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BACKGROUND:Within the United Kingdom's National Health System (NHS), patients suffering from obesity may be provided with bariatric surgery. After receiving surgery many of these patients require further support to continue to lose more weight or to maintain a healthy weight. Remotely monitoring such patients' physical activity and other health-related variables could provide healthworkers with a more 'ecologically valid' picture of these patients' behaviours to then provide more personalised support. The current study assesses the feasibility of two smartphone apps to do so. In addition, the study looks at the barriers and facilitators patients experience to using these apps effectively. METHODS:Participants with a BMI > 35 kg/m2 being considered for and who had previously undergone bariatric surgery were recruited. Participants were asked to install two mobile phone apps. The 'Moves' app automatically tracked participants' physical activity and the 'WLCompanion' app prompted participants to set goals and input other health-related information. Then, to learn about participants' facilitators and barriers to using the apps, some participants were asked to complete a survey informed by the Theoretical Domains Framework. The data were analysed using regressions and descriptive statistics. RESULTS:Of the 494 participants originally enrolled, 274 participants data were included in the analyses about their activity pre- and/or post-bariatric surgery (ages 18-65, M = 44.02, SD ± 11.29). Further analyses were performed on those 36 participants whose activity was tracked both pre- and post-surgery. Participants' activity levels pre- and post-surgery did not differ. In addition, 54 participants' survey responses suggested that the main facilitator to their continued use of the Moves app was its automatic nature, and the main barrier was its battery drain. CONCLUSIONS:The current study tracked physical activity in patients considered for and who had previously undergone bariatric surgery. The results should be interpreted with caution because of the small number of participants whose data meet the inclusion criteria and the barriers participants encountered to using the apps. Future studies should take note of the barriers to develop more user-friendly apps. TRIAL REGISTRATION:ClinicalTrials.gov- NCT01365416 on the 3rd of June 2011.

Visual cryptography is a method used to secure images by converting them into several shares that are finally stacked to recover the original image without any calculations. Most existing techniques that can encrypt gray and color images often convert them to binary or support only limited colors, which results in reducing the quality of recovered images. Pixel expansion is another problem with existing methods. Thus, a new approach is required to encrypt gray and color images with real value, without converting them to binary or limited-color images, and also without imposing any pixel expansions. Besides, generated shares should have security, and the recovered images should be of high quality. In this research, fuzzy random grids and a meta-heuristic algorithm are used for the share generation in the encryption step. Next, the decryption step uses the fuzzy OR operator to recover high-quality images. The evaluation results demonstrate the ability of the proposed solution in encrypting gray and color images without converting them to binary, and also without pixel expansion. Besides, the results show that the proposed method is secure as individual shares do not show any information from the original image. The quality of the decrypted images has also been evaluated using subjective and objective evaluation metrics, which prove the high quality of recovered images. [ABSTRACT FROM AUTHOR]

An investigation on the usage of ficin-tenderized mean and cysteine-modified soy proteins in producing bologna and the influence of chemical modification on this is presented.

In this paper, a novel method of producing bi-metallic alloy nanoparticles at low temperatures using hydrogen bombardment of thin films, deposited on glass substrates, is introduced. Optical and morphological characteristics of the nanoparticles were extensively studied for various conditions of plasma treatment, such as plasma power density, temperature, duration of hydrogen bombardment, thickness of the initial thin metallic film etc. As an important application of fabricated alloy nanoparticles, humidity sensor based on the alloy nanoparticles was introduced. It was shown that Ag-Cu alloy nanoparticles ionizing ability of the fabricated alloy nanoparticle is higher than Ag and Cu nanoparticles. Scanning Electron Microscopy, Atomic Force Microscopy and Transmission Electron Microscopy were used to analyze the nanostructures. [ABSTRACT FROM AUTHOR]

