analyses for baseline anxiety levels. Analysis showed that groups were not different. Also, there was no significant difference in the mean scores of RASS between the two experimental and control groups at any of the seven stages (P> 0.05). Conclusion According to the findings of the present study, the presence of a family member does not reduce the level of anxiety and agitation of patients undergoing cardiac surgery. However, it can be concluded that this intervention is feasible in acute and complex situations after open heart surgeries. Trial registration This study has been registered in the Iranian Registry of Clinical Trials with the code IRCT201609014299N4.

Background. Aerobic training somewhat corrects endothelial dysfunction in patients with coronary artery disease (CAD), but the most effective form of exercise is still unclear; therefore, the purpose of the present study was to investigate the effect of 8 weeks of continuous aerobic exercise on serum vascular endothelial growth factor (VEGF) as an angiogenic factor and endostatin (ES) as an angiostatic factor in male rats with coronary artery disease. Methods. The subjects of the present experimental study were 30 healthy male 2-months old Wistar rats divided into three groups: the experimental group, the control group with coronary artery disease, and the healthy control group. After rupturing 20 of the rats by isoproterenol, 10 rats in the experimental group performed eight weeks of continuous aerobic exercise on a treadmill, with an incremental intensity of 50% in the first session to 78% in the last session, whereas both control groups did not exercise. Seventy-two hours after the final training session, blood samples were taken for serum VEGF and ES indices, and one-way ANOVA with Scheffer posthoc tests was used to compare the mean of variables among the studied groups. Results. The results showed that discontinuous aerobic exercise could increase the blood VEGF in rats with coronary artery disease (P≤0.01), while there was no difference in the level of endostatin in the experimental group compared with control groups (P>0.05). Conclusion. It seems that continuous aerobic exercises can be used in the rehabilitation of patients with coronary artery disease and might be effective in the process of angiogenesis.

Background. One of the strategies for overcoming diuretic resistance among heart failure (HF) patients is adding thiazide-type diuretics. The main aim of this article is to compare the adverse clinical outcomes, including death and re-hospitalization, among individuals suffering from severe acute decompensated HF (ADHF) that consumed furosemide or furosemide plus metolazone. Methods. This retrospective cohort study was done in the context of the Persian registry of cardiovascular disease (PROVE) from September 2017 to September 2018. One thousand and four hundred thirty-eight individuals (furosemide: 972 and furosemide plus metolazone: 466) with the final diagnosis of severe ADHF (left ventricular ejection fraction < 30%) were selected and followed for 10.3 ± 7.8 months. The association between two groups, as mentioned above, with the incidence of death and re-admission, was evaluated with different models. Results. The mean age of the study population was 68.19 ± 12.98 years. There was no significant relation in terms of death or re-hospitalization between patients with different diuretic regimens. After adjustment of potential confounders, we found that adding metolazone as an adjuvant HF therapy was not independently associated with death or re-hospitalization (hazard ratio (HR): 0.78,95% confidence interval (CI) = 0.59–1.03, P = 0.085, and odds ratio (OR): 0.80, 95% CI: 0.60–1.07, P = 0.135, respectively). Conclusion. Our findings revealed that adding metolazone in patients with furosemide resistance is not associated with higher morbidity and mortality. Therefore, usage of these two therapeutic agents could be a helpful strategy for severe HF patients.

Purpose Geriatric nutritional risk index (GNRI) is one of the new tools to determine nutritional status in the elderly. This study assessed the association between GNRI and muscular strength through handgrip strength (HGS) in patients undergoing hemodialysis. Methods This cross-sectional analytical study assessed 110 hemodialysis patients at Guilan, North of Iran, (mean age of 70.3 ± 6.93), 57 men and 53 women through simple random sampling. Demographic characteristics, GNRI, and HGS of patients were determined. Data were analyzed using descriptive and inferential statistics, including independent t test, AVOVA, Pearson correlation, and linear multiple regression tests. Results The mean values of the GNRI and HGS were 93.90 ± 11.06 and 14.82 ± 3.72, respectively. Finally, it was identified that there is a direct and significant association between GNRI and HGS (p = 0.001, r = 0.734). Linear multiple regression showed that GNRI is an independent predictor of HGS (Adj.R2 = 0.67, βGNRI = 8.13). Conclusion GNRI can be used as a predictor of muscular strength in hemodialysis patients.

