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To accurately predict the regional spread of coronavirus disease 2019 (COVID-19) infection, this study proposes a novel hybrid model, which combines a long short-term memory (LSTM) artificial recurrent neural network with dynamic behavioral models. Several factors and control strategies affect the virus spread, and the uncertainty arising from confounding variables underlying the spread of the COVID-19 infection is substantial. The proposed model considers the effect of multiple factors to enhance the accuracy in predicting the number of cases and deaths across the top ten most-affected countries at the time of the study. The results show that the proposed model closely replicates the test data, such that not only it provides accurate predictions but it also replicates the daily behavior of the system under uncertainty. The hybrid model outperforms the LSTM model while accounting for data limitation. The parameters of the hybrid models are optimized using a genetic algorithm for each country to improve the prediction power while considering regional properties. Since the proposed model can accurately predict the short-term to medium-term daily spreading of the COVID-19 infection, it is capable of being used for policy assessment, planning, and decision making.

Background Gliomas are the most common type of central nervous system tumor in adults, and they have an extremely poor prognosis. Gliomas are classified into 4 grades, with low-grade gliomas (LGGs) constituting grades I and II and glioblastoma multiforme (GBM) constituting grade IV. Breast cancer susceptibility genes BRCA1 and BRCA2 play a role in DNA repair and are required for genome stability. Methods We analyzed the LGG and GBM cohorts from The Cancer Genome Atlas. We used Kaplan-Meier and log-rank analysis to determine the relationship between BRCA1 and BRCA2 expression and survival. Results Correlation of BRCA1 and BRCA2 expression with survival in patients with LGG was significant (P = 0.00 and P = 0.00). The higher the levels of expression were, the lower survival rates were in both LGG and GBM cohorts, but the correlation was not significant in patients with GBM (P Conclusions Our findings suggest that BRCA1 and BRCA2 can be regarded as poor prognostic factors in patients with glioma, with greater significance in patients with LGG. In the future, more in-depth experiments will enable us to elucidate the mechanism of gliomagenesis and identify potential gene therapy targets.

Introduction: Fatigue is defined as extreme weakness and exhaustion by work and physical or mental effort. Sleep disturbances are among the most important causes of fatigue among people in various occupational societies. The aim of this study was to determine the relationship of occupational fatigue with sleep quality and factors affecting it among nurses working in governmental hospitals. Methods: This cross-sectional study was conducted on 240 nurses working in public hospitals selected by convenience sampling method during a two-month period. In order to collect data, the Fatigue Exhaustion / Fatigue Recovery Questionnaire (OFER-15) and the Pittsburgh Sleep Quality Questionnaire (PSQI-18) were administered. The data were analyzed using SPSS software version 16. Furthermore, Chi-Square, Spearman’s correlation, Independent Sample T-test, and one–way analysis of variance were run. Results: In this study, 55% and 70% of the participants were at inappropriate sleep quality status and the moderate level of occupational excessive fatigue, respectively. Spearman’s correlation test showed a direct and significant correlation between occupational excessive fatigue and sleep quality (p

Background Nurses are key to the success of patient engagement, yet we know little about nurses’ perceptions on treatment engagement and how they can contribute to treatment engagement. Qualitative evidence to identify factors that influence treatment engagement among patients with CVD from nurse’s perspective is limited. Methods This systematic review of qualitative research was based on the PRISMA reporting guidelines. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess quality by two reviewers independently. Data were collected from Medline, Web of Science, CINAHL, PsychINFO, Embase- Non-Medline, Scopus, and the Cochrane Library, were systematically searched from 2001 to 2020. The search strategy included keywords and MeSH terms to identify relevant studies written in English. Results Eight articles were included in the review. Four key themes were synthesised from the findings: nurses need training and up to date information, providing support for patients, patient motivation to engage with treatment plans and perceived lack of time. Conclusion Nurses described the importance of training to help them support patients to engage as effectively as possible and their role in providing social and psychological support. They also described the importance of patient motivation to engage in a treatment and plan and sustain engagement and time.

Background Thrombosis and pulmonary embolism appear to be major causes of mortality in hospitalized coronavirus disease 2019 (COVID-19) patients. However, few studies have focused on the incidence of venous thromboembolism (VTE) after hospitalization for COVID-19. Methods In this multi-center study, we followed 1529 COVID-19 patients for at least 45 days after hospital discharge, who underwent routine telephone follow-up. In case of signs or symptoms of pulmonary embolism (PE) or deep vein thrombosis (DVT), they were invited for an in-hospital visit with a pulmonologist. The primary outcome was symptomatic VTE within 45 days of hospital discharge. Results Of 1529 COVID-19 patients discharged from hospital, a total of 228 (14.9%) reported potential signs or symptoms of PE or DVT and were seen for an in-hospital visit. Of these, 13 and 12 received Doppler ultrasounds or pulmonary CT angiography, respectively, of whom only one patient was diagnosed with symptomatic PE. Of 51 (3.3%) patients who died after discharge, two deaths were attributed to VTE corresponding to a 45-day cumulative rate of symptomatic VTE of 0.2% (95%CI 0.1%–0.6%; n = 3). There was no evidence of acute respiratory distress syndrome (ARDS) in these patients. Other deaths after hospital discharge included myocardial infarction (n = 13), heart failure (n = 9), and stroke (n = 9). Conclusions We did not observe a high rate of symptomatic VTE in COVID-19 patients after hospital discharge. Routine extended thromboprophylaxis after hospitalization for COVID-19 may not have a net clinical benefit. Randomized trials may be warranted., Highlights • In a large multi-center study, the incidence of venous thromboembolism in COVID-19 patients followed for 45 days after hospitalization was relatively low. • Routine extended thromboprophylaxis in COVID-19 patients who have been discharged from the hospital may not have a net clinical benefit. • Older age, history of recent cancer, and history of recent diabetes were associated with higher risk of mortality after hospital discharge

BACKGROUND Several groups have previously developed logistic regression models for predicting delayed graft function (DGF). In this study, we used an automated machine learning (ML) modeling pipeline to generate and optimize DGF prediction models en masse. METHODS Deceased donor renal transplants at our institution from 2010 to 2018 were included. Input data consisted of 21 donor features from United Network for Organ Sharing. A training set composed of ~50%/50% split in DGF-positive and DGF-negative cases was used to generate 400 869 models. Each model was based on 1 of 7 ML algorithms (gradient boosting machine, k-nearest neighbor, logistic regression, neural network, naive Bayes, random forest, support vector machine) with various combinations of feature sets and hyperparameter values. Performance of each model was based on a separate secondary test dataset and assessed by common statistical metrics. RESULTS The best performing models were based on neural network algorithms, with the highest area under the receiver operating characteristic curve of 0.7595. This model used 10 out of the original 21 donor features, including age, height, weight, ethnicity, serum creatinine, blood urea nitrogen, hypertension history, donation after cardiac death status, cause of death, and cold ischemia time. With the same donor data, the highest area under the receiver operating characteristic curve for logistic regression models was 0.7484, using all donor features. CONCLUSIONS Our automated en masse ML modeling approach was able to rapidly generate ML models for DGF prediction. The performance of the ML models was comparable with classic logistic regression models.

