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Biocompatible nanocomposites (NCs) with antibacterial activity containing organic matrix and inorganic nanoparticles (NPs) are vital for providing a suitable substrate for hydroxyapatite (HA) formation. Therefore, we fabricated a series of biocompatible NCs of chitosan (CS) and tragacanth gum (TG) and different percentages of ZnO NPs and ZnO@Ag NPs as fillers into the CS-TG blend. The characteristics of the NCs were distinguished with the field-emission scanning electron microscope (FE-SEM), X-Ray diffraction, Fourier transform infrared, and transmission electron microscopy (TEM). The CS-TG/ZnO@Ag(1:0.500) NC 8 wt% showed a rough surface according to FE-SEM. Moreover, the TEM image of CS-TG/ZnO NC 8 wt% depicted a uniform dispersion of NPs into the matrix. The biocompatibility of these NCs was evaluated by the formation of HA on their surfaces. The outcomes depicted the deposition of HA on the surface of all NCs. Also, CS-TG/ZnO@Ag(1:0.500) NC 8 wt% exhibited the most HA deposition on its surface. The antibacterial activity of these NCs toward Staphylococcus aureus and Escherichia coli bacteria was evaluated. The CS-TG/ZnO@Ag(1:0.500) NC 8 wt% exhibited a higher inhibition zone diameter in comparison to the ZnO@Ag (1:0.500) NPs for the S. aureus bacteria. Generally, antibacterial activity of the NCs containing ZnO@Ag NPs are more than NCs containing ZnO NPs.

Aims We aimed to assess the compound muscle action potential (CMAP) scan in the follow-up of chronic inflammatory demyelinating polyneuropathy (CIDP) patients and investigate the correlation of CMAP scan parameters with functional and standard electrodiagnostic tests. Methods We evaluated four parameters of abductor pollicis brevis (APB) CMAP scan (i.e., step numbers, step percentage, S10, S90), functional measures (e.g., Medical Research Council Sum Scores), and electrodiagnostic tests, including nerve conduction study (NCS) and motor NCS of the median nerve in the baseline and after six months of treatment. Results Twenty patients completed baseline clinical and electrodiagnostic studies. However, sixteen patients completed the follow-up study. The median of step numbers at baseline was 3.5 (2–4.2), which decreased to 2.5 (0–3) (p = 0.005). After the treatment, step percentage reduced from 28.6 (23.9–38.7) to 13.4 (0–23.6) (p = 0.001). The scores obtained from the clinical scales showed significant recovery of most of the functions, while the alterations of NCSS and NCS of the median nerve were not significant. Conclusions We found a significant reduction in step number and step percentage after follow-up. This alteration was not reflected in standard electrodiagnostic values. The improvement of functional scales alongside the CMAP scan parameters suggests that the CMAP scan could be considered an appropriate outcome measurement in research and clinical fields.

Epigenetic mechanisms occurring in the brain as well as alterations in the gut microbiome composition might contribute to Alzheimer’s disease (AD). Human amyloid precursor protein knock-in (KI) mice contain the Swedish and Iberian mutations (AppNL-F) or those two and also the Arctic mutation (AppNL-G-F). In this study, we assessed whether behavioral and cognitive performance in 6-month-old AppNL-F, AppNL-G-F, and C57BL/6J wild-type (WT) mice was associated with the gut microbiome, and whether the genotype modulates this association. The genotype effects observed in behavioral tests were test-dependent. The biodiversity and composition of the gut microbiome linked to various aspects of mouse behavioral and cognitive performance but differences in genotype modulated these relationships. These genotype-dependent associations include members of the Lachnospiraceae and Ruminococcaceae families. In a subset of female mice, we assessed DNA methylation in the hippocampus and investigated whether alterations in hippocampal DNA methylation were associated with the gut microbiome. Among other differentially methylated regions, we identified a 1 Kb region that overlapped ing 3′UTR of the Tomm40 gene and the promoter region of the Apoe gene that and was significantly more methylated in the hippocampus of AppNL-G-F than WT mice. The integrated gut microbiome hippocampal DNA methylation analysis revealed a positive relationship between amplicon sequence variants (ASVs) within the Lachnospiraceae family and methylation at the Apoe gene. Hence, these microbes may elicit an impact on AD-relevant behavioral and cognitive performance via epigenetic changes in AD-susceptibility genes in neural tissue or that such changes in the epigenome can elicit alterations in intestinal physiology that affect the growth of these taxa in the gut microbiome.