La enfermedad del COVID-19 fue declarada pandemia en marzo de 2020, causando complicaciones de salud graves e incluso la muerte, a la fecha, en más de dos millones de personas a nivel mundial. Hasta el momento no existe ningún medicamento eficaz contra el COVID-19 y la única esperanza para mitigar la pandemia será el uso masivo de la vacuna. En esta misma línea, en la última década se han formado movimientos contra la vacunación en el mundo, creando incertidumbre sobre la efectividad de las mismas. Por tal razón son importantes las estrategias de educación sobre vacunación como pilares para el avance en políticas de salud pública en nuestro país. Con el objetivo de determinar la percepción de la población en República Dominicana (R.D.) acerca de la vacunación contra el COVID-19, se diseñó un estudio descriptivo de corte transversal, usando un formulario en línea, compuesto por preguntas cerradas y semicerradas. De un total de 841 respuestas válidas (59.5 % mujeres y 40.5 % hombres) con una media de 31,33 años. La mayoría de los participantes (43.3 %, n=364) fueron residentes de la provincia de Santiago de los Caballeros (n=364; 43.3 %). Los estudiantes universitarios representaron el 45.1 % (n= 379) de la población encuestada. Actualmente, 208 de los participantes están desempleados (24.7 %), la comorbilidad más frecuente fue la hipertensión arterial (11.4 %). Un 44.7 % de ellos respondió positivamente a la eventual aplicación de la vacuna y el género con mayor aceptación fue el masculino (54.3 %), solo un 28.8 % contestó que se vacunará en cuanto haya disponibilidad; 61.6 % piensa que la vacuna será moderadamente efectiva, 26.2 % temen de los efectos adversos en futuro y un 11.2 % cambiaría su opinión si una figura pública se aplicase la vacuna. La información por parte de las autoridades locales e internacionales no tuvo alcance para un 70.4 % de los participantes. Un 68 % de la población tiene dudas sobre el desarrollo de la vacuna y un 70.7 % considera que no debe ser obligatoria su aplicación. La mayoría confía en el trabajo de los científicos (68.5 %) y en las empresas farmacéuticas (58.4 %) acerca del desarrollo de la vacuna. La población de estudio mostró una percepción no favorable hacia la vacunación contra COVID-19, evidenciando la necesidad de implementar una campaña de información y orientación masiva.

Patients with anterior circulation ischemic strokes due to large vessel occlusion (AIS-LVO) and very severe neurological deficits (National Institutes of Health Stroke Scale (NIHSS) score > 25) were under-represented in clinical trials on endovascular treatment (EVT). We aimed to evaluate safety and outcomes of EVT in patients with very severe vs. severe (NIHSS score 15–25) neurological deficits. We included consecutive patients undergoing EVT for AIS-LVO between January 2015 and December 2019 at Lille University Hospital. We compared rates of parenchymal hemorrhage (PH), symptomatic intracranial hemorrhage (SICH), procedural complications, and 90-day mortality between patients with very severe vs. severe neurological deficit using univariable and multivariable logistic regression analyses. Functional outcome (90-days modified Rankin Scale) was compared between groups using ordinal logistic regression analysis. Among 1484 patients treated with EVT, 108 (7%) had pre-treatment NIHSS scores > 25, 873 (59%) with NIHSS scores 15–25 and 503 (34%) with NIHSS scores 25 and NIHSS 15–25. Patients with NIHSS > 25 had a lower likelihood of improved functional outcome (adjcommon OR 0.31[95% CI 0.21–0.47]) and higher odds of mortality at 90 days (adjOR 2.3 [95% CI 1.5–3.7]) compared to patients with NIHSS 15–25. Successful recanalization was associated with better functional outcome (adjcommon OR 3.8 [95% CI 1.4–10.4]), and lower odds of mortality (adjOR 0.3 [95% CI 0.1–0.9]) in patients with very severe stroke. The therapeutic effect of recanalization on functional outcome and mortality was similar in both groups. In patients with very severe neurological deficit, EVT was safe and successful recanalization was strongly associated with better functional outcome at 90 days.

