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Background &Objective: Laryngoscopy and tracheal intubation increase not only blood pressure and heart rate but also Bispectral Index (BIS) of the patients. In this study, hemodynamic and BIS changes were surveyed after tracheal intubation and during general anesthesia followed by mexiletine prescription. Materials & Methods: In this study, 50 patients aged between 20 and 60 who were candidates for orthopedic surgery of the upper limbs were surveyed. They were divided in two groups randomly. Two hours before induction of anesthesia, case and control groups received mexiletine 200 mg as capsule and oral placebo, respectively. Systolic and diastolic blood pressures, heart rate, and BIS of both groups were compared before induction and intubation; 1,3 and 10 minutes after intubation; and immediately, 15, 30, 45, and 60 minutes after surgical incision. Results: There was not any significant difference in systolic and diastolic pressures of the two groups. The heart rate was lower in mexiletine group compared to control group, 30 minutes after surgical incision and immediately after extubation (P<0.05). BIS was significantly more in mexiletine group compared to control group (p<0/05). Conclusion: It was revealed that the hemodynamic changes after laryngoscopy and during general anesthesia were significantly lower in mexiletine group compared to the control group. It's suggested that the prescription of this drug leads to the increase of BIS after intubation and during general anesthesia. [ABSTRACT FROM AUTHOR]

Bone marrow erythroid progenitor cells were examined from 50 cases of acute leukaemia and from 20 normal subjects using an in vitro semisolid culture method. Numbers of both primitive erythroid progenitor cells (BFU-e) and later-stage erythroid progenitor cells (CFU-e) were remarkably depressed in patient with acute leukaemia in active phase. However, both BFU-e and CFU-e recovered to within normal range when the patients achieved remission. Peripheral blood BFU-e of children with acute lymphocytic leukaemia in remission were also examined and found to have values not significantly different from those of control subjects. There was no distinct correlation between the numbers of erythroid bursts or colonies and the duration of remission in patients with acute leukaemia in remission. The reduction of BFU-e and CFU-e in active acute leukaemia suggests the involvement of erythropoietic progenitors in the pathophysiology of this type of leukaemia. [ABSTRACT FROM PUBLISHER]

This paper presents a deep learning approach for predicting rail corrugation based on on-board rolling-stock vertical acceleration and forward velocity measurements using One-Dimensional Convolutional Neural Networks (CNN-1D). The model's performance is examined in a 1:10 scale railway system at two different forward velocities. During both the training and test stages, the CNN-1D produced results with mean absolute percentage errors of less than 5% for both forward velocities, confirming its ability to reproduce the corrugation profile based on real-time acceleration and forward velocity measurements. Moreover, by using a Gradient-weighted Class Activation Mapping (Grad-CAM) technique, it is shown that the CNN-1D can distinguish various regions, including the transition from damaged to undamaged regions and one-sided or two-sided corrugated regions, while predicting corrugation. In summary, the results of this study reveal the potential of data-driven techniques such as CNN-1D in predicting rails' corrugation using online data from the dynamics of the rolling-stock, which can lead to more reliable and efficient maintenance and repair of railways.