Colorectal cancer (CRC) is one of the most common cancers in the world. The aim of this study was to investigate its incidence and risk factors in the Iranian population. A literature search was conducted in PubMed, Web of Science, Scopus, SID, and Magiran from inception until 2019. Studies that reported the incidence rate and risk factors of colorectal cancer were included in this review. Twenty-one articles that reported the incidence rate and 13 that reported the risk factors were included. The incidence rate was different according to the population type, gender, age, and study year in different regions. The main risk factors for colorectal cancer were high consumption of red meat and fried food and low intake of fruits and vegetables, diabetes, a positive family history, and obesity. The incidence of CRC has a marked variation in different parts of Iran, and various risk factors are associated with colorectal cancer. According to incidence rate and various risk factors, precise planning is needed to control colorectal cancer in the future.

Background: Provision of education to a person with myocardial infarction and an active family member, who takes care of the patient can prevent or delay the onset of the disease. Telephone tracking is a very useful and inexpensive way to assess the patients’ needs and help them with their care problems. This clinical trial (interventional) protocol was conducted over the impact of family-based multimedia education based on the telephone tracking (tele-nursing) to improve the quality of life and self-efficacy in patients with myocardial infarction. Methods: Two phases are identified to design this study; the first phase includes designing a curriculum by investigating various studies and the panel of experts’ opinions. This phase will be conducted in the form of multimedia training and telephone contact. Multimedia training (including audio, video, image, and animation) over the patients’ lifestyle, nutrition, and care will be conducted through a one-day workshop in 2-3 hours for patients and one of their active family members. The active family member is defined as the primary caregiver, who spends more time with the patient. The educational course will be conducted at a coordinated date and time in the ward where the patients are hospitalized. The researcher will make telephone calls as the educational intervention and continue the follow-ups once a week for one month. The second phase of the intervention will contain a pre/post-test design along with application of Minnesota quality of life and Scherer general self-efficacy standard questionnaires in the intervention (with training) and control (without training) groups. The target participants will include all patients (and their active family members) admitted to CCUs of hospitals affiliated to Shahrekord University of Medical Sciences. Discussion: The present study provides useful data for designing a family-based multimedia educational intervention using the telephone-tracking method (telenursing) to improve the quality of life and self-efficacy in patients with myocardial infarction. It can also reduce their medical and treatment costs. The strategies of this program could be important and cost effective, and therefore we hope that the success of such a program is a step forward in improving cardiovascular patient’s health status. Highlights Family-based multimedia educational (tele-nursing) to improve the quality of life and self-efficacy in patients with myocardial infarction. Family-based multimedia educational (tele-nursing) can also reduce their medical and treatment costs. The program is a step forward in improving cardiovascular patient’s health status.

Myasthenia Gravis (MG) is an autoimmune disorder that can exacerbate for various reasons including infections. In this study, we describe clinical symptoms, outcomes, and management of MG patients affected by COVID-19 infection.This observational retrospective study was performed on patients previously diagnosed as MG, presenting with COVID-19 in the clinic or emergency department between April 2020 and August 2021. The clinical data, outcome, and therapeutic interventions were assessed in 83 patients with MG and COVID-19 infection.Seventy-seven patients performed PCR testing for COVID-19, of which 73 (94.8 %) were positive. Seven patients had the positive serologic test for COVID-19 (IgG and IgM). Fifty-seven (68.7 %) patients had lung involvement. Thirty-five (42.1 %) of patients were admitted to the hospital. Twelve (14.5 %) patients needed hospitalization in an intensive care unit (ICU), with a mean stay of 7.36 ± 5.6 days (rang: 2-20 days). Four (4.8 %) patients were intubated and required mechanical ventilation. Sixteen (19.3 %) patients experienced an exacerbation of myasthenia gravis and were treated with PLEX (n = 2), IVIG (n = 7), and intravenous (IV) methylprednisolone (n = 7). The outcome was favorable in 79 patients and fatal in four patients, three of whom had other comorbidities. One patient died due to severe COVID-19 involvement.The findings from our study demonstrated that patients with previous MG concurrence with COVID-19 have favorable clinical outcomes. Most patients did not need to be hospitalized and more than 80 % of patients did not display MG exacerbation.

