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Context: Telomeres maintain chromosome stability and mark cellular aging, and their shortening with age compromises genomic stability., Objective: The purpose of this study was to conduct a meta-analysis of existing evidence to evaluate the relationship between the maternal pregnancy body mass index (BMI) and children's telomere length (TL)., Data Source: Web of Science, Scopus, and PubMed databases were systematically searched from their inception to August 27, 2023, for pertinent observational studies., Data Extraction: The random-effects meta-analysis was conducted on eligible studies that investigated the linear relationship between exposure and the outcomes of interest, utilizing the reported β-coefficient. Cochran's Q test and I2 statistics were used to assess heterogeneity., Data Analysis: A significant association was observed between maternal pregnancy BMI and children's TL (32 studies, pooled effect size [ES]: -0.04; 95% CI: -0.06 to -0.01; I2 = 47.51%, P < .001) and maternal prepregnancy BMI and children's TL at birth (16 studies; pooled ES: -0.05; 95% CI: -0.08 to -0.02; I2 = 53.49%, P < .001)., Conclusion: The findings indicate an inverse association between maternal prepregnancy BMI and TL in infants, which is evident within the normal to obese BMI range. This underscores the significance of maternal weight status before pregnancy as a determinant of offspring TL., Systematic Review Registration: PROSPERO registration no. CRD42023466425., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Hepatocellular carcinoma (HCC) is a prevalent type of primary liver cancer and one of the leading causes of cancer-related mortality worldwide. Antivascular Ultrasound (AVUS) is a novel therapy approach that utilizes the mechanical and thermal interactions between ultrasound and microbubbles to disrupt tumor vasculature or potentiate effects of chemotherapy or radiation therapy in a dose-dependent fashion. In this review, we aim to illustrate the mechanisms of AVUS, focusing on the preclinical and clinical evidence of AVUS applications in HCC., Methods: Peer-reviewed publications pertaining to the use of AVUS in HCC were collected and analyzed., Results: 12 preclinical studies and 1 clinical trial were analyzed. At lower energy levels, AVUS can enhance tumor perfusion, facilitating the delivery of chemotherapy agents and resulting in improved therapeutic outcomes. Conversely, at higher energy levels, AVUS can disrupt tumor perfusion, leading to ischemic damage of the tumors. Combining AVUS with other therapeutic approaches, such as chemotherapy, radiation therapy, and transarterial radioembolization (TARE), can synergistically enhance therapeutic outcomes., Conclusions: AVUS is a promising novel treatment modality for HCC. Current evidence suggests that AVUS exhibits a dose-dependent nature, making it a versatile approach that can be effectively combined with other therapeutic regimens. Further clinical studies and long-term follow-ups are needed to establish the optimal clinical protocol and safety profile of AVUS.

Multi-objective optimization holds particular significance for medical applications, wherein enhancing sensitivity is crucial to avoid costly missed diagnoses, and maintaining high specificity is imperative to prevent unnecessary procedures. In particular, when optimizing machine learning architectures for clinical diagnostics, it becomes essential to balance target quality measures such as accuracy, sensitivity, and specificity. Therefore, we developed MOOF, a multi-objective optimization framework that employs NSGA-II and TOPSIS to simultaneously optimize the model parameters of three selected ML algorithms: random forest, support vector machine, and multilayer perceptron. Finally, we evaluated the performance of the optimized MOOF models compared to gold standard methods such as multi-score grid search and single objective optimizations. Our results show that MOOF generally outperforms other approaches by inherently providing optimal solutions, representing the trade-offs between the target objectives. In conclusion, the study supports the importance of multi-objective optimization in medical informatics, with MOOF as a powerful tool for precise ML models, potentially improving patient care and clinical decision support systems.

Purpose: This study aims to investigate and compare quantitative factors of the cesarean scar defect (CSD) in symptomatic patients with and without uterine adenomyosis., Method: This study was conducted as a case-control study. Patients who met the inclusion criteria were divided into two groups: with adenomyosis (case) and without adenomyosis (control). The demographic data, medical history, and sonohysterography findings were extracted from the patient's documents and archived images., Result: During 2 years, 310 symptomatic women with a history of previous cesarean section underwent sonohysterography. Among them, 204 patients met the inclusion criteria. The most common chief complaints were post-menstrual bleeding (34.3%) and prolonged bleeding (27%). Cesarean scar depth and width significantly differed between these two groups, and patients with underlying adenomyosis had significantly larger defects (P-value of .009 and .005, respectively). Mean RMT/AMT ratio was 31.83% in the case group and 42.88% in the control group. In our study, RMT/AMT ratios were significantly lower in the case group (P-value of .001). In addition, we performed analysis on a subgroup of patients with one prior cesarean section. Similar results were achieved with a lower RMT/AMT ratio in case group (mean of 31.20% in case group and 46.47% in control group; P-value of .000)., Conclusion: Our study showed a strong association between the presence of adenomyosis and larger clinically more significant CSDs. To establish a causative relationship, we suggest a prospective cohort study to follow up the patients and compare the evolution of CSD in patients with and without adenomyosis., (© 2023 American Institute of Ultrasound in Medicine.)