Background: Neonatal hypernatremic dehydration (NHD) is a severe condition associated with neonatal morbidity and mortality., Purpose: The present study evaluated maternal risk factors, including duration of maternal hospitalisation, primiparity, caesarean section, and pregnancy complications, as well as social factors, such as depression, fatigue, and inadequate support for NHD., Data Sources: PubMed, Cochrane Library, International Scientific Indexing, Scopus, and Google Scholar were the databases searched until 2023., Study Selection: Articles written in English or Persian focusing on the relationship between maternal risk factors and NHD among neonates and providing sufficient information on NHD were included in this study. On the other hand, articles whose abstracts were only available were excluded., Data Extraction: The extracted data were presented in Excel software with the following titles: authors' names, year, type of study, study location, and maternal risk factors. The methodological quality of the articles was determined using the quality assurance tool for the diagnostic accuracy score (QUADAS)., Results: Of the 58 searched articles, 16 were investigated, which included five prospective, seven cross-sectional, and four retrospective articles. Maternal risk factors for NHD included labour and delivery complications, childbirth complications, factors causing insufficient breast milk intake (including breast milk insufficiency, nipple problems, wrong breastfeeding techniques, breast disorders, types of feeding, and breastfeeding training/counselling in pregnancy), as well as delivery and the postpartum period., Implications for Practice and Research: Maternal problems in pregnancy and delivery, breast disorders, breastfeeding status, maternal knowledge, and lactation skills are the most common maternal risk factors for NHD. Timely (antenatal) identification and proper management of maternal risk factors help reduce the incidence and severity of NHD complications., (© 2024 Zakerihamidi Maryam et al., published by Sciendo.)

Stem cell-based therapies have emerged as a promising approach for treating various neurological disorders by harnessing the regenerative potential of stem cells to restore damaged neural tissue and circuitry. This comprehensive review provides an in-depth analysis of the current state of stem cell applications in primary neurological conditions, including Parkinson's disease (PD), Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), stroke, spinal cord injury (SCI), and other related disorders. The review begins with a detailed introduction to stem cell biology, discussing the types, sources, and mechanisms of action of stem cells in neurological therapies. It then critically examines the preclinical evidence from animal models and early human trials investigating the safety, feasibility, and efficacy of different stem cell types, such as embryonic stem cells (ESCs), mesenchymal stem cells (MSCs), neural stem cells (NSCs), and induced pluripotent stem cells (iPSCs). While ESCs have been studied extensively in preclinical models, clinical trials have primarily focused on adult stem cells such as MSCs and NSCs, as well as iPSCs and their derivatives. We critically assess the current state of research for each cell type, highlighting their potential applications and limitations in different neurological conditions. The review synthesizes key findings from recent, high-quality studies for each neurological condition, discussing cell manufacturing, delivery methods, and therapeutic outcomes. While the potential of stem cells to replace lost neurons and directly reconstruct neural circuits is highlighted, the review emphasizes the critical role of paracrine and immunomodulatory mechanisms in mediating the therapeutic effects of stem cells in most neurological disorders. The article also explores the challenges and limitations associated with translating stem cell therapies into clinical practice, including issues related to cell sourcing, scalability, safety, and regulatory considerations. Furthermore, it discusses future directions and opportunities for advancing stem cell-based treatments, such as gene editing, biomaterials, personalized iPSC-derived therapies, and novel delivery strategies. The review concludes by emphasizing the transformative potential of stem cell therapies in revolutionizing the treatment of neurological disorders while acknowledging the need for rigorous clinical trials, standardized protocols, and multidisciplinary collaboration to realize their full therapeutic promise., (© 2024. The Author(s).)

Given that tumor cells primarily instigate systemic changes through exosome secretion, our study delved into the role of colorectal cancer (CRC)-secreted exosomal miR-224 in stromal reprogramming and its impact on endothelial cell angiogenesis. Furthermore, we assessed the potential clinical significance of a specific signature of circulating serum-derived miRNAs, serving as a non-invasive biomarker for CRC diagnosis. Circulating serum-derived miR-103a-3p, miR-135b-5p, miR-182-5p, and miR-224-5p were significantly up-regulated, while miR-215-5p, and miR-455-5p showed a significant down-regulation in CRC patients than in healthy individuals. Our findings indicated that the expressions of CAF-specific markers (α-SMA and FAP) and CAF-derived cytokines (IL-6, and SDF-1) were induced in fibroblasts stimulated with SW480 CRC exosomes, partly due to Akt activation. As a plausible mechanism, exosomal transfer of miR-224 from SW40 CRC cells may activate stromal fibroblasts, which in turn, may promote endothelial cell sprouting. The study identified PHLPP1 and PHLPP2 as direct targets of miR-224 and demonstrated that CRC-secreted exosomal miR-224 activates Akt signaling by regulating PHLPP1/2 in activated fibroblasts, thereby affecting the stromal cell proliferation and migration. This study established a panel of six-circulating serum-derived miRNAs as a non-invasive biomarker for CRC diagnosis. Also, we proposed a supporting model in which CRC-secreted exosomal miR-224 takes part in the stromal reprogramming to CAFs partly through regulating Akt signaling. This may affect the malignant biological behavior of activated stromal cells and thereby elicit a vascular response within the microenvironment of CRC cells. See also the graphical abstract(Fig. 1)., Competing Interests: The authors declare that they have no conflict of interest., (Copyright © 2024 Khaloozadeh et al.)