Introduction/Aims: Objective outcome measures to monitor treatment response and guide treatment are lacking in chronic inflammatory demyelinating polyneuropathy (CIDP). In this study we aimed to evaluate the motor unit number index (MUNIX) as an outcome measurement in patients with CIDP and determine the correlation of MUNIX with functional and standard electrodiagnostic tests in a single follow-up study. Methods: We evaluated MUNIX of the abductor pollicis brevis, abductor digiti minimi, and tibialis anterior (TA) muscles bilaterally. Muscle force was assessed by Medical Research Council Sum Score (MRCSS). Functional measures used were the Overall Neuropathy Limitation Score (ONLS) and the Rasch-built Overall Disability Scale (R-ODS) score at baseline and after 6 months of treatment. Standard electrophysiology was evaluated by the Nerve Conduction Study Score (NCSS). Results: Twenty patients were included at baseline, and 16 completed the follow-up study. Significant correlations were found between the MUNIX sum score and both MRCSS and NCSS at baseline, between both the pinch strength and grip and upper limb MUNIX at baseline and follow-up, and between MUNIX of TA and both lower limb MRCSSs with lower limb ONLS at baseline and follow-up. Significant correlations also were found between MUNIX sum score change and MRCSS change, R-ODS change, and ONLS change. Discussion: MUNIX changes correlated with strength and electrophysiological improvements in CIDP patients. This suggests that MUNIX may represent a useful objective biomarker for patient follow-up.

Opium sale is prohibited in Iran, and sellers mix it with lead to increase the weight. Herein, we describe neuromuscular findings in nine patients who developed lead poisoning due to opium/drug consumption. The mean age of patients was 53 ± 3.5 years and their mean blood lead level was 122.6 ± 20.8 μg/dL. Most of the patients had an acute/subacute course presenting as axonal or demyelinating sensorimotor polyneuropathy, motor neuron disease, and multiple mononeuropathies with favorable response to the chelation therapy. Lead poisoning should be considered in patients with a history of opium use and neuromuscular symptoms.

BackgroundCoronavirus disease 2019 was declared a pandemic on 11th March 2020. All non-urgent surgical procedures have been postponed indefinitely. The British Association of Head and Neck Oncology state that only those with treatable head and neck cancer unsuitable for alternative treatment should undergo surgery. This paper details our management of a patient who tested positive for severe acute respiratory syndrome coronavirus-2 days before curative surgery for laryngeal cancer.Case reportBy following British Association of Head and Neck Oncology guidance, a 49-year-old male scheduled for total laryngectomy and bilateral neck dissection for a T3 transglottic squamous cell cancer was pre-operatively identified as an asymptomatic carrier of severe acute respiratory syndrome coronavirus-2. Following 14-day isolation and laboratory proven viral clearance, he underwent successful major surgery. He was managed throughout the peri- and post-operative phases without complications or adverse effects on staff.ConclusionWith careful planning, previous coronavirus disease 2019 positive status should not prevent an individual from undergoing successful total laryngectomy and bilateral neck dissection in a safe and timely manner during the pandemic.

Cellulose acetate is frequently used in reverse osmosis (RO) and ultrafiltration (UF) applications. In the present study, effects of different surfactant additives including Span-20 (sorbitanmonolaurate), Tween-40 (polyoxyethylenesorbitanmonopalmitate) and Tween-60 (polyoxyethylenesorbitanmonostearate) on the phase behavior and morphology of flat sheet cellulose acetate (CA) membranes prepared from CA/N,N-dimethylformamide (DMF)/water system via phase inversion technique were investigated. The phase separation behavior of the investigated systems was studied by determination of cloud point curves of each system in presence of different surfactant concentrations. Cross-sectional morphologies of the prepared membranes were studied by scanning electron microscopy (SEM). It was found that even addition of small amount of investigated surfactant additives to the casting solution could affect the phase separation behavior of polymeric solutions and increased sub-structure porosity. On the other hand, denser membranes were synthesized due to decrease in rate of demixing process and preventing growth of nucleuses. Findings suggested addition of 0.2 wt % of studied surfactants increases the exchange rate of solvent and non-solvent causing formation of macrovoids and finger-like structures. Moreover, the effect of surfactant hydrophobicity on contact angle and water permeation flux of prepared membranes was studied. It was found that membrane derived from tween-60 exhibits the lowest flux and highest contact angle (77.2°).