AIM To synthesise quantitative evidence on factors that impact hospital readmission rates following ACS with comorbidities. DESIGN Systematic review and narrative synthesis. DATA SOURCES A search of eight electronic databases, including Embase, Medline, PsycINFO, Web of Science, CINAHL, Cochrane Library, Scopus and the Joanna Briggs Institute (JBI). REVIEW METHODS The search strategy included keywords and MeSH terms to identify English language studies published between 2001 and 2020. The quality of included studies was assessed by two independent reviewers, using Joanna Briggs Institute (JBI) critical appraisal tools. RESULTS Twenty-four articles were included in the review. All cause 30-day readmission rate was most frequently reported and ranged from 4.2% to 81%. Reported factors that were associated with readmission varied across studies from socio-demographic, behavioural factors, comorbidity factors and cardiac factors. Findings from some of the studies were limited by data source, study designs and small sample size. CONCLUSION Strategies that integrate comprehensive discharge planning and individualised care planning to enhance behavioural support are related to a reduction in readmission rates. It is recommended that nurses are supported to influence discharge planning and lead the development of nurse-led interventions to ensure discharge planning is both coordinated and person-centred.

Due to the shortcomings of conventional machine hearing methods in tackling data with high-dimension search space, such as the need for initial configuration and feature extraction manually, high complexity, and long processing time, real-time processing is challenging in the field of sonar image processing. Therefore, this paper proposes a hierarchical three-stage deep learning (DL)-based approach for real-time accurate sonar image recognition. A conventional deep convolutional neural network (DCNN) is used as an automatic feature extractor in the first stage. In the second stage, ELM replaces the last fully connected layer to reduce tuning and testing time. Due to the uncertainty imposed via the addition of ELM to the model, in the third stage, the slime mould algorithm (SMA) will be used to tune the input weights and biases of the ELM. Finally, fuzzy maps are used to balance the relationship between the SMA’s exploration and exploitation phases. For evaluating the efficiency of the designed fuzzy SMA (FSMA), we first use 23 standard benchmark mathematical optimization functions. Subsequently, we employ three experimental sonar datasets to examine the efficiency of DCNN–ELM–FSMA in dealing with high-dimensional datasets. For a comprehensive investigation, we compare FSMA to the standard SMA, whale optimization algorithm (WOA), gray wolf optimizer (GWO), kalman filter (KF), henry gas solubility optimization (HGSO), Harris Hawks optimization (HHO), chimp optimization algorithm (ChOA), genetic algorithm (GA), and particle swarm optimization (PSO), with respect to convergence rate, entrapment in local minima, and detection accuracy. The results demonstrate that the proposed strategy performs better in detecting underwater anomaly targets by an average of 2.11 percent compared to the best benchmark model.

Background To measure the quality of care for lip and oral cavity cancer worldwide using the data from the Global Burden of Disease (GBD) Study 2017. Methods After devising four main indices of quality of care for lip and oral cavity cancer using GBD 2017 study’s measures, including prevalence, incidence, years of life lost, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine a component that bears the most proportion of info among the others. This component of the PCA was considered as the Quality-of-Care Index (QCI) for lip and oral cavity cancer. The QCI score was then reported in both men and women worldwide and different countries based on the socio-demographic index (SDI) and World Bank classifications. Results Between 1990 and 2017, care quality continuously increased globally (from 53.7 to 59.6). In 1990, QCI was higher for men (53.5 for men compared with 50.8 for women), and in 2017 QCI increased for both men and women, albeit a slightly higher rise for women (57.2 for men compared with 59.9 for women). During the same period, age-standardised QCI for lip and oral cavity cancer increased in all regions (classified by SDI and World Bank). Globally, the highest QCI scores were observed in the elderly age group, whereas the least were in the adult age group. Five countries with the least amount of QCIs were all African. In contrast, North American countries, West European countries and Australia had the highest indices. Conclusion The quality of care for lip and oral cavity cancer showed a rise from 1990 to 2017, a promising outcome that supports patient-oriented and preventive treatment policies previously advised in the literature. However, not all countries enjoyed such an increase in the QCI to the same extent. This alarming finding could imply a necessary need for better access to high-quality treatments for lip and oral cavity cancer, especially in central African countries and Afghanistan. More policies with a preventive approach and paying more heed to the early diagnosis, broad insurance coverage, and effective screening programs are recommended worldwide. More focus should also be given to the adulthood age group as they had the least QCI scores globally.

Medicinal plants and dietary supplements may provide an effective and safe treatment for pain relief. Green tea is one of the most common beverages with many several pharmacological activities. The results of various studies have indicated that green tea possesses antinociceptive effects. Many of the protective effects of green tea in terms of pain relief are attributed to its antioxidant and anti-inflammatory properties. Epigallocatechin -3-gallate (EGCG), as one of the major phytochemical components in green tea, is effective in the management of pain through suppression of inflammation and oxidative stress. We have reviewed the effects of green tea on pain and also discussed mechanisms involved in pain relief. This review suggests that green tea can be a safe and often effective treatment for pain.

