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Background and aims: Cervix cancer is the second most common cancer in women. Peganum harmala L. is a native herb used in traditional medicine as an anticancer, antibacterial, fungicidal and antiulcer agent in Iran. The current study was designed to evaluate the anticancer effect of this herb on cervix cancer cell lines. Methods: In this experimental study, the proliferated and cultured HeLa cells (human cervical epithelial- derived tissue) were used to determine the anticancer effect of harmala seed extract. The cells exposed to different doses of harmala seed extract (12, 25, 50.5 and 100 µg/ml) and were incubed for 24, 48 and 72 hours. After the incubation period, modified colorimetric MTT [(3-(4.5-dimethyl Thiazole-2yl)]-2.5Diphenyl Tetrazolium Bromide) method was used to determine cytotoxicity. After collecting data, statistical analysis was performed using analysis of variance (ANOVA). Results: The results of MTT assay showed that the HeLa extract anticancer effect is dependent to time and dose. The highest percentage of cell death was observed after 72 h incubation and increase in extract concentration (P<0.001). The 50% growth inhibitory concentration (IC50) of harmala in 24 h was 12.5 micrograms per milliliter. Conclusion: Harmala extract could have dose and time dependent for preventing growth on HeLa cancer cell line. It seems to come with further research, and utilizes its compound in cancer treatment. [ABSTRACT FROM AUTHOR]

Engineered skin substitutes (ESSs) comprising both keratinocytes and fibroblasts can afford many advantages over the use of autologous keratinocyte grafts for the treatment of full-thickness and partial-thickness burns. In this study, we investigated the efficacy of a novel ESS containing both genetically altered fibroblasts that express the immunosuppressive factor indoleamine 2,3-dioxygenase (IDO) and primary keratinocytes from a nonautologous source to confer immune protection of xenogeneic cells cultured in a bilayer ESS. The results show that engraftment of IDO expressing skin substitutes on the back of rats significantly improves healing progression over 7 days compared with both nontreated and non-IDO-expressing skin substitutes ( p<0.001). Immuno-staining of CD3 and CD31 suggests that IDO-expressing skin substitutes significantly suppress T cell infiltration ( p<0.001) and improve neovascularization by four-fold (12.6±1.2 vs. 3.0±1.0 vessel-like structure/high power field), respectively. In conclusion, we found that IDO expression can improve the efficacy of nonautologous ESS for the purpose of wound healing by mitigating T-cell infiltration as well as promoting vascularization of the graft. [ABSTRACT FROM AUTHOR]

We aimed to study transcriptional and phenotypic changes in circulating immune cells associated with increased risk of mortality in COVID-19, resolution of pulmonary fibrosis in post-COVID-19-interstitial lung disease (ILD), and persistence of idiopathic pulmonary fibrosis (IPF). Whole blood and peripheral blood mononuclear cells (PBMCs) were obtained from 227 subjects with COVID-19, post-COVID-19 interstitial lung disease (ILD), IPF, and controls. We measured a 50-gene signature (nCounter, Nanostring) previously found to be predictive of IPF and COVID-19 mortality along with plasma levels of several biomarkers by Luminex. In addition, we performed single-cell RNA sequencing (scRNA-seq) in PBMCs (10x Genomics) to determine the cellular source of the 50-gene signature. We identified the presence of three genomic risk profiles in COVID-19 based on the 50-gene signature associated with low-, intermediate-, or high-risk of mortality and with significant differences in proinflammatory and profibrotic cytokines. Patients with COVID-19 in the high-risk group had increased expression of seven genes in CD14 + HLA-DR low CD163 + monocytic-myeloid-derived suppressive cells (7Gene-M-MDSCs) and decreased expression of 43 genes in CD4 and CD8 T cell subsets. The loss of 7Gene-M-MDSCs and increased expression of these 43 genes in T cells was seen in survivors with post-COVID-19-ILD. On the contrary, patients with IPF had low expression of the 43 genes in CD4 and CD8 T cells. Collectively, we showed that a 50-gene, high-risk profile, predictive of IPF and COVID-19 mortality is characterized by a genomic imbalance in monocyte and T-cell subsets. This imbalance reverses in survivors with post-COVID-19-ILD highlighting genomic differences between post-COVID-19-ILD and IPF. NEW & NOTEWORTHY Changes in the 50-gene signature, reflective of increase in CD14 + HLA-DR low CD163 + monocytes and decrease in CD4 and CD8 T cells, are associated with increased mortality in COVID-19. A reversal of this pattern can be seen in post-COVID-19-ILD, whereas its persistence can be seen in IPF. Modulating the imbalance between HLA-DR low monocytes and T cell subsets should be investigated as a potential strategy to treat pulmonary fibrosis associated with severe COVID-19 and progressive IPF.