Medical innovation is crucial to advancing our field, and physicians have the potential to play a leading role due to their daily patient care experiences. The objective of this study was to evaluate the interest in, and barriers to participating in innovation. Two surveys were conducted; the first cross-sectional survey was conducted among attendees of the Advancing Innovation in Dermatology Forum in Feburary 2019. The second survey was conducted among trainees (resident/fellows) and faculty dermatologists at Brown, Emory, Iowa, Stanford, and Vanderbilt Universities between June and November 2019. Demographic data were collected, as well as factors involved with identifying problems, developing solutions, training in innovation, and perceived barriers to innovation. In the first survey, the greatest perceived benefits include bringing joy to one's work and increasing professional fulfillment with work. Innovation was also perceived to decrease burnout. In the second survey of academic centers, faculty more commonly expressed interest in identifying problems (p = 0.04), and was also more confident in their ability to generate solutions to these problems as compared to trainees (p

Co-option of transposable elements (TEs) to become part of existing or new enhancers is an important mechanism for evolution of gene regulation. However, contributions of lineage-specific TE insertions to recent regulatory adaptations remain poorly understood. Gibbons present a suitable model to study these contributions as they have evolved a lineage-specific TE called LAVA (LINE-AluSz-VNTR-AluLIKE), which is still active in the gibbon genome. The LAVA retrotransposon is thought to have played a role in the emergence of the highly rearranged structure of the gibbon genome by disrupting transcription of cell cycle genes. In this study, we investigated whether LAVA may have also contributed to the evolution of gene regulation by adopting enhancer function. We characterized fixed and polymorphic LAVA insertions across multiple gibbons and found 96 LAVA elements overlapping enhancer chromatin states. Moreover, LAVA was enriched in multiple transcription factor binding motifs, was bound by an important transcription factor (PU.1), and was associated with higher levels of gene expression in cis. We found gibbon-specific signatures of purifying/positive selection at 27 LAVA insertions. Two of these insertions were fixed in the gibbon lineage and overlapped with enhancer chromatin states, representing putative co-opted LAVA enhancers. These putative enhancers were located within genes encoding SETD2 and RAD9A, two proteins that facilitate accurate repair of DNA double-strand breaks and prevent chromosomal rearrangement mutations. Co-option of LAVA in these genes may have influenced regulation of processes that preserve genome integrity. Our findings highlight the importance of considering lineage-specific TEs in studying evolution of gene regulatory elements.

ObjectiveTo perform a validation assessment of a novel porcine ex vivo model for otoplasty training.MethodsA total of nine otolaryngology trainees performed a standard approach otoplasty on a porcine ear. They completed a series of tasks including posterior skin incision, anterior scoring, Mustardé suture placement and concha–mastoid suture placement. Trainees completed a post-task questionnaire assessing face validity, global content validity and task-specific content validity.ResultsTrainees’ median scores for the porcine model were: 4 for face validity (interquartile range, 3–4), 5 for global content validity (interquartile range, 4–5) and 4 for task-specific content validity (interquartile range, 4–4).ConclusionThis study is the first to formally validate the ex vivo porcine auricular model as a useful tool for training in otoplasty. The model should be incorporated into simulation training for otoplasty in order to improve learning, enable acquisition of specific surgical skills and improve operative outcomes.

Bubble dynamics (i.e., bubble shape, bubble size, bubble rise velocity) and bed voidage in a semi-cylindrical gas-solid fluidized bed at various superficial gas velocities and particle sizes were measured by fiber optic probe and image analysis. Measurements in the semi-cylindrical bed were compared with those in the cylindrical bed to investigate the similarity of two fluidized beds and verifying whether a semi-cylindrical bed can be used for measuring hydrodynamic properties of fluidized beds. Experiments were carried out in two Plexiglas semi-cylindrical and cylindrical fluidized beds of 14 cm in diameter at ambient pressure and temperature. Glass beads of various sizes (120, 290 and 450 μm) were used as the bed material. The superficial gas velocity was varied in the range of 0.2–0.8 m/s and both beds were operating in the bubbling fluidization regime. It was shown that increase in the particle size leads to decrease in the emulsion phase fraction while increases the fraction of bubble phase. At low gas velocity, the semi-cylindrical fluidized bed contains normal bubbles while at higher superficial gas velocity, elongated bubbles with normal rising velocity can be found. Increase in the particle size leads to increase in the aspect ratio of bubbles. It was found that the average bubble size and rise velocity increases with increasing particle size and superficial gas velocity. Results indicated that the gas-solid distribution, bubble rise velocity and bubble size in both beds are similar and geometry of the cross-section of column (semi-circular and circular) has no significant effect on these parameters. It was shown that the hydrodynamics of both beds are very similar and the difference is negligible. Since measuring the bubble size and rise velocity in the semi-cylindrical bed can be easily done by visual observation compared to those in a cylindrical bed, using a semi-cylindrical fluidized bed instead of two dimensional fluidized bed in the laboratory scale is the preferred choice which provides bubble dynamics close to that in a three-dimensional bed.