Despite antibiotic prophylaxis, most patients with acute leukemia receiving mucotoxic chemotherapy develop neutropenic fever (NF), many cases of which remain without a documented etiology. Antibiotics disrupt the gut microbiota, with adverse clinical consequences, such as Clostridioides difficile infection. A better understanding of NF pathogenesis could inform the development of novel therapeutics without deleterious effects on the microbiota. We hypothesized that metabolites absorbed from the gut to the bloodstream modulate pyrogenic and inflammatory pathways. Longitudinal profiling of the gut microbiota in 2 cohorts of patients with acute leukemia showed that Akkermansia expansion in the gut was associated with an increased risk for NF. As a prototype mucolytic genus, Akkermansia may influence the absorption of luminal metabolites; thus, its association with NF supported our metabolomics hypothesis. Longitudinal profiling of the serum metabolome identified a signature associated with gut Akkermansia and 1 with NF. Importantly, these 2 signatures overlapped in metabolites in the γ-glutamyl cycle, suggesting oxidative stress as a mediator involved in Akkermansia-related NF. In addition, the level of gut microbial–derived indole compounds increased after Akkermansia expansion and decreased before NF, suggesting their role in mediating the anti-inflammatory effects of Akkermansia, as seen predominantly in healthy individuals. These results suggest that Akkermansia regulates microbiota-host metabolic cross talk by modulating the mucosal interface. The clinical context, including factors influencing microbiota composition, determines the type of metabolites absorbed through the gut barrier and their net effect on the host. Our findings identify novel aspects of NF pathogenesis that could be targets for precision therapeutics. This trial was registered at www.clinicaltrials.gov as #NCT03316456.

Breast cancer is one of the leading causes of cancer mortality worldwide. 5-fluorouracil (5-FU) is one of the chemotherapy drugs to treat breast cancer, but it is associated with several side effects. Combination therapy is a way to increase the effectiveness of chemo drugs and decrease their usage dose. Quercetin (Quer) is one of the natural polyphenols with anti-cancer properties. This study investigated the apoptotic effect of 5-FU in combination with Quer compared with 5-FU alone on MCF-7 breast cancer cells. Different single and combined concentrations of 5-FU and Quer were applied to MCF 7 cells for 48 h. Cell viability, apoptosis, gene expression of Bax, Bcl2, and p53, caspase activity, and colony number were assessed using MTT assay, flow cytometry, quantitative real-time PCR, enzyme-linked immunosorbent (ELISA), and Colony formation assay, respectively. The combination of 5-FU and Quer compared to 5-FU alone improved apoptosis by increasing the gene expression of Bax and p53 and caspase-9 activity and decreasing the Bcl2 gene expression. Colony formation in MCF-7 cells significantly decreased in the combined state compared to 5-FU alone. Quer potentiates the sensitivity of breast cancer to 5-FU so that this combination may be proposed as a treatment for breast cancer. Therefore, this combination can be suggested for future in vivo studies.

BACKGROUND: Relatively little is known about the use patterns of potential pharmacologic treatments of COVID-19 in the United States. OBJECTIVE: To use the National COVID Cohort Collaborative (N3C), a large, multicenter, longitudinal cohort, to characterize the use of hydroxychloroquine, remdesivir, and dexamethasone, overall as well as across individuals, health systems, and time. DESIGN: Retrospective cohort study. SETTING: 43 health systems in the United States. PARTICIPANTS: 137 870 adults hospitalized with COVID-19 between 1 February 2020 and 28 February 2021. MEASUREMENTS: Inpatient use of hydroxychloroquine, remdesivir, or dexamethasone. RESULTS: Among 137 870 persons hospitalized with confirmed or suspected COVID-19, 8754 (6.3%) received hydroxychloroquine, 29 272 (21.2%) remdesivir, and 53 909 (39.1%) dexamethasone during the study period. Since the release of results from the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial in mid-June, approximately 78% to 84% of people who have had invasive mechanical ventilation have received dexamethasone or other glucocorticoids. The use of hydroxychloroquine increased during March 2020, peaking at 42%, and started declining by April 2020. By contrast, remdesivir and dexamethasone use gradually increased over the study period. Dexamethasone and remdesivir use varied substantially across health centers (intraclass correlation coefficient, 14.2% for dexamethasone and 84.6% for remdesivir). LIMITATION: Because most N3C data contributors are academic medical centers, findings may not reflect the experience of community hospitals. CONCLUSION: Dexamethasone, an evidence-based treatment of COVID-19, may be underused among persons who are mechanically ventilated. The use of remdesivir and dexamethasone varied across health systems, suggesting variation in patient case mix, drug access, treatment protocols, and quality of care. PRIMARY FUNDING SOURCE: National Center for Advancing Translational Sciences; National Heart, Lung, and Blood Institute; and National Institute on Aging.

As part of a research on structural response of modular buildings and assemblages, this experimental study investigates the effects of gypsum sheathed light-gauge steel stud walls on the natural dynamic characteristics of modular steel frames. A full-scale volumetric steel module is instrumented with sensitive accelerometers connected to a data acquisition system, to study the effects of different infill wall configurations. To this end, the module’s sides are covered with bare light gauge steel frames and then different configurations and arrangements of gypsum plasterboard linings. The module’s acceleration responses are recorded during free and ambient vibration tests for each case. Then the operational modal analysis is conducted on the recorded data using output-only algorithms to extract the main dynamic characteristics of the steel module, including natural frequencies, mode shapes, and modal damping ratios. The contribution of different configurations and arrangements of infill walls to the response are examined and their effects are discussed. It is observed that the infill walls can change the dynamic characteristics of the modular steel frame more than the level suggested by the design specifications, such as 30–50% reduction by ASCE7-16.

This research endeavor intends to use the numerical and analytical approaches to investigate the ultimate shear capacity of steel plate shear walls with partial plate-column connection (SPSW-PC). This study aims to provide an analytical relationship for estimating the ultimate capacity of SPSW-PC. Using plastic analysis and considering the mechanism of plastic hinge formation, a relation has been obtained for estimating the ultimate capacity of SPSW-PCs. Extensive parametric studies have been carried out using a nonlinear finite element method to examine the accuracy of the obtained analytical relationships. The parametric studies include investigating the influence of infill plate thickness and width-to-height ratio as well as the ratio of the plate-column detachment length of SPSW-PCs. To this end, comprehensive verification studies are initially performed by comparing the numerical predictions with several reported experimental results to demonstrate the numerical method's reliability and accuracy. Comparison is made between the hysteresis curves, failure modes, and base shear capacities predicted numerically or obtained/observed experimentally. The results show a sound compromise between the ultimate capacity of the analytical relationship and numerical models of parametric studies. Although removing the connection between the web-plate and columns can be beneficial by decreasing the overall system demand on the vertical boundary members, based on the results and findings of this research study, such detachment can reduce the stiffness and strength capacities of steel shear walls by about 25%, on average.

