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Abstract Attention as a cognition ability plays a crucial role in perception which helps humans to concentrate on specific objects of the environment while discarding others. In this paper, auditory attention detection (AAD) is investigated using different dynamic features extracted from multichannel electroencephalography (EEG) signals when listeners attend to a target speaker in the presence of a competing talker. To this aim, microstate and recurrence quantification analysis are utilized to extract different types of features that reflect changes in the brain state during cognitive tasks. Then, an optimized feature set is determined by employing the processes of significant feature selection based on classification performance. The classifier model is developed by hybrid sequential learning that employs Gated Recurrent Units (GRU) and Convolutional Neural Network (CNN) into a unified framework for accurate attention detection. The proposed AAD method shows that the selected feature set achieves the most discriminative features for the classification process. Also, it yields the best performance as compared with state-of-the-art AAD approaches from the literature in terms of various measures. The current study is the first to validate the use of microstate and recurrence quantification parameters to differentiate auditory attention using reinforcement learning without access to stimuli.

Abstract Introduction This article examines the potential of using liquid biopsy with piRNAs to study cancer survival outcomes. While previous studies have explored the relationship between piRNA expression and cancer patient outcomes, a comprehensive investigation is still lacking. To address this gap, we conducted a systematic review and meta-analysis of existing literature. Methods We searched major online databases up to February 2024 to identify articles reporting on the role of piRNA in cancer patient survival outcomes. Our meta-analysis used a random-effects model to pool hazard ratios with 95% confidence intervals (CI) and assess the prognostic value of deregulated piRNA-823. For survival analysis, the Kaplan–Meier method and COX analysis were used. Results Out of 6104 articles screened, 20 met our inclusion criteria. Our analysis revealed that dysregulated piRNA expression is associated with cancer patient survival outcomes. Specifically, our meta-analysis found that overexpression of piR-823 is significantly linked with poorer overall survival in patients with colorectal cancer and renal cell cancer (HR: 3.82, 95% CI = [1.81, 8.04], I2 = 70%). Conclusion Our findings suggest that various piRNAs may play a role in cancer survival outcomes and that piRNA-823 in particular holds promise as a prognostic biomarker for multiple human cancers. Implications for cancer survivors Our systematic review and meta-analysis of piRNA-823 has important implications for cancer survivors. Our findings suggest that piRNA-823 can be used as a prognostic biomarker for predicting cancer recurrence and survival rates. This information can help clinicians develop personalized treatment plans for cancer survivors, which can improve their quality of life and reduce the risk of recurrence.

Abstract Citrus canker is a bacterial disease caused by Xanthomonas citri subsp. citri (Xcc) that affects the citrus industry worldwide. Hrp pili subunits (HrpE), an essential component of Type III secretion system (T3SS) bacteria, play a crucial role in the pathogenesis of Xcc by transporting effector proteins into the host cell and causing canker symptoms. Therefore, development of antibodies that block HrpE can suppress disease progression. In this study, a specific scFv detecting HrpE was developed using phage display technique and characterized using sequencing, ELISA, Western blotting, and molecular docking. In addition, a plant expression vector of pCAMBIA-scFvH6 was constructed and agroinfiltrated into Nicotiana tabacum cv. Samson leaves. The hypersensitive response (HR) in the leaves of transformed and non-transformed plants was evaluated by inoculating leaves with Xcc. After three rounds of biopanning of the phage library, a specific human scFv antibody, named scFvH6, was identified that showed high binding activity against HrpE in ELISA and Western blotting. Molecular docking results showed that five intermolecular hydrogen bonds are involved in HrpE-scFvH6 interaction, confirming the specificity and high binding activity of scFvH6. Successful transient expression of pCAMBIA-scFvH6 in tobacco leaves was verified using immunoassay tests. The binding activity of plant-produced scFvH6 to detect HrpE in Western blotting and ELISA was similar to that of bacterial-produced scFvH6 antibody. Interestingly, tobacco plants expressing scFvH6 showed a remarkable reduction in HR induced by Xcc compared with control plants, so that incidence of necrotic lesions was significantly higher in non-transformed controls (≥ 1.5 lesions/cm2) than in the plants producing scFvH6 (≤ 0.5 lesions/cm2) after infiltration with Xcc inoculum. Our results revealed that the expression of scFvH6 in tobacco leaves can confer resistance to Xcc, indicating that this approach could be considered to provide resistance to citrus bacterial canker disease.

