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Abstract Background Polycystic Ovary Syndrome (PCOS) is associated with high levels of phsychological implications and detriments to Quality of Life (QoL). The aim of this study was to assess Health- Related Quality of Life (HRQoL), depression, and anxiety in Iranian women with different PCOS phenotypes. Methods The present observational, cross-sectional study was carried out on 239 PCOS women who were classified on the basis of Rotterdam criteria into four categories: A (n = 77), B (n = 38), C (n = 68), and D (n = 56). They asked to fill out three questionnaires, namely, HRQoL, SF-12, and HADS. Results No significant differences were observed between the four PCOS phenotypes for anxiety, depression and QoL, as well as HRQoL domains related to infertiliy, weight and emotional problems (P > 0.05). Phenotypes A and B had worse HRQoL related to hirsutism (13.98 ± 5.22, 14.13 ± 6.23, P

Erfaneh Ghassami,1 Jaleh Varshosaz,1 Ali Jahanian-Najafabadi,2 Mohsen Minaiyan,3 Parvin Rajabi,4 Effat Hayati5 1Department of Pharmaceutics, School of Pharmacy and Novel Drug Delivery Systems Research Centre, 2Department of Pharmaceutical Biotechnology, 3Department of Pharmacology, School of Pharmacy, 4Department of Pathology, Isfahan University of Medical Sciences, Isfahan, 5North Research Center, Pasteur Institute of Iran, Amol, Iran Purpose: Epithelial ovarian cancer is the fourth cause of cancer death in developed countries with 77% of ovarian cancer cases diagnosed with regional or distant metastasis, with poor survival rates. Docetaxel (DTX) is a well-known anticancer agent, with clinically proven efficacy in several malignancies, including ovarian cancer. However, the adverse effects caused by the active ingredient or currently marketed formulations could even deprive the patient of the advantages of treatment. Therefore, in the current study, polymeric nanoparticles (NPs) equipped with aptamer molecules as targeting agents were proposed to minimize the adverse effects and enhance the antitumor efficacy through directing the drug cargo toward its site of action.Materials and methods: Electrospraying technique was implemented to fabricate poly (butylene adipate-co-butylene terephthalate) (Ecoflex®) NPs loaded with DTX (DTX-NPs). Afterward, aptamer molecules were added to the DTX-NPs, which bound via covalent bonds (Apt-DTX-NPs). The particle size, size distribution, zeta potential, entrapment efficiency, and release profile of the NPs were characterized. Using MTT assay and flow-cytometry analysis, the in vitro cytotoxicity and cellular uptake of the NPs were compared to those of the free drug. Following intravenous administration of Taxotere®, DTX-NPs, and Apt-DTX-NPs (at an equivalent dose of 5 mg/kg of DTX), pharmacokinetic parameters and antitumor efficacy were compared in female Balb/c and HER-2-overexpressing tumor-bearing B6 athymic mice, respectively.Results: The obtained results demonstrated significantly enhanced in vitro cytotoxicity and cellular uptake of Apt-DTX-NPs in a HER-2-overexpressing cell line, comparing to DTX-NPs and the free drug. The results of in vivo studies indicated significant increment in pharmacokinetic parameters including the area under the plasma concentration–time curve, mean residence time, and elimination half-life. Significant increment in antitumor efficacy was also observed, probably due to the targeted delivery of DTX to the tumor site and enhanced cellular uptake as evaluated in the aforementioned tests.Conclusion: Hence, the proposed drug delivery system could be considered as an appropriate potential substitute for currently marketed DTX formulations. Keywords: Ecoflex, nanoparticles, aptamer, electrospraying, pharmacokinetic, ovarian cancer, docetaxel