Selenium is a micronutrient element that is beneficial for the growth and development of plants. It has antioxidant, anticancer, and antiviral properties that are essential for human and animal health. Low-consumption mineral elements such as selenium can be included in the diet from various sources. To investigate the growth and phytochemical attributes of a broccoli cultivar "Heracklion", an experiment with five levels of selenium concentration (0, 5, 10, 15, 20 mg/L sodium selenate) was carried out in a randomized complete block design with 3 replications in the field condition. With increasing the concentration of sodium selenate in the foliar application, the accumulation of sodium selenate in broccoli increased and the highest amount (1.47 mg/kg dry weight) was measured at 20 mg/L of sodium selenate. The highest amount of photosynthetic pigments in leaves was recorded at 15 mg/L of sodium selenate. In the case of glucosinolates, with increasing selenium concentration up to 20 mg/L concentration, glucoraphanin, 4-methoxy glucobrassicin, and aliphatic glucosinolates increased in leaves. It could be demonstrated that foliar application of selenium at 10 mg/L led to an improvement of secondary metabolites, especially glucoraphanin, both in leaves and florets, and could also have a positive effect on human nutrition., (© 2024 Wiley-VHCA AG, Zurich, Switzerland.)

Background: COVID-19 is an example of an epidemic and sudden crisis that has affected many aspects of life and work and identifying the factors that contribute to its impact can help prevent similar crises in the future. The purpose of this study was to investigate fear of COVID-19, health anxiety, and work-family conflict in nurses working in COVID-19 wards in hospitals affiliated with the Tehran University of Medical Sciences (TUMS)., Materials and Methods: This descriptive-analytical study used a census method to survey 226 nurses working in eight hospitals affiliated with TUMS. Demographics information and three questionnaires including; the Fear of COVID-19 Scale, Short Health Anxiety Inventory, and Work-Family Conflict Scale were completed online. Data were analyzed using descriptive statistics and analytical statistics, and a significance level of p < 0.05 was considered., Results: Structural equation modeling test showed that work-family conflict had an effect on health anxiety, and health anxiety had an effect on fear of COVID-19 ( p < 0.05). The severity of the effect of work-family conflict on health anxiety was 0.73, and the severity of the effect of health anxiety on fear of COVID-19 was 0.46. Work-family conflict had an indirect effect on fear of COVID-19 mediated only by health anxiety ( p < 0.05) and the severity of the indirect effect was 0.33., Conclusions: Health anxiety plays a mediating role in the relationship between work-family conflict and fear of COVID-19. Workplaces should provide more support to their employees during a crisis such as the COVID-19 pandemic, and prevention programs should be implemented to decrease anxiety., Competing Interests: Nothing to declare., (Copyright: © 2024 Iranian Journal of Nursing and Midwifery Research.)

The 1986 Bethesda Conference on Cardiovascular Disease (CVD) in the Elderly, co-chaired by Drs. Nanette Wenger, Frank Marcus, and Robert O'Rourke, delineated the anticipated social, political, ethical, economic and technological impact of an aging population on the incidence, prevalence, and management of CVD in the US and worldwide. In the ensuing 4 decades, older patients have come to comprise an increasingly large proportion of the CVD population, and there has been an explosion of research in all aspects of CVD affecting older adults. Correspondingly, Geriatric Cardiology is now an established field within cardiovascular medicine. In this communication, we provide a focused update on intersections between CVD and geriatrics from basic science to clinical practice, a review of major advances in diagnosis and treatment of older adults with CVD, and a preview of future research directions in the still evolving field of geriatric cardiology.

This study aims to evaluate the impact that the presence of interventional collaterals has on the outcomes of CTO PCI. We examined the clinical and angiographic characteristics and procedural outcomes of 11 205 patients who underwent 11 444 CTO PCIs at 45 US and non-US centers between 2012 and 2023.