The effect of metformin use in patients with diabetes against the hematological cancers (HCs) has been contradictory. This meta-analysis, carried out on studies published in databases, aimed to investigate the association of metformin use and the odds of HCs. We systematically searched Scopus and PubMed databases to include related studies considering the relation of metformin use and the risk of HCs as outcome. Eleven studies, comprising a total of 2 318 217 participants, were included. The analysis revealed that metformin use in patients with diabetes was significantly associated with a decreased risk of HCs (OR=0.88; 95%CI: 0.79–0.98), with significant heterogeneity. In the subgroup analysis, this association was found to be significant only for multiple myeloma (OR=0.67; 95% CI: 0.55–0.81). A significant evidence for heterogeneity and publication bias was detected. Metformin use in patients with diabetes may be linked to the reduced risk of HCs. FUNDING: No external funding.

This study aimed to investigate the prevalence and factors associated with arthritis rheumatoid using a screening program among Shahrekord cohort study population. The present analytical cross-sectional study was performed on 1043 participants of the PERSIAN cohort study in Shahrekord, Iran. The prevalence of rheumatic disorder (RD) was 57.5% (95% CI: 53-62 %). Females were more likely to develop RD than males (odds ratio [OR]=2.83, P

Intertextuality or Taāṣ is one of the linguistic techniques that examines the relationship and interaction between various literary works in prose and poetry, and presents in different forms in the works of authors. Ma’d al-Jubūrī’s poems, a contemporary Iraqi poet, are no exception to this rule. This article, using a descriptive-analytical method, aims to identify the most important objectives and semantic implications of the Quranic heritage in Ma’d al-Jubūrī’s poetry. The research findings indicate that the signs of Quranic Intertextuality have been reflected in various forms in Intertextuality. The deep connection of the poet with the Quran has allowed him to incorporate Quranic images and stories into his creative text according to the context. Drawing on Quranic concepts and foundations, al-Jubūrī can eloquently explain the plight of the oppressed people in the Arab world, especially in Iraq, with a rich poetic sensibility and elegant expression.

Abstract Background The evaluation of e-learning systems ensures the provision of quality training. The goal was to identify the perspectives of teachers and students on e-learning in medical education during the COVID-19 pandemic at Shiraz University of Medical Sciences (SUMS), Iran. Methods This study utilized a convergent mixed methods research design with a two-phase approach to collect and analyze data between June and August 2022. In the first stage, a cross-sectional descriptive study was conducted to evaluate the quality of e-learning systems from the perspective of 400 students. In the second stage, semi-structured interviews were conducted with 10 virtual education professors and 10 student representatives to identify the strengths, weaknesses, opportunities, and threats of virtual education. A validated questionnaire was administered to assess the quality of the e-learning system, and data were analyzed using SPSS-21. Qualitative data were subjected to content analysis. Results Our findings revealed that the student support system, the course structure, and the infrastructure and technology subscales’ mean scores were significantly higher than the average level (P