Carbon dioxide (CO2) sequestration through CO2 enhanced oil recovery (EOR) in oil reservoirs is one way to reduce this gas in the atmosphere. Undesirable chemical reactions that occur during these operations can affect the reservoir structure and characteristics. In this study, the effect of CO2-water-rock interaction on the rock permeability alteration and final oil recovery has been evaluated experimentally during CO2 injection into a carbonate rock. The effect of flow rate, displacement type and pressure were investigated during CO2 EOR injection. Different scenarios of miscible/immiscible displacement, secondary/tertiary recovery has been evaluated for different levels of connate water salinity and injection rate. The results show that the severity of damage is directly related to the injection rate, however change in displacement type from miscible to immiscible reduce the intensity of chemical reactions in porous medium. Moreover, in the tertiary CO2 injection, the chemical reactions become more severe due to the higher water saturations. Interestingly, this growth in the level of chemical reactions has a negligible impact on permeability reduction, since the major volume of possible reactions occurs in coarse and high permeable pores. Results reveal that damage is more intense in the case of more saline water.

Ordered mesoporous carbons have recently been given significant attention because of their unique hexagonal structure, tunable large pore volumes, high thermal stability, and high surface-to-volume ratio. In this research paper, for achieving the maximum compatibility between the FDU-15 and poly(methyl methacrylate) (PMMA), KH-550 was used as a modifying and coupling agent to facilitate the bond formations between the mesoporous carbon and PMMA with the help of ultrasonic irradiation. Nanocomposite (NC) films were produced via the in-situ polymerization method aligned with various amounts of modified FDU-15. Sample characterizations were done by Field-emission scanning electron microscope (FE-SEM), low angle X-ray diffraction (LXRD), Fourier transform infrared spectroscopy, transmission electron microscopy (TEM), and thermogravimetric analysis (TGA). The LXRD pattern proved that the modification process did not affect the hexagonal mesoporous structure of FDU-15. The PMMA-m-FDU 2 wt% showed the existence of some pores on its surface according to FE-SEM. The TEM image of the NC depicted a uniform dispersion of mesoporous carbon into the polymer matrix and also confirmed the hexagonal 2D structure of the mesopores. TGA data also confirmed that as the m-FDU-15 increases into the PMMA matrix, the higher thermal stability will achieve, and also the Td will increase to the higher temperatures.

adesso hat mit der New School of IT das Paradigma, die Vorteile des Cloud-Einsatzes voll auszuschöpfen ohne die Nachteile in Kauf nehmen zu müssen. Im Rahmen des Auswahlprozesses eines neuen ERP-Systems stand früh fest, dass Cloud Lösungen favorisiert werden. Klassische Vorbehalte gegenüber Cloud Lösungen wie Sicherheit, etc. gab es bei adesso nicht. Alle Anbieter mussten aufzeigen, wie die Funktionalität und Erweiterbarkeit des entsprechenden Systems ausgeprägt ist. Nach der Entscheidung für S/4HANA Public Cloud (S4HC) begann die Übertragung und Anpassung der eigenen Prozesse auf die Standardabläufe im System wie auch der Umbau der Betriebsorganisation. Bei der Umgestaltung der eigenen Prozesse wurde schnell klar, dass es in S4HC nicht nur einen Standard-Weg, sondern auch verschiedene Optionen gibt. Ebenso besteht die Möglichkeit für Erweiterungen durch Partnerprodukte oder Eigenentwicklungen im SAP Technologiestack.