BACKGROUND Early-onset scoliosis (EOS) is common in children with cerebral palsy (CP). The effectiveness of magnetically controlled growing rods (MCGR) and the risk for unplanned return to the operating room (UPROR) remain to be studied in this patient population. The primary outcome of this study was to examine the frequency of UPROR between MCGRs as compared with traditional growth friendly (TGF) surgeries for children with EOS secondary to CP. METHODS Patients with EOS secondary to CP were prospectively identified from an international database, with data retrospectively analyzed. Scoliosis, kyphosis, T1-S1, and T1-T12 height were measured preoperation, immediate postoperation, and at minimum 2-year follow-up. The risk and etiology of UPRORs were compared between MCGR and TGF. RESULTS Of the 120 patients that met inclusion criteria, 86 received TGF (age 7.5±0. 1.8 y; mean follow-up 7.0±2.9 y) and 34 received MCGR (age 7.1±2.2 y, mean follow-up 2.8±0.0.5 y). Compared with TGF, MCGR resulted in significant improvements in maintenance of scoliosis (P=0.007). At final follow-up, UPRORs were 8 of 34 patients (24%) for MCGR and 37 of 86 patients (43%) for TGF (P=0.05). To minimize the influence of follow-up period, UPRORs within the first 2 years postoperation were evaluated: MCGR (7 of 34 patients, 21%) versus TGF (20 of 86 patients, 23%; P=0.75). Within the first 2 years, etiology of UPROR as a percentage of all patients per group were deep infection (13% TGF, 6% MCGR), implant failure/migration (12% TGF, 9% MCGR), dehiscence (4% TGF, 3% MCGR), and superficial infection (4% TGF, 3% MCGR). The most common etiology of UPROR for TGF was deep infection and for MCGR was implant failure/migration. CONCLUSION For patients with EOS secondary to CP, there was no difference in the risk of UPROR within the first 2 years postoperatively whether treated with TGF surgery or with MCGRs (23% TGF, 21% MCGR). LEVEL OF EVIDENCE Level III-retrospective cohort, therapeutic study.

In Morocco, the phenomenon of silting affects all the dams, where more than 75 Mm3 of sediments are deposited every year at the bottom of the reservoirs. The aim of our study is to assess the contribution of the bathymetric multi-beam sonar as well as static and mobile laser scanners in the estimation of siltation of the basin of the Tanger-Med dam in the north of Morocco. The proposed methodology consists of performing and fusion of a bathymetric survey by multi-beam echo-sounder with terrestrial laser scanner surveys in static mode and mobile mode. The result of these surveys is used, for the calculation of the siltation volume and the inspection of the upstream facing of the main structure. Siltation calculation was carried out with comparison to a reference survey obtained by single beam sonar. The comparison between these two instruments showed that the multi-beam presents many advantages: high density of the cloud of points acquired and precision. The density allows providing a better description of the dam's bottom. The comparative study between the two types of scanners showed that static scanner offers a better accuracy. However, mobile scanner gives more accessibility of all parts of the dam. As a conclusion, the multi-beam echo-sounder with additional laser scanner data have many advantages in this study: volume calculation precision, reduction of the acquisition time and the enhancement of the acquired point cloud density. We also obtained a global 3d modelling useful for the monitoring of the infrastructure.

Objective: Non-steroidal anti-inflammatory drugs (NSAIDs) exposure might be considerably associated with a decreased risk of Alzheimer's disease (AD). Therefore, we conducted an experiment to investigate the impact of indomethacin (IND) on inflammasome as a key player of neuroinflammation.Methods: The Alzheimer's-like condition was induced by streptozotocin (STZ) in rats. IND was injected intraperitoneally 1 d prior to STZ administration and resumed with 2 d interval up to 60 d. Morris water maze (MWM) was utilized to assess learning and memory. The expression level of genes that contribute to the inflammasome pathway was measured using real-time polymerase chain reaction (PCR). To authenticate the obtained outcomes, immunostaining for caspase-1, interleukin-1β (IL-1β), and phosphorylated tau (p-Tau) protein was conducted.Results: Behavioral experiments indicated that IND treatment was able to improve learning and memory performance (p