Background and objective: Posttraumatic stress disorder (PTSD) is one of the anxiety disorders which occurs in response to facing events and accidents accompanied by fear, frustration, and terror. Nurses who worked in the emergency departments witness unpleasant accidents and are exposed to stress and violence more than others. The aim of this study was to investigate the prevalence of PTSD among Iranian nurses working in the emergency department. Materials and Methods: In this cross-sectional study, all nurses working in the emergency department of educational hospitals affiliated with Mazandaran University of Medical Sciences were included through census method (n = 131). Each of the participants in this study responded to the questionnaires individually. The first part of the questionnaire captured demographics, while the second part was the Civilian Mississippi Scale for PTSD, which was used to investigate the extent of PTSD in this study. Data were analyzed using SPSS version 22. Results: In this study, 131 respondents were included. In the classification of age, nurses with 20-30-year- old had the maximum frequency (41.2 %,). Most nurses in the study (93.1%, n = 122) had a bachelor’s degree in nursing and 84 were married. The prevalence of PTSD in emergency nurses was 82.96%, which was higher in nurses with shorter working background and nurses with lower levels of education. Further, the average score of PTSD was higher in married nurses. Conclusion: The results of this study revealed the high prevalence of PTSD among nurses who worked in emergency department. Therefore, it seems that designing and providing supportive and educational services to emergency nurses can be effective for preventing and managing this disorder, which probably can improve their performance.

Abstract Background Lung cancer, accounting for a significant proportion of global cancer cases and deaths, poses a considerable health burden. Non-small cell lung cancer (NSCLC) patients have a poor prognosis and limited treatment options due to late-stage diagnosis and drug resistance. Dysregulated of the mitogen-activated protein kinase (MAPK) pathway, which is implicated in NSCLC pathogenesis, underscores the potential of MEK inhibitors such as binimetinib. Despite promising results in other cancers, comprehensive studies evaluating the safety and efficacy of binimetinib in lung cancer are lacking. This systematic review aimed to investigate the safety and efficacy of binimetinib for lung cancer treatment. Methods We searched PubMed, Scopus, Web of Science, and Google Scholar until September 2023. Clinical trials evaluating the efficacy or safety of binimetinib for lung cancer treatment were included. Studies were excluded if they included individuals with conditions unrelated to lung cancer, investigated other treatments, or had different types of designs. The quality assessment was conducted utilizing the National Institutes of Health tool. Results Seven studies with 228 participants overall were included. Four had good quality judgments, and three had fair quality judgments. The majority of patients experienced all-cause adverse events, with diarrhea, fatigue, and nausea being the most commonly reported adverse events of any grade. The objective response rate (ORR) was up to 75%, and the median progression-free survival (PFS) was up to 9.3 months. The disease control rate after 24 weeks varied from 41% to 64%. Overall survival (OS) ranged between 3.0 and 18.8 months. Notably, treatment-related adverse events were observed in more than 50% of patients, including serious adverse events such as colitis, febrile neutropenia, and pulmonary infection. Some adverse events led to dose limitation and drug discontinuation in five studies. Additionally, five studies reported cases of death, mostly due to disease progression. The median duration of treatment ranged from 14.8 weeks to 8.4 months. The most common dosage of binimetinib was 30 mg or 45 mg twice daily, sometimes used in combination with other agents like encorafenib or hydroxychloroquine. Conclusions Only a few studies have shown binimetinib to be effective, in terms of improving OS, PFS, and ORR, while most of the studies found nonsignificant efficacy with increased toxicity for binimetinib compared with traditional chemotherapy in patients with lung cancer. Further large-scale randomized controlled trials are recommended.

