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Indocyanine green (ICG) fluorescence angiography has emerged as an intraoperative method to accurately assess real-time tissue vascularity, perfusion and anastomotic patency in flap surgery. We illustrate a complex case of elbow reconstruction in an elderly patient with a free anterolateral thigh flap, which relied on intraoperative ICG to evaluate the flap pedicle and map the site of arterial occlusion. Supermicrosurgical instrumentation was employed to perform complex perforator-to-perforator anastomosis following resection of the vascular site of the lesion. These unique applications in a patient of known surgical risk enabled immediate flap salvage, and after 6 months postoperatively, the flap remained healthy with adequate wound healing.

Abstract In this randomized controlled trial, we assessed the effects of three consecutive intra-silicone oil (SO) injections of methotrexate (MTX) on the outcomes of surgery for proliferative vitreoretinopathy grade C (PVR-C). Seventy-four eyes of 74 patients with PVR-C were included. Of these, 37 eyes were assigned to the MTX group and 37 eyes to the control group. Fourteen patients failed to comply with the 6-month follow-up period. All eyes underwent vitrectomy and SO injection. In the MTX group, 250 µg MTX was injected into the SO after surgery and at weeks 3 and 6 postoperatively. The primary outcome was the retinal reattachment rate at 6 months. The secondary outcomes included limited PVR recurrence and adverse events. Retinal reattachment was achieved in 22 eyes (73.3%) in the MTX group and 23 eyes (76.7%) in the control group (difference: -3.4%, 95% CI: -25.2–18.5%). Limited PVR recurrence was observed in one eye (4.5%) in the MTX group versus nine eyes (39.1%) in the control group at 6 months (P = 0.01). No adverse effects were observed. Adjunctive treatment with three consecutive applications of intra-SO MTX did not reveal a significant effect on the retinal re-detachment rate but could statistically significantly reduce limited PVR recurrence. Trial registration: http//ClinicalTrials.gov NCT04482543, 22/07/2020.

Abstract One of the primary challenges faced by generation companies (GenCos), which operate multiple generation units within the electricity market, is the determination of the optimal bid price for these units to maximize profit. This paper proposes a novel approach to ascertain the optimal bid price direction for GenCos by leveraging the gradient vector of the profit function within the constraints of the electricity market. First, the Jacobian matrix of unit profits is computed using the electricity market structural decomposition method. This matrix highlights how the profit of generation units is affected by market input parameters, including the bid prices of the units. Then, the gradient vector of the GenCos' profit function and the optimal bid price direction are derived from the Jacobian matrix. The methodology is applied to a 24‐bus IEEE network, with results validated against those from a simulation method to confirm the efficacy of the proposed approach. The simulation results show that the highest and lowest profit changes with a step increase of 0.1$/MWh are observed for GenCo 4 and GenCo 6 with values of 60.28 and 2.20 $/h, respectively. The proposed approach can be effective in the changes of bid direction of the units of a GenCo to achieve the highest possible profit.

Abstract Objective The primary objective of this systematic review and meta-analysis was to assess the association between iron deficiency anemia (IDA) and retinal changes via optical coherence tomography (OCT). Methods The search was conducted in MEDLINE, Scopus, Embase, Web of Science, and Google Scholar until February 1, 2024. Two independent researchers included the articles based on the inclusion and exclusion criteria. Data regarding the study design, patient characteristics, number of patients with and without IDA, mean and SD of the retinal nerve fiber layer (RNFL), C/D ratio, foveal avascular zone (FAZ) area and perimeter, foveal density and superficial and deep capillary plexus (SCP and DCP) vascular density (VD) were collected. STATA version 17.0 was used to compute pooled measures of the standardized mean difference. I2 and chi-square tests were used to assess heterogeneity between studies. Results We found 1378 nonduplicate studies, 35 of which were potentially relevant. 19 articles met the inclusion criteria and were included in the review. The meta-analysis confirmed that there was a statistically significant association between IDA and RNFL thickness reduction (SMD = -0.76, 95% CI: -1.09 to -0.44 ; p-value = 0.001, I2 = 86.88%), FAZ area (SMD =-0.35, 95% CI: -0.67 to -0.02; p value = 0.04, I2 = 59.76%) and SCP VD (SMD = -1.12, 95% CI: -1.85 to -0.39; p-value = 0.001, I2 = 83.15%). The associations between IDA and the C/D ratio (SMD = 0.07, 95% CI: -0.13 to 0.28; p value = 0.49, I2 = 0.0%) and DCP VD (SMD = -0.30, 95% CI: -0.89 to 0.29; ,p-value = 0.32 ,I2 = 77.20%) were not significant. There was no considerable publication bias. Conclusion The results of this meta-analysis demonstrated that, compared with healthy controls, individuals with IDA presented a thinner RNFL, a smaller FAZ, and lower SCP and DCP vascular densities. However, further studies are needed to reach more conclusive results.

