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Wound healing process significantly impeded by prolonged inflammation responses, infection at the wound site, and insufficient angiogenesis. The sustained release of anti-inflammation and anti-bacterial drugs has the potential to control immune responses, improve angiogenesis, accelerate wound healing, and re-epithelialization. In this research a multifunctional hydrogel containing carboxy methyl cellulose (CMC) and polycaprolactone (PCL), along with Ciprofloxacin (CIP) and Curcumin (Cur) was developed. Physicochemical characteristics as well a biological one such as antibacterial and drug release properties, Collagen deposition, inflammatory responses, angiogenesis, and epidermal regenerated thickness were investigated via in vitro and in vivo assay. The results revealed that the CMC/PCL-based wound dressing has the potential to provide an appropriate level of water absorption (∼300 %) to absorb wound exudate and ideal WVTR in range of 2279-2363 g/m 2 for wound healing application. Addition of CIP and Cur to CMC/PCL hydrogel improved the skin cell proliferation, cell migration, and antibacterial activity. It also led to superior Collagen I synthesis (∼2-4 times), controlled pro-inflammatory and improved anti-inflammatory cytokine secretion of macrophages, and accelerated wound healing in comparison to CMC/PCL hydrogel. In conclusion, the engineered multifunctional hydrogel showed a potential effect for accelerating wound healing and skin regeneration., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Wound healing is a complicated process, especially when surgical, traumatic, burn, or pathological injury occurs, which requires different kinds of dressing covers including hydrogels, hydrocolloids, alginates foams and films for treatment. The human amniotic membrane (hAM) is a biodegradable extracellular matrix with unique and tailorable physicochemical and biological properties, generated by the membrane itself or other cells that are located on the membrane surface. It is noted as a promising aid for wound healing and tissue regeneration due to the release of growth factors and cytokines, and its antibacterial and immunosuppressive properties. Moreover, hAM has optimal physical, biological, and mechanical properties, which makes it a much better option as a regenerative skin treatment than existing alternative materials. In addition, this layer has a structure with different layers and cells with different functions, which act as a regenerative geometry and reservoir of bioactive substances and cells for wound healing. In the present work, the structural and biological features of hAM are introduced as well as the application of this layer in different forms of composites to enhance wound healing. Future studies are recommended to detect possible further functionalization to enhance the hAM effectiveness on wound healing., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The utilization of complementary and alternative medicine (CAM) is experiencing a global surge, accompanied by the adoption of national CAM policies in numerous countries. Traditional Persian medicine (TPM) is highly used as CAM in Iran, and the ongoing scientific evaluation of its interventions and the implementation of evidence-based medicine (EBM) encounters various barriers. Therefore, comprehending the characteristics and interactions of stakeholders is pivotal in advancing EBM within TPM policies. In this study, we utilized both classical stakeholder analysis and social network analysis to identify key stakeholders and potential communication patterns, thereby promoting EBM in TPM policy-making., Methods: A cross-sectional nationwide stakeholder analysis was conducted in 2023 using snowball sampling. The interviews were carried out using a customized version of the six building blocks of health. Data were collected through semi-structured interviews. Stakeholders were assessed based on five factors (power, interest, influence, position, and competency). The connections and structure of the network were analyzed using degree, betweenness, closeness centrality, and modularity index to detect clusters of smaller networks., Results: Among twenty-three identified stakeholders, the Ministry of Health and Medical Education (MOHME) and the Public were the most powerful and influential. The Iranian Academy of Medical Sciences was the most competent stakeholder. Social network analysis revealed a low density of connections among stakeholders. Pharmaceutical companies were identified as key connectors in the network, while the Public, supreme governmental bodies, and guilds acted as gatekeepers or brokers. The MOHME and Maraji were found to be high-ranking stakeholders based on four different centrality measures., Conclusion: This study identifies powerful stakeholders in the network and emphasizes the need to engage uninterested yet significant stakeholders. Recommendations include improving competence through education, strengthening international relations, and fostering stronger relationships. Engaging key connectors and gatekeepers is essential for bridging gaps in the network., (© 2024. The Author(s).)

Background: Mizaj (Temperament) is a concept to express individual differences in Persian medicine and according to this theory, there is a relationship between Mizaj type and the abilities of different body organs. This cross-sectional study aimed to investigate the relationship between the type of Mizaj and the memory score (Quotient)., Methods: The target population was the 18 to 38 years old students of Babol University of Medical Sciences. Mojahedi's Mizaj questionnaire (MMQ) was used for determining the whole Mizaj. The physical Persian version of Wechsler Memory Scale III (WMS III) was used to assess memory score. The collected data were analyzed by SPSS Version 22 and the chi square (x2) and t-test were run and p- value 0.05 was considered as significant difference., Results: Forty-two of participants were females and 18 were males. The average age of them was 23.6 (21-27). The average of Memory Quotient (MQ) was 122.1 ± 5.7. The average of MQ in warm Mizaj was 125.46 ± 1.2 and in cold Mizaj was 118.79 ± 6.5. The difference between two groups is statistically significant (p< 0.001). The average of MQ in dry Mizaj was 124.16 ± 2.67 and in wet Mizaj was 118.40 ± 7.64. The difference between two groups is statistically significant (P= 0.005)., Conclusion: The results showed there are significant relationship between memory score and warm/cold Mizaj and dry /wet Mizaj. It means students with warm or dry Mizaj had better memory score than students with cold or wet Mizaj. This relation was also detected between subtypes of memory and Mizaj expect between working memory and dry/wet Mizaj. These results are in accordance with theories in PM which indicate people with warm Mizaj and dry Mizaj have better memory and people with cold Mizaj and wet Mizaj have weaker memory and are more at risk of memory dysfunction., Competing Interests: no conflict of interest., (© The Author(s).)

In a novel approach to layer-based holography, we propose a machine learning-assisted light sheet holography-an optimized holography technique which projects a target scene onto sheets of light along the longitudinal planes (i.e. planes perpendicular to the plane of the hologram). Using a convolutional neural network in conjunction with superposition of Bessel beams, we generate high-definition images which can be stacked in parallel onto longitudinal planes with very high fidelity. Our holography system provides high axial resolution and excellent control over the light intensity along the optical path, which is suitable for augmented reality and/or virtual reality applications.