Systemic arterial hypertension is an independent risk factor for coronary heart disease, stroke, heart failure, and chronic kidney diseases. Spirulina is microalgae with nutritious ingredients and has potential attenuating effects on chronic diseases including hypertension. Spirulina can be added to food products in order to develop functional foods. The aim of this study was to assess the effects of 8-week consumption of a salad dressing containing 2 g of spirulina platensis powder versus a placebo dressing on patients with hypertension. In this triple-blind randomized clinical trial, 48 patients with hypertension were enrolled to receive daily either spirulina-fortified dressing or placebo for 2 months. A total of 41 patients completed this study. We observed that the consumption of spirulina dressing significantly reduced systolic blood pressure (p = .02), diastolic blood pressure (p = .03), serum triglyceride (p = .01), total cholesterol, and low-density lipoprotein (LDL) levels, compared to nonsignificant changes in the placebo group. Significant changes in TAC and hs-CRP levels were observed in none of the groups. According to our findings, spirulina-fortified dressing as a functional food can be used a supportive treatment for patients with hypertension along with standard antihypertensive drugs. However, further investigations are required for a more comprehensive conclusion.

Background: Kidney stones form by the precipitation or crystallization of minerals and urinary constituents. It is a common problem worldwide manifested with recurrent intermittent pain episodes, surgical interventions, and medication consumption which affect the patients’ quality of life. The current study explored patients’ satisfaction with the management of kidney stones disease, along with their experience with the treatment. Methods: Qualitative face-to-face semi-structured interviews were conducted with kidney stones patients from Hospital Universiti Sains Malaysia in January 2018. Interviews were verbatim transcribed and thematic content analysis was carried out to understand the phenomena of patients’ experiences. Results: The fifteen patients who were interviewed judged their health and clinical outcomes based on several aspects. They build perceptions and make opinions based on outcomes including whether the disease is cured or not, relief of symptoms, prevention of disease progression, or absence of symptoms relapse, and whether the diagnostic and follow-up tests became normal. Based on the interviews, most patients were more satisfied with medical treatment than interventional treatment. Conclusion: The satisfaction towards the management of kidney stones was influenced by the treatment option chosen for each patient, expectations and perceptions of the treatment and disease, and healthcare system-related issues. This understanding could improve targeted support and therapy provided by health care providers so patients can better deal with the many disputes they face during suffering from kidney stones. Key words: Satisfaction, Perception, Kidney stones, Interview, Qualitative research.

Diencephalic region of the brain harbors sites with a considerable amount of aquaporin-4 expression. Neuromyelitis optica spectrum disorder (NMOSD) primarily involves autoimmune processes against this molecule. However, little is known about the frequency of symptoms of diencephalic involvement in NMOSD patients. To investigate the frequency of symptoms of diencephalic involvement in NMOSD patients and describe the associated characteristics in patients presenting such symptoms. This retrospective cohort included 145 NMOSD patients (39 males and 106 females) who visited Isfahan Multiple Sclerosis Center from January 2013 to February 2020 for approximately 61 months. Demographic and clinical information of patients and findings from radiological and serological investigations were retrieved. The frequency of diencephalic involvement in NMOSD patients was 3.4% (five cases). Diencephalic syndrome-associated symptoms observed in this cohort consisted of narcolepsy (n = 2; 40%), hypotension (n = 1; 20%), amenorrhea (n = 1; 20%), and syndrome of inappropriate antidiuretic hormone secretion (n = 1; 20%). These manifestations responded well to NMOSD-associated treatments, i.e., rituximab and azathioprine. Although rarely manifested through symptoms suggestive of diencephalic involvement, NMOSD should be considered when encountering patients with the diencephalic syndrome to identify the primary cause of these manifestations.

Reducing fat consumption is a current trend followed in the food processing industry. However, it is also true that fat plays a crucial role in retaining the quality, texture, taste, and emulsion stability of food. Avocado is being increasingly employed in the assembly of commodities like purees, concentrates, powders, and oil. The aim of the present study was to provide an appropriate formulation for avocado salad dressing enriched with omega-6 to promote health. Response surface methodology was applied to assess the impact of avocado (40, 60, 80%), whey protein (3, 6.5, 10%), and mint extract (1, 1.5, 2%) on total soluble solids, viscosity, peroxide level, physical stability, and microbial and sensory attributes of processed food. Preconcentrated fatty acid methyl esters of the selected salad dressing were evaluated using gas chromatography to obtain qualitative and quantitative information. Considering 63.91% avocado, 7.87% whey protein, and 1.27% mint extract, optimal formulation was obtained with highest total soluble solids (34.62%), viscosity (11,245 cP), stability (99.84%), sensory (4.83), and lowest peroxide level (1.04 mEq/kg oil) and Escherichia coli (4.11 log CFU/g). Whey protein mixed with avocado increased total soluble solids, resulting in high pseudoplasticity. Mint improved physical stability and reduced peroxide and microbial levels. In optimal avocado salad dressing, fatty acids included oleic acid (55.20%), palmitic acid (22.73%), linoleic acid (10.77%), palmitoleic acid (9.28%), and linolenic acid (2.02%). Results revealed that avocado/whey protein application with mint had led to healthier commodity design. Avocado salad dressing is considered a rich source of omega-6. It is used for enhancing the functional and nutritional status of food in the food processing industry.