Twitter, which recently changed its name to "X," is a popular social media platform that is used widely across the world due to its easy accessibility through the internet. Due to more public familiarity, we referred to this social media platform as "Twitter (X)" in this article. Users can create posts, also called as "tweets" with a limitation of 280 characters and can add images, videos, and weblinks. While there are several social media platforms used by health care professionals, eg, Facebook, Instagram, Snapchat, TikTok, LinkedIn, and Periscope, Twitter (X) is an extremely popular platform among physicians, especially cardiologists. Due to its persistent growth and ever-expanding outreach, Twitter (X) is facilitating dissemination of scientific information including complex medical knowledge leading the way in collaborations, and in organizing and networking of various health care professionals, patients, and caregivers with shared medical interests. While there are several advantages of Twitter (X) as an important tool in our contemporary medical armamentarium, there are also some drawbacks. False information can be distributed effortlessly and can entrench unscientific beliefs as there is no peer-review process. Occasionally, discourteous discussions between health care professionals can be misinterpreted by users with limited medical knowledge. Other disadvantages include Health Insurance Portability and Accountability Act violations and hacking of accounts. Therefore, it is imperative for health care professionals interested to use this valuable tool to be familiar with and cautious about its potential risks and limitations., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2023 The Author(s).)

Background: The fat storage capacity of the adipose tissue prevents ectopic lipid deposition, which is one of the risk factors for metabolic abnormalities in obesity. This capacity depends upon the adipogenic gene expression and blood supply provision for tissue expansion through angiogenesis. Here, we studied hyperplasia/hypertrophy of subcutaneous white adipose tissue (scWAT) concerning adipogenic gene expression, angiogenic status, and metabolic parameters in non-obese and different classes of obese individuals., Methods: The scWAT samples were collected from 80 individuals. The anthropometric parameters, adipose tissue cell size, serum biochemistry, ER stress-induced XBP1 splicing, PPARγ2, SFRP1, WNT10B, and VEGFA gene expression levels were studied. In addition, the CD31 level was investigated by Western blotting., Results: The obese individuals had greater waist circumferences and higher serum TG, TC, insulin, and HOMA-IR than the non-obese group. However, the largest adipocyte size, increased TNFα, insulin, and HOMA-IR, and the highest expression level of sXBP1, WNT10B, and VEGFA were observed in Class I obese individuals. It means that inflammation, insulin resistance, and ER stress accompany hypertrophic scWAT adipocytes with limited adipose tissue expansion ability. Furthermore, the Class II + III obese individuals showed high PPARγ2 expression and CD31 levels. There is adipogenesis through hyperplasia in this group. The SFRP1 expression was not significantly different in the studied groups., Conclusion: The results suggest that the capability of adipogenesis with inadequate angiogenesis is related to the metabolic status, inflammation, and ER function. Therefore, therapeutic strategies that support both angiogenesis and adipogenesis can effectively prevent the complications of obesity., (© 2023. The Author(s).)

Cardiogenic shock complicating acute MI carries high mortality and morbidity in many cases. Mechanical circulatory support devices are often used in these cases, aimed at improving patient-centered outcomes, although there is a lack of large randomized clinical trial-based evidence for many of such devices. Various circulatory support devices are available with their associated risks and benefits. Ideal circulatory support device intends to unload the myocardium, halt the spiral of ischemia, provide support for revascularization, and/or allow time for myocardial recovery. In this review paper, the commonly used mechanical circulatory support devices available for use in acute myocardial infarction settings are discussed, and the pros and cons of these devices are examined, considering the contemporary data for each. While this is an evolving field, the authors believe this paper can be helpful to review the current status of the use of mechanical support devices in the setting of acute MI and highlight some of the unmet needs in this field., Competing Interests: Disclosure: FF is a section editor on the US Cardiology Review editorial board; this did not influence peer review. All other authors have no conflicts of interest to declare., (Copyright © The Author(s), 2023. Published by Radcliffe Group Ltd.)