Background: Gastric Cancer (GC)is the third leading cause of cancer death worldwide. We aimed to compare the quality of care of GC at global, regional, and national levels from 1990 to 2017 in different age, sex, and socio-demographic groups using the quality-of-care index., Material: METHOD: We used Mortality to Incidence Ratio, DALY to Prevalence Ratio, YLL to YLD Ratio, and Prevalence to Incidence Ratio, that all indicate the quality of care. Then, using Principal Component Analysis (PCA), these values are combined. A new index called QCI (Quality of Care Index), which indicates quality, is introduced to compare the quality of care in different countries in 1990 and 2017. Scores were calculated and scaled 0-100, with higher scores indicating better status., Results: The global QCI of GC in 1990 and 2017 was 35.7 and 66.7, respectively. The QCI index is 89.6 and 16.4 in high and low SDI countries, respectively. In 2017, Japan had the highest QCI with a 100 score. Japan was followed by South Korea, Singapore, Australia, and the United States with 99.5, 98.4, 98.3, and 90.0. On the other hand, the Central African Republic, Eritrea, Papua New Guinea, Lesotho, and Afghanistan with 11.6, 13.0, 13.1, 13.5, and 13.7 had the worst QCI, respectively., Conclusion: The quality of care of GC has increased worldwide from 1990 to 2017. Also, higher SDI was associated with more quality of care. We recommend conducting more screening and therapeutic programs for early detection and to improve gastric cancer treatment in developing countries., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Nowadays, the adverse effects of smoking on general, oral, and dental health are reported time and again worldwide. However, evidence to quantify the effects of tobacco smoking and smoking cessation on health-related quality of life (HRQoL) and oral health-related quality of life (OHQoL) is inadequate. Accordingly, this study aimed to assess the effects of nicotine gum on HRQoL and OHQoL of cigarette smokers., Methods: This pilot study was conducted on 40 smokers, half of whom received nicotine gum. HRQoL and OHQoL were measured twice at the beginning of the study and after three months using standard versions of Short Form Health Survey (SF-12) and Oral Health Impact Profile (OHIP-5) questionnaires. T-test, Fischer's exact test, and Pearson's correlation coefficient were used to compare the participants' scores on the questionnaires., Findings: The mean age of the participants was 43.39±12.32 years. Using nicotine gum significantly increased the scores of general health ( P =0.046) and physical functioning ( P =0.021) domains of HRQoL in comparison with the cigarette smoking group. Moreover, using nicotine gum significantly increased the scores of the two questions about the reduced sense of taste ( P <0.001) and difficulty doing usual jobs ( P =0.071)., Conclusion: Using nicotine gum was associated with the improvement of HRQoL and OHQoL to some extent. To better understand the relationship between smoking cessation and improved OHQoL, it is necessary to conduct further studies in this field., Competing Interests: Competing Interests The authors declared no conflict of interest., (© 2024 Kerman University of Medical Sciences.)

Epstein-Barr virus (EBV), one of the most significant causes of lymphoid and epithelial cancers, has been linked to oral carcinogenesis; however, this etiological association remains controversial. To investigate this association, the present study aimed to determine the prevalence of EBV in cancerous and non-cancerous oral tissues from Ahvaz, Iran. In total, 164 blocks of formalin-fixed paraffin-embedded tissues from oral squamous cell carcinoma (OSCC), including 76 tongue squamous cell carcinomas and 88 non-cancerous tongue tissues, were collected from Ahvaz Imam Khomeini Hospital, Ahvaz, Iran, from December 2014 to March 2019, for this case-control study. The tissues were cut into 15-μm-thick sections, and DNA was extracted using a solution of Phenol, Chloroform, and Isoamyl Alcohol. The EBV detection and typing were performed using nested polymerase chain reaction. The EBV was detected in 9 (5.48%) out of the 164 samples studied, including 4 (5.26%) of the 76 SCC cases and 5 (5.68%) of the 88 samples in the control group (P>0.05). The EBV was positive in 2.40% of the 83 male and 8.6% of the 81 female samples (P>0.05). In terms of the histological grades of the case group, 3 (3/57) and 1 (1/13) of the EBV-positive samples were well and moderately differentiated, respectively (P>0.05). For EBV typing, the 9 EBV-positive samples were tested, and it was found that 2 and 7 of the cases were EBV type I and II, respectively. Results of the current study demonstrated the low frequency of EBV in Iranian patients with OSCC, with EBV type II predominating. Further studies are required to clarify the association between EBV and OSCC., Competing Interests: The authors have no relevant conflicts of interest to declare.