Adiabatic Y-junction power splitters have low loss, large bandwidth, high polarization insensitivity, and high tolerance to fabrication errors. However, the adiabatic transition lengths required are generally much longer than other power splitters. Using a nonlinear taper profile can considerably shorten the device length. Here, we introduce a taper profile optimization algorithm based on polynomial functions, which significantly reduces the lengths of the adiabatic power splitters without increasing losses. We experimentally demonstrate the performance of the adiabatic power splitters for minimum feature sizes of 80 nm, 120 nm, and 160 nm on the 220 nm silicon-on-insulator (SOI) platform. Our best device has a minimum feature size of 120 nm and a length of 14 µm, with measured losses of 0.25 dB and 0.23 dB for the transverse electric (TE) and transverse magnetic (TM) modes, respectively, in the 1500-1600 nm region. This device has an average transmission of -3 ± 0.5 dB in the 1500-1600 nm region, indicating highly balanced splitting over a large spectral range.

In order to prevent miscarriage in RPL patients, the goal of this study was to determine how well lymphocyte immunotherapy (LIT) works in modifying immunological responses produced by cells, cytokines, transcription factors, and microRNAs. 200 RPL patients and 200 healthy controls were included in the study. Using flow cytometry, it was possible to compare the frequency of cells before and after lymphocyte treatment. Real-time PCR was used to assess the gene expression levels of transcription factors, cytokines, and microRNAs. ELISA method was used to evaluate the level of secretion of cytokines in the serum. Primary evaluation of the immune profile between healthy controls and RPL cases showed a higher frequency of Th17, NK, B cells and a lower frequency of Treg cells in RPL cases. Also, pro-inflammatory cytokines showed increased expression at mRNA and protein levels in the RPL group in comparison with the control group. Whereas, anti-inflammatory cytokines showed decreased expression in RPL patients. Decreased and increased frequency of Th17 and Treg lymphocytes observed in RPL cases following LIT, respectively. The same results obtained for RORγt and FoxP3 mRNA expression as transcription factor of Th17 and Treg cells, respectively. NK cell cytotoxicity decreased after LIT in RPL patients. miR-326a and miR-155 expression after LIT reduced, but miR-146a and miR-10a expression increased in RPL instances. LIT in RPL cases causes to elevation and modulation of anti-inflammatory and pro-inflammatory cytokines. Our data showed that lymphocyte therapy can be proposed as an effective therapeutic agent in RPL patients with immunological background by a modulating inflammatory condition., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Competing Interests: There are no conflicts of interest.

Background: Mizaj is an individualized viewpoint in Persian Medicine (PM) that is used for the prevetion of diseases and also treatment. Evaluating Mizaj in the two domains of hotness-coldness, and wetness-dryness, 10 criteria have been introduced, most of them are qualitative. To achieve valid and reliable questionnaires, the weight of these criteria must be determined in assessing the Mizaj., Methods: In a cross-sectional study with Delphi method, 10 indices were extracted from PM references and sent to PM experts via e-mail. They were asked to score the weight of each index in determining the Mizaj from 0 to 10. The scores ranked and comparing previous preliminary studies, criteria of major and minor were proposed., Results: Out of 147 invited PM experts, 122 completed the tables. Based on scores, physical functions, physique, and responsiveness of organs obtained the highest scores in the field of hotness-coldness. In wetness-dryness muscle/fat mass and sleep/wakefulness received the highest scores from the viewpoint of experts., Conclusion: Physical functions, physique (Anthropometry), responsiveness of organs and psychic function can be used as major criteria in Mizaj assessment methods in the hotness-coldness field. In the field of wetness-dryness, muscle/fat mass, sleep/wakefulness, tactile condition and physique (anthropometry) can be considered as major criteria., Competing Interests: We have no conflict of interest.

Purpose: The authors developed nanostructured lipid carriers (NLCs) loaded with sirolimus (SRL) and cyclosporine (CsA) to improve their therapeutic efficacy in recurrent pregnancy loss (RPL) patients., Methods: Mono-delivery and co-delivery of SRL and CsA by NLCs (S-NLCs, C-NLCs, and S-C-NLCs) were developed. The MTT assay was used to study the optimum dose of formulations. PCR, Western blotting, and ELISA were also conducted., Results: Well-designed nanodrugs with a suitable size, zeta potential, desirable encapsulation efficiency drug loading, and cellular uptake confirmed optimum formulations. Based on cell viability, the amounts of SRL and CsA could be reduced greatly due to the co-delivery by NLCs. Following S-NLCs and C-NLCs interventions in T cells of patients with RPL and immune abnormality, a significant difference was observed in transcription factors and cytokine levels of Th1, Th17, and Tregs compared with healthy samples. Thus, a higher level of pro-inflammatory cytokines (IFN-γ, TNF-α, IL-17, and IL-21) and their regulators (T-bet and RORγt), as well as a lower level of an anti-inflammatory cytokine (IL-10) and its regulatory (Foxp3), were observed. However, no significant difference was found following the S-C-NLCs intervention., Conclusions: S-C-NLCs effectively balance the immune responses in peripheral T cells in RPL patients to induce maternal immune tolerance., Competing Interests: The authors declare that there is no conflict of interests., (© 2023 The Authors. Reproductive Medicine and Biology published by John Wiley & Sons Australia, Ltd on behalf of Japan Society for Reproductive Medicine.)

Background: The process of diagnosis and treatment in Persian medicine (PM) are based on the concept of Mizaj (temperament). Among the indices of Mizaj determination, anthropometric indices are less influenceable regarding age change and other environmental factors. The purpose of this study was to investigate the relationship between anthropometric indices and Mizaj., Methods: Four PM experts determined the Mizaj of 121 participants. Those who had ≥70% agreement in their Mizaj determination by the experts were selected and their anthropometric indices were measured. The best cutoff point of each index and its relationship with the defined Mizaj were extracted using Receiver Operative Characteristic Curve and Binary Logistic Regression., Results: 52 out of 121 participants entered the main study. The warm-Mizaj people had larger dimensions in height, shoulder, chest, palm and sole width, and head height. Cold-Mizaj people had smaller dimensions in weight, height, shoulder, chest and head. High levels of BMI, chest depth and head dimensions had the highest correlation with the wet Mizaj and lower dimensions of these indices had the highest correlation with the dry Mizaj., Conclusion: Among the anthropometric indices, chest, palm, sole dimensions, head height and weight had the highest correlation with warmness/coldness and BMI, head width and chest dimensions had the highest correlation with wetness/dryness. The BMI which is more closely related to the soft tissue, only correlates with the wetness/dryness, while, bone dimensions are associated with warmness/coldness. Further studies are needed to metricize the anthropometric indices for Mizaj determination., Competing Interests: None declared.