Background: Starting vaccination in pregnant women; numerous theories have been proposed that the vaccine might affect the mother or the fetus., Objective: The goal of this research was to see whether there was a link between the Sinopharm vaccination and certain pregnancy outcomes in COVID-19-vaccinated women., Study Design: This is a retrospective cohort study., Method: This study was conducted on pregnant women who delivered from 1 August 2021 to 1 January 2022 in Yazd city. We have followed the STROBE Guidelines when preparing the manuscript. In this period time, all pregnant women were 5787 people in which 5666 were in the second and third trimester. Among these women, 1222 women were randomly selected., Results: Among 1222 pregnant women, 558 (45.6%) women had received one dose vaccine, 162 (13.3%) people had received two doses, and 502 (41.1%) women had not been vaccinated. On crude analysis, there was no significant difference between vaccinated and non-vaccinated groups. After adjusting for maternal age, maternal body mass index, parity, stillbirth history, abortion history, and gestational diabetes in multivariate analysis, no differences were found between the groups in pregnancy as well., Conclusion: Vaccinations during pregnancy seem to have no negative effects on the mother or the baby. This finding may aid pregnant women in deciding whether or not to take the vaccination.

Introduction: Psychological interventions are shown to be effective in migraine, but not utilized routinely yet. We aimed to evaluate the efficacy of transdiagnostic cognitive behavioral therapy (TCBT) on people with migraine (PwM)., Method: This study was conducted on 40 PwM aged 20-50 years. We randomly assigned participants to two groups of intervention, receiving 10 sessions of TCBT, and control, attending one session on relaxation and stress-management techniques. Days with headache, headache severity, migraine-related disability and effects on daily life, number of pain-relivers taken for headache, depression, and anxiety were assessed pre-intervention, post-intervention (three-month follow-up), and one-month after TCBT termination (four-month follow-up)., Results: Thirty-five participants suffering moderate to severe migraine completed the study (16 and 19 in TCBT and control groups, respectively). TCBT improved all measured items between study time-points (p < 0.05) in the intervention group, while such an improvement was not observed in the control group. Between group comparisons revealed superiority of TCBT group compared to the control group in most measured items at three- and four-month follow-ups (p < 0.05)., Conclusion: Ten sessions of TCBT improved migraine severity, associated disability, anxiety, and depression in PwM, with persistent effects after one month of therapy termination. However, the generalizability of these findings is limited due to the placebo effect in the intervention arm, given the more time each participant has spent with the therapist. TCBT could be an affordable, practical, and feasible intervention to be utilized for PwM and larger studies with equal number of sham therapy sessions are needed to further explore this., Trial Registration Number: The study protocol was registered in clinicaltrial.gov ( NCT03701477 ) prior to enrollment., (© 2022. The Author(s).)

Objective: This study aims to explore a public volunteer's hospital response model in natural disasters in Iran., Methods: This study employed grounded theory using the Strauss and Corbin 2008 method and data analysis was carried out in three steps, namely open, axial, and selective coding. The present qualitative study was done using semi-structured interviews with 36 participants who were on two levels and with different experiences in responding to emergencies and disasters as "public volunteers" and "experts". National and local experts were comprised of professors in the field of disaster management, hospital managers, Red Crescent experts, staff and managers of Iran Ministry of Health and Medical Education., Results: The main concept of the paradigm model was "policy gap and inefficiency" in the management of public volunteers, which was rooted in political factions, ethnicity, regulations, and elites. The policy gap and inefficiency led to chaos and "crises over crises." Overcoming the policy gap will result in hospital disaster resilience. Meanwhile, the model covered the causal, contextual, and intervening conditions, strategies, and consequences in relation to the public volunteers' hospital response phase., Conclusions: The current public volunteers' hospital in Iran suffered from the lack of a coherent, comprehensive, and forward-looking plan for their response. The most important beneficiaries of this paradigm model will be for health policy-makers, to clarify the main culprits of creating policy gap and inefficiency in Iran and other countries with a similar context. It can guide the decision-makings in upstream documents on the public volunteers. Further research should carried out to improve the understanding of the supportive legal framework, building the culture of volunteering, and enhancing volunteers' retention rate.