Background and purpose: Trauma to the knee is one of the most common injuries in people, especially young people, and delay in the diagnosis of knee fractures and soft tissue injuries in the knee causes limitation of movement, instability, and constant knee pain. In this research can show the correlation between the initial symptoms of the patients and the need for further procedures. To be able to identify traumatic knee injuries that are not clear in the simple knee radiography and to evaluate the findings of the patients for further procedure. Materials and methods: This research is an observational study in which all patients who presented with knee trauma during the course of the study were included in the study. All the information of these patients in a form including age, age group and sex, admission and discharge information such as visit date, discharge date, duration of hospitalization, mechanism of trauma, underlying disease, knee pain, limitation of range of motion, hemarthrosis, associate injury, skin abrasion, Inability to walk, history of knee trauma, radiography findings, knee CT findings, MRI findings, arthroscopy findings, Lysholm and Tegner knee score, probable diagnosis in the emergency room, type of treatment the emergency room, duration of hospitalization in the emergency room, discharge from the emergency room, in The hospitalization form of the performed procedures, the time of hospitalization in the ward and the definitive diagnosis were collected, and then 4 weeks after discharge, they were followed up by phone call with referral to the orthopedic clinic, and other diagnostic and therapeutic measures were reviewed in these patients. The information was provided by the project manager without interfering in the patient care process. Quantitative data were expressed as mean and standard deviation and qualitative data were expressed as frequency and percentage. Independent student t-tests were used to evaluate quantitative variables in two groups, and the Chi-Square test and Fisher's exact test were used to evaluate qualitative variables. Results: During the study period, 177 people were studied. The average age of the patients was 24.21±13.08, of which 138 (76.7%) were men. Most of the injury was caused by traffic accidents. The initial diagnosis in the emergency department had a significant relationship with the definite diagnosis. A statistically significant relationship was seen between MRI findings with knee movement limitation and non-weight bearing. There was a statistically significant relationship between the existence of definitive injury in the knee, limitation of knee movement, lacerations and scratches on the knee, and non-weight bearing. The mechanism of knee injury and laceration, the inability to weight bearing, and the positive findings of X-ray and MRI in the patients who underwent invasive procedures were significantly different from those who received conservative treatment. Conclusion: Injury mechanisms in patients and clinical symptoms such as knee range of motion limitation and non-weigh bearing and abrasion or laceration of the skin on the knee, despite the lack of findings in the initial investigations in the emergency department, is a high chance of injury to the knee joint and they need further evaluation and follow-up.

Autophagy is a ubiquitous process through which damaged cytoplasmic structures are recycled and degraded within cells. Aging can affect autophagy regulation in different steps leading to the accumulation of damaged organelles and proteins, which can contribute to cell dysfunction and death. Motor neuron (MN) loss and sarcopenia are prominent features of neuromuscular aging. Previous studies on phrenic MNs showed increased levels of the autophagy proteins LC3 and p62 in 24 month compared to 6 month old mice, consistent with the onset of diaphragm muscle sarcopenia. In the present study, we hypothesized that aging leads to increased expression of the autophagy markers LC3 and p62 in single lumbar MNs. Expression of LC3 and p62 in lumbar MNs (spinal levels L1-L6) was assessed using immunofluorescence and confocal imaging of male and female mice at 6, 18 and 24 months of age, reflecting 100 %, 90 % and 75 % survival, respectively. A mixed linear model with animal as a random effect was used to compare relative LC3 and p62 expression in choline acetyl transferase-positive MNs across age groups. Expression of LC3 and p62 decreased in the white matter of the lumbar spinal cord with aging, with ~29 % decrease in LC3 and ~ 7 % decrease in p62 expression at 24 months of age compared to 6 months of age. There was no change in LC3 or p62 expression in the gray matter with age. LC3 expression in MNs relative to white matter increased significantly with age, with 150 % increase at 24 months of age compared to 6 months of age. Similarly, p62 expression in MNs relative to white matter increased significantly with age, with ~14 % increase at 24 months of age compared to 6 months of age. No effect of sex or MN pool was observed in LC3 and p62 expression in MNs. Overall, these data suggest autophagy impairment during elongation (increased LC3) and degradation (increased p62) phases with aging in lumbar MNs.