We propose a dual-polarization optimization method for the bulk sensitivity of silicon-on-insulator (SOI) waveguides by defining a multi-objective function that accounts for the substrate leakage losses. The proposed optimization method was used to design micro-ring resonator bulk sensors with strip, slot, subwavelength grating, and subwavelength grating slot waveguides. The subwavelength grating slot waveguide has a bulk sensitivity of 520 nm/RIU and 325 nm/RIU for the TE and TM modes, respectively, both of which are higher than the bulk sensitivities of strip, slot, and subwavelength grating waveguides. Moreover, our Monte Carlo analysis shows that the subwavelength grating slot waveguide has the highest immunity to fabrication errors.

Fissure sealant application is an efficient method for dental caries prevention. Self-etch fissure sealants (SE-FS) eliminate the separate etching step for bonding. The present study investigated the micro-shear bond strength (μSBS) of a SE-FS (Prevent seal®, Itena©, Paris, France) to enamel pretreated with different methods including Er,Cr:YSGG laser, under noncontaminated and saliva-contaminated conditions. Sixty human premolars were sectioned into halves and randomly assigned into two groups of saliva-contaminated and noncontaminated. Each group was further divided into six subgroups (N = 10) of different enamel pretreatment methods: (Laser+SE-FS), (Acid-etch+SE-FS), (Laser+Acid-etch+SE-FS), (Mechanical preparation+SE-FS), (SE-FS), and (Acid-etch+Bonding+Conventional fissure sealant) as positive control. The μSBS of the sealant material to enamel was measured in all subgroups. The two-way ANOVA and Tukey tests were applied at P &lt; 0.05. Saliva contamination had a significant effect on μSBS (P &lt; 0.001), while pretreatment with laser or acid etching did not significantly affect the μSBS (P = 0.251). The μSBS of SE-FS to untreated enamel surface was significantly lower than the positive control (P = 0.035). The μSBS value in the subgroup receiving laser+etching+SE-FS was significantly higher than the remaining five subgroups (P &lt; 0.001). Other pairwise comparisons were not statistically significant (P &gt; 0.05). Acid-etch and Er,Cr:YSGG laser exert a synergic effect on μSBS of Prevent Seal®, irrespective of saliva contamination., (© 2022 The American Society for Photobiology.)

Decontamination of implant surfaces is important to the treatment of peri-implantitis. Er:YAG laser and air-powder abrasion system are regarded as the most effective means of decontamination of implant surfaces. The aim of this in vitro study was to compare the activity of human dental pulp stem cells (hDPSCs) cultured on decontaminated sandblasted titanium discs using Er:YAG laser irradiation and air-powder abrasion. Forty-five titanium discs were contaminated with Escherichia coli (E. coli) bacteria and fifteen titanium discs served as sterile control groups. Thirty contaminated titanium discs were decontaminated with Er:YAG laser or air-powder abrasion system and fifteen contaminated discs were used as contaminated control group. Afterwards, hDPSCs were seeded on all sixty experimental titanium discs. The effects of two decontamination tools on hDPSCs viability were evaluated by MTT assay. Alkaline phosphatase (ALP) activity assay, quantitative real-time PCR analysis and alizarin red staining method were performed to assess hDPSCs osteogenic differentiation. Scanning microscope electron (SEM) was also used to evaluate the effects of two different decontaminated methods on cellular morphology. Our study showed that decontamination using Er:YAG laser caused maximum cell viability. However, the ALP activity was not different in laser and air-abrasion groups. The significant expression of an osteoblastic marker and stronger Alizarin red staining were observed in laser irradiation groups. In addition, SEM observation indicated that grown cells were more stretched and more filopodia in Er:YAG-treated discs. In the present study, Er:YAG laser and air-powder abrasion improved the activity of the cells cultured on the decontaminated titanium discs. However, in comparison with air-powder abrasion, Er:YAG laser was more effective., (© 2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Background: One of the principles of Persian medicine (PM) is the individualized approach that is presented with the concept of Mizaj. In this viewpoint, on the whole body, Mizaj is determined for every person based on 10 criteria, which is a result of the Mizaj of the main organs, including the brain, liver, and heart. There is no standard diagnostic tool for Mizaj assessment yet. The purpose of this study is to explain the method of Mizaj assessment and data analysis in the elderly in one of the biggest health and aging projects in Iran. The second phase of the Amirkola health and aging project (AHAP) evaluated more than 1,700 clinical and laboratory examinations of 2135 elderly people., Methods: In this study, a novel Mizaj assessment method in two phases is presented. In the first phase, 1541 elderly were assessed by a PM expert and typical diagnoses (the high confidence of expert's proficiency) were determined. At the second phase, an expert panel including 5 PM experts evaluated the cases. The data of the elderly whose Mizaj agreed in the expert panel was used to assess its correlation with Mizaj. Also, the Mizaj of the main organs of these cases was evaluated this way., Conclusion: In the lack of valid and reliable questionnaires to assess the personalized viewpoint of PM, a new expert-based method has been introduced that can be used in similar studies. The result of the Mizaj assessment in this way will be used to obtain objective values for the Mizaj assessment., Competing Interests: There is no competing interest.

Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era., Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City., Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament., Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools., Competing Interests: None declared.