Aim:Technology has enabled the utilization of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) through mobile video call for layman bystanders as opposed to the conventional audio call. This study aimed to examine the effects of medical guidance through a video call on cardiopulmonary resuscitation (CPR) quality during the management of cardiac arrest.Materials and Methods:A quasi-experimental study was conducted on 102 participants. These participants were divided into two groups: laymen who received CPR instructions through dispatcher-assisted video call (n=51) and healthcare personnel (n=51) who did not receive any assistance. The compression rate and depth, compression fraction, chest recoil, and hand positioning were compared between the groups.Results:Laymen who received video call DA-CPR performed better than the healthcare personnel in adhering to the recommended compression rate (109.7 min-1 vs 126.7 min-1, p

Aim:This study aimed to assess the adequacy of knowledge among emergency residents (ERs) and determine the correlation between the knowledge and practice of capnography waveform (CW).Materials and Methods:This 6-month questionnaire-based cross-sectional study was conducted at the emergency department of a hospital. All ERs were included in this study. Respondents’ knowledge was evaluated by exploring their interpretation of CW according to clinical situations and their ability in making appropriate clinical decisions and management. Pearson correlation statistic was used to determine the correlation between knowledge and practice.Results:This study included 48 ERs. The mean scores for knowledge and practice (± standard deviation) were 5.69±1.82 and 4.40±1.8, respectively. No correlation was found between knowledge and practice (r=0.186, p=0.207).Conclusion:ERs’ ability to interpret CW was satisfactory. However, understanding the relevance of the CW findings and subsequent clinical management was poor.

Background Novel coronavirus disease-19 (COVID-19) was declared as a global pandemic in 2020. With the spread of the disease, a better understanding of patient outcomes associated with their symptoms in diverse geographic levels is vital. This study aimed to evaluate clinical outcomes of COVID-19 patients by disease symptoms in Ilam province, Iran. Methods This was a cross-sectional study. Data were collected from integrated health system records for all hospitals affiliated with the Ilam University of Medical Sciences between 26-Jan-2020 and 02-May-2020. All patients with a confirmed positive test were included in this study. Descriptive analyses, chi-square test, and binary logistic regression model were performed by using SPSS version 22. Results The mean age of participants was 46.47 ± 18.24 years. Of the 3608 patients, 3477 (96.1%) were discharged, and 129 (3.9%) died. 54.2% of the patients were male and were in the age group of 30–40 years. Cough, sore throat, shortness of breath or difficulty breathing, and fever or chills were the most common symptoms. Patients with symptoms of shortness of breath, abnormal radiographic findings of the chest, and chest pain and pressure were relatively more likely to die. According to binary logistic regression results, the probability of death in patients with shortness of breath, abnormal chest radiographic findings, and chest pain was 1.34, 1.24, and 1.32 times higher, respectively, than for those without. Conclusion Our study provides evidence that the presentation of some symptoms significantly impacts outcomes of patients infected with SARS-CoV-2. Early detection of symptoms and proper management of outcomes can reduce mortality in patients with COVID-19.

Colon Cancer is the fourth most common form of cancer and the second-leading cause of cancer related deaths in the United States. A large part of the reason the number of fatalities is so high is late detection as when detected in the early stages of development 9 out of 10 cases of colon cancer are non-fatal 5 years after detection. Currently the main method of colon cancer detection are colonoscopies which are highly invasive and time intensive procedures. In this work we propose a new diagnostic technique for colon cancer using an InSb based device that works by a change in the spectral response of the metamaterial when exposed to electromagnetic waves in the terahertz regime and combined with cancerous colon tissue as compared to the response when combined with healthy colon tissue. We attribute this change in spectral response is due to the differing optical properties of the healthy and cancerous colon tissue as well as the creation of surface plasmon polaritons within our device.

Single-cell sequencing data has great potential in reconstructing the evolutionary history of tumors. Rapid advances in single-cell sequencing technology in the past decade were followed by the design of various computational methods for inferring trees of tumor evolution. Some of the earliest of these methods were based on the direct search in the space of trees. However, it can be shown that instead of this tree search strategy we can perform a search in the space of binary matrices and obtain the most likely tree directly from the most likely among the candidate binary matrices. The search in the space of binary matrices can be expressed as an instance of integer linear or constraint satisfaction programming and solved by some of the available solvers, which typically provide a guarantee of optimality of the reported solution. In this review, we first describe one convenient tree representation of tumor evolutionary history and present tree scoring model that is most commonly used in the available methods. We then provide proof showing that the most likely tree of tumor evolution can be obtained directly from the most likely matrix from the space of candidate binary matrices. Next, we provide integer linear programming formulation to search for such matrix and summarize the existing methods based on this formulation or its extensions. Lastly, we present one use-case which illustrates how binary matrices can be used as a basis for developing a fast deep learning method for inferring some topological properties of the most likely tree of tumor evolution.

Background The prevalence of primary headache in patients with systemic lupus erythematosus (SLE) varies widely and whether it should be attributed to neurological involvement is controversial. We aimed to investigate the prevalence and characteristics of headache in SLE patients, describe its association with disease-related variables and brain imaging, and explore its impact on life. Results The overall prevalence of headache was 54.4%, and migraine was the most common type among headache sufferers (48.4%). Headache severity (VAS) and impact (HIT-6) correlated with SLEDAI-2K (P = 0.019 and P < 0.001, respectively) as well as with each other (P = 0.006). Brain imaging abnormalities were found in 25.8%, with white-matter hyperintensities (WMH) being the most frequent pathology. Musculoskeletal manifestations, positive anti-phospholipid (aPL) antibodies, and SLEDAI score ≥ 13.5 were identified as predictors of headache. Conclusion Primary headache, especially migraine, is a common feature of patients with SLE, and its presence is associated with negative impact on quality of life. Musculoskeletal features, aPL positivity, and overall disease activity appear to predict primary headache in SLE.

Background and Aim: The diagnosis of COVID-19 is an essential step toward controlling the pandemic. For this purpose, a series of laboratory methods have been developed. This study evaluated the efficiency of the ELISA method for COVID-19 IgM and IgG detection. Materials and Methods: In this case-control study, 46 blood samples from PCR positive COVID-19 patients and 49 samples from PCR negative COVID-19 subjects were collected. Subsequently, the presence of IgM and IgG in all blood samples was assessed using the Pishtaz Teb ELISA kit. Results: The data demonstrated that among 49 PCR negative, 40 (81.6%) were IgM negative and 9 (19.1%) were IgM positive. Besides, out of the 49 PCR-negative patients, 42 (85.7%) and 7 (14.3%) were IgG negative and positive, respectively. In 46 PCR-positive individuals, 40 (87%) were IgM negative, while 6 (13 %) were IgM positive. Of the 46 PCR-positive patients, 24 (52.2%) were IgG negative, and 22(47.8%) were IgG positive. Conclusion: Our results showed that detection of SARS-CoV-2 IgG and IgM using Pishtaz Teb ELISA kit is not enough for COVID diagnosis, but it can serve as a diagnostic RNA supplement to confirm infection with SARS-CoV-2 in approved clinics and other scientific communities, owing to its easy, rapid, and inexpensive availability.