Patients with diabetes are at an increased risk of intestinal parasitic infections (IPIs). We evaluated the pooled prevalence and OR of IPIs in patients with diabetes through a systematic review and meta-analysis. A systematic search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol for studies reporting IPIs in patients with diabetes through 1 August 2022. The collected data were analyzed using comprehensive meta-analysis software version 2. Thirteen case-control studies and nine cross-sectional studies were included in this study. The overall prevalence of IPIs in patients with diabetes was calculated to be 24.4% (95% CI 18.8 to 31%). Considering the case-control design, the prevalence of IPIs in case (25.7%; 95% CI 18.4 to 34.5%) was higher than controls (15.5%; 95% CI 8.4 to 26.9%) and a significant correlation was observed (OR, 1.80; 95% CI 1.08 to 2.97%). Moreover, a significant correlation was seen in the prevalence of Cryptosporidium spp. (OR, 3.30%; 95% CI 1.86 to 5.86%), Blastocystis sp. (OR, 1.57%; 95% CI 1.11 to 2.22%) and hookworm (OR, 6.09%; 95% CI 1.11 to 33.41%) in the cases group. The present results revealed a higher prevalence of IPIs in patients with diabetes than in controls. Therefore, the results of this study suggest a proper health education program to preventing measures for the acquisition of IPIs in patients with diabetes., (© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Objective: Reactivation of latent toxoplasmosis is the main cause of severe infection among immunocompromised patients, including patients with cancer. Hence, this study is aimed at screening the status of Toxoplasma gondii infection among breast cancer patients by serological and molecular methods and determining their associated risk factors in Jahrom County, Fars Province, south of Iran., Methods: One hundred and seven women with breast cancer (aged 34 to 80 years) were screened for anti- T. gondii antibodies (IgG and IgM) during 2019-2020. A questionnaire regarding demographic factors was filled out by participants. Molecular detection was performed by polymerase chain reaction (PCR) using the primer pair targeting the repetitive element (RE) gene of T. gondii . The risk factors and demographic data were analyzed by SPSS software (ver. 20, Chicago, IL, USA) using the Chi-squared test., Results: Anti- T. gondii IgG was detected in 45.8% (49/107) of the patients, which indicates latent infection, but anti- T. gondii IgM and PCR were negative in all samples. Demographic factors revealed a statistically significant increased T. gondii seropositivity among nonmenopause cancer patients ( P < 0.0005), patients without previous breast cancer ( P = 0.0001), and human epidermal growth factor receptor 2- ( HER2- ) negative patients ( P = 0.00002). As such, patients with a history of previous abortions and who were at stages II, III, and IIII of cancer had higher seropositivity rates than patients without a history of previous abortions or who were at stage I cancer, but the statistical analysis was not significant. We did not find a statistically significant association between T. gondii seropositivity and other risk factors of toxoplasmosis (e.g., education level, type of water source, washing raw fruits and vegetables, consumption of raw or undercooked meat, and contact with soil, cats, and domestic animal)., Conclusion: A high seroprevalence rate of latent T. gondii infection was detected among patients with breast cancer; hence, these patients may be at high risk for reactivation of latent infection. Screening of T. gondii infection is recommended to detect active infection among patients with malignancies., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Marzeieh Haghbin et al.)

Background: Breast cancer (BC) is the main cause of cancer death in women. Idiopathic granulomatous mastitis (IGM), a rare chronic disease that clinically mimics breast carcinoma, and is associated with high mortality and morbidity, but an immediate and accurate diagnosis can substantially decrease these rates. Expressed by numerous human tissues, interleukin-33 (IL-33) has an inductive role in the network of pro-inflammatory cytokines. The aim of this study was to investigate the serum levels of IL-33 in BC and IGM patients in comparison with healthy women., Materials and Methods: This descriptive-analytical study was carried out on 28 patients with BC and 25 patients with IGM as the patient groups and 25 healthy volunteers with normal screening reports as the control group. Histopathological pattern of BC and IGM were confirmed by specialized pathologists. The serum concentration of IL-33 was measured using enzyme-linked immunosorbent assay (ELISA) kit according to the manufacturer's instructions., Results: The mean age of the patients with BC and IGM and the control group was 49.1, 37.1, and 36.8 years, respectively. There was no significant difference in IL-33 expression among the participants with regard to age, marital status, body mass index (BMI), and menopausal status. IL-33 assay indicated a significant difference between the BC (P=0.011) and IGM (P=0.031) groups compared to the controls, although no substantial differences were observed between the IGM and BC groups., Conclusion: IL-33 can be considered a significant factor distinguishing IGM and BC patients from controls, although it cannot be applied to diagnose and differentiate BC from IGM patients., .