Objective: To characterize the relationship between institutional robotic-assisted pulmonary lobectomy volume and hospitalization costs., Background: The high cost of robotic-assisted thoracoscopic surgery (RATS) is among several drivers of hesitation among nonadopters. Studies examining the impact of institutional experience on costs of RATS lobectomy are lacking., Methods: Adults undergoing RATS lobectomy for primary lung cancers were identified from the 2016 to 2018 Nationwide Readmissions Database. A multivariable regression to model hospitalization costs was developed with the inclusion of hospital RATS lobectomy volume as restricted cubic splines. The volume corresponding to the inflection point of the spline was used to categorize hospitals as high- (HVH) or low-volume (LVH). We subsequently examined the association of HVH status with adverse events, length of stay, costs, and 30-day, nonelective readmissions., Results: An estimated 14,756 patients underwent RATS lobectomy during the study period, with median cost of $23,000. Upon adjustment for patient and operative characteristics, hospital RATS volume was inversely associated with costs. Although only 17.2% of centers were defined as HVH, 51.7% of patients were managed at these centers. Patients at HVH and LVH had similar age, sex, and distribution of comorbidities. Notably, patients at HVH had decreased risk-adjusted odds of adverse events (adjusted odds ratio: 0.62, P <0.001), as well as significantly reduced length of stay (-0.8 d, P <0.001) and costs (-$3900, P <0.001)., Conclusions: Increasing hospital RATS lobectomy volume was associated with reduced hospitalization costs. Our findings suggest the presence of streamlined care pathways at high-volume centers, which influence costs of care., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Wearable devices and fitness trackers have gained popularity in healthcare and telemedicine as tools to reduce hospitalization costs, improve personalized health management, and monitor patients in remote areas. Smartwatches, particularly, offer continuous monitoring capabilities through step counting, heart rate tracking, and activity monitoring. However, despite being recognized as an emerging technology, the adoption of smartwatches in patient monitoring systems is still at an early stage, with limited studies delving beyond their feasibility. Developing healthcare applications for smartwatches faces challenges such as short battery life, wearable comfort, patient compliance, termination of non-native applications, user interaction difficulties, small touch screens, personalized sensor configuration, and connectivity with other devices. This paper presents a case study on designing an Android smartwatch application for remote monitoring of geriatric patients. It highlights obstacles encountered during app development and offers insights into design decisions and implementation details. The aim is to assist programmers in developing more efficient healthcare applications for wearable systems.

Background: Cancer is still the most challenging disease and is responsible for many deaths worldwide. Considerable research now focuses on targeted therapy in cancer using natural components to improve anti-tumor efficacy and reduce unfavorable effects. Lactoferrin is an iron-binding glycoprotein found in body fluids. Increasing evidence suggests that lactoferrin is a safe agent capable of inducing anti-cancer effects. Therefore, we conducted a study to evaluate the effects of the exosomal form of bovine milk lactoferrin on a human MDA-MB-231 breast cancer cell line., Methods: The exosomes were isolated from cancer cells by ultracentrifugation and incorporated with bovine milk lactoferrin through the incubation method. The average size of the purified exosome was determined using SEM imaging and DLS analysis. The maximum percentage of lactoferrin-loaded exosomes (exoLF) was achieved by incubating 1 mg/ml of lactoferrin with 30 µg/ml of MDA-MB-231 cells-derived exosomes. Following treatment of MDA-MB-231 cancer cells and normal cells with 1 mg/ml exoLF MTT assay applied to evaluate the cytotoxicity, PI/ annexin V analysis was carried out to illustrate the apoptotic phenotype, and the real-time PCR was performed to assess the pro-apoptotic protein, Bid, and anti-apoptotic protein, Bcl-2., Results: The average size of the purified exosome was about 100 nm. The maximum lactoferrin loading efficiency of exoLF was 29.72%. MTT assay showed that although the 1 mg/ml exoLF treatment of MDA-MB-231 cancer cells induced 50% cell growth inhibition, normal mesenchymal stem cells remained viable. PI/ annexin V analysis revealed that 34% of cancer cells had late apoptotic phenotype after treatment. The real-time PCR showed an elevated expression of pro-apoptotic protein Bid and diminished anti-apoptotic protein Bcl-2 following exoLF treatment., Conclusion: These results suggested that exoLF could induce selective cytotoxicity against cancer cells compared to normal cells. Incorporating lactoferrin into the exosome seems an effective agent for cancer therapy. However, further studies are required to evaluate anti-tumor efficacy and the underlying mechanism of exoLF in various cancer cell lines and animal models., (© 2023. The Author(s).)