Introduction: Stem cell activities have different effects on tissue response and its outcomes. Low-level laser therapy (LLLT) can be considered a trigger to modify stem cell activities. The objective of the present experimental investigation was to study the effects of two protocols of LLLT on the proliferation and differentiation of human dental pulp stem cells (hDPSCs) cultured on sandblasted titanium discs. Methods: Cells obtained from human dental pulp were seeded/cultured on titanium discs and were set in 2 main groups: ( i ) Radiated cells using the gallium-aluminium-arsenide (GaAlAs) diode laser at a continuous wavelength of 808 nm at 3 J/cm 2 for 12 sec or 5 J/cm 2 for 20 seconds, and ( ii ) Non-irradiated cells serving as control groups. The impact of LLLTs on hDPSC-proliferation and viability was investigated using the MTT assay after 24, 72 and 96 hours. The alkaline phosphatase activity was studied with p-nitrophenylphosphate after 14 and 28 days. The ability of hDPSCs to express osteocalcin was investigated using real-time polymerase chain reaction after 28 days, while their attachment was observed under a scanning electron microscope (SEM) after 14 and 28 days. Results: Our study showed that LLLTs caused maximum cell proliferation in 96 hours ( P <0.001) with 3 J/cm 2 resulting in a higher proliferation rate. The highest activity of alkaline phosphatase and osteocalcin expression was observed in the laser radiation groups after 28 days. Conclusion: The outcomes of the current study showed that cultured hDPSCs on sandblasted titanium discs had a tendency towards increased cellular activity in response to LLLTs. Thus, LLLTs could regulate the activities of hDPSCs on bone repair surrounding the sandblasted titanium discs., (Copyright © 2022 J Lasers Med Sci.)

The aim of the present study is to investigate the trend of suicide and its attempt and the factors related to completed suicide during a 5-year period (2014-2019) in South Khorasan province, Iran. Data analysis was performed using chi-square, independent t-test and backward logistic regression in SPSS ver. 16. Cochran-Armitage test was used to evaluate the trends of suicide attempt and completed suicide. P-value < 0.05 was considered as the significance level. There was a significantly higher rate of suicide attempt among women and a significantly higher rate of completed suicide among men (p = 0.007). The incidence of suicide attempt (p = 0.001) and suicide deaths (p = 0.003) have also increased significantly during these years and the most common method of suicide attempt is drug poisoning. Also increasing age, rural residence, having a history of mental disorder, marital separation and lower level of education led to a significant increase in the rate of completed suicide (p < 0.001). The present study showed no significant relationship between the history of suicide attempt and completed suicide (p = 0.19). The rate of suicide attempt was higher among women and the rate of completed suicide was higher among men. The rate of suicide attempts and completed suicides has increased during these five years. Factors such as untreated mental disorders, living in rural areas, separation, and older age were considered as risk factors for completed suicide. On the other hand, higher education level has played a protective role in this regard., (Copyright © 2021. Published by Elsevier B.V.)

Designing optical fields with predetermined properties in source-free inhomogeneous media has been a long-sought goal due to its potential utilization in many applications, such as optical trapping, micromachining, imaging, and data communications. Using ideas from the calculus of variations, we provide a general framework based on the Helmholtz equation to design optical fields with prechosen amplitude and phase inside an inhomogeneous medium. The generated field is guaranteed to be the closest physically possible rendition of the desired field. The developed analytical approach is then verified via different techniques, where the approach's validity is demonstrated by generating the desired optical fields in different inhomogeneous media.

Objectives: Increased incidence of Multiple Sclerosis (MS) calls for supporting complementary therapies in this field. Persian Medicine (PM) specialists present various assumptions to help patients through Mizaj (temperament) modification, but its confirmation requires scientific evidence. This study aimed at identifying the Mizaj of MS patients, and comparing it with their Mizaj before the onset of the disease, and with that of healthy people., Methods: Forty-two MS and fifty-four healthy subjects participated in the study as case and control groups. General and brain Mizaj in patients were identified by five PM specialists before and after the onset of the disease. Mojahedi Mizaj Questionnaire (MMQ) was completed by the two groups. The validity of MMQ was assessed using Mizaj diagnosis by PM specialists as the gold standard. T-test, McNemar-Bowker, Wilcoxon, and Chi-square ( χ 2 ) tests were used to compare the Mizaj of patients before and after the onset of the disease, and between the two groups (p<0.05)., Results: The sensitivity and specificity of MMQ for Hotness (75, 81%) and Coldness (75, 65%) were acceptable. There were no significant differences between patients and healthy subjects in terms of general Mizaj. But general and brain Mizaj of patients after developing MS inclined to coldness and dryness, although merely inclination of general Mizaj to coldness was significant (p=0.03)., Conclusions: According to our results, the Mizaj of MS patients has an inclination toward coldness and dryness; Also, MMQ can be used as a validated scale for identifying the Mizaj of MS patients in future studies., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Complementary and Alternative Medicine (CAM) have recently become more popular and accepted worldwide. One principal step to identify the status and organize strategies of CAM is evaluating the manner and the prevalence of its usage among people. This study aimed to investigate the prevalence of CAM modalities usage by the people of Babol, a central city in the North of Iran, in 2018., Methods: Using the original International CAM Questionnaire (I-CAM-Q), a questionnaire was redesigned in Persian (Farsi) with some changes such as adding special modalities in Iran and its validity and reliability were assessed. Six hundred households were evaluated using a cluster sampling method in 2018 spring by 12 trained interviewers., Results: Finally, 1770 questionnaires were correctly completed. A total of 110 participants (6.21% of the completed questionnaires) had visited CAM therapists in the last year, 109 persons (6.15%) had received prescriptions from physicians and paramedics to use CAM, and a total of 1032 people (58.30%) used herbs and herbal medicines in the last 12 months. Also, 1265 individuals (71.46%) had used CAM throughout their lives. The most popular methods were herbal medicine (65.76%), Persian Medicine (13.78%), water therapy (10.45%) and music therapy (8.36%). The use of CAM was more popular among women., Conclusions: The general use of CAM in Babol was similar to other studies, but there were fewer visits by CAM therapists and less frequent adoption of common methods including homeopathy, acupuncture, and energy therapy. It was found that CAM was mostly used for non-serious diseases such as cold and transient gastrointestinal disorders, a pattern that is different from other studies in this field.