Homogeneous Charge Compression Ignition (HCCI) engine is a promising idea to reduce fuel consumption and engine emissions. Natural Gas (NG), usually referred as clean fuel, is an appropriate choice for HCCI engines due to its suitable capability of making homogenous mixture with air. However, varying composition of Natural Gas strongly affects the auto-ignition characteristics of in-cylinder mixture and the performance of the HCCI engine. This paper has focused on the influence of Natural Gas composition on engine operation in HCCI mode. Six different compositions of Natural Gas (including pure methane) have been considered to study the engine performance via a thermo-kinetic zero-dimensional model. The simulation code covers the detailed chemical kinetics of Natural Gas combustion, which includes Zeldovich extended mechanism to evaluate NOx emission. Validations have been made using experimental data from other works to ensure the accuracy needed for comparison study. The equivalence ratio and the compression ratio are held constant but the engine speed and mixture initial temperature are changed for comparison study. Results show that the peak value of pressure/temperature of in-cylinder mixture is dependent of fuel Wobbe number. Furthermore, engine gross indicated power is linearly related to fuel Wobbe number. Gross indicated work, gross mean effective pressure, and NOx are the other parameters utilized to compare the performance of engine using different fuel compositions. Le moteur HCCI (Homogeneous Charge Compression Ignition, ou à allumage par compression d’une charge homogène) est une idée prometteuse pour réduire la consommation de carburant et les émissions polluantes. Le gaz naturel, considéré généralement comme un carburant propre, est un choix approprié pour les moteurs HCCI en raison de sa capacité à former avec l’air un mélange homogène. Cependant, la composition du gaz naturel influe fortement sur les caractéristiques d’auto-inflammation du mélange dans le cylindre et la performance du moteur HCCI. Cet article met l’accent sur l’influence de la composition du gaz naturel sur le fonctionnement du moteur en mode HCCI. Six différentes compositions de gaz naturel (y compris le méthane pur) ont été examinées pour étudier les performances du moteur au moyen d’un modèle thermo-cinétique zéro-dimensionnel. Le code de simulation inclut la cinétique chimique détaillée de la combustion du gaz naturel, y compris le mécanisme étendu de Zeldovich pour évaluer les émissions de NOx. Les résultats ont été validés par comparaison avec des données expérimentales provenant d’autres travaux. La richesse et le taux de compression ont été maintenus constants, mais les effets de la vitesse du moteur et de la température initiale du mélange ont été étudiés. Les résultats montrent que la valeur maximale de la pression dans le cylindre et la température dépendent du nombre Wobbe du carburant. En outre, la puissance indiquée du moteur est linéairement liée au nombre Wobbe du carburant. Le travail indiqué brut, la pression moyenne indiquée brute et les NOx ont aussi été utilisés pour comparer les performances du moteur utilisant des carburants de compositions différentes.

IntroductionFunctional magnetic resonance imaging (fMRI) has become a fundamental tool for studying brain function. However, the presence of serial correlations in fMRI data complicates data analysis, violates the statistical assumptions of analyses methods, and can lead to incorrect conclusions in fMRI studies.MethodsIn this paper, we show that conventional whitening procedures designed for data with longer repetition times (TRs) (>2 s) are inadequate for the increasing use of short-TR fMRI data. Furthermore, we comprehensively investigate the shortcomings of existing whitening methods and introduce an iterative whitening approach named “IDAR” (Iterative Data-adaptive Autoregressive model) to address these shortcomings. IDAR employs high-order autoregressive (AR) models with flexible and data-driven orders, offering the capability to model complex serial correlation structures in both short-TR and long-TR fMRI datasets.ResultsConventional whitening methods, such as AR(1), ARMA(1,1), and higher-order AR, were effective in reducing serial correlation in long-TR data but were largely ineffective in even reducing serial correlation in short-TR data. In contrast, IDAR significantly outperformed conventional methods in addressing serial correlation, power, and Type-I error for both long-TR and especially short-TR data. However, IDAR could not simultaneously address residual correlations and inflated Type-I error effectively.DiscussionThis study highlights the urgent need to address the problem of serial correlation in short-TR (< 1 s) fMRI data, which are increasingly used in the field. Although IDAR can address this issue for a wide range of applications and datasets, the complexity of short-TR data necessitates continued exploration and innovative approaches. These efforts are essential to simultaneously reduce serial correlations and control Type-I error rates without compromising analytical power.