Abstract Objective Sarcopenia is linked to escalating health costs, heightened risk of physical disability, diminished quality of life and an increased demand for care services. This study aimed to assess the economic impact of sarcopenia-related disability in Iran. A prevalence-based economic burden study was conducted utilizing the Population Attributable Risk (PAR) method, based on 2022 price index. Prevalence data for sarcopenia, categorized by gender and disease severity, were extracted from recent comprehensive studies. The relative risk of sarcopenia disability was determined from the most robust available evidence. Subsequently, direct medical costs, direct non-medical costs, and indirect costs for each individual with sarcopenia were computed and adjusted to 2022 values to estimate disability costs. Results Taking into account the prevalence of sarcopenia and the Iranian population across various age groups, 2,192,168 adults aged ≥ 60 years with sarcopenia in Iran were included. The total PAR of sarcopenia for men and women was estimated at 49% and 28%, respectively. The cumulative direct medical costs, direct non-medical costs, and indirect costs amounted to $215.1 million, $7.76 million, and $34.1 million, respectively. Additionally, the average total economic burden of sarcopenia-related disability in Iranian population aged ≥ 60 years was estimated at $257.1 million.

Black mulberry is considered one of the most valuable fruits in complementary medicine, with its fruit, leaves, bark, and roots offering significant benefits in the food industry, cosmetics, and especially in the treatment of various diseases. In traditional medicine, black mulberry and its products have been used to treat pharyngitis, enlarged tonsils, sore throat, oral rashes, and swelling of the tongue. The purpose of this study is to review the therapeutic effects of black mulberry in both complementary medicine and modern research. This study is a review. In this review, traditional Iranian medical texts such as Makhzan Al-Aavieh, Qanun fi Tab, Alshamel, Zakhire Kharazmashahi, Riyaz Al-Adavieh, and pharmacopoeias like Qarabadin Kabir and Qarabadin Halali, along with other traditional medicine books like Summary of Al-Hakamh, Tab Akbari, and Elixir Azam, were examined regarding the habitat, appearance, actions, and therapeutic properties of black mulberry in traditional medicine. Important and effective formulations containing black mulberry were extracted from these pharmacopoeias. To explore recent studies related to the therapeutic effects of black mulberry, relevant articles were searched using Persian and English keywords in domestic and international databases from 2000 to October 2023. Keywords such as "black mulberry," "Morus nigra," "Shahtoot," "Toot siah," "traditional medicine," and "complementary medicine" were used to search databases like SID, Magiran, Irandoc, PubMed, ScienceDirect, DOAJ, and Google Scholar, and both Persian and English articles were reviewed. According to traditional Iranian medicine texts, black mulberry is used to treat mouth ulcers, rashes, plague, and swelling and inflammation of the pharynx, larynx, and tongue. It is also used to strengthen joints, lower blood pressure, treat fever, protect against liver damage, and aid urination. Furthermore, black mulberry paste is recommended for improving nocturnal snoring and dyspnea in children. In Chinese medicine, black mulberry and its various parts have been used to improve symptoms of type 2 diabetes, obesity, lipid disorders, and antimicrobial conditions. Black mulberry is a rich source of polyphenols, including anthocyanins. It has been shown to have one of the highest antioxidant capacities among fruits. In patients with type 2 diabetes, black mulberry products have been found to reduce symptoms such as frequent urination and polyphagia, as well as alleviate neurological complications. Other benefits include increasing HDL levels, reducing LDL, lowering hemoglobin A1C, and decreasing triglycerides. The findings suggest a strong concordance between traditional medicine sources and modern scientific research. Therefore, by examining historical texts and incorporating new scientific discoveries, medicinal products from black mulberry could be developed for the treatment of various diseases.