Objective: Lasers which can reduce epithelium thickness will enhance the penetration of topical drugs. To date, no study has assessed the efficacy of this technique in the oral mucosa. The aim of this study was the evaluation of efficacy of this technique in increasing the effect of topical anesthesia in the oral mucosa., Materials and Methods: On 20 volunteers, half of the lower lip mucosa was irradiated with Er,Cr:YSGG laser with 2780 nm wavelength and 1.3 J/cm 2 energy for 1 min; then, topical lidocaine was applied on the entire lower lip mucosa. After 5 min, a 27-gauge needle was inserted to each half of the lip mucosa, and the length of the needle inserted into the mucosa without feeling pain was considered the depth of insertion. This measurement was repeated every 15 min for 1 h., Results: The mean depth of anesthesia at the control side was 6.95 ± 2.43, 8.45 ± 4.05, 6.5 ± 3.00, and 3.85 ± 2.08 mm at 5, 20, 35, and 60 min, respectively. These values at the test side were 12.25 ± 5.42, 13.25 ± 5.02, 11.4 ± 5.03, and 9.10 ± 5.84 mm, respectively. According to repeated-measures ANOVA, the effect of the type of the treatment on the depth of insertion was significant (P < 0.001)., Conclusions: The results showed that irradiation of Er,Cr:YSGG laser before the topical application of the anesthetic agents on the oral mucosa increases their efficacy., Clinical Relevance: Topical anesthesia is used to enhance dental procedures painlessly, but there is controversy in their efficacy. Laser-assisted drug delivery to the oral mucosa can enhance their efficacy.

Competing Interests: There are no conflicts of interest.

Persian Medicine (PM) or Humoral Medicine is a traditional school of medicine with thousands of years of prolific history. The concept of Mizaj (temperament) and hot-cold theory is one of PM's most important foundations. In the clinical setting, Mizaj represents individual differences in phenotypical, psychological, spiritual, and physiological functions. Mizaj has a crucial role in determining the treatment plan, to the point that a similar disease in patients with different Mizaj types may demand different treatments. In this chapter, the role of hot and cold theory in the diagnosis and treatment of diseases to develop an integrative medical approach is discussed., (© 2021. Springer Nature Switzerland AG.)

Introduction Mizaj or temperament is a main concept in Persian Medicine (PM), which the process of diagnosis, treatment and preventive prescriptions are developed based on it. In this study, the articles written on the concept of Mizaj were reviewed. Method Credited electronic resources, including Pubmed, Scopus, Cochrane Library and web-of-science were searched using keywords Temperament, Mizaj, Mizadj, Midzaj and Mezaj (with the concept of Mizaj in Persian and/or Greek medicine). Search results were limited to English articles, published in 1995-2017. The articles in which temperament had the psychoanalytic aspect or was based on Ayurveda or Chinese/Korean medicine were removed. A team of four PM experts evaluated the method and the results. Results Among the total of 32 articles were published in this field, 14 were review articles, 2 were on animal subject, 14 were on human subject and 2 were surveys for designing questionnaire for people's Mizaj assessment. Most of review studies were just new versions of ancient Persian texts translated into English and the innovations on the subject were few. Studies on animal subject and developing questionnaires were also limited. In some human studies, use of standard questionnaires and homogenous methodology in Mizaj assessment was not considered. Conclusions It seems that studies on temperaments have increased in the past few years but are still at the forefront. In human studies a homogenous method for evaluating temperament has not been used and some of them failed to address the main concept of Mizaj in PM. Therefore, it is necessary to use the original category of Mizaj and to design standard method.

Objective: Low-level laser therapy is a method for osteogenesis since it stimulates cell proliferation, vascularization and osteoblastic activity. Various protocols applying low-level laser with different outcomes exist. The aim of the present study was to review the result of different methods on bone formation in critical-size defects of in vivo studies., Design: According to PRISMA statement, electronic search of PubMed, google scholar, Scopus and Web of Science and a hand search limited to in vivo English language studies until December 2019. Studies used low-level laser therapy in bone regeneration of critical-size defects met the inclusion criteria and which used high power lasers or a defect size smaller than 5 mm, were excluded., Results: Finally, 18 studies were included. Fourteen studies utilized low-level laser with a wavelength ranging from 606 to 980 nm and 53 % of studies applied low-level laser in a single session. Ten studies utilized continuous wave mode of laser. Highest and lowest values of power density were 1.5 W/cm 2 and 0.1 W/cm 2 in order. Eleven studies evaluated low-lever laser therapy on defects of 5 mm in calvaria. Meta-analysis showed the positive effect of low-level laser therapy on osteogenesis after 30 days compared to control group and no significant difference after 60 days., Conclusions: New bone formation can be increased in early stage by applying low-level laser therapy through stimulating osteoblasts and fibroblasts' proliferation. This effect would be more remarkable by combining with bone substitutes. Hence, for each case, protocol selection should be performed according defect's properties, attentively., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The ability to generate any arbitrarily chosen optical field in a three-dimensional (3D) space, in the absence of any sources, without modifying the index of refraction, remains an elusive but much-desired capability with applications in various fields such as optical micromanipulation, imaging, and data communications, to name a few. In this work, we show analytically that it is possible to generate any desired scalar optical field with predefined amplitude and phase in 3D space, where the generated field is an exact duplicate of the desired field in case it is a solution of Helmholtz wave equation, or if the existence of such field is strictly forbidden, the generated field is the closest possible rendition of the desired field in amplitude and phase. The developed analytical approach is further supported via experimental demonstration of optical beams with exotic trajectories and can have a significant impact on the aforementioned application areas.

Background: Diabetes mellitus (DM), named Ziabites in Persian medicine (PM), was categorized as hot or cold Ziabites according to the Mizaj of patients. This study aimed to compare the Mizaj of patients with newly diagnosed type 1 DM (T1DM) with chronic cases and healthy children., Materials and Methods: In a case-control study, three groups including chronic T1DM patients ( n = 31), newly diagnosed T1DM patients ( n = 37), and healthy children as the control group ( n = 80) were recruited. Mojahedi Mizaj Questionnaire was used to measure two subscales, hot/cold and wet/dry, of Mizaj for participants. The mean scores of the Mizaj subscales were compared between the groups. Cutoff values were determined using receiver operating characteristic analysis, and the corresponding odds ratio (OR) for each subscale was identified., Results: Overall 148 participants, with a mean age of 10.0 ± 6.2 years, were enrolled in the study. Analysis showed that the mean total heat and total dryness scores were significantly higher in new T1DM than that of chronic patients and healthy children (19.59 ± 1.7 vs. 16.6 ± 2.1 and 18.17 ± 1.9, P < 0.001 for hot/cold and 4.70 ± 1.0 vs. 4.09 ± 0.9 and 4.31±0.8, P = 0.02 for wet/dry). "Extra heat" based on the cutoff value of >18.5 was found to be a risk factor for T1DM (OR = 3.62, 95% confidence interval = 1.52-8.63)., Conclusion: New T1DM patients have higher frequency of hot and dry Mizaj, which is consistent with the concept of hot Ziabites in PM. Most importantly, we found that "extra heat" in children can be considered as a risk factor for T1DM., Competing Interests: There are no conflicts of interest.