Background: Breast cancer mainly affects women aged >50 years; however, younger women may also have advanced breast cancer, so early detection is important., Purpose: To collect and review the imaging findings of women aged <30 years with breast cancer to find better diagnostic approaches for the early diagnosis of breast cancer in young women., Material and Methods: In this study, 45 patients aged <30 years with a diagnosis of breast cancer were evaluated. Imaging assessments were performed based on ultrasound, mammography, and magnetic resonance imaging (MRI) findings. Finally, the findings were compared with the pathological results., Results: Predominant findings in ultrasound included irregular spiculated mass in 59.4%. In mammography, irregular high-density mass (46.5%) and suspicious micro calcification (42.8%) were the most common findings. In MRI, the predominant feature was a heterogeneous enhancing mass with an irregular shape and irregular margin (81%) with a 45% plateau and 36% washout kinetic pattern. In the pathology assessment, invasive ductal carcinoma was the most common finding (84.4%). All three modalities-MRI, ultrasonography, and mammography-are valuable, with sensitivities of 100%, 93.3%, and 90%, respectively., Conclusion: Ultrasound, mammography, and MRI are highly sensitive and accurate tools for detecting breast cancer lesions in young women. Regular clinical breast examination with breast self-examination, and in suspected cases, ultrasound as the first imaging modality followed by mammography and/or MRI are the preferred diagnostic approach.

Introduction: This study intended to assess the dose length product (DLP), effective cumulative radiation dose (E.D.), and additional cancer risk (ACR) due to a chest CT scan to detect or follow up the Covid-19 disease in four university-affiliated hospitals that used different imaging protocols. Indeed, this study aimed to examine the differences in decision-making between different imaging centers in choosing chest CT imaging protocols during the pandemic, and to assess whether a new diagnostic reference level (DRL) is needed in pandemic situations., Methods: This retrospective study assessed the E.D. of all chest imagings for Covid-19 for six months in four different hospitals in our country. Imaging parameters and DLP (mGy.cm) were recorded. The E.D.s and ACRs from chest CT scans were calculated using an online calculator., Results: Thousand-six hundred patients were included in the study. The mean cumulative dose due to chest CT was 3.97 mSv which might cause 2.59 × 10 -2 ACR. The mean cumulative E.D. in different hospitals was in the range of 1.96-9.51 mSv., Conclusions: The variety of mean E.D.s shows that different hospitals used different imaging protocols. Since there is no defined DRL in the pandemic, some centers use routine protocols, and others try to reduce the dose but insufficiently.In pandemics such as Covid-19, when CT scan is used for screening or follow-up, DLPs can be significantly lower than in normal situations. Therefore, international regularized organizations such as the international atomic energy agency (IAEA) or the international commission on radiological protection (IRCP) should provide new DRL ranges., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Published by Elsevier Ltd.)

Background: Dynamic contrast-enhanced magnetic resonance imaging (MRI) is the modality of choice for the diagnosis of pituitary microadenomas; however, it may be associated with a relatively high false-negative rate, especially in small lesions., Purpose: To evaluate the usefulness of subtraction images for enhancing the visual detection of pituitary microadenomas., Material and Methods: In total, 50 patients with clinically established diagnosis hyperprolactinemia, acromegaly, and Cushing's disease were enrolled. Ten patients referred for brain MRI for reasons other than pituitary abnormality were selected as control group. Routine dynamic MRI of the pituitary gland and obtained subtraction MRI scans were scrutinized separately on different sessions by an experienced radiologist blinded to the study design and patient's data. The investigator's opinion on the presence or absence of a lesion and lesion size were collected., Results: In patients with pituitary microadenoma, dynamic MRI images were reported positive in 42 (84%) patients and negative in 8 (16%). Subtraction images were described as positive in all patients (100%)-including all patients with negative dynamic MRI-and the difference was statistically significant ( P =0.016). Undetected lesions on dynamic MRI had a mean size of 2.84 ± 1.79 mm (median= 2.20 mm, interquartile range=1.62-4.62 mm) and a significant inverse correlation was noted between lesion size and negative report of dynamic MRI ( P =0.018). Brain MRI scans in the control group were reported negative for pituitary microadenoma in both dynamic contrast-enhanced and subtraction images., Conclusion: Subtraction images can successfully identify all lesions detectable with conventional dynamic MRI as well as improving visualization of lesions undetected on dynamic MRI, especially in small lesions.