The main purpose of this study is to synthesize and characterize Persian gum-based hydrogel composited with gentamicin (Gen)-loaded natural zeolite (Clinoptilolite) and to evaluate its biological properties. Clinoptilolite (CLN) was decorated with Gen, and the conjugation was confirmed using computational and experimental assessments. The Monte Carlo adsorption locator module was used to reveal the physicochemical nature of the adsorption processes of Gen on CLN and ALG and gum on Gen@ CLN in Materials Studio 2017 software. Based on the high negative results, the adsorption process was found to be endothermic in all studied cases, and the interaction energies were in the range of physisorption for Gen on CLN and ALG and gum on Gen@CLN. Dynamic light scattering (DLS) and zeta potential analysis showed that the size of pristine CLN was around 2959 nm and the conjugation decreased the size significantly to approximately 932 nm. The hydrogel characterizations showed that the Gen-decorated CLNs are homogenously dispersed into the hydrogel matrix, and the resultant hydrogels have a porous structure with interconnected pores. The release kinetics evaluation showed that around 80 % of Gen was released from the nanocomposite drug during the first 10 h. In vitro studies revealed hemocompatibility and cytocompatibility of the nanocomposite. Microbial assessments indicated dose-dependent antibacterial activity of the hydrogel against gram (+) and gram (-) bacteria. The results showed that the fabricated hydrogel nanocomposite exhibits favorable physicochemical and biological properties., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Hadi Samadian reports financial support was provided by Kermanshah University of Medical Sciences., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Sediment pick-up rate has been investigated using experimental and numerical approaches. However, the use of soft computing methods for its prediction has received less attention so far. In this study, genetic programming (GP), grammatical evolution (GE), and gradient boosting machine (GBM) algorithms are employed to develop a relation in dimensionless form for predicting sediment pick-up rate in open channel flow based on two experimental datasets. Dimensionless Froude number, particle diameter, and depth-averaged turbulent kinetic energy are input variables for prediction. Prediction performance is evaluated with performance indices (root mean square error, mean absolute error, and coefficient of correlation), visual comparisons (scatter, dot, and Bland-Altman plots), and uncertainty indicators (Tsallis and Renyi entropies). Three mathematical expressions for sediment pick-up rate prediction are obtained, with GE producing the most accurate results., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: Breast cancer is the main cause of cancer death in women worldwide. Elevated plasma levels of circulating cell-derived microparticles (MPs) have been reported in various types of cancer, including breast cancer, with the ability to mediate inflammation and thrombosis. Microparticles are bioactive agents, and it has been suggested that MPs can be used as a diagnostic, prognostic, or therapeutic biomarker in various diseases. The aim of this study was to investigate the levels of platelet-derived MPs (PMPs) in breast cancer patients., Materials and Methods: In this case-control study, 30 patients with breast cancer and 20 normal subjects were sampled after obtaining written consent. MPs were isolated from blood samples by centrifugation technique. CD42b and annexin V markers were used respectively for counting PMPs and procoagulant MPs with flow cytometry., Results: Flow cytometry results showed that the number of PMPs and procoagulant annexin V positive MPs was significantly higher in the breast cancer patients than normal subjects (p <0.001). The number of the annexin V MPs differed significantly in patients with high tumor size (T2) compared to the patients with low tumor size (T1) and controls (p <0.001). Significant and positive correlations were found between PMP levels and tissue-based biomarkers, tumor grading, and distant metastasis (p <0.05). Tumor histological type did not correlate with the numbers of PMPs (p=0.065)., Conclusion: Increased levels of PMPs and activity in terms of hemostasis and having a positive and significant relationship with tumor grading and metastasis may indicate the effective role of PMPs in the pathogenesis and prognosis of breast cancer.

Introduction: a routine small bowel biopsy (SBB) during the follow up of celiac disease (CD) is controversial. Little information is available regarding the histological changes during (gluten free diet (GFD) in the long term., Objectives: the aim of the study was to evaluate a novel criterion to compare duodenal histology in CD patients after six months and two years of gluten withdrawal., Methods: this was a cross-sectional study of 200 patients with confirmed Marsh I-III who were under the six months (group A, n = 100) and 24 months (group B, n = 100) of a GFD. Nineteen patients were excluded due to an inadequate adherence to the GFD and another 23 patients were excluded as they were unwilling to undergo a re-endoscopy and did not comply with the necessary criteria. Endoscopy with a duodenal biopsy, serological assays and clinical evaluation were performed and compared with baseline data in the remaining 58 patients (20 patients in group A and 38 patients in group B)., Results: a significant complete histological recovery was found in 47.4% of patients in group B compared to 30% in group A (p = 0.026). A partial histological recovery was reported in seven (35%) and eleven (28.9%) patients in groups A and B, respectively. Any changes in mucosal histology after GFD was observed in 35% of patients in group A and 23.7% in group B. Serological assessment and endoscopic appearance normalized in 78.9% vs 75.0% in group B and 68.4% vs 65.0% in group A, respectively. However, this improvement did not reach statistical significance (p > 0.05)., Conclusions: the results of this study show that histological recovery in patients with Marsh ≥ III is slow and does not correlate with symptomatic improvement. We suggest that the long-term effects of a GFD can play an important role in achieving histological improvement, especially in older patients.