Background and Objective: Due to the growing global trend of obesity, it is necessary to study the diet quality as a modifiable factor to reduce the dangerous consequences of obesity. Therefore, the aim of this study was to evaluate the association between meal-based diet quality index-international (DQI-I) with obesity in adults., Methods: This cross-sectional study was performed on 850 men and women in Tehran (aged 20-59 y). Dietary intakes were assessed using three 24-h dietary recalls. Meal-based Diet quality was assessed based on the construction of DQI-I. The total DQI-I score ranged from 0 to 100, with higher scores denoting better diet quality. Multiple linear regression analysis was used to examine the association of DQI-I and BMI in each meal and Logistic regression analysis was used to examine the association of DQI-I and obesity in each meal., Results: The mean (± SD) of age, body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR) were 42.35(± 10.90) years, 27.32(± 5.61) kg/m2, 89.09 (± 12.04) cm and 0.86 (± 0.11), respectively. In none of the meals, after adjusting for confounders, no significant difference in BMI was observed in the both women and men groups. After controlling of confounders, there was not any relationship between meal-based DQI-I and BMI resulted from multiple linear regression analysis also there was not any significant association between meal-based DQI-I and obesity resulted from Logistic regression analysis., Conclusion: In this study, we did not find any significant association between meal-specified DQI with obesity. To reach the better evaluation, more prospective studies with large sample size are needed., (© 2022. The Author(s).)

Present study focused on improvement of the formulation of conventional hard gelatin capsules using gastric acid-resistant polymers. We have utilized the same approach of making conventional drug capsules to develop novel capsules with delayed release properties. For this purpose, delayed-release capsules were produced by improving the formulation of hard gelatin capsules. In addition, the effect of adding intestinal polymers such as Hydroxy propyl methyl cellulose phthalate, Glucomannan, and Polyvinyl alcohol to hard gelatin capsules were investigated. The capsules' release rate was determined. The degradation tests in an acidic environment were performed and the results were recorded. In fact, the delayed-release hard gelatin capsules pass through the stomach with small amount of the drug release; but their shell remains intact and dissolves as it enters the intestine environment. This article shows that enteric polymers with out interactions, only by changing the formulations will have delayed release properties. this makes sensitive drugs pass through stomach environment and have higher absorption., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

It is critical for hospitals to accurately predict patient length of stay (LOS) and mortality in real-time. We evaluate temporal convolutional networks (TCNs) and data rebalancing methods to predict LOS and mortality. This is a retrospective cohort study utilizing the MIMIC-III database. The MIMIC-Extract pipeline processes 24 hour time-series clinical objective data for 23,944 unique patient records. TCN performance is compared to both baseline and state-of-the-art machine learning models including logistic regression, random forest, gated recurrent unit with decay (GRU-D). Models are evaluated for binary classification tasks (LOS > 3 days, LOS > 7 days, mortality in-hospital, and mortality in-ICU) with and without data rebalancing and analyzed for clinical runtime feasibility. Data is split temporally, and evaluations utilize tenfold cross-validation (stratified splits) followed by simulated prospective hold-out validation. In mortality tasks, TCN outperforms baselines in 6 of 8 metrics (area under receiver operating characteristic, area under precision-recall curve (AUPRC), and F-1 measure for in-hospital mortality; AUPRC, accuracy, and F-1 for in-ICU mortality). In LOS tasks, TCN performs competitively to the GRU-D (best in 6 of 8) and the random forest model (best in 2 of 8). Rebalancing improves predictive power across multiple methods and outcome ratios. The TCN offers strong performance in mortality classification and offers improved computational efficiency on GPU-enabled systems over popular RNN architectures. Dataset rebalancing can improve model predictive power in imbalanced learning. We conclude that temporal convolutional networks should be included in model searches for critical care outcome prediction systems., (© 2022. The Author(s).)