This study aimed to investigate Iranian pre-service primary teachers' self-efficacy and attitudes toward teaching science during the COVID-19 pandemic. Data were collected through surveys with 360 pre-service primary teachers who completed their Science Education courses through virtual learning platforms. Results showed that the participants had positive attitudes, high science teaching outcome expectancy, and teaching science efficacy. The study also revealed no significant differences in self-efficacy and attitudes toward teaching science based on gender and year of entering the university. However, there was a statistically significant difference in self-efficacy and attitudes based on the type of high school field. Graduates in the Humanities field have a lower average attitude and self-efficacy toward teaching science than participants in the Science field. Additionally, a highly significant positive correlation was observed between pre-service teachers' attitudes and their self-efficacy toward science teaching, suggesting that assessing their attitudes toward science teaching can be a robust predictor of their self-efficacy. These findings underscore the importance of nurturing positive attitudes among pre-service teachers to enhance their confidence and effectiveness in teaching science.

Fluorescence tomography (FT) has become a powerful preclinical imaging modality with a great potential for several clinical applications. Although it has superior sensitivity and utilizes low-cost instrumentation, the highly scattering nature of bio-tissue makes FT in thick samples challenging, resulting in poor resolution and low quantitative accuracy. To overcome the limitations of FT, we previously introduced a novel method, termed temperature modulated fluorescence tomography (TMFT), which is based on two key elements: (1) temperature-sensitive fluorescent agents (ThermoDots) and (2) high-intensity focused ultrasound (HIFU). The fluorescence emission of ThermoDots increases up to hundredfold with only several degree temperature elevation. The exceptional and reversible response of these ThermoDots enables their modulation, which effectively allows their localization using the HIFU. Their localization is then used as functional a priori during the FT image reconstruction process to resolve their distribution with higher spatial resolution. The last version of the TMFT system was based on a cooled CCD camera utilizing a step-and-shoot mode, which necessitated long total imaging time only for a small selected region of interest (ROI). In this paper, we present the latest version of our TMFT technology, which uses a much faster continuous HIFU scanning mode based on an intensified CCD (ICCD) camera. This new, to the best of our knowledge, version can capture the whole field-of-view (FOV) of 50×30m m 2 at once and reduces the total imaging time down to 30 min, while preserving the same high resolution (∼1.3m m) and superior quantitative accuracy (

Objective: This study evaluated the effectiveness of laser Doppler flowmetry (LDF) in detecting perfusion disturbances during microvascular free tissue transfer. Methods: Conducted at a single centre from December 2020 to September 2022, this prospective study involved 71 patients mainly undergoing head and neck free flap reconstructions, using the Pocket LDF™ for continuous perfusion monitoring. Results: Out of the 71 cases, data from 69 cases were analysed after excluding those with significant noise or sensor detachment. Blood flow disturbances were observed in 9 cases (13.0 %), with 5 of these cases with a history of surgery or radiation in the same area. There were 5 cases of ischaemia, 4 of which occurred during monitoring. There were 4 cases of venous congestion, with 1 occurring during monitoring. Re-operation was necessary in 8 cases (11.6 %), involving flap replacements, vascular re-anastomoses and hematoma evacuation. Complete flap necrosis occurred in 5 cases (7.2 %) and partial necrosis occurred in 3 cases (4.3 %). The LDF device demonstrated the ability to identify perfusion issues hours before the clinical symptoms manifested, suggesting its potential for early intervention. However, challenges included maintaining continuous monitoring immediately post-surgery and during patient transfers. Conclusion: LDF is a valuable, non-invasive tool for early detection of perfusion disturbances in free flap procedures. It provides continuous, real-time feedback on microcirculation, facilitating timely interventions. Despite its benefits, enhancements in sensor adhesion and wireless technology are needed to improve monitoring reliability. Further studies are recommended to refine LDF usage and validate its efficacy in various clinical settings.