A reliable simulation of wastewater effluent parameters is important for reducing the operational costs of a wastewater treatment plant. In this study, optimized artificial neural networks and inclusive multiple models are used to predict the effluent biochemical oxygen demand, chemical oxygen demand and total suspended solids of a WWTPs in Shahrekord basin, Iran. The influent quality parameters (CODinf, BODinf, TSSinf and PHinf) are used as inputs to the models. The naked mole-rat algorithm is used to tune ANN parameters. This investigation compares the capabilities of ANN-NMRA with those of ANN-firefly, ANN-sine cosine algorithm, ANN-genetic algorithm and ANN models. The output of hybrid and standalone models is incorporated into an ANN model as an IMM model. Several individual models are used in an IMM model for predicting outputs. Hence, an IMM model increases the accuracy of individual models. In this study, ANN models are modified by using a goodness factor to reduce computational time. This paper presents a new preprocessing method for selecting the best input combination and analyzes the uncertainty of model and input parameters. IMM, ANN-NMRA, ANN-SCA, ANN-FFA, ANN-GA and ANN models achieve MAEs of 0.789, 0.998, 1.19, 1.26, 1.34 and 1.40 mg/L for predicting BODeff in the testing stage, respectively. The IMM model has the highest accuracy for predicting CODeff and TSSeff. A good factor reduces the computational time of ANN models by removing redundant hidden neurons. The uncertainty analysis results show that model parameters provide higher uncertainty than input parameters.

Objectives Proficiency in medical writing and publishing is essential for medical researchers. Workshops can play a valuable role in addressing these issues. However, there is a lack of systematic summaries of evidence on the evaluation of their impacts. So, in this systematic review, we aimed to evaluate all articles published on the impact of such workshops worldwide. Methods We searched Ovid EMBASE, Ovid Medline, ISI Web of Science, ERIC database, and grey literature with no language, time period, or geographical location limitations. Randomized controlled trials, cohort studies, before-after studies, surveys, and program evaluation and development studies were included. We performed a meta-analysis on data related to knowledge increase after the workshops and descriptively reported the evaluation of other articles that did not have sufficient data for a meta-analysis. All analyses were performed using Stata software, version 15.0. Results Of 23 040 reports, 222 articles underwent full-text review, leading to 45 articles reporting the impacts of workshops. Overall, the reports on the impact of such workshops were incomplete or lacked the necessary precision to draw acceptable conclusions. The workshops were sporadic, and researchers used their own method of assessment. Meta-analyses of the impact on the knowledge showed that workshops could nonsignificantly increase the mean or percentage of participants’ knowledge. Conclusion In the absence of systematic academic courses on medical writing/publishing, workshops are conducted worldwide; however, reports on educational activities during such workshops, the methods of presentations, and their curricula are incomplete and vary. Their impact is not evaluated using standardized methods, and no valid and reliable measurement tools have been employed for these assessments.

Colloid-based computing devices offer remarkable fault tolerance and adaptability to varying environmental conditions due to their amorphous structure. An intriguing observation is that a colloidal suspension of ZnO nanoparticles in dimethylsulfoxide (DMSO) exhibits reconfiguration when exposed to electrical stimulation and produces spikes of electrical potential in response. This study presents a novel laboratory prototype of a ZnO colloidal computer, showcasing its capability to implement various Boolean functions featuring two, four and eight inputs. During our experiments, we input binary strings into the colloid mixture, where a logical ‘True’ state is represented by an impulse of an electrical potential. In contrast, the absence of the electrical impulse denotes a logical ‘False’ state. The electrical responses of the colloid mixture are recorded, allowing us to extract truth tables from the recordings. Through this methodological approach, we demonstrate the successful implementation of a wide range of logical functions using colloidal mixtures. We provide detailed distributions of the logical functions discovered and offer speculation on the potential impacts of our findings on future and emerging unconventional computing technologies. This research highlights the exciting possibilities of colloid-based computing and paves the way for further advancements.