Abstract Considering that interventions related to lifestyle, especially nutrition have been proposed as the first line of prevention and treatment of polycystic ovarian syndrome (PCOS), and regarding the proven relationship between PCOS and inflammation, the present study was designed to find out the possible association of Diet Inflammatory Index (DII) with the inflammatory markers like C-reactive protein (CRP) and Interleukin-6 (IL-6), and compare the obtained results in PCOS and non-PCOS women. This case–control study was conducted on 45 PCOS and 40 non-PCOS women. Food intake and DII were measured using a 147-item Food Frequency Questionnaire. All participants were tested for the serum levels of IL-6 and CRP. Finally, the obtained results were compared between the two groups of PCOS and non-PCOS women. Significant differences were observed between the two groups in terms of age, menstrual status and number of pregnancies (P 0.05). The difference of DII between the case and control groups were not significant and Pearson's correlation test did not show a significant correlation between DII and IL-6 (P˃0.05). This result can be due to the influence of several factors affecting the determination of DII such as education level, health status, physical activity level, age, and calorie intake. It seems that diet, especially consumption of more carbohydrates plays a role in causing chronic inflammation, as well as the occurrence and exacerbation of PCOS.

Background: Tubal ligation (TL) with more than 99% effectiveness considered an irreversible contraceptive method among many couples. Objectives: This study was conducted to identify the challenges and problems of women after tubal ligation (TL) and its physical, psychosocial and familial consequences of this method with a qualitative study. Methods: This descriptive qualitative study was conducted on 14 sterilized women between the ages of 25 and 40 from March to October 2017 in Rasht, Iran. The participants were selected with a purposeful method. Semi-structured interviews were used to collect data. Qualitative data were analyzed using conventional content analysis. Results: The experiences of sterilized women were classified into six main themes: dissatisfaction with sexual and marital life, regret, feelings of resentment and physical-emotional damage, menstrual disorder, feelings of low self-esteem and changes in female identity, disruption of social interactions. Conclusion: Sterilized women experienced a wide range of physical, familial, sexual, and social problems after TL. Therefore, it is necessary to provide effective counseling regarding the positive and negative complications of this method when proposing sterilization.

Dear Editor-in-Chief Monkeypox is a global public health concern that needs serious attention to prevent it from spreading worldwide and encountering a new pandemic like COVID-19 again. Since the 1970s, monkeypox has been endemic in several African countries, but the biggest outbreak of monkeypox started in May 2022 in non-endemic countries (1). On June 23, 2022, the World Health Organization (WHO) declared monkeypox an "emerging threat of moderate public concern" due to the observation of more than 3,000 cases of monkeypox in more than 50 countries from five regions of the world in less than three months (2). Although monkeypox is a mild and self-limiting disease, it can cause severe consequences in pregnant women, children, and immunocompromised individuals (1). In this article, the authors described the epidemiology and clinical features of monkeypox and chickenpox in order to better equip clinicians and public health specialists to provide a correct and timely diagnosis.