The increasing prevalence of obesity is one of the major problems of today's society. Man needs food to continue living, daily activities, and even the metabolism of food; and appetite plays an important role in receiving foods. Appetite and weight reducing synthetic drugs, which are mostly costly and have significant side effects, are recommended for some patients, and have limited effectiveness in the treatment of obesity. Given the epidemic of obesity and the lack of satisfaction with synthetic drugs these days, people are more likely to use herbal medicines. Complementary medicine has always been considered for the choice of new treatment. This medicine has a long history. Persian Medicine is one of the traditional medicine systems. This study was a qualitative study on the Books of Canon and the Makhzan Al-Aladvia. Saffron has been introduced in both modern medicine and in Iranian medicine to reduce appetite. In the case of Purslane seed and Chio nut, Figs, Sesame seeds, Camphor, and Solomon's seal, and Opium poppy, which have been appetite suppressant in traditional medicine books, in the books and articles of modern medicine, they have not proved to be appetite reducing. Modern medicine has known Gourd as a weight reducing food with the effects on fat but there is no talk about its effects on appetite. According to traditional Iranian medicine, Chio nut causes anorexia due to weakness in the stomach. Therefore, it is not advisable for weight loss. More clinical studies are conducted to prove the effects of appetite suppressant and weight loss effects of these herbal medicines seem logical., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Owing to the effect of acute and chronic hypohydration on health and the lethal effects of hyperhydration, an appropriate amount of water intake is important for each individual. Traditional Iranian medicine (TIM) is a holistic system one of whose important parts deals with lifestyles and how to maintain health, including the amount of water intake for every person and the appropriate principles of drinking water. In this study, Avicenna's Canon of Medicine, Rhazes' Benefits of Food and Its Harmfulness, and conventional medical articles were reviewed to evaluate the amount of water intake for each person and the principles of drinking water. TIM has expressed an individualized difference in the amount of water intake in the form of temperament and the relationship between the appropriate time of drinking water with other daily activities. In this view, drinking water at the inappropriate time causes liver and gastrointestinal diseases; it can create the foundation for conducting new studies in the field of appropriate water intake and lifestyle changes to reduce malnutrition complications., (© 2019 S. Karger AG, Basel.)

Background: Functional gastrointestinal diseases are common in general populations and comprise more than 40% visits to gastroenterologists . Treatment options of gastrointestinal diseases have been limited. There are a few medications for functional gastrointestinal diseases and some of medications are not available in the market or in the place where the patient lives. Traditional Persian medicine (TPM) is a branch of alternative and traditional medicine based on individual viewpoint and humoral theory, focuses on lifestyle modification and uses natural products to manage the patients., Methods: In this study, a set of compound drugs known as digesters (jawarishes) and other applications are described based on main TPM text books., Results: Jawarishes have different formulations containing various medicinal herbs used for better food digestion and improved gastric functions and also used for other disorders including reinforcing the brain, heart, liver and some therapeutic approaches., Conclusions: By reviewing medieval Persian pharmaceutical manuscripts, we can conclude that many herbs are effective in different systems of the body and improve gastric functions. Zingiber officinalis and Piper nigrum are mixed together to get various formulations. The variety of jawarishes formulations and their different clinical applications can indicate continuity of their use., Competing Interests: Authors did not have any conflict of interest.

The index of refraction plays a decisive role in the design and classification of optical materials and devices; therefore, its proper and accurate determination is essential. In most refractive index (RI) sensing schemes, however, there is a trade-off between providing high-resolution measurements and covering a wide range of RIs. We propose and experimentally demonstrate a novel mechanism for sensing the index of refraction of a medium by utilizing the orbital angular momentum (OAM) of structured light. Using a superposition of co-propagating monochromatic higher-order Bessel beams with equally spaced longitudinal wavenumbers, in a comb-like setting, we generate non-diffracting rotating light structures in which the orientation of the beam's intensity profile is sensitive to the RI of the medium (here, a fluid). In principle, the sensitivity of this scheme can exceed ~2700°/RI unit (RIU) with a resolution of ~ 1 0 - 5  RIU. Furthermore, we show how the unbounded degrees of freedom associated with OAM can be deployed to offer a wide dynamic range by generating structured light that evolves into different patterns based on the change in RI. The rotating light structures are generated by a programmable spatial light modulator. This provides dynamic control over the sensitivity, which can be tuned to perform coarse or fine measurements of the RI in real time. This, in turn, allows high sensitivity and resolution to be achieved simultaneously over a very wide dynamic range, which is a typical trade-off in all RI sensing schemes. We thus envision that this method will open new directions in refractometry and remote sensing., Competing Interests: The authors declare that they have no conflict of interest.

Introduction: Sexual health is one of the key factors to sustain marital life and having a good sexual function. On the other hand, temperament affects sexual function. Training is also one of the basic foundations for promoting sexual health. Therefore, the researcher has designed and implemented a study (2017) aimed "determining the study of educational package on sexual function in cold temperament women of reproductive age.", Methods: This randomized clinical trial study was performed on 80 women in two groups (40 in each group). This study was done, in available method, on no pregnant women aged 20-40 years old that referred to health centers in Mashhad. DASS 21 sexual function and determining temperament questionnaires were completed in two groups before intervention. At first, the sexual function training package was held by the researcher at 6 sessions (twice a week for 3 weeks) that was based on nutrition, sport, and lifestyle axes. The control group also received routine care. A week after intervention finished, all the units completed a sexual function questionnaire. The results were analyzed by these techniques as SPSS software (version 16) and statistical tests such as Independent t -test, T-pair, Mann-Whitney, Chi-square, and Fisher's exact test., Results: At the beginning of the study, there was no statistically significant difference between the personal characteristics and the mean score of sexual function and all its dimensions in the two groups. The mean sexual performance score and all its dimensions after intervention were significantly different in intervention and control groups P < 0.001. Sexual function and all its dimensions were improved after intervention in the intervention group., Conclusion: Giving sexual function package has improved the sexual function of cold temperament women. So, for routine caring of cold temperament women, it is better that health center employees consider this training package as an effective, easy, available, nonpharmacological, and economic intervention., Competing Interests: There are no conflicts of interest.