Abstract Background Clostridioides difficile infection (CDI) is one of the most common health care-acquired infections. The dramatic increase in antimicrobial resistance of C. difficile isolates has led to growing demand to seek new alternative medicines against CDI. Achillea millefolium L. extracts exhibit strong biological activity to be considered as potential therapeutic agents. In this work, the inhibitory effects of A. millefolium, its decoction (DEC) and ethanol (ETOH) extracts, were investigated on the growth of C. difficile RT001 and its toxigenic cell-free supernatant (Tox-S) induced inflammation and apoptosis. Methods Phytochemical analysis of extracts was performed by HPLC and GC analysis. The antimicrobial properties of extracts were evaluated against C. difficile RT001. Cell viability and cytotoxicity of Caco-2 and Vero cells treated with various concentrations of extracts and Tox-S were examined by MTT assay and microscopy, respectively. Anti-inflammatory and anti-apoptotic effects of extracts were assessed in Tox-S stimulated Caco-2 cells by RT-qPCR. Results Analysis of the phytochemical profile of extracts revealed that the main component identified in both extracts was chlorogenic acid. Both extracts displayed significant antimicrobial activity against C. difficile RT001. Moreover, both extracts at concentration 50 µg/mL had no significant effect on cell viability compared to untreated cells. Pre-treatment of cells with extracts (50 µg/mL) significantly reduced the percentage of Vero cells rounding induced by Tox-S. Also, both pre-treatment and co-treatment of Tox-S stimulated Caco-2 cells with extracts significantly downregulated the gene expression level of IL-8, IL-1β, TNF-α, TGF-β, iNOS, Bax, caspase-9 and caspase-3 and upregulated the expression level of Bcl-2. Conclusion The results of the present study for the first time demonstrate the antimicrobial activity and protective effects of A. millefolium extracts on inflammatory response and apoptosis induced by Tox-S from C. difficile RT001 clinical strain in vitro. Further research is needed to evaluate the potential application of A. millefolium extracts as supplementary medicine for CDI prevention and treatment in clinical setting.

Abstract Introduction Hospitals, as complex organizations with clinical, financial, and social functions, face different barriers to providing high-quality and safe services at reasonable costs. Various initiatives have been carried out in hospital governance to improve quality, safety, and accountability. This research aims to identify the structures and dimensions that make hospital governance accountable. Methods The research used Arksey and O'Malley's scoping review framework to examine the research literature on hospital governance structure and accountability. The literature review included PubMed, Web of Science, Embase, Scopus ProQuest, Google search engine, and Google Scholar databases from 2010 to 2023. Data were analyzed using the content analysis method. Results Excluding unrelated and duplicate sources, 40 articles and reports were included in the study. The studies were reviewed and analyzed based on organizational type, type of source, year of publication, objectives, and key findings. Accountable governance features were extracted from the selected articles and reports. The four main themes include inclusive governance, commitment to accountability, planning for accountability, and autonomous governance. Thirteen subthemes were extracted from the study literature. Conclusion Various initiatives have been implemented regarding the reform of the governance structure of public hospitals in different countries. Many of these reforms aim to improve financial and clinical accountability. The study results could be used to identify the structures and dimensions that make hospital governance accountable.

Abstract Background Aedes aegypti is the main vector of arboviral diseases worldwide. The species invaded and became established in southern Iran in 2020. Insecticide-based interventions are primarily used for its control. With insecticide resistance widespread, knowledge of resistance mechanisms is vital for informed deployment of insecticidal interventions, but information from Iranian Ae. aegypti is lacking. Methods Fifty-six Ae. aegypti specimens were collected from the port city of Bandar Lengeh in Hormozgan Province in the South of Iran in 2020 and screened for kdr mutations. The most common kdr mutations in Latin America and Asia (V410L, S989P, V1016G/I and F1534C), especially when present in combinations, are highly predictive of DDT and pyrethroid resistance were detected. Phylogenetic analyses based on the diversity of S989P and V1016G/I mutations were undertaken to assess the phylogeography of these kdr mutations. Results Genotyping all four kdr positions of V410L, S989P, V1016G/I and F1534C revealed that only 16 out of the 56 (28.57%) specimens were homozygous wild type for all kdr mutation sites. Six haplotypes including VSVF (0.537), VSVC (0.107), LSVF (0.016), LSIF (0.071), VPGC (0.257) and LPGC (0.011) were detected in this study. For the first time, 11 specimens harbouring the V410L mutation, and 8 samples with V1016I mutation were found. V410L and V1016I were coincided in 8 specimens. Also, six specimens contained 1016G/I double mutation which was not reported before. Conclusions The relatively high frequency of these kdr mutations in Iranian Ae. aegypti indicates a population exhibiting substantial resistance to pyrethroid insecticides, which are used widely in control operations and household formulations. The detection of the 410L/1016I kdr mutant haplotype in Iranian Ae. aegypti suggests possible convergence of invasive populations from West Africa or Latin America. However, as Iran has very limited maritime/air connections with those African countries, a Latin American origin for the invasive Ae. aegypti in Iran is more plausible. Graphical abstract