Glioblastoma multiforme (GBM) is a common, aggressive, fast-growing tumor of the central nervous system that currently has no effective treatment. Although stem cell therapy has shown promising in vitro achievements, the blood-brain barrier (BBB) has always been a major hurdle to clinical success. To overcome this challenge, exosomes have been targeted as attractive drug delivery agents in numerous studies since they are small enough to enter the BBB. Furthermore, exosomes' characteristics and compositions are directly determined by the parent cell and these heritable traits affect their cell interactions. This article focuses on exosomes as an alternative to stem cell therapy to regulate glioma cell activity. Exosomes were isolated from rat bone marrow mesenchymal stem cells (rBMMSCs) by ultracentrifugation method and then characterized via western blot, dynamic light scattering, scanning, and transmission electron microscopy. Next, various concentrations of the exosomes were incubated with C6 cells and their effects at different time points were evaluated in vitro. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and Annexin/Pi assay results confirmed that the isolated exosomes cause cell death mostly through apoptosis, and a linear correlation was observed between exosomes' concentration and their cytotoxicity. Following that, the scratch test, colony formation test, and Transwell assay confirmed exosomes' significant impact on the migration and invasion behavior of C6 cells. For the first time, rBMMSC-derived exosomes have been used as a single treatment for GBM rather than in combination with other treatments or as a pharmaceutical carrier., (© 2022 International Federation for Cell Biology.)

At the forefront of biopharmaceutical industry, the messenger RNA (mRNA) technology offers a flexible and scalable platform to address the urgent need for world-wide immunization in pandemic situations. This strategic powerful platform has recently been used to immunize millions of people proving both of safety and highest level of clinical efficacy against infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here we provide preclinical report of COReNAPCIN ® ; a vaccine candidate against SARS-CoV-2 infection. COReNAPCIN ® is a nucleoside modified mRNA-based vaccine formulated in lipid nanoparticles (LNPs) for encoding the full-length prefusion stabilized SARS-CoV-2 spike glycoprotein on the cell surface. Vaccination of C57BL/6 and BALB/c mice and rhesus macaque with COReNAPCIN ® induced strong humoral responses with high titers of virus-binding and neutralizing antibodies. Upon vaccination, a robust SARS-CoV-2 specific cellular immunity was also observed in both mice and non-human primate models. Additionally, vaccination protected rhesus macaques from symptomatic SARS-CoV-2 infection and pathological damage to the lung upon challenging the animals with high viral loads of up to 2 × 10 8 live viral particles. Overall, our data provide supporting evidence for COReNAPCIN ® as a potent vaccine candidate against SARS-CoV-2 infection for clinical studies., (© 2022. The Author(s).)

Summarization is the process of compressing a text to obtain its important informative parts. In recent years, various methods have been presented to extract important parts of textual documents to present them in a summarized form. The first challenge of these methods is to detect the concepts that well convey the main topic of the text and extract sentences that better describe these essential concepts. The second challenge is the correct interpretation of the essential concepts to generate new paraphrased sentences such that they are not exactly the same as the sentences in the main text. The first challenge has been addressed by many researchers. However, the second one is still in progress. In this study, we focus on the abstractive summarization of biomedical documents. In this regard, for the first challenge, a new method is presented based on the graph generation and frequent itemset mining for generating extractive summaries by considering the concepts within the biomedical documents. Then, to address the second challenge, a transfer learning-based method is used to generate abstractive summarizations from extractive summaries. The efficiency of the proposed solution has been evaluated by conducting several experiments over BioMed Central and NLM's PubMed datasets. The obtained results show that the proposed approach admits a better interpretation of the main concepts and sentences of biomedical documents for the abstractive summarization by obtaining the overall ROUGE of 59.60%, which, on average, is 17% better than state-of-the-art summarization techniques. The source code, datasets, and results are available in GitHub 1 ., (Copyright © 2022 Elsevier Inc. All rights reserved.)