Here, the regenerative potential of menstrual blood-derived mesenchymal stem cells (MenSCs) was examined on restoration of premature ovarian failure (POF) ovaries in rats' POF model. Freshly isolated CD146+ MenSCs using magnetic-activated cell storing method were immediately injected into ovaries of POF rats. Four and eight weeks after cell administration, both ovarian tissues were sampled for histological examination and the expression of fibrosis-related genes. Serum samples were also prepared for hormonal analysis. At the endpoint, mating trials were performed to assess the fertility of POF rats following MenSC transplantation. Histopathological examination revealed the induction of POF after Ceftriaxone injection by increasing atretic follicles and abnormal morphologies. MenSCs transplantation increased the number of normal follicles and coincided with the reduction of follicular atresia. Biochemical analyses exhibited the reduction and increase of systemic follicle-stimulating hormone (FSH) and E2 respectively after MenSCs transplantation compared to the POF rats (P < .05). No significant differences in anti-mullerian hormone (AMH) blood levels were detected in this study between POF controls and MenSCs-treated rats. We noted moreover the transcriptional up-regulation of Smad 2, 4, and TGF-β1 in POF rats, and these values were decreased after MenSCs transplantation (P < .01). By contrast, the RNA expression of Smad 6 remained increased in both pre- and post-treatment with MenSCs groups (P < .05). Finally, we found an increase in neonate births in POF rats treated with MenSCs, and that this feature was associated with ovarian rejuvenation through amelioration of fibrosis. These data showed that MenSCs are promising cell lineage for the alleviation of POF in the rat model by controlling the fibrosis rate.

A body of studies has examined the circulating concentration of adipokines including apelin, vapin, resistin, and chemerin in polycystic ovary syndrome (PCOS) patients. However, their findings have been inconclusive. Therefore, we systematically reviewed available studies to illuminate the overall circulating concentration of adipokines in PCOS subjects. Cochrane’s Library, PubMed, Scopus, and ISI Web of Science databases were searched from the earliest available date up to April 2021 for relevant articles. The quality of each study was assessed by the Newcastle–Ottawa Quality Assessment Scale. The pooled effect size was estimated based on the random effects model, and the standard mean differences (SMD) with a 95% confidence interval (CI) were reported. A total of 88 studies met the inclusion criteria and were included in the current systematic review and meta-analysis. The results of the analysis showed that serum levels of vaspin (SMD 0.69; 95% CI, 0.22 to 1.17; P = 0.004; I2 = 90.6%), chemerin (SMD 1.87; 95% CI, 1.35 to 2.40; P

ZnO nanotubes play a substantial role in various optoelectronic applications such as light-emitting diodes, solar cells and photodetectors. In this study, the structural, electronic, and optical effects of (n,0) single-walled ZnO nanotubes with different radius are discussed. An ab-initio approach of density functional theory with the generalized gradient approximation has been done by Quantum ESPRESSO software on nanotubes with n = 3 to 6. All simulated ZnO nanotubes illustrate semiconducting behavior, which due to the quantum confinement effect, the band gap value decreases by the increase in diameter. Moreover, optical characteristics including dielectric function e ( ω ) , refractive index n( ω ) , optical absorption coefficient α ( ω ) , conductivity σ ( ω ) , energy loss spectrum L( ω ) and reflectivity R ( ω ) have been analyzed and compared. The predicted optical features show that the mentioned nanotubes transmit light in perpendicular polarization better than parallel one and present superior reflect characters. Additionally, ZnO NTs act as a good absorbent in the visible wavelength which they can absorb various colors of the visible spectrum or even UV emission by altering the number of n. This ability turns ZnO NTs into remarkable photodetectors. Furthermore, according to optical characteristics like energy loss spectrum and dielectric function, it is obvious that results are approximately similar for different nanotubes and despite the miner red-shift of the position of the main peak, their appearance is close to each other. Therefore, ZnO NTs can be utilized in various applications such as optical filters, polarizers, and UV shields.