Objective(s): This study evaluated the necessity of a ventilation scan in patients suspected of PE with a history of COVID-19 infection.Methods: This was a cross-sectional study of patients with PCR-confirmed COVID-19 and suspected PE at a tertiary care hospital in 2020. They underwent ventilation/perfusion (V/Q) scintigraphy using single-photon emission computed tomography/computed tomography (SPECT/CT) and CT scans with or without contrast. Two blinded nuclear medicine physicians interpreted the images for PE and COVID-19. Clinical and laboratory data were extracted and analyzed.Results: 96 patients with suspected PE and COVID-19 infection. The study excluded eight patients who could not undergo ventilation scans and confirmed PE in five patients with multiple mismatched V/Q defects on SPECT/CT. The study ruled out PE in 83 patients who had either regular perfusion scans, perfusion defects with COVID-19 features, or matched V/Q defects. The study found that the prevalence of PE was 5.68%, and the necessity of ventilation scans was 28.40% in this population.Conclusion: It was found that PE was present in 5.68% of the patients, and ventilation scans were needed for 28.40% of the patients to confirm or exclude it.

Abstract Mosquito-borne diseases, such as malaria, dengue, and Zika, pose major public health challenges globally, affecting millions of people. The growing resistance of mosquito populations to synthetic insecticides underscores the critical need for effective and environmentally friendly larvicides. Although chemical pesticides can initially be effective, they often lead to negative environmental consequences and health hazards for non-target species, including humans. This study aimed to evaluate the larvicidal effects of Trachyspermum ammi essential oil and Delphinium speciosum extract on the larvae of three major mosquito species: Aedes aegypti, Anopheles stephensi, and Culex quinquefasciatus. Mosquito larvae of Ae. aegypti, An. stephensi, and Cx. quinquefasciatus were reared under controlled laboratory conditions. The larvicidal activity of T. ammi essential oil and D. speciosum extract was evaluated through standard bioassays, using various concentrations of essential oils (10, 20, 40, 80, and 160 ppm) and extracts (160, 320, 640, 1280, and 2560 ppm) to determine the lethal concentration (LC50) values after 24 h of exposure. Fresh plant materials were collected, with the essential oil extracted via hydro-distillation, and the extract prepared using methanol solvent extraction. The chemical composition of T. ammi essential oil was examined using gas chromatography-mass spectrometry (GC-MS). Additionally, the preliminary analysis of the chemical compounds in D. speciosum extract was carried out using thin layer chromatography (TLC) and nuclear magnetic resonance spectroscopy (NMR) techniques. The results indicated that the essential oil of T. ammi exhibited more effective larvicidal activity compared to the D. speciosum extract. Specifically, the essential oil demonstrated LC50 values of 18 ppm for Cx. quinquefasciatus and 19 ppm for Ae. aegypti. In contrast, the D. speciosum extract showed the strongest larvicidal effect against An. stephensi, with an LC50 of 517 ppm. Concentrations of 40 ppm of the essential oil and 1280 ppm of the extract resulted in 100% mortality across all three species. Both the essential oil of T. ammi and the D. speciosum extract exhibited concentration-dependent larvicidal activity, and these results were statistically significant (p

Abstract Background Late-onset multiple sclerosis (LOMS), defined as the development of MS after the age of 50, has shown a substantial surge in incidence rates and is associated with more rapid progression of disability. Besides, studies have linked tobacco smoking to a higher chance of MS progression. However, the role of smoking on the risk of developing LOMS remains unclear. This study aims to evaluate the possible association between lifetime exposure to cigarette and waterpipe smoking, drug abuse, and alcohol consumption and the risk of LOMS. Methods This population-based case-control study involved LOMS cases and healthy sex and age-matched controls from the general population in Tehran, Iran. The primary data for confirmed LOMS cases were obtained from the nationwide MS registry of Iran (NMSRI), while supplementary data were collected through telephone and on-site interviews. Predesigned questionnaire for multinational case-control studies of MS environmental risk factors was used to evaluate the LOMS risk factors. The study employed Likelihood ratio chi-square test to compare qualitative variables between the two groups and utilized two independent sample t-test to compare quantitative data. Adjusted odds ratio (AOR) for age along with 95% confidence intervals (CI) were calculated using matched logistic regression analysis in SPSS 23. Results Totally, 83 LOMS cases and 207 controls were included in the analysis. The female to male ratio in the cases was 1.5: 1. The mean ± SD age of 83 cases and 207 controls was 61.14 ± 5.38) and 61.51 ± 7.67 years, respectively. The mean ± SD expanded disability status scale (EDSS) score was 3.68 ± 2.1. Although the results of waterpipe exposure had no significant effect on LOMS development (P-value: 0.066), ever cigarette-smoked participants had a significantly higher risk of developing LOMS than those who never smoked (AOR: 2.57, 95% CI: 1.44–4.60). Furthermore, people with a history of smoking for more than 20 years had 3.45 times the odds of developing MS than non-smokers. Drug and alcohol abuse were both associated with LOMS in our study; of which opioids (AOR: 5.67, 95% CI: 2.05–15.7), wine (AOR: 3.30, 95% CI: 1.41–7.71), and beer (AOR: 3.12, 95% CI: 1.45–6.69) were found to pose the greatest risk of LOMS, respectively. Conclusion For the first time, we identified smoking, drug, and alcohol use as potential risk factors for LOMS development. According to the global increase in cigarette smoking and alcohol use, these findings highlight the importance of conducting interventional approaches for prevention.