One of the important issues in project management is cost contingency estimation. Although this has been investigated in previous studies, the underlying assumptions on presuming specific p...

Aim: The aim of this study is to determine the nutritional knowledge of patients with Type 2 diabetes who come to diabetes outpatient clinics.Method: The descriptive study was conducted with a total of 100 patients who came to the diabetes outpatient clinics of training and research hospitals with the necessary permissions. The data were collected using a semi-structured information form consisting of 27 questions including sociodemographic and introductory characteristics of the patients, and 20 questions measuring nutritional knowledge levels, and a total of 47 questions. The analysis of the data was done using the SPSS program on the computer.Results: Nutritional knowledge level of patients with type 2 diabetes was found to be 9,45 ± 3,96. The nutritional knowledge levels of the patients who received nutrition training and had normal BMI were higher (p, Amaç: Bu araştırmanın amacı diyabet polikliniğine gelen Tip 2 diyabetli hastaların beslenme bilgi düzeylerini belirlemektir.Yöntem: Tanımlayıcı tipteki araştırma gerekli izinler alınarak eğitim ve araştırma hastanelerinin, diyabet polikliniğine başvuran toplam 100 hasta ile yürütüldü. Veriler hastaların sosyodemografik, tanıtıcı özelliklerini içeren 27 soru ve beslenme bilgi düzeylerini ölçen 20 soru olmak üzere toplam 47 sorudan oluşan yarı yapılandırılmış bilgi formuyla toplandı. Verilerin analizi bilgisayar ortamında SPSS programı kullanılarak yapıldı.Bulgular: Tip 2 diyabetli hastaların beslenme bilgi düzeyleri 9,45±3,96 olarak saptandı. Beslenme eğitimi alan ve Beden Kitle İndeksi (BKİ) normal olan hastaların beslenme bilgi düzeyleri daha yüksekti (p

Nutrition and its awareness play an important role in medical education for the management, as well as in the treatment of various chronic illnesses. Moreover, it always has been a concern about the knowledge and awareness of nutrition among physicians. Therefore, we aimed to study the nutritional knowledge, as well as awareness of primary health care physicians (PHC) working in Hail City, Saudi Arabia. A questionnaire-based cross-sectional survey was conducted among PHC physicians working in Hail, Saudi Arabia from September 2019 to December 2019. The questionnaire was distributed to PHC physicians and responses were recorded and data were statistically analyzed by applying Chi-square tests using SPSS 21.0. Questionnaires were circulated to 124 physicians, participated in this study. However, out of 124 physicians only 41 physicians filled out the complete questionnaire, indicating a very poor response rate (33%). The mean percentage of correct answers was 71.56%. Physicians who described their knowledge as “good” were found to be 75%. Furthermore, physicians working in PHC centers were aware of the basic nutritional knowledge regarding food content, pregnancy, lactation, diabetes, hypertension, etc. Our assessment revealed that physicians working in PHC of Hail Region had average nutritional knowledge. Moreover, it was also found that addition of various nutrition related educational programs in medical schools and hospital premises would improve the knowledge and awareness among the physicians.

The diagnosis of joint infiltration by a malignant bone tumor affects surgical management. The specificity of standard magnetic resonance imaging (MRI) for diagnosing joint infiltration is limited. During our MRI evaluations with ferumoxytol nanoparticles of pediatric and young adult patients with bone sarcomas, we observed a surprising marked T1 enhancement of joint and pleural effusions in some patients but not in others. To evaluate if nanoparticle extravasation differed between joints and pleura with and without tumor infiltration. We retrospectively identified 15 pediatric and young adult patients (mean age: 16±4 years) with bone sarcomas who underwent 18 MRI scans at 1 h (n=7) or 24 h (n=11) after intravenous ferumoxytol infusion. Twelve patients also received a gadolinium-enhanced MRI. We determined tumor invasion into the joint or pleural space based on histology (n=11) and imaging findings (n=4). We compared the signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) of the joint or pleural fluid for tumors with and without invasion using a Mann-Whitney U test. MRI scans 24 h after intravenous ferumoxytol infusion demonstrated a positive T1 enhancement of the effusion in all joints and pleural spaces with tumor infiltration and no joint or pleural space without infiltration. Corresponding SNR (P=0.004) and CNR (P=0.004) values were significantly higher for joints and pleural spaces with tumor infiltration than without. By contrast, unenhanced MRI, gadolinium-enhanced MRI and 1-h post-contrast ferumoxytol MRI did not show any enhancement of the joint or pleural effusion, with or without tumor infiltration. This pilot study suggests that 24-h post-contrast ferumoxytol MRI scans can noninvasively differentiate between joints with and without tumor infiltration.

Resveratrol is a phenol compound produced by some plants in response to pathogens, infection, or physical injury. It is well-known that resveratrol has antioxidant and protective roles in damages potentially caused by cancer or other serious disorders. Thus, it is considered as a candidate agent for the prevention and treatment of human diseases. Evidence has confirmed other bioactive impacts of resveratrol, including cardioprotective, anti-tumorigenic, anti-inflammatory, phytoestrogenic, and neuroprotective effects. Ischemia-reperfusion (IR) can result in various disorders, comprising myocardial infarction, stroke, and peripheral vascular disease, which may continue to induce debilitating conditions and even mortality. In virtue of chronic ischemia or hypoxia, cells switch to anaerobic metabolism, giving rise to some dysfunctions in mitochondria. As the result of lactate accumulation, adenosine triphosphate levels and pH decline in cells. This condition leads cells to apoptosis, necrosis, and autophagy. However, restoring oxygen level upon reperfusion after ischemia by producing reactive oxygen species is an outcome of mitochondrial dysfunction. Considering the neuroprotective effect of resveratrol and neuronal injury that comes from IR, we focused on the mechanism(s) involved in IR injury in the nervous system and also on the functions of resveratrol in the protection, inhibition, and treatment of this injury.