We present a 4-year-old newly diagnosed T1DM boy who presented with sever polyuria and polydipsia and HbA1C of 9.3%. Coincident with onset of ITM program insulin doses were tapered and the baby got free from insulin soon. Only three months after traditional anti-diabetic medications, his HbA1C improved to 5.8%., (Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

We show the possibility of arbitrary longitudinal spatial modeling of non-diffracting light beams over micrometric regions. The resulting beams, which are highly non-paraxial, possess subwavelength spots and can acquire multiple intensity peaks at predefined locations over regions that are few times larger than the wavelength. The formulation we present here provides exact solutions to the Maxwell's equations where the linear, radial, and azimuthal beam polarizations are all considered. Modeling the longitudinal intensity pattern at small scale can address many challenges in three-dimensional optical trapping and micromanipulation.

We have experimentally demonstrated a compact polarization beam splitter (PBS) based on the silicon nitride/silicon-on-insulator platform using the recently proposed augmented-low-index-guiding (ALIG) waveguide structure. The two orthogonal polarizations are split in an asymmetric multimode interference (MMI) section, which was 1.6 μm wide and 4.8 μm long. The device works well over the entire C-band wavelength range and has a measured low insertion loss of less than 1 dB. The polarization extinction ratio at the Bar Port is approximately 17 dB and at the Cross Port is approximately 25 dB. The design of the device is robust and has a good fabrication tolerance.

Introduction: The efficacy of erbium-doped yttrium aluminum garnet (Er:YAG) laser for root debridement in comparison with curettes has been the subject of many recent investigations. Considering the possibility of chemical and ultra-structural changes in root surfaces following laser irradiation, this study sought to assess the effects of scaling and root planing (SRP) with curettes and Er:YAG laser on chemical properties and ultrastructure of root surfaces using spectroscopy and scanning electron microscopy (SEM). Methods: In this in vitro experimental study, extracted sound human single-rooted teeth (n = 50) were randomly scaled using manual curettes alone or in conjunction with Er:YAG laser at 100 and 150 mJ/pulse output energies. The weight percentages of carbon, oxygen, phosphorous and calcium remaining on the root surfaces were calculated using spectroscopy and the surface morphology of specimens was assessed under SEM. Data were analyzed using one-way analysis of variance (ANOVA). Results: No significant differences ( P > 0.05) were noted in the mean carbon, oxygen, phosphorous and calcium weight percentages on root surfaces following SRP using manual curettes with and without laser irradiation at both output energies. Laser irradiation after SRP with curettes yielded rougher surfaces compared to the use of curettes alone. Conclusion: Although laser irradiation yielded rougher surfaces, root surfaces were not significantly different in terms of chemical composition following SRP using manual curettes with and without Er:YAG laser irradiation. Er:YAG laser can be safely used as an adjunct to curettes for SRP.

A plasmon waveguide resonance (PWR) sensor is proposed for studying the interaction between gold nanoparticles and proteins. The ability of the PWR sensor to operate in both TM and TE Polarizations, i.e. its polarization diversity, facilitates the simultaneous spectroscopy of the nanoparticles surface reactions using both polarizations. The response of each polarization to streptavidin-biotin binding at the surface of gold nanoparticles is investigated in real time. Finally, using the principles of multimode spectroscopy, the nanoparticle's surface reactions are decoupled from the bulk solution refractive index variations. Schematic diagram of the NP-modified PWR sensor., (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

We demonstrate a compact (30 μm long) broadband bilayer inverse taper edge-coupler for silicon photonics with a 1.7 dB coupling loss from a commercially available focused fiber with 5 μm mode diameter. We compare the performance of our bilayer taper with a conventional SOI inverse taper coupler and show that our bilayer coupler achieves between 1.5 dB to 2 dB improvement in the coupling efficiencies for both the TE and TM polarizations. The dimensions and fabrication steps for our bilayer taper are simple and compatible with standard foundry processes.

In this work we extend the so called frozen wave method in order to obtain new diffraction resistant light structures that can be shaped on demand, with possible applications in atom guidance. The resulting beams and the corresponding optical dipole potentials exhibit a strong resistance to diffraction effects and their longitudinal and transverse intensity patterns can be chosen a priori. Besides the theoretical development, we also present the experimental confirmation of our approach; specifically, by generating three different beam profiles using a spatial light modulator that is addressed by a computer-generated hologram. In addition to its many potential applications in atom guiding, the method developed here can also lead to many new developments in optics and photonics in general.

We demonstrate a class of nondiffracting beams, called frozen waves, with a central spot that can be made to maintain a predefined intensity profile while propagating in an absorbing fluid. Frozen waves are composed of Bessel beams with different transverse and longitudinal wavenumbers, and are generated using a programmable spatial light modulator. The attenuation-resistant frozen waves demonstrated here address the problem of propagation losses in absorbing media. This development can be beneficial for many applications in particle micro-manipulation, data communications, remote sensing, and imaging.