Fraud (Tadlīs) refers to deceit that occurs when a defect is concealed, or a non-existent perfection is attributed to the subject of a contract. At the same time, the option of defect and the option of breach of description arise due to the presence of an existing defect and a failure to fulfill the agreed-upon description, respectively. This shared characteristic might make distinguishing between these options in similar cases difficult and lead to errors in the application of the relevant legal rules. However, most legal scholars distinguish fraud from the option of defect and the option of breach of description by considering the element of intent and willful deception, treating the relationship between them as one of generality and specificity from a particular perspective. Nonetheless, from a jurisprudential perspective, such a view seems to conflict with the purpose of the Sharia in establishing options to compensate for the damage caused, and in some cases, it may result in the failure to compensate the harmed party. Therefore, in order to fulfill the Sharia’s objective of ensuring compensation for the injured party, we have sought to examine the nature, effects, and rules of each of the mentioned options in order to accurately explain the relationship and possible differences between them.

Objective: Diabetes and thyroid disorders (TD) are two prevalent endocrine conditions in adults. While the association between TD and type 1 diabetes is well documented, the relationship between type 2 diabetes mellitus (T2DM) and TD remains unclear due to its complex mechanisms and the involvement of multiple variables. This study aimed to evaluate the prevalence of TD in patients with T2DM referred to Yazd Diabetes Research Center in 2019. Materials and Methods: This cross-sectional descriptive study included 411 patients with T2DM. Data were collected using a checklist comprising demographic information (age, sex, type of drug used, duration of diabetes) and clinical and laboratory information. Data were analyzed using SPSS version 24 software. Results: Among the 411 patients with T2DM, 352 (85.6%) had no TD, 38 (9.24%) had hypothyroidism, and 21 (5.10%) had hyperthyroidism. There were no significant differences among groups in terms of gender (P= 0.269), age (P= 0.154), fasting blood sugar (FBS) level (P= 0.196), type of treatment (P= 0.9), and duration of T2DM (P= 0.138). However, a significant relationship was found between TD and the average level of glycosylated hemoglobin (HbA1c) (P= 0.021). Conclusion: This study highlights a significant prevalence of TD among patients with T2DM, particularly noting the impact on HbA1c levels. Regular screening for TD in patients with T2DM is recommended to improve glycemic control and overall diabetes management. Further research is needed to elucidate the mechanisms linking TD and T2DM and to develop targeted interventions.

Objective: Type 2 Diabetes mellitus (T2DM) is the most prevent metabolic disease. Gender differences are important in the epidemiology, pathophysiology, and treatment of many diseases. The aim of this study is to investigate the gender effect on laboratory variables and complications in patients with T2DM. Materials and Methods: In this descriptive cross-sectional study, patients with T2DM between 35 -65 years old who referred to Diabetes Research Center, Yazd, Iran during 2018-2019 were studied. Demographic features and clinical information of patients were extracted from patients' medical records. All information and variables were examined in two groups according to gender and the data were analyzed using SPSS 19. Results: Totally, 1931 patients were enrolled in the study (988 females and 943 males). Most of the patients (68.6%) were treated with insulin. Body mass index was higher in women than in men. The variables of LDL (P= 0.029), triglyceride (P< 0.001) and retinopathy (P= 0.021), were significantly different between men and women. Conclusion: The results of this study showed there are significant differences between male and female patients with T2DM in terms of lipid profiles and retinopathy.