Introduction Tobacco causes more than 8 million deaths each year. Behavioral interventions such as group therapy, which provides counselling for smoking cessation, can be delivered in group form and smokers who receive cessation counselling are more likely to quit smoking compared to no assistance. We review the evidence of group-based counselling for smoking cessation for smokers in Asian countries. Methods The review aims to determine the availability of group-based therapy for smoking cessation in Asian countries. The outcome measured was abstinence from smoking following group therapy. Electronic database searches in PubMed, OVID Medline, SCOPUS, Google Scholar, and PsycINFO, using keywords such as: 'smoking', 'cigarette', 'tobacco', 'nicotine', 'group therapy' and 'cessation' (smok*, *cigarette*, tobacco, nicotine, group therap*, cessation) were used. The results were reported following PRISMA and PROSPERO guidelines. Review Manager was used for data analysis. Results A total of 21251 records were retrieved for screening the abstracts. In all, 300 articles for review were identified and assessed for eligibility. Nine articles, including Cochrane reviews, randomized control trials, cohort, observational and cross-sectional studies, were included in the final review. There were three observational qualitative studies, two prospective cohort studies, two crosssectional studies, one non-randomized quasi-experimental study and a single cluster-randomized, controlled trial. Group therapy was found to significantly increase the abstinence rate. Group therapy provided at the workplace, smoking cessation services, availability of pharmacotherapy, and socioeconomic status, appear to be key factors determining success. Conclusions Evidence of the use of group therapy for smoking cessation in Asian countries is still lacking despite publications in the Western population showed that group therapy was effective. Further research on group-based interventions for smoking cessation in Asian countries is required and direct one-to-one comparisons between group therapy and individual therapy for smokers who want to quit smoking, are needed.

Objectives To describe the epidemiological characteristics of the first 69,382 patients with COVID-19 infection in Oman. Methods A retrospective case series study of patients diagnosed with SARS-CoV-2 infection in Oman from 24 February to 23 July 2020. The data were obtained from the National surveillance COVID-19 network. Results The overall mean age of patients was 34 (± 14) years, 74% (n = 51,391) were males, 40,859 (59%) were Omani citizens, and 28,523 (41%) were foreign-born individuals. The most common symptoms at presentation were fever 50% (n = 34,600), cough 46% (n = 32,062), sore throat 46% (n = 31,953) and shortness of breath (SOB) 35% (n = 24,567). Overall, 8,960 (12.9%) patients required hospitalization with 1189 (13.3%) individuals requiring admission to the intensive care unit (ICU) and mechanical ventilation (MV). Patients hospitalized with COVID-19 infection were mostly Omani nationals and males between 30 and 39 years old (p n = 359) with rates of 9.4 (n = 278) and 4.8 (n = 81) deaths per 100,000 population in Omani nationals and foreign-born individuals, respectively. Females hospitalized with COVID-19 had a mean age of 64 (± 18) years versus a mean age of 55 (± 17) years in males. Mean age of patients with COVID-19-related mortality was 58 (± 18) years with significant differences in mean age between females and males 64 (± 18) versus 55 (± 17) years, respectively. Conclusions Young Omani males accounted for the highest incidence of COVID-19 infection and hospitalization, while mortality rates were higher among males and the older age (> 50 years). Identifying the epidemiological characteristics and outcomes of COVID-19-infected patients is essential for developing targeted intervention strategies and preparing for the resurgence of anticipated second and third waves of this pandemic.

In this study, a novel and simple optical fiber sensor is proposed, simulated, and experimentally demonstrated for simultaneous measurement of high refractive index (RI) and temperature. The sensor consists of a section of single-mode-silica rod-single-mode (SSRS) fiber structure cascaded to fiber Bragg grating (FBG) (SSRS-FBG). The simultaneous measurement of high RI and temperature was realized in this study by monitoring the output power level and wavelength shift of the SSRS-FBG single dip transmission spectrum corresponding to different surrounding high RI and ambient temperature values. The experimental results showed that the cascaded sensor had a sensitivity of 108.07 dBm/RIU for high RI ranging at 1.45-1.531, while the temperature sensitivity was 9.31 pm/°C from 35 °C to 85 °C. This sensor is most suitable for high RI applications, such as for monitoring oil quality stored in terminal and power transformers.

El objetivo de este estudio fue investigar la relación entre el componente de tecnología de la información y el espíritu empresarial organizacional en la industria de la aviación. El método de esta investigación fue descriptivo. La población estadística del estudio incluyó a todos los empleados del departamento administrativo de la Organización de Aviación Civil de Irán de la provincia de Teherán, que fue de 140 empleados. Debido al tamaño limitado de la población, se seleccionó y examinó a toda la población como muestra. La presente investigación es tipo encuesta descriptiva. Los instrumentos de este estudio son cuestionarios de tecnología de la información elaborados por investigadores y cuestionario de emprendimiento organizacional cuya validez y confiabilidad en este estudio se obtuvieron con base en el coeficiente alfa de Cronbach de 0.89. Para analizar los datos, se utilizó el coeficiente de correlación de Pearson y regresiones múltiples para probar las hipótesis y se utilizó el método alfa de Cronbach para calcular los coeficientes de confiabilidad. Los resultados de probar hipótesis de investigación mostraron que existe una relación significativa entre la tecnología de la información y la tendencia al espíritu empresarial organizacional. Según los resultados, decimos que la tecnología de la información es una de las herramientas del emprendimiento que no puede reemplazar el desarrollo real, pero proporciona herramientas que pueden acelerar el desarrollo de la organización. Se sugiere que las clases de capacitación y reciclaje en tecnología de la información y emprendimiento se realicen simultáneamente con el fin de desarrollar y basarse en una planificación adecuada para el uso de computadoras en el emprendimiento.

According Global Cancer Statistics 2020 GLOBOCAN estimates female breast cancer was found as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), and the fourth leading cause (6.9%) of cancer death among women worldwide. Identification of new diagnostic marker sharply characterize the tumor feature is intensive need. The present work was performed to investigate the involvement of the INF-γ + 874 T/A gene polymorphism in different breast cancer prognostic factors. Polymorphism detection analysis was performed on 163 subjects from breast cancer patients, 79 with inflamed cells of breast patients and 144 controls. The gene polymorphism was detected using the amplification refractory mutation system- polymerase chain reaction method (ARMS-PCR). The distribution of INF-γ T + 874A gene polymorphism shows strong significant association between INF-γ + 874 T/A genotypes TT in BC patients (ORTT: 6.41 [95% CI = 2.72–15.1] P

Objective Recent studies have shown a possible association between vitamin D deficiency and the severity of primary dysmenorrhea. The present study aimed to investigate the effect of vitamin D supplementation on pain and systemic symptoms in patients with primary dysmenorrhea.Methods This double-blind, randomized, placebo-controlled trial was conducted on female students aged 18 to 32 years with primary dysmenorrhea and vitamin D deficiency (25 [OH]D PPPP