The chemokine receptor CXCR3 and its ligands CXCL10 and CXCL11 have been suggested to give rise to the most relevant chemokine axis able to facilitate the entrance of immune cells into inflamed tissues and be activated in different inflammatory disorders, such as celiac disease (CD).The aim of this study was to investigate the expression level of CXCR3, CXCL10, and CXCL11 genes in celiac patients compared to healthy controls. Both cohorts have been recruited from the Iranian population.In this case-control study, biopsy specimens were collected from 71 celiac patients (60.5% female) and 90 control subjects (57% female) during 2016. Total RNA was extracted and mRNA expression levels of CXCR3, CXCL10, and CXCL11 genes were investigated by SYBR green qPCR.Based on qPCR and relative quantification method, the mRNA expression levels of CXCR3, CXCL10, and CXCL11 were significantly higher in duodenal biopsies of celiac patients compared to healthy controls in the study population (P = .038, P = .021, and P = .012 respectively).The result of this study showed that CXCR3/CXCL10/CXCL11 signaling axis is overexpressed in the small intestinal mucosa of CD patients compared to controls. This finding might explain the specific enrollment of the main cell populations that infiltrate the epithelium.

Background and Aims: Over the last two decades, research into video game addiction has grown increasingly. The present research aimed to examine the relationship between video game addiction, self-control, and academic achievement of normal and ADHD high school students. Based on previous research it was hypothesized that (i) there would be a relationship between video game addiction, self-control and academic achievement (ii) video game addiction, self-control and academic achievement would differ between male and female students, and (iii) the relationship between video game addiction, self-control and academic achievement would differ between normal students and ADHD students., Methods: The research population comprised first grade high school students of Khomeini-Shahr (a city in the central part of Iran). From this population, a sample group of 339 students participated in the study. The survey included the Game Addiction Scale (Lemmens, Valkenburg & Peter, 2009), the Self-Control Scale (Tangney, Baumeister & Boone, 2004) and the ADHD Diagnostic checklist (Kessler et al., 2007). In addition to questions relating to basic demographic information, students' Grade Point Average (GPA) for two terms was used for measuring their academic achievement. These hypotheses were examined using a regression analysis., Results: Among Iranian students, the relationship between video game addiction, self-control, and academic achievement differed between male and female students. However, the relationship between video game addiction, self-control, academic achievement, and type of student was not statistically significant., Conclusions: Although the results cannot demonstrate a causal relationship between video game use, video game addiction, and academic achievement, they suggest that high involvement in playing video games leaves less time for engaging in academic work.

DNA index (ploidy) and S-phase fraction (SPF) were measured by flow cytometry in 131 invasive stage I and II breast carcinomas. Ploidy showed a strong correlation with SPF (p = 0.0001), with aneuploid tumors having a high SPF. Both cytometric parameters correlated with tumor size and hormonal receptor status. Smaller tumors tended to be diploid and have low SPF. Nodal status did not demonstrate an association with cytometric findings. There was a highly significant connection between tumor grade, especially nuclear grade, and SPF (p = 0.0001). The study demonstrates the relationship between conventional prognostic factors, DNA content, and proliferative activity of breast tumors.

Twenty-one children with acute nonlymphoblastic leukemia (ANLL) were treated with a combination regimen consisting of arabinosyl cytosine (Ara-C), 6-thioguanine (TG), and Adriamycin, The incidence of complete remission was 74%. For consolidation, addition courses of Ara-C and TG were given, followed by L-asparaginase. The maintenance program was the same as that for the lymphoblastic type (L-2) including intrathecal methotrexate for prophylaxis of meningeal leukemia. Of the 16 who were evaluable for the duration of complete remission, six developed bone marrow relapse, one meningeal leukemia within 3-14 months after entering complete remission and one was lost to follow-up. Eight remain in complete remission for 9-72 months. In five of eight, chemotherapy has been terminated after 3 years, and all continue in remission for 11-32 months post-treatment. Although the results do not compare well to those of the lymphoblastic morphology, long-term disease-free survival can be achieved with multiple-drug intensive treatment in childhood ANLL.

Insertion of an indwelling ventricular cannula via the transfrontal approach by the method described, and the use of an attached reservoir is a safe technique in the hands of experienced personnel. Intraventricular chemotherapy prolongs the duration of remission in those individuals who have evidence of meningeal leukemia. The superiority of this method over intralumbar therapy as a preventive measure has not been demonstrated.