Objective(s): Convulsions caused by fever in children and parents not knowing about the nature of this disease cause severe anxiety and inappropriate performance in parents. Due to the cost-effectiveness of the telenursing method, nurses can use it to provide a large amount of information in a short period with distance education. Therefore, the present study was conducted with the aim of determining the effect of telenursing training on the anxiety of mothers with children suffering from febrile convulsions. Methods: This quasi-experimental intervention study was conducted in 2020-2021 among 60 mothers with children suffering from febrile seizures in the hospitals of Birjand, Iran. The sampling method was accessible and then people were randomly divided into two intervention and control groups. After being discharged from the hospital, the intervention group received telenursing (for 2 weeks and 3 sessions each week for 15 minutes via mobile phone and by calling the mothers and sending an educational video). The control group received routine training at discharge. The data collection questionnaire included the demographic and background information and the Spielberger anxiety questionnaire. The Spielberger questionnaire was completed at the beginning and after the end of the intervention. SPSS software version 16 and paired t, independent t and chi-square statistical tests were used for data analysis. Results: Stait and trait anxiety before the intervention was not significant between the control and intervention groups (P=0.865 and P=0.153, respectively). There was a statistically significant difference between the two intervention and control groups in Stait and trait anxiety after the intervention, and it was reduced in the intervention group (P

Extended Abstract Background: Considering the complex and dynamic environmental conditions, all firms need to create and apply effective skills for the firm's goals to continue their activities. On the other hand, with the use of new technologies and digital platforms, firms were required to adapt their goals in this direction. One of the variables that can guide firms in the direction of improving performance and is in line with today's technology platform and digital environment is related to technological entrepreneurship because it is a leader in absorbing the value and innovative implementation of science and knowledge and can help the firm to reach directly its goals. Moreover, the use of digital technologies integrates new business ventures into business models and operations, leading to digital entrepreneurship through digital products, tools, and platforms. In this regard, digitalization can accelerate sustainable changes and respond to environmental and governance challenges while improving performance at the same time by accessing opportunities. In a complex and changing world, innovation is a key factor for creating a competitive advantage that requires support and investment because favorable innovation can increase the share of firms. For this reason, this study aimed to investigate the mediating role of digitalization and innovation in the relationship between technological entrepreneurship and the growth of knowledge-based firms active in the fields of biotechnology, agriculture, and food, which has not been noticed in previous studies. Methods: The statistical population of this research includes Iranian knowledge-based firms active in the fields of biotechnology, agriculture, and food. The number of statistical population is equal to 480 firms, and a sample size of 213 units was estimated using Cochran’s formula. Data were collected through a five-level Likert scale questionnaire, and 189 questionnaires were analyzed statistically. Several hypotheses were presented to investigate the relationships between the variables, which were analyzed using the structural equation modeling method. Finally, SPSS24 and SmartPLS3 software were used for data analysis. Results: The output of the software showed that technological entrepreneurship had a positive and significant effect on the firm's growth at a confidence level of 99%. The mediating role of digitalization in the relationship between technological entrepreneurship and firm growth was obtained at a significant level of 99%. In addition, the mediating role of innovation in the relationship between technological entrepreneurship and firm growth was confirmed at the 99% level. Conclusion: The contribution of this study from the analyses is to provide a new conceptual framework to fill the existing gap and provide practical solutions in line with the subject of the studied society. In line with the growth of knowledge-based firms active in the fields of biotechnology, agriculture, and food, this survey used digitalization and innovation variables as mediating variables considering today's complex and dynamic environment. It should be noted that this issue was not investigated in previous studies. The result of the first hypothesis of the research shows that entrepreneurial initiatives facilitate decisions in line with corporate goals. Focusing on entrepreneurship based on strategic processes that deal with long-term goals can also positively affect firm performance, leading to competitive advantage and economic prosperity of firms according to research on technological entrepreneurship capability. Therefore, this study specifically demonstrates that technological entrepreneurship is a key predictive factor for improving the growth of knowledge-based firms active in the fields of biotechnology, agriculture, and food. In line with the result of the second research hypothesis, the government can develop entrepreneurship in the agricultural sector by investing in infrastructures of agriculture and by applying incentive policies, such as removing or discounting taxes for investors. Based on this, knowledge-based firms active in the fields of biotechnology, agriculture, and food, focusing on entrepreneurship with a technological platform, can digitalize their operational, process, and production processes. The results show that an emphasis on digitalization can improve the growth of firms. The result of the third hypothesis of the research shows that knowledge-based companies active in the fields of biotechnology, agriculture, and food can focus on technological entrepreneurship to improve innovation levels in their products and processes, develop performance, and improve their market share. It should be noted that innovation and change have become important sources of competitive advantage for firms, and the desire for entrepreneurship also plays an important role in improving performance and ensuring the source of their growth. In general, this study documents that knowledge-based firms active in the fields of biotechnology, agriculture, and food can invest in technological entrepreneurship activities to positively influence their firm's growth. In the meantime, the existence of digitalization and innovation variables were identified as crucial factors that could strengthen the growth foundations of the studied firms. The results of this research can help knowledge-based firms active in the fields of biotechnology, agriculture, and food in the direction of strategic and technological decisions for firm growth and performance improvement. Based on the results of the hypotheses, this study has provided several practical suggestions, which can be implemented in the studied firms.