Introduction: The efficiency of routine scaling and root planning is negatively influenced by the tooth anatomy and residual bacteria all possibly affecting the treatment outcomes in future. The present study compared the microbiologic effectiveness of the photodynamic therapy (PDT) as an adjunctive treatment modality for nonsurgical treatment in chronic periodontitis., Methods: In this randomized controlled clinical trial, 18 chronic periodontitis patients were selected. Four quadrants were randomly treated by scaling and root planning (SRP), diode laser (810n m wavelength, 1.5 W and 320 μm fiber, contact and sweeping technique), SRP + PDT (with diode laser 808 nm, 0.5 W) and laser + SRP (with diode laser 808 nm, 1 W) in each patient. Presence of periodontal pathogen species in the treated areas were measured before the treatment, at 1 and 3 months afterwards. The identification and reproduction of the specific genes of pathogen bacteria were done by means of polymerase chain reaction (PCR) technique. Presence of oral pathogen bacteria in the treatment groups were analyzed by chi-square test. A semi quantitative analysis was used to measure the intensity of white light in each band. This was calculated by number of pixels in each band., Results: In the qualitative analysis, Fusobacterium nucleatum (Fn) and Treponema denticola (Td) species were killed after 1 month in all treatment modalities. PDT had more effects to decrease Prevotella intermedia (Pi) species than SRP while Tannerella forsythensis count (Tf) species increased in all treatments. Furthermore, Actinobacillus actinomycetemcomitans (Aa) species decreased in all treatments and Porphyromonas gingivalis (P.g) species increased in all treatments after 1 and 3 months., Conclusion: It can be concluded that PDT was more effective as an adjunctive treatment to SRP than SRP alone; however, no distinct differences were found between both treatment modalities regarding reduction of certain pathogen bacteria.

We propose a compact polarization beam splitter (PBS) based on a silicon nitride enhanced silicon-on-insulator platform using an augmented low-index guiding (ALIG) waveguide structure. In the ALIG structure, the TM mode is mostly confined in the low-index silicon nitride, while the TE mode is confined in the high-index silicon. Since the two modes are confined in two separate layers, their properties can be controlled independently. The PBS is formed using an asymmetric multimode interference (MMI) section. The TM mode is directed to an output port by the ALIG waveguide, while the TE mode is coupled to the other output port via the multimode interferometer. Such a PBS has a very small footprint, low insertion loss, high polarization extinction ratio, and broadband response.

Introduction: Different modalities have been used to achieve better results in wound healing among which are laser and pharmacological agents. To our knowledge, there is no investigation to compare phenytoin and laser together. In this study, we aimed to evaluate laser and phenytoin efficacy and compare their effect on wound healing., Methods: We used 60 rats. The animals were divided into 4 groups, 15 rats in each and each group was subdivided into 3 subgroups for which postoperative evaluation was performed on days 3, 7, and 14. After general anesthesia and back hair shaving of each rat, an excisional wound was made. The wounds in group 2 were treated with 1% phenytoin cream. In group 3, the wounds were irradiated with diode laser. The wounds of group 4 were treated with both phenytoin cream and laser administration. The animals of group 1 served as control. For histopathological evaluation, hematoxylin and eosin staining was used. Polymorphonuclear leucocytes (PMNs), re-epithelization, fibroblasts, new vessels and collagen were evaluated., Results: Faster reduction in polymorphonuclear cells after 7 and 14 days and more collagen fibers on the third day in laser treated group was statistically significant (P < .05) .The result for the phenytoin treated group were not better than control group. When both laser and phenytoin were used samples showed more collagen fibers on the third day, which was statistically significant (P < .05)., Conclusion: It seems that low level laser is effective in skin wound healing and have better results than phenytoin application.

Spectral reshaping and nonuniform phase delay associated with an electromagnetic pulse propagating in a temporally dispersive medium may lead to interesting observations in which the group velocity becomes superluminal or even negative. In such cases, the finite bandwidth of the superluminal region implies the inevitable existence of a cutoff distance beyond which a superluminal pulse becomes subluminal. In this paper, we derive a closed-form analytic expression to estimate this cutoff distance in abnormal dispersive media with gain. Moreover, the method of steepest descent is used to track the time-frequency dynamics associated with the evolution of the center of mass of a superluminal pulse to the subluminal regime. This evolution takes place at longer propagation depths as a result of the subluminal components affecting the behavior of the pulse. Finally, the analysis presents the fundamental limitations of superluminal propagation in light of factors such as the medium depth, pulse width, and the medium dispersion strength.

A plasmon waveguide resonance (PWR) sensor is designed, fabricated, and tested for self-referenced biosensing. The PWR sensor is able to support two different polarizations, TM and TE. The TM polarization has a large sensitivity to variations in the background refractive index while the TE polarization is more sensitive to the surface properties. The ability of the PWR sensor to simultaneously operate in both TM and TE modes is used to decouple the background index variations (bulk effects) from the changes in adlayer thickness (surface effects) via multimode spectroscopy. To benchmark the performance of the PWR, a conventional surface plasmon resonance (SPR) sensor is fabricated and tested under the same conditions.

A new platform is proposed to solve one of the main shortcomings of surface plasmon resonance biosensors, namely, the cross sensitivity to surface and bulk effects. This approach is based on multimode spectroscopy in which three different modes are excited simultaneously. The proposed design consists of an SPR sensor loaded with a dielectric grating. The design parameters (dimensions and wavelength) are optimized with a genetic algorithm. The optimized design has two resonance modes excited with TM polarized light, each sensitive to surface effects, and one TE mode mostly sensitive to variations in the bulk fluid refractive index. Numerical and analytical methods are used to justify the simulation results, which are in good agreement. Finally, it is shown that, by applying three-mode spectroscopy, decoupling the properties of the attached biomaterial from the background index variations is possible with the proposed design.

We fabricated and measured a compact 3 dB hybrid plasmonic directional coupler for silicon photonics integrated circuits with a length of 21.2 μm. The coupler has a 50∶50 coupling ratio over a spectral bandwidth of more than 100 nm around a wavelength of 1.55 μm and has an insertion loss of less than 1 dB.

Precursor field theory has been developed to describe the dynamics of electromagnetic field evolution in causally attenuative and dispersive media. In Debye dielectrics, the so-called Brillouin precursor exhibits an algebraic attenuation rate that makes it an ideal pulse waveform for communication, sensing, and imaging applications. Inspired by these studies in the electromagnetic domain, the present paper explores the propagation of acoustic precursors in dispersive media, with emphasis on biological media. To this end, a recently proposed causal dispersive model is employed, based on its interpretation as the acoustic counterpart of the Cole¿Cole model for dielectrics. The model stems from the fractional stress¿strain relation, which is consistent with the empirically known frequency power-law attenuation in viscoelastic media. It is shown that viscoelastic media described by this model, including human blood, support the formation and propagation of Brillouin precursors. The amplitude of these precursors exhibits a sub-exponential attenuation rate as a function of distance, actually being proportional to z(-p), where z is the distance traveled within the medium and 0.5