Aims: It has been revealed that membrane androgen receptor activation modulates avoidance memory and synaptic plasticity. In a previous study, we showed that Calcineurin, a calcium dependent phosphatase, could be a potential mediator of these AR effects. Also, it is reported that AR activation leads to L-type calcium channel activation. The aim of the current study is to test whether L-type calcium channels are downstream of AR and whether this signal pathway mediates the impairment effect of androgenic steroids on passive avoidance memory and synaptic plasticity., Materials and Methods: We measured the effect of Nandrolone Decanoate (AR agonist), AR antagonist (Nilutamide) plus ND or L-type calcium channel inhibitor (Nifedipine) plus ND on passive avoidance performance of adolescent male rats. For extracellular field potential recordings hippocampal slices were perfused with ND, Nilutamide-ND or Nifedipine-ND., Key Findings: Our results clarified that AR activation by ND could impair avoidance behavior as step through latency decreased in ND-treated group while application of both Nilutamide and Nifedipine reestablished normal avoidance behavior. Also, LTP induction in the CA1 area of hippocampus was diminished by ND perfusion and both AR antagonist and L-type calcium channel inhibitor application lead to normal LTP. These findings support our hypothesis that activation of L-type calcium channels are involved in ARs mechanism effects on both avoidance behavior and hippocampal synaptic plasticity., Significance: Understanding the biological effects of AR agonists on cognitive processes and its cellular mechanism may be a new/supplementary way to treating fear-related disorders., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2022. Published by Elsevier Inc.)

Background: Patient absconding from hospital is one of the permanent issues the hospitals face, which poses many risks and challenges to the patient, hospital, and society. The present study aimed to identify the reasons for patient absconding behavior for public hospitals in southeastern Iran., Methods: The present study is a qualitative study which was conducted at three public hospitals in southeastern Iran using purposive sampling through semi-structured interviews with 63 informants involved in patient treatment process. Data were analyzed using Colaizzi content analysis (CCA) method., Results: Three main themes of economic, social factors, and factors related to the hospital covering 15 subthemes were identified to explain the reasons for patients absconding behavior., Conclusion: There are many reasons for reducing patients absconding from hospitals, and one of the main reasons is the patients' economic and social problems. The absconding behavior can lead to harm and problems for patients, and some emotional and occupational consequences for the employees and nurses. Paying attention to this issue and considering some courses of action to prevent patient absconding might lead to a considerable promotion of public trust and eliminate many problems for hospitals.

We propose a device for monitoring the number of people who are physically present inside indoor environments. The device performs local processing of infrared array sensor data detecting people's direction, which allows monitoring users' occupancy in any space of the building and also respects people privacy. The device implements a novel real-time pattern recognition algorithm for processing data sensed by a low-cost infrared (IR) array sensor. The computed information is transferred through a Z-Wave network. On-field evaluation of the algorithm has been conducted by placing the device on top of doorways in offices and laboratory rooms. To evaluate the performance of the algorithm in varying ambient temperatures, two groups of stress tests have been designed and performed. These tests established the detection limits linked to the difference between the average ambient temperature and perturbation. For an in-depth analysis of the accuracy of the algorithm, synthetic data have been generated considering temperature ranges typical of a residential environment, different human walking speeds (normal, brisk, running), and distance between the person and the sensor (1.5 m, 5 m, 7.5 m). The algorithm performed with high accuracy for routine human passage detection through a doorway, considering indoor ambient conditions of 21-30 °C.