Background: Cockayne syndrome (CS) is a rare autosomal recessive disorder with characteristic multisystem involvement including pre- or post-natal growth failure, progressive neurological dysfunction, psychomotor retardation, cerebral atrophy, microcephaly and mental retardation, due to mutations in either the ERCC8/CSA or ERCC6/CSB gene., Method: We present two Iranian patients with remarkable growth failure, developmental delay, microcephaly, severe speech delay, vision problem, sun sensitivity, hearing loss, dental anomalies, unstable gait, mild contractures in knees, kyphosis and spasticity in lower limbs, balance disorders and typical dysmorphic features including long nose, aged face, large ears and sunken eyes. Clinical evaluation, magnetic resonance imaging, Peripheral blood karyotype, Multiplex ligation-dependent probe amplification (MLPA), and whole-exome sequencing were used to characterize etiology in two patients from two unrelated consanguineous families of Iranian descent with Cockayne syndrome., Results: We detected two novel pathogenic mutations in two unrelated families, a homozygous duplication mutation (c.317&#95;320dupAGTG, p.Trp107Ter) and a splicing variant (c.481 + 1G > A) in ERCC8 gene., Conclusion: WES results together with the characteristic clinical manifestations of Cockayne syndrome, provided an accurate diagnosis for two patients. Also, our study identified two novel variants in Iranian families., (Copyright © 2021. Published by Elsevier B.V.)

We aimed to describe SARS-CoV-2 strains in Iranians from nine distributed cities infected during two months expanding late 2020 and early 2021 by genotyping known informative single nucleotide in five PCR amplicons. Two variants associated with haplotype H1 (clade G) and nine additional variants associated with other haplotypes were genotyped, respectively, in RNA isolates of 244 and 85 individuals. The variants associated with the H1a (GR) and H1b (GH) haplotypes were most prevalent, indicating a significant change in infection pattern with passage of time. The most important findings were that recombinant genomes and co-infection, respectively, were surmised in 44.7% and 12.9% of the samples extensively genotyped. Partners of many of the recombinations were relatively common strains. Co-existing viruses were among those currently circulating in Iran. In addition to random mutations, co-infection with different existing strains and recombination between their genomes may significantly contribute to the emergence of new SARS-CoV-2 strains., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: We sought to examine the procedural and clinical outcomes of patients who underwent chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in the setting of acute myocardial infarction (AMI)., Methods: We assessed the clinical and procedural characteristics, technical success, procedural success, and in-hospital outcomes of 2314 patients who underwent CTO-PCI at 20 experienced centers between 2012 and 2017, classified according to whether or not they presented with AMI., Results: Mean patient age was 65 ± 10 years, 85% were men, and 154 (6.7%) presented with AMI (5.5% with non-ST segment elevation myocardial infarction, 1.1% with ST-segment elevation myocardial infarction). Compared with non-AMI patients who underwent CTO-PCI, AMI patients had higher prevalence of diabetes (56% vs 42%; P<.01) and lower median left ventricular ejection fraction (48% vs 54%; P<.001). The CTO angiographic characteristics were similar between the 2 groups. Compared with non-AMI patients undergoing CTO-PCI, AMI patients had more frequent use of antegrade wire escalation (86.0% vs 78.9%; P=.03) and more frequent use of hemodynamic support devices (16.2% vs 3.4%; P<.01), and were more likely to have a non-CTO lesion treated (34.0% vs 26.6%; P=.03). AMI and non-AMI patients had similar technical success (90% vs 87%; P=.26), procedural success (88% vs 85%; P=.38), and incidence of in-hospital MACE (2.6% vs 2.5%; P=.94)., Conclusion: CTO-PCI is performed infrequently in AMI patients and is associated with similar technical and procedural success rates and in-hospital major adverse cardiovascular event rates when compared with CTO-PCI performed in non-AMI patients.

This report presents a review of progress on peristaltic micropumps since their emergence, which have been widely used in many research fields from biology to aeronautics. This paper summarizes different techniques that have been used to mimic this elegant physiological transport mechanism that is commonly found in nature. The analysis provides definitions of peristaltic micropumps and their different features, distinguishing them from other mechanical micropumps. Important parameters in peristalsis are presented, such as the operating frequency, stroke volume, and various actuation sequences, along with introducing design rules and analysis for optimizing actuation sequences. Actuation methods such as piezoelectric, motor, pneumatic, electrostatic, and thermal are discussed with their advantages and disadvantages for application in peristaltic micropumps. This review evaluates research efforts over the past 30 years with comparison of key features and outputs, and suggestions for future development. The analysis provides a starting point for researchers designing peristaltic micropumps for a broad range of applications.