Power consumption of wellbore drilling in oil and gas exploitations count for 40% of total costs, hence power saving of WBM (water-based mud) by adding different concentrations of Al2O3, TiO2 and SiO2 nanoparticles is investigated here. A high-speed Taylor–Couette system (TCS) was devised to operate at speeds 0–1600 RPM to simulate power consumption of wellbore drilling using nanofluids in laminar to turbulent flow conditions. The TCS control unit uses several sensors to record current, voltage and rotational speed and Arduino microprocessors to process outputs including rheological properties and power consumption. Total power consumption of the TCS was correlated with a second-order polynomial function of rotational speed for different nanofluids, and the correlated parameters were found using an optimization technique. For the first time, energy saving of three nanofluids at four low volume concentrations 0.05, 0.1, 0.5 and 1% is investigated in the TCS simulating wellbore drilling operation. It is interesting to observe that the lower concentration nanofluids (0.05%) have better power savings. In average, for the lower concentration nanofluids (0.05%), power was saved by 39%, 30% and 26% for TiO2, Al2O3 and SiO2 WBM nanofluids, respectively. TiO2 nanofluids have better power saving at lower concentrations of 0.05 and 0.1%, while Al2O3 nanofluids have saved more power at higher concentrations of 0.5 and 1.0% compared with their counterpart nanofluids.

Background Emerging evidence indicates that propolis as a novel potential antioxidant has unique benefits. This study aimed to evaluate the effect of propolis on oxidative stress, inflammation, body composition, and athletic performance in healthy active subjects. Methods This clinical trial was conducted on 54 male military cadets. Eligible subjects were randomly allocated to receive a single dose of 450 mg propolis twice daily for four weeks or a matching placebo containing microcrystalline cellulose. Cooper 12‐min run test and running‐based anaerobic sprint test were performed to measure aerobic and anaerobic performance. Blood samples were obtained immediately after Cooper's test to evaluate oxidative stress and inflammation status. Fat mass and fat‐free mass were analyzed using bioelectrical impedance. Results Mean changes in fat mass, fat‐free mass, anaerobic powers, fatigue index, and VO2 max did not differ significantly between the two groups after the adjustment for baseline values (P‐value>0.05). A significant change was observed in plasma levels of IL‐6 (−1.43 ± 0.11pg/mL), total oxidant status (−3.9 ± 0.2µmol/L), total antioxidant capacity (164 ± 12 µmol/L), malondialdehyde (−0.52 ± 0.03µmol/L), oxidative stress index (−0.45 ± 0.04), and glutathione (48.72±2µmol/L) in the propolis group compared with the placebo group after the adjustment for baseline values and weight changes (P‐value, As far as we know, this is the first trial to evaluate the effect of propolis supplementation on exercise performance. This clinical trial study shows that propolis supplementation can significantly reduce plasma levels of total oxidants, IL‐6, malondialdehyde, oxidative stress index, and IL‐6/IL‐10 ratio and can significantly improve plasma levels of total antioxidant capacity and glutathione following intense physical activity. However, our trial indicates that propolis intake had no significant effect on anaerobic and aerobic performance and body composition.

Background: Advantages of digital clock drawing metrics for dementia subtype classification needs examination. Objective: To assess how well kinematic, time-based, and visuospatial features extracted from the digital Clock Drawing Test (dCDT) can classify a combined group of Alzheimer’s disease/Vascular Dementia patients versus healthy controls (HC), and classify dementia patients with Alzheimer’s disease (AD) versus vascular dementia (VaD). Methods: Healthy, community-dwelling control participants (n = 175), patients diagnosed clinically with Alzheimer’s disease (n = 29), and vascular dementia (n = 27) completed the dCDT to command and copy clock drawing conditions. Thirty-seven dCDT command and 37 copy dCDT features were extracted and used with Random Forest classification models. Results: When HC participants were compared to participants with dementia, optimal area under the curve was achieved using models that combined both command and copy dCDT features (AUC = 91.52%). Similarly, when AD versus VaD participants were compared, optimal area under the curve was, achieved with models that combined both command and copy features (AUC = 76.94%). Subsequent follow-up analyses of a corpus of 10 variables of interest determined using a Gini Index found that groups could be dissociated based on kinematic, time-based, and visuospatial features. Conclusion: The dCDT is able to operationally define graphomotor output that cannot be measured using traditional paper and pencil test administration in older health controls and participants with dementia. These data suggest that kinematic, time-based, and visuospatial behavior obtained using the dCDT may provide additional neurocognitive biomarkers that may be able to identify and tract dementia syndromes.

Background/aim Adipocytokine, an adipocyte-derived protein, well-known to be involved in the pathogenesis of breast cancer. We aimed to measure the mRNA expression of resistin, TNF-?, interleukin six and eight (IL-6, and IL-8), and estrogen receptor alpha (ER-?) in peripheral blood mononuclear cells (PBMCs) of women with and without breast cancer. Materials and methods Blood samples were obtained from 32 women with breast cancer and 18 women without breast cancer. The PBMCs were isolated from whole blood using density gradient centrifugation. Target genes mRNA expression was measured by reverse-transcription polymerase chain reaction (RT-PCR). Body mass index was calculated, and the clinicopathological characteristics of subjects were also determined by histopathological examination. Results Our results indicated that the mRNA expression of resistin and IL-6 in PBMCs of breast cancer patients was significantly increased (approximately 3.5-fold, and 15-fold respectively) compared to healthy controls. Resistin expression was significantly associated with inflammatory markers including TNF-?, IL-6, IL-8, but not with anthropometric indices. Logistic regression analysis revealed that these adipokines were not associated with breast cancer. Based on the ROC curve analysis the diagnostic performance of IL-6 was significant (0.825, 95% CI: 0.549-0.947), thus, it might be considered as a breast cancer biomarker that reflecting an advanced and inflammatory stage of the disease. Conclusion Breast cancer is associated with increased expression of adipocytokines in PBMCs. Our results suggested that a PBMC-based gene expression test may be developed to detect breast cancer early.