Knowledge of heat-tolerant/sensitive cultivars based on morpho-physiological indicators and an understanding of the action and interaction of different genes in the molecular network are critical for genetic improvement. To screen these indicators, the physiological performance of two different varieties of white and red cabbages ( B. oleracea var. capitate f. alba and f. rubra , respectively) under heat stress (HS) and non-stress (NS) was evaluated. Cultivars that showed considerable cell membrane thermostability and less reduction in chlorophyll content with better head formation were categorized as the heat-tolerant cultivars (HTC), while those with reduction in stomatal conductance, higher reduction incurred in chlorophyll and damage to thylakoid membranes are categorized as the heat-sensitive cultivars (HSC). Expression profiling of key genes in the HS response network, including BoHSP70 (HEAT SHOCK PROTEIN 70), BoSCL13 (SCARECROW-LIKE 13) and BoDPB3-1 (transcriptional regulator DNA POLYMERASE II SUBUNIT B3-1 (DPB3-1))/NUCLEAR FACTOR Y SUBUNIT C10 (NF-YC10), were evaluated in all cultivars under HS compared to NS plants, which showed their potential as molecular indicators to differentiate HTC from HSC. Based on the results, the morphophysiological and molecular indicators are applicable to cabbage cultivars for differentiating HTC from HSC, and potential target genes for genome editing were identified for enhancing food security in the warmer regions of the world.

Background: The cognitive impairment in patients with generalized epilepsy may affect their social efficiency and quality of life (QOL). The aim of this study is to determine the cognitive dysfunction and related risk factors in patients with generalized epilepsy as compared to patients with non-epileptic neurological disorders. Methods: In the present descriptive cross-sectional study, the cognitive function was assessed by Montreal Cognitive Assessment (MoCA) test in 62 patients with generalized epilepsy and also 62 patients with non-epileptic neurological diseases who referred to the Neurology Clinic, Semnan University of Medical Sciences, Semnan, Iran. The relationship between cognitive impairment and related risk factors was also investigated. The data were analyzed by SPSS software. Results: The mean score of MoCA in the patients with generalized epilepsy and the control group was 22.80 ± 4.14 and 26.48 ± 2.85, respectively (P < 0.050). The results indicated significantly lower MoCA scores in the epileptic group rather than the non-epileptic one (P < 0.001). Moreover, there was a significant relationship between MoCA score and age, education level, living place, the dose and rate of medicines, and the number of seizures in patients with epilepsy (P < 0.001). Gender and the duration of disease had no significant effects on the cognitive impairment of patients with epilepsy (P > 0.05). Conclusion: Patients with epilepsy had a significant cognitive impairment as compared to the patients with non-epileptic neurological disorders. Age, education level, living place, the dose and rate of medicines, and the number of seizures were the risk factors of cognitive impairment in the patients with epilepsy, while duration of disease and gender had no effects on the intensity of cognitive deficits., (Copyright © 2020 Iranian Neurological Association, and Tehran University of Medical Sciences Published by Tehran University of Medical Sciences.)

Clustered regularly interspaced short palindromic repeat (CRISPR) and Cas9-associated protein systems provide a powerful genetic manipulation tool that can drive plant research forward. Nuclease-dead Cas9 (dCas9) is an enzymatically inactive mutant of Cas9 in which its endonuclease activity is non-functional. The applications of CRISPR/dCas9 have expanded and diversified in recent years. Originally, dCas9 was used as a CRISPR/Cas9 re-engineering tool that enables targeted expression of any gene or multiple genes through recruitment of transcriptional effector domains without introducing irreversible DNA-damaging mutations. Subsequent applications have made use of its ability to recruit modifying enzymes and reporter proteins to DNA target sites. In this paper, the most recent progress in the applications of CRISPR/dCas9 in plants, which include gene activation and repression, epigenome editing, modulation of chromatin topology, live-cell chromatin imaging and DNA-free genetic modification, will be reviewed. The associated strategies for exploiting the CRISPR/dCas9 system for crop improvement with a dimer of the future of the CRISPR/dCas9 system in the functional genomics of crops and the development of traits will be briefly discussed., (© 2019 The Authors. Plant Biotechnology Journal published by Society for Experimental Biology and The Association of Applied Biologists and John Wiley & Sons Ltd.)

Development of in vitro plant regeneration method from Brassica explants via organogenesis and somatic embryogenesis is influenced by many factors such as culture environment, culture medium composition, explant sources, and genotypes which are reviewed in this study. An efficient in vitro regeneration system to allow genetic transformation of Brassica is a crucial tool for improving its economical value. Methods to optimize transformation protocols for the efficient introduction of desirable traits, and a comparative analysis of these methods are also reviewed. Hence, binary vectors, selectable marker genes, minimum inhibitory concentration of selection agents, reporter marker genes, preculture media, Agrobacterium concentration and regeneration ability of putative transformants for improvement of Agrobacterium-mediated transformation of Brassica are discussed.