Nowadays the importance of selenium for human health is widely known, but most of the plants are poor in terms of selenium storage and accumulation because of the low selenium mineralization potential of the soil. For this purpose, foliar application of different sodium selenate concentrations (0, 5, 10, 15, 20 mg/L) was used to treat the cauliflower cultivars "Clapton" and "Graffiti". Higher yields and other related vegetative attributes were improved at 10 and 15 mg/L sodium selenate application. At a concentration of 10 mg/L sodium selenate, photosynthetic pigments, total phenolic compounds and antioxidant capacity were enhanced in both cultivars, but the "Graffiti" cultivar responded stronger than the "Clapton" cultivar. The glucosinolates were accumulated in response to selenium fortification and the highest amounts were found in the "Graffiti" cultivar at 10 mg/L. Selenium accumulated concentration-dependently and rose with higher fertilization levels. In general, foliar application of selenium at 10 mg/L led to an accumulation of secondary metabolites and also positively affected the growth and yield of florets.

In patients presenting with ST-elevation MI, prompt primary coronary intervention is the preferred treatment modality. Several studies have described improved outcomes in patients with door-to-balloon (D2B) and symptom onset-to-balloon (OTB) times of less than 2 hours, but the specific implications of the coronavirus disease 2019 (COVID-19) pandemic on D2B and OTB times are not well-known. This review aims to evaluate the impact of COVID-19 on D2B time and elucidate both the factors that delay D2B time and strategies to improve D2B time in the contemporary era. The search was directed to identify articles discussing the significance of D2B times before and during COVID-19, from the initialization of the database to December 1, 2020. The majority of studies found that onset-of-symptom to hospital arrival time increased in the COVID-19 era, whereas D2B time and mortality were unchanged in some studies and increased in others., Competing Interests: Disclosure: FF is a section editor on the US Cardiology Review editorial board; this did not influence peer review. All other authors have no conflicts of interest to declare., (Copyright © The Author(s), 2021. Published by Radcliffe Group Ltd.)

Background: Volunteers' presence, as a critical issue in hospital response to disasters and emergencies, helps to readiness and quick response to the phenomena, preventing deaths caused by such incidences. This study aimed to determine the main factors affecting popular volunteers' presence in hospital response to disasters and emergencies in Iran., Methods: This qualitative study, conducted on 31 semi-structured interviews during the years 2019 and 2020, concerning emergency specialist working in various health organization nationwide between June 2019 and April 2020. The non-structured and semi-structured interviews were adopted to gather concept code and analyzed using Graneheim recommendation method., Results: Four main categories, identified as effective factors on volunteers' presence in hospital response to disasters and emergencies, including nine subcategories: (1) organizing and managing volunteers (with two sub-categories: (a) calling and registering volunteers, and (b) identifying volunteers' ability); (2) organizational structure (with two sub-categories: (a) operational planning and (b) coordination and communication); (3) training (with two sub-categories: (a) training in disasters and (b) volunteer training); and (4) volunteer challenges (with three sub-categories: (a) volunteer interaction with organizations, (b) volunteer logistics, and (c) volunteering culture)., Conclusions: Exploring effective factors as regards volunteers' presence in hospital response phase in disasters to adopt a policy based on the experiences of managers and heads of health can help planners to provide effective design and implementation. It can scientifically contribute to disaster risk management and hospital emergency response in Iran.

Here we present a 3D-printed, wirelessly controlled microsystem for drug delivery, comprising a refillable microreservoir and a phase-change peristaltic micropump. The micropump structure was inkjet-printed on the back of a printed circuit board around a catheter microtubing. The enclosure of the microsystem was fabricated using stereolithography 3D printing, with an embedded microreservoir structure and integrated micropump. In one configuration, the microsystem was optimized for murine inner ear drug delivery with an overall size of 19 × 13 × 3 mm 3 . Benchtop results confirmed the performance of the device for reliable drug delivery. The suitability of the device for long-term subcutaneous implantation was confirmed with favorable results of implantation of a microsystem in a mouse for six months. The drug delivery was evaluated in vivo by implanting four different microsystems in four mice, while the outlet microtubing was implanted into the round window membrane niche for infusion of a known ototoxic compound (sodium salicylate) at 50 nL/min for 20 min. Real-time shifts in distortion product otoacoustic emission thresholds and amplitudes were measured during the infusion, demonstrating similar results with syringe pump infusion. Although demonstrated for one application, this low-cost design and fabrication methodology is scalable for use in larger animals and humans for different clinical applications/delivery sites.