Objective(s): Until recently, a conventional chemotherapy regimen for Acute lymphoblastic leukemia (ALL) is considered an efficient therapeutic method in children. However, suboptimal long-term survival rates in adults, disease relapse, and drug-induced toxicities require novel therapeutic agents for ALL treatments. Today, natural products with pharmacological benefits play a significant role in treating different cancers. Among the most valued natural products, honey bees’ royal jelly (RJ) is one of the most appreciated which has revealed anti-tumor activity against different human cancers. This study aimed to evaluate anti-leukemic properties and the molecular mechanisms of RJ cytotoxicity on ALL-derived Nalm-6 cells.Materials and Methods: The metabolic activity was measured by MTT assay. Apoptosis, cell distribution in the cell cycle, and intracellular reactive oxygen species (ROS) level were investigated using flow cytometry analysis. Moreover, quantitative real-time PCR (qRT-PCR) was performed to scrutinize the expression of various regulatory genes. Results: RJ significantly decreased the viability of Nalm-6 cells but had no cytotoxic effect on normal cells. In addition, RJ induced ROS-mediated apoptosis by up-regulating pro-apoptotic genes while decreasing anti-apoptotic gene expression. The results outlined that ROS-dependent up-regulation of FOXO4 and Sirt1 inhibits the cells’ transition to the S phase of the cell cycle through p21 up-regulation. The qRT-PCR analysis of autophagy-related gene expression also demonstrated that RJ induced BECN1 mediated autophagy in Naml-6 cells.Conclusion: Taken together, this study showed that RJ can be utilized as a potent natural substance to induce ALL cells’ programmed cell death. However, further studies are required to examine this compound’s pharmaceutical application.

Wireless capsule endoscopy (WCE) is capable of non-invasively visualizing the small intestine, the most complicated segment of the gastrointestinal tract, to detect different types of abnormalities. However, its main drawback is reviewing the vast number of captured images (more than 50,000 frames). The recorded images are only sometimes clear, and different contaminating agents, such as turbid materials and air bubbles, degrade the visualization quality of the WCE images. This condition could cause serious problems such as reducing mucosal view visualization, prolonging recorded video reviewing time, and increasing the risks of missing pathology. On the other hand, accurately quantifying the amount of turbid fluids and bubbles can indicate potential motility malfunction. To assist in developing computer vision-based techniques, we have constructed the first multicentre publicly available clear and contaminated annotated dataset by precisely segmenting 17,593 capsule endoscopy images from three different databases.In contrast to the existing datasets, our dataset has been annotated at the pixel level, discriminating the clear and contaminated regions and subsequently differentiating bubbles and turbid fluids from normal tissue. To create the dataset, we first selected all of the images (2906 frames) in the reduced mucosal view class covering different levels of contamination and randomly selected 12,237 images from the normal class of the copyright-free CC BY 4.0 licensed small bowel capsule endoscopy (SBCE) images from the Kvasir capsule endoscopy database. To mitigate the possible available bias in the mentioned dataset and to increase the sample size, the number of 2077 and 373 images have been stochastically chosen from the SEE-AI project and CECleanliness datasets respectively for the subsequent annotation. Randomly selected images have been annotated with the aid of ImageJ and ITK-SNAP software under the supervision of an expert SBCE reader with extensive experience in gastroenterology and endoscopy. For each image, two binary and tri-colour ground truth (GT) masks have been created in which each pixel has been indexed into two classes (clear and contaminated) and three classes (bubble, turbid fluids, and normal), respectively.To the best of the author's knowledge, there is no implemented clear and contaminated region segmentation on the capsule endoscopy reading software. Curated multicentre dataset can be utilized to implement applicable segmentation algorithms for identification of clear and contaminated regions and discrimination bubbles, as well as turbid fluids from normal tissue in the small intestine.Since the annotated images belong to three different sources, they provide a diverse representation of the clear and contaminated patterns in the WCE images. This diversity is valuable for training the models that are more robust to variations in data characteristics and can generalize well across different subjects and settings. The inclusion of images from three different centres allows for robust cross-validation opportunities, where computer vision-based models can be trained on one centre's annotated images and evaluated on others.