Due to the fact that the use of nanomaterial technology has expanded in recent years in tissue culture studies, the present study is based on the use of graphene nanomaterials and has been studied its derivatives such as graphene oxide and graphene oxide with putrescine in different levels of Ammonium nitrate was studied for increase microtuberization efficiency . This study was performed with aim of to induce suitable environmental conditions for microtuberization and stimulate anatomical and biochemical changes for in vitro conditions on potato microtuberization of Agria cultivar.The general purpose of using these compounds is to increase the osmotic potential, as well as the possibility of increasing the amount of starch grains in cells by using these nanomaterials.Nitrogen content of control medium included control, 50 and 25 percent of nitrogen of MS medium. Graphene treatments were used as control (without graphene oxide), 25 and 50 mg / l graphene oxide (alone) and 25 and 50 mg / l graphene oxide with putrescine. In this experiment, the number of microtuber in the first, second and final month microtuber, as well as the number of microtuber sproute, number of eyes, average microtuber weight, diameter of microtubers and microtubers yield were evaluated.The results showed that the most positive response to microtuberization was obtained in treatments with 25 percent nitrogen and graphene oxide with putrecsine treatments. It was also observed that the reduction of 25 percent of the culture medium nitrogen and the addition of graphene oxide with putrescine increased the final microtuberization, while the microtuberization in the control treatment (without nitrogen reduction and without graphene oxide) showed the lowest percentage. On the other hand, the results showed that 25 percent nitrogen and 50 mg / l graphene oxide with putrescine had the highest average microtuber weight (39 mg) compared to the lowest average microtuber weight (graphene oxide with putrescine without nitrogen reduction treatment) that Showed 240 percent increase in microtuber weight. In general, the use of graphene oxide with putrescine and 25 percent nitrogen could have positive effects on the microtuberization.The general results showed that reducing the amount of nitrogen in the culture medium increases the amount of microtuberization and also its effective the use of graphene and graphene oxide with putrescine in microtuberization. The results of this experiment showed that the culture medium containing 25% nitrogen and graphene oxide with putrescine were the most suitable treatments for this experiment.

Introduction: This research aimed to provide a model for empowering the academic staff members to enhance medical sciences.Methods: This research had a mixed-method design (qualitative and quantitative). The statistical population for the qualitative part included start-up experts, and the quantitative part included all academic staff members working in the medical units of the Islamic Azad University of Tehran. In the qualitative part of the study, a purposive sampling approach was utilized to select participants. On the other hand, a randomly clustered sampling technique was employed for the quantitative part to ensure a representative sample. The research tool consisted of a semi-structured interview and a researcher-made Likert-scale questionnaire. T-test and multivariate regression were computed using SPSS 23.Results: The effect of various components on empowerment, listed in order of priority based on the beta coefficients, is as follows: marketing and commercialization of knowledge (β=0.354), attracting business elites (β=0.306), knowledge sharing (β=0.265), analysis of financial risk (β=0.143), formation of business support association (β=0.111), value design and use of new technologies (β=0.075), financial and legal support of the government (0.066) =β), environmental changes (β=0.056), increasing value-creating activities (β=0.044), infrastructure provision (β=0.037), and discussion about startups (β=0.024).Conclusion: The effectiveness of business activities in the competitive landscape of launching start-ups is enhanced through the empowerment of academic staff members. Empowered academic staff members enable managers to clearly understand their organization's position and make informed decisions in response to the prevailing conditions. This empowerment enables them to identify the appropriate application areas and take strategic steps towards developing medical knowledge.

This study aimed to develop and evaluate the ARM (arm repetitive movement) algorithm using inertial measurement unit (IMU) data to assess repetitive arm motion in manual wheelchair (MWC) users in real-world settings. The algorithm was tested on community data from four MWC users with spinal cord injury and compared with video-based analysis. Additionally, the algorithm was applied to in-home and free-living environment data from two and sixteen MWC users, respectively, to assess its utility in quantifying differences across activities of daily living and between dominant and non-dominant arms. The ARM algorithm accurately estimated active and resting times (>98%) in the community and confirmed asymmetries between dominant and non-dominant arm usage in in-home and free-living environment data. Analysis of free-living environment data revealed that the total resting bout time was significantly longer (P = 0.049) and total active bout time was significantly shorter (P = 0.011) for the non-dominant arm. Analysis of active bouts longer than 10 seconds showed higher total time (P = 0.015), average duration (P = 0.026), and number of movement cycles per bout (P = 0.020) for the dominant side. These findings support the feasibility of using the IMU-based ARM algorithm to assess repetitive arm motion and monitor shoulder disorder risk factors in MWC users during daily activities.