Cellular processes, including differentiation, proliferation, and migration, have been linked to the alignment (anisotropy) and orientation (directionality) of collagen fibers in the native extracellular matrix (ECM). Given the critical role that biophysical cell-matrix interactions play in regulating biological functions, several microfluidic-based methods have been used to establish 3D collagen gels with defined fiber properties; these gels have helped to establish quantitative relationships between structural ECM cues and observed cell responses. Although existing microfluidic fabrication methods provide excellent definition over collagen fiber anisotropy, they have not demonstrated the independent control over fiber anisotropy and directionality necessary to replicate in vivo collagen architecture. Therefore, to advance collagen microengineering capabilities, we present a user-friendly technology platform that uses controlled fluid flows within a non-uniform microfluidic channel network to create collagen landscapes that can be tuned as a function of extensional strain rate. Herein, we demonstrate capabilities to i) control the degree of fiber anisotropy, ii) create spatial gradients in fiber anisotropy, iii) independently define fiber directionality, and iv) generate multi-material interfaces within a 3D environment. We then address the practical issue of integrating cells into microfluidic systems by using a peel-off template technique to provide direct access to microengineered collagen gels, and demonstrate that cells respond to the defined properties of the landscape. Finally, the platform's modular capability is highlighted by integrating a sub-micrometer thick porous parylene membrane onto the microengineered collagen as a method to define cell-substrate interactions.

Objectives: We sought to study the impact of COVID-19 pandemic on the presentation delay, severity, patterns of care, and reasons for delay among patients with ST-elevation myocardial infarction (STEMI) in a non-hot-spot region., Background: COVID-19 pandemic has significantly reduced the activations for STEMI in epicenters like Spain., Methods: From January 1, 2020, to April 15, 2020, 143 STEMIs were identified across our integrated 18-hospital system. Pre- and post-COVID-19 cohorts were based on March 23rd, 2020, whenstay-at-home orders were initiated in Ohio. We used presenting heart rate, blood pressure, troponin, new Q-wave, and left ventricle ejection fraction (LVEF) to assess severity. Duration of intensive care unit stay, total length of stay, door-to-balloon (D2B) time, and radial versus femoral access were used to assess patterns of care., Results: Post-COVID-19 presentation was associated with a lower admission LVEF (45 vs. 50%, p = .015), new Q-wave, and higher initial troponin; however, these did not reach statistical significance. Among post-COVID-19 patients, those with >12-hr delay in presentation 31(%) had a longer average D2B time (88 vs. 53 min, p = .033) and higher peak troponin (58 vs. 8.5 ng/ml, p = .03). Of these, 27% avoided the hospital due to fear of COVID-19, 18% believed symptoms were COVID-19 related, and 9% did not want to burden the hospital during the pandemic., Conclusions: COVID-19 has remarkably affected STEMI presentation and care. Patients' fear and confusion about symptoms are integral parts of this emerging public health crisis., (© 2020 Wiley Periodicals LLC.)

Background: Death anxiety is one of the most common problems among women with cancer, which can affect the useful treatment process. With regard to the superior role of spiritual well-being over other aspects of health, the present study is aimed to compare the relationship between spiritual well-being and death anxiety among women with breast and cervical cancers and women with gastric and colorectal cancers., Methodology: This was a descriptive-correlational study. Research statistical population included Iranian women with cancer at major hospitals in Isfahan, Iran. 160 research samples were selected through convenience sampling method based on inclusion criteria using a demographic questionnaire, spiritual well-being scale (Paloutzian et al .) and death anxiety scale (Templer). Research data were analyzed through SPSS 22 using independent t -test, Pearson's correlation, and analysis of variance at significance level 0.05., Results: The study findings indicated a significant inverse relationship between death anxiety and spiritual well-being (at 0.05) in both groups. As a result, people with higher spiritual well-being would experience less anxiety about death. In addition, the relationship between death anxiety and spiritual well-being in women with gastric and colorectal cancers was stronger than those with breast and cervical cancers., Conclusion: Spiritual well-being is of effective factors of death anxiety among women suffering from cancer. Spirituality and meeting spiritual needs are considered as nursing care priorities for these women. Furthermore, paying attention to the spirituality by nurses may shield against individual difficulties., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)