Background: Breast cancer is one of the most prevalent cancers in women worldwide. Considering the side effects of chemotherapy treatments, we investigated the anticancer effects and mechanisms of bromelain (Br) on breast cancer cells in this systematic review. Methods: The PRISMA recommendations were followed to design this systematic review. Web of Science, PubMed, Cochrane Library, and Scopus were high-coverage databases used for searching. After considering the inclusion and exclusion criteria for the study, 18 articles were included. The desired information was gathered, entered into an Excel file, and the study outcomes were surveyed. Results: Br revealed its anticancer effects by preventing the proliferation of cancer cells, inducing cytotoxicity, apoptosis, autophagy, and cellular oxidation in breast cancer cells. Moreover, its anti-inflammatory activity and immunomodulatory effects in the tumor environment can increase treatment outcomes. No significant side effects of this proteolytic substance have been reported, and it is a safe herbal constitution. Its combination with anticancer drugs such as cisplatin has revealed synergic effects. Besides reducing the toxicity of chemotherapy drugs, Br improves treatment outcomes. Conclusion: Br has shown promising anticancer effects against breast cancer in in vivo and in vitro studies. However, more clinical trial studies are needed to achieve more reliable results.

Abstract Background Aflatoxins are regarded as the most potent genotoxic and carcinogenic type of mycotoxins. This meta-analysis was performed to investigate a the relation of aflatoxin B1 (AFB1) to growth measurements of infants/children, including wasting, underweight, stunting, as well as weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ) z-scores. Methods Electronic databases of PubMed, Web of Science, and Scopus were searched to identify related publications. Effect sizes for associations were pooled using the random effects analysis. Subgroup analysis by study design, method used to assess AFB1, and adjustment for covariateswas performed to detect possible sources of heterogeneity. Results Pooled analysis of available data showed that AFB1 exposure was negatively associated growth z-scores, including WHZ (β = -0.02, 95%CI = -0.07 to 0.03), with WAZ (β = -0.18, 95%CI = -0.33 to -0.02), and HAZ (β = -0.17, 95%CI = -0.30 to -0.03) in infants/children. There was a remarkable heterogeneity among studies on WAZ and HAZ (P ≤ 0.001). In prospective cohort studies, AFB1 exposure was found to be significantly associated with the elevated risk of underweight (OR = 1.20, 95%CI = 1.03 to 1.40) and stunting (OR = 1.21, 95%CI = 1.11 to 1.33). Conclusions This meta-analysis highlighted the importance of AFB1 exposure as a potential risk factor for growth impairment in infants/children.

Non-alcoholic fatty liver disease (NAFLD) affects over 1/3 of the Iranian adult population. NAFLD is predicted to soon become an epidemic with widespread social and economic consequences due to the increasing prevalence of its risk factors. So far, NAFLD has received less attention from the public health system. It is necessary to adopt and develop effective national policies and guidelines based on evidence related to the prevention, diagnosis, care, and treatment of NAFLD. The researchers of the Gut and Liver Research Center, affiliated to Mazandaran University of Medical Sciences, with the aim of helping to solve this challenge, have presented the current policy brief using the research evidence available in databases and the review of the national higher-order documents. First of all, it is suggested that the government should legally and financially support NAFLD as a serious social health issue. Subsequently, the Ministry of Health should provide relevant standards and executive guidelines according to the existing conditions in Iran's healthcare system, under the legal and financial support of the government. In this policy summary, some of the implenetable and high-priority measures included designing national service standards by specialized liver working groups; providing funds for the development of human, physical, and study resources; developing people-oriented health/educational systems, and providing care and treatment services through multi-specialty clinics