Background:. There is no consensus about the best treatment for Dupuytren contracture in the hand. In particular, whether to use a percutaneous needle fasciotomy (PCNF) in preference to a limited fasciectomy (LF). Methods:. We performed a retrospective review of the outcomes of 74 joints treated with either PCNF or LF. Baseline characteristics, complications, and active extension deficit (AED) were assessed at 3 weeks and 3 months posttreatment. Reoperative procedures were analyzed to assess the effectiveness of repeated procedures. Results:. Our results suggest that there is no significant difference between PCNF and LF in reducing AED at 3 weeks (P = 0.504) or 3 months (P = 0.66). Moreover, our data suggest that the risk of a surgical complication was the same for both procedures, after adjustment for confounders (P = 0.613). Our study suggests that a reoperative PCNF was 15.3% less effective in reducing the AED compared with a primary PCNF at 3 months postoperatively (P = 0.032); whereas there was no change in the effectiveness of a reoperative LF in reducing AED at both 3 weeks (P = 0.839) and 3 months (P = 0.449). Conclusions:. We believe that PCNF should be used as the primary treatment for nonrecurrent and recurrent Dupuytren contractures. More frequent use of PCNF may help to reduce waiting times for treatment and may enable better resource allocation. Further prospective studies should be carried out.

BackgroundPrevious research demonstrated that caregivers of children with cancer desired a mobile health (mHealth) tool to aid them in the medical management of their child. Prototyping and alpha testing of the Cope 360 app (Commissioning Agents, Inc) resulted in improvements in the ability to track symptoms, manage medications, and prepare for urgent medical needs. ObjectiveThis study aims to engage caregivers of children with cancer in beta testing of a smartphone app for the medical management of children with cancer, assess acceptance, identify caregivers’ perceptions and areas for improvement, and validate the app’s design concepts and use cases. MethodsIn this pilot, study caregivers of children with cancer used the Cope 360 mHealth app for 1 week, with the goal of daily logging. Demographics and a technology acceptance survey were obtained from each participant. Recorded semistructured interviews were transcribed and analyzed iteratively using NVivo (version 12, QSR International) and analyzed for information on usage, perceptions, and suggestions for improvement. ResultsA total of 10 caregivers participated in beta testing, primarily women (n=8, 80%), married, with some college education, and non-Hispanic White (n=10, 100%). The majority of participants (n=7, 70%) had children with acute lymphocytic leukemia who were being treated with chemotherapy only (n=8, 80%). Overall, participants had a favorable opinion of Cope 360. Almost all participants (n=9, 90%) believed that using the app would improve their ability to manage their child’s medical needs at home. All participants reported that Cope 360 was easy to use, and most would use the app if given the opportunity (n=8, 80%). These values indicate that the app had a high perceived ease of use with well-perceived usefulness and behavioral intention to use. Key topics for improvement were identified including items that were within the scope of change and others that were added to a future wish list. Changes that were made based on caregiver feedback included tracking or editing all oral and subcutaneous medications and the ability to change the time of a symptom tracked or medication administered if unable to do so immediately. Wish list items included adding a notes section, monitoring skin changes, weight and nutrition tracking, and mental health tracking. ConclusionsThe Cope 360 app was well received by caregivers of children with cancer. Our validation testing suggests that the Cope 360 app is ready for testing in a randomized controlled trial to assess outcome improvements.