COVID-19 is a novel viral pandemic. It is believed that due to physiological changes within the pregnancy, pregnant women may be more susceptible to COVID-19. Currently, there exists no reliable evidence being available regarding the likelihood of infection for pregnant women compared to the general population. On the other hand, given the previous experiences with SARS and MERS, pregnant women are likely to be at high risk for COVID-19 and its complications. Comparing the results of studies on COVID-19 during pregnancy and that of the general population, it can be concluded that pregnant women develop COVID-19 at a younger age than the general population. The results showed that due to changes during pregnancy, pregnant women have a higher risk for COVID-19 than other people, perhaps due to the lower mean age of COVID-19 in pregnant women, this leads to less COVID-19 on the adverse pregnancy outcomes. © 2021.

The aim of this study was to determine the role of Lawsonia inermis (L. inermis) extract in the chronic constriction injury (CCI)-induced neuropathic pain. Following CCI surgery, L. inermis extract (250 mg/kg and 500 mg/kg) and gabapentin (100 mg/kg) were administered intraperitoneally for 14 consecutive days. Heat hyperalgesia and allodynia were assessed by radiant heat, aceton drop, and von frey filament tests, respectively. Rat pain behaviors were evaluated on -1sh, 3rd, 5th, 7th, 10th and 14th days post CCI surgery. At the end of the study, the spinal levels of malondialdehyde (MDA), total thiol, IL1-β, and TNF-α were estimated. Treatment of L. inermis extract reversed the decreased level of thiol and the elevation of MDA level in the spinal cord of CCI rats. Besides, L. inermis extract treatment decreased the elevation of inflammatory markers including IL1-β, and TNF-α in the spinal cord of CCI rats. These results indicated that L. inermis has potential neuroprotective effects against CCI induced neuropathic pain due to its anti-oxidant, and anti-inflammatory effects.

Coronavirus disease (COVID-19) is a newly emerged respiratory illness, which has spread around the world. Pregnant women are exposed to additional pressure due to the indirect adverse effects of this pandemic on their physical and mental health. Since the psychological wellness framework is weak in developing countries, it is likely that geographical factors affect the prevalence. Therefore, the goal of this meta-analysis is to investigate the prevalence of anxiety and depression among pregnant women during the COVID-19 pandemic.We searched databases including PubMed/MEDLINE, Web of Science, Cochrane Library for articles. The quality of studies was determined based on the STROBE checklist. I2 and Cochrane Q-test were used to determine heterogeneity. Fixed effects and/or random effects models were also employed to estimate pooled prevalence.Since heterogeneity was fairly high in all analyses, the random effect model was used. According to the results of random effects in the meta-analysis, the pooled prevalence was 18.7% (95% CI: 0.06-0.36%;Covid-19 may impose extra pressure on the emotional wellbeing of pregnant women. Therefore, there is an urgent need for resources to help mitigate anxiety and depression in pregnant women.

An optically tunable perfect light absorber as a refractive index (RI) metamaterial (MM) nanobiosensor (NBS) is designed for sensing chemicals, monitoring the concentration of water-soluble glucose, and detecting viruses. This plasmon induced tunable metasurface works based on multiband super-absorption in the infrared frequency regime. It consists of a metal mirror that facilitates the MM to work as an absorber where the metal pattern at the top layer creates an enhanced evanescent wave that facilitates the metasurface to work as a RI optical sensor. The modelling and numerical analysis are carried out using Finite Difference Time Domain (FDTD) method-based software, CST microwave studio where a genetic algorithm (GA) is used to optimize the geometric parameters. We demonstrate multiband super-absorption spectra having maximum absorption of more than 99%. Furthermore, we show how the multiband super-absorber nanostructure can be used as a RI NBS, where the resonance frequency shifts with the RI of the surrounding medium. The achieved opto-chemical sensitivity is approximately ${65}{\textit {nm}}/{\textit {RIU}}~{\textit {RIU}}$ , the bio-optical sensitivity to detect viruses is approximately 76 nm $/$ RIU; and the optical sensitivity of the water-soluble glucose concentration is about ${300}{\textit {nm}}/ {\textit {RIU}}$ ; all sensitivities are comparable in comparison with the reported values in the literature.

We present a novel workflow based on artificial intelligence (AI) techniques to automate interior design processes. We discuss the essential steps for creating an intelligent agent that can automatically perceive the design environment (perception) and produce design ideas (action). In the first step, we use photographs or video images to model three-dimensional coordinates and exact positions of surface points on objects inside the interior space. We then convert the collected spatial data to a set or cloud of points. To fully model the interior space, we create either a triangulated surface or a mesh from the points and then transform it into a detailed building information model (BIM). Last, we apply texture data to either the 3D surface/mesh or the building information model. In the second step, we develop a sequential decision-making model based on Markov decision process for the intelligent agent to make design decisions in the BIM environment. We apply the proposed workflow to a case study with 512 possible design options, conduct experiments with 20 participants where design decisions are made based on AI insights, and perform statistical analysis on the experiment results. Our findings show the proposed workflow is capable of improving participants’ satisfaction by only searching through on average 5.1% of all possible design options. Also, across all performance measures, design decisions proposed by the AI system outperform designs made randomly.

Objective ‒ to assess the possibility of increasing the time of surgical restoration of blood flow in the acute period of ischemic stroke due to occlusive lesion of the internal carotid artery (ICA).Materials and methods. Among the patients who were admitted for treatmentat in the Regional Odessa Hospital with acute ischemic stroke in the carotid region a group of 6 patients was identified in whom the cause of stroke was occlusion of the ICA by an atherosclerotic plaque. Age of patients ‒ from 54 to 71 years. Patients were hospitalized later 6 hours from the onset of stroke. The survey was carried out according to the established protocol. Neurological deficits are mild to moderate. In order to eliminate the occlusion of the ICA, all patients underwent endarterectomy.Results. Carotidendarterectomy was performed from 2 to 11 days after onset of stroke. Retrograde blood flow through the ICA was obtained in three (50 %) patients in whom surgical interventions were performed up to 4 days after the disease. In the postoperativeperiod a typical therapy was carried out. In cases with the obtained retrograde blood flowon control carotid angiograms demonstrated revascularization of the ICA basin according to mTICI-3. On the control CT of the brain in postoperative period in one case the point subarachnoid hemorrhages was determined. In the other two cases there was no evidence hemorrhagic transformation. Operated patients showed positive dynamics: a decrease hemiparesis by 1 poin and regression of mental disorders. The patients were discharged withm RS 1‒2. During the follow-up examination 90 days the neurological condition of the patients improved to mRS 1‒0.Conclusions. Results obtained in increasing the “therapeutic window” for revascularization of the occluded ICA allow to continue research in the indicated direction and improve the quality of surgical care for patients with acute stroke.