The results of the administration of two antimetabolites, methotrexate (MTX) and cytosine arabinoside (Ara-C), for the prevention and treatment of established central nervous system (CNS) disease in children with acute lymphoblastic leukemia are discussed. Two protocols (L-2 and L-10) for the management of patients with acute lymphoblastic leukemia have been developed. In the L-2 protocol, prophylaxis consists of repeated intralumbar injections of MTX alone, and in the L-10 regimen, both MTX and Ara-C are administered; for the patients with an initial leukocyte count of greater than or equal to 25,000/mm3, the two drugs are given intraventricularly instead of by the usual intralumbar route. In the treatment of established CNS leukemia, intralumbar MTX and Ara-C in addition to CNS irradiation are employed; for maintenance, periodic intraventricular MTX injections are given. Of the 70 children receiving the L-2 protocol, four developed CNS leukemia and in a fifth patient, CNS and bone marrow relapse were concurrent. Among the 31 children receiving the L-10 regimen, CNS disease has been observed in only one child. Of the five children treated for the established CNS leukemia, recurrence was observed in two at 19 and 29 months after remission; the other three remain in remission for 2, 15, and 39 months, respectively.

Heat-stable opsonic activity against Pseudomonas aeruginosa and Staphylococcus epidermidis was measured in sera of 33 children with acute lymphoblastic leukemia at selected times during treatment of their disease. Compared to adults, opsonization of P. aeruginosa was normal in children tested at the time of diagnosis and before chemotherapy. Immediately after achievement of remission, opsonic activity against Pseudomonas was significantly decreased (P smaller than 0.05) compared with pretreatment activity. Activity usually returned to normal and remained so during long-term remission maintenance therapy. In children studied just prior to death from unremitting leukemia, however, anti-Pseudomonas opsonic activity was significantly decreased when compared with that of a group of children before any leukemic treatment (p smaller than 0.005). Anti-S. EPIDERMIDIS OPSONIC ACTIVITY SHOWED NO CHANGES DURING THE PATIENT'S COURSE. Decreased serum opsonic activity may significantly contribute to the increased incidence of severe Pseudomonas infections in patients with acute lymphoblastic leukemia.

Between 1976 and 1986, 64 patients with rectal adenocarcinoma who were considered unresectable or had prognostic signs suggestive of high risk for local failure received preoperative adjuvant therapy. They were treated with pelvic irradiation (40 Gy) combined with 5-fluorouracil (5-FU) and mitomycin-C, followed by surgery. All had definitive resections resulting in 12.5% of operative specimens free of tumor and only 26.5% containing nodal metastases. The projected 5-year disease-free survival rate is 64% with an actuarial survival of 68%. No mortality or severe morbidity has been observed. Combined modality therapy is a safe and effective regimen for those rectal tumors in the high risk category.

Sventy-five children under the age of 15 years, with acute lymphoblastic leukemia, were treated with a multiple drug chemotherapy regimen (L-2) and intrathecal methodtrexate. Remission was achieved in all except 1. Three died from infection early in remission and 1 was lost to follow-up. Of the remaining 70, relapse occurred in 19; in 3 children this was confined to the central nervous system (CNS) and in 1 was in both the CNS and bone marrow. Fifty-one children continue in complete remission from 14 to 54 months. Fourteen of these children have completed 3 years of chemotherapy and are disease free 2 to 18 months posttreatment. The results indicate that periodic administration on intrathecal methotrexate with no CNA irradiation, plus intensive systemic chemotherapy, can effectively control CNA leukemia and prolong the duration of complete remissions.

Between 1969-1973, 75 consecutive children under the age of 15 years with acute lymphoblastic leukemia were treated with a multiple-drug regimen (L-2). Prophylaxis for meningeal leukemia was limited to the repeated intrathecal injections of methotrexate. Seventy-four patients achieved remission; the duration of remissions could be evaluated only for 70. Relapse terminated complete remission within 1-54 months in 21 children. Four of these relapses were confined to the central nervous system. Forty-nine patients continue in complete remission from 23 to 63 months. Chemotherapy has been discontinued in 29 children, and 25 of these remain without evidence of recurrence for 2-27 months posttreatment.

Between 1958-1983, 79 patients with a diagnosis of epithelial tumor of the nasopharynx received definitive irradiation at Thomas Jefferson University Hospital. Seventy-two percent of the patients had a Stage IV lesion. The dose to the nasopharynx was over 6,000 cGy in all but four patients. The 5- and 10-year actuarial survivals were 33% and 19% respectively. The 5-year disease-free survival was 33%. Histology had no bearing on survival. Survival was influenced by the stage of primary tumor and nodes. Advanced nodal disease correlated with distant metastasis, being present in 13/15 cases with hematogenous spread.