Hydrogels have unique properties such as water retainer, softness, flexibility, and biocompatibility that cause their application in biology. Among the various hydrogel structures can be referred to intelligent hydrogels. These structures can respond to environmental stimuli. Environmental stimuli can be physical, including temperature or chemicals, such as pH. In this study, the application of smart hydrogels in the fields of medicine, protein, and gene delivery, as well as tissue engineering has been divided and the results of this study show that different types of smart hydrogels with different capabilities have been identified. The mechanical strength of hydrogels is suitable for physiological function and various purposes such as biomedical applications, tendon and ligament repair, cartilage replacement, and tissue engineering. Currently, hydrogels are used to make contact lenses, health products, tissue engineering scaffolds, drug delivery systems, and wound dressing. Most studies in the field of smart drug delivery have been reported, especially in anticancer drugs, and also tissue engineering that can achieve more desirable results in the near future.

Hydropower boasts the capability to consistently generate electricity throughout the year, offering the lowest operating costs and the longest lifespan among renewable energy technologies. Given the aforementioned considerations and the absence of prior investigations into Iran's hydropower potential, this study employs HOMER software to explore the feasibility of supplying electricity to a village comprising 10 households near Koohrang Tunnel in Chaharmahal and Bakhtiari Province, leveraging solar, wind, and hydro turbine renewable energies. Three distinct scenarios, centered around hydro turbine utilization, were examined. These scenarios aimed to provide electricity in off-grid (1st scenario) and grid-connected modes (2nd scenario), as well as to generate electricity and hydrogen in a grid-connected mode (3rd scenario). In the first scenario, the most economically viable design yielded a cost of $0.187 per kWh of generated electricity, with 99% of the electricity sourced from the hydro turbine and the remaining 1% from a diesel generator. This scenario resulted in a CO2 emission of 23.2 kg/y. In the second scenario, the most cost-effective option supplied 94% of the electricity from the hydro turbine and the remaining portion from the main grid, at a cost of $0.033 per kWh. Notably, surplus electricity sold to the main grid facilitated an annual reduction of 1297 kg of CO2 emissions. The third scenario, which combined the hydro turbine with the main grid, presented the most financially viable option. Here, the costs of per kWh of generated electricity and per kg of produced hydrogen were $2.012 and $0.49, respectively.

Abstract Background Neutropenia is the most important cause of life-threatening invasive fungal infections (IFIs). Here, we studied the frequency and antifungal susceptibility profiles of Candida species that colonized or caused infections among neutropenic patients with solid or hematological malignancies. Methods A total of 362 clinical samples were collected from 138 patients. After initial isolation using a mix of mycological methods, isolates were screened using chromogenic culture media. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was applied for molecular identification. Positive or suspected cases were confirmed using the reference method of sequencing. Antifungal susceptibility testing for voriconazole and caspofungin was carried out using the microbroth dilution method. An in-silico assay was applied for phylogenetic analysis. Results Thirty-four Candida strains were isolated. C. albicans (47.06%) and C. glabrata (29.41%) were the most frequent strains. Antifungal treatment reduced the chance of Candida colonization by almost 76% in neutropenic patients (OR: 1.759; 95% CI: 1.349 to 2.390; p value: 0.000). An unusual and non-resistant strain, C. lambica, was reported from the bloodstream of a 56-year-old man with hematologic malignancy (HM). Eight isolates were non-susceptible, and one isolate was resistant to voriconazole. Also, four isolates were non-susceptible to caspofungin. Conclusion We can conclude that there is a cause-and-effect relationship between neutropenia, HM background, and Candida species separated from neutropenic patients, which can lead to possible infections. Further and repetitive studies are recommended using different molecular methods for better prediction and management of fungal infections in neutropenic patients.