This article proposes a novel step-up interleaved dc–dc converter that is suitable for renewable energy systems. Coupled inductor and built-in transformer voltage multiplier cell are applied to extend the voltage gain while increasing the power density. Hence, the step-up ratio can be adjusted by the turns ratios of the coupled inductor and the built-in transformer. Compared with the other converters with only built-in transformer or only coupled inductor, the combination of these techniques gives an extra degree of freedom to increase the voltage gain. The configuration of the proposed converter not only reduces the current stress through the components, but also the input current ripple is maintained at low values that lengthen the life time of the renewable power source. The energy of the leakage inductors is successfully recycled and the high-voltage spikes across the power switches are avoided, which improves the conversion efficiency. Due to the reduced voltage stress, low-voltage power MOSFET s can be adopted for reduction of conduction losses and cost. The principle operation and steady-state analysis are given to explore the advantages of the proposed converter. Finally, a 1-kW prototype with 45–675 V voltage conversion is built to demonstrate the effectiveness of the proposed converter.

In this paper, a secure and efficient Blind Source Separation (BSS) based cryptosystem is presented. The use of BSS in audio and image cryptography in wireless networks has attracted more attention. A BSS based cryptosystem consists of three main parts: secret data, secret keys, and mixing matrix. In this paper, we propose a new design to create a proper mixing matrix in BSS based cryptosystem. We offer a mathematical criterion to select mixing matrix elements before encryption. The proposed criterion gives a simple way to attach the secret sources to keys, which makes source separation very hard for the adversary. Versus, we show that using the random mixing matrix can lead to data security loss. The attacks used for security tests in this paper are "Differential Attack" and "Denoising Attack," which are among the most effective in this field. These attacks will apply to cryptosystems based on the random and the proposed mixing matrix. The visual results of the attacks in the experiments will show that the "proposed mixing matrix based cryptosystem" will be more secure than the "random mixing matrix based cryptosystem." We also used the correlation coefficient criterion to compare the two cryptosystems more accurately. According to the experiments of this paper, the "proposed mixing matrix based cryptosystem" vs. the "random mixing matrix based cryptosystem" was able to reduce the adversary's source extraction quality rate from about 76% to 16%, on average.

Background: Pemphigus consists of a group of rare autoimmune blistering diseases involving the skin and mucous membranes. Pemphigus pathophysiology is mediated by autoantibodies against two desmosomal cadherins, namely, desmoglein (Dsg) 1 and (Dsg) 3 that are present in the skin and mucosal membranes. The involvement of coding and non-coding RNAs in the pathophysiology of pemphigus has been studied in the literature. MicroRNAs are small RNAs that could also be used as diagnostic biomarkers for some autoimmune diseases. The aim of this research was to explore the potential of this specification of some RNAs to be used as biomarkers for diagnosing pemphigus or its severity. This review discussed RNA expressions in patients with pemphigus. Methods: A comprehensive search was performed on published studies from 1990 to May 2020 using different search engines including PubMed, Scopus, and Web of Science. Results: In general, 335 articles were obtained according to search keywords. Then, 41 relevant studies were selected based on the inclusion and exclusion criteria. MiR-338-3p, miR-424-5p, and miR-584-5p were among the miRNAs that were reported to be increased in pemphigus. The C3 mRNA, mRNA of CD36, mRNA of CD163, mRNA of urokinase plasminogen activator (PA), IL23R mRNA, RORγt mRNA, and human leukocyte antigen G1 (HLA-G1) mRNA were coding RNAs that increased in pemphigus in addition to the activity of the mRNA of tissue-type PA while HLA-G2 mRNA decreased in pemphigus. Conclusion: Overall, this study investigated the role of Mir-338-3p, miR-424-5p, MiR-127, miR-584-5p, and some mRNAs in pemphigus, and it was revealed that some RNAs may be impressive on pemphigus. More studies and clinical assessments need more information about the role of RNAs on pemphigus to obtain a better view of their mechanisms and use them as biomarkers for earlier diagnosis or probable treatment.