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The search for extraterrestrial intelligence is a fascinating and important endeavor, but it raises significant ethical and safety concerns. In the search for extraterrestrial intelligence, scientists use knowledge of physics to identify potential communication methods and signals that may be used by extraterrestrial civilizations. One of the most notable scientists to highlight these concerns was the late physicist Stephen Hawking, who cautioned that actively attempting to communicate with extraterrestrial civilizations could harm humanity. While it is true that we cannot predict the intentions of any potential extraterrestrial civilizations, some scientists argue that the potential advantages of seeking contact outweigh the potential risks. Deciding to initiate contact with extraterrestrial civilizations is a complex issue that requires balancing scientific curiosity with concerns for our own safety. The “Intelligence Trap” is a concept in psychology that suggests that highly intelligent people are more susceptible to cognitive biases and flawed thinking than less intelligent people. It can be argued that Hawking’s warnings may be an example of the so-called intelligence trap, as some evidence from the field of physics suggests. Nonetheless, Hawking emphasized that it is crucial for scientists and policymakers to carefully weigh the potential risks and benefits of such efforts and proceed with caution.

This review highlights the pivotal role of Kaplan fibers (KFs) in knee stability, particularly in the anterolateral aspect. Studies reveal their complex anatomy with varying attachments to the distal femur, demonstrating a significant impact on knee joint mechanics across different populations. Investigations into the biomechanics of KFs show their crucial role in maintaining rotational stability of the knee, especially during rotational movements. Their synergistic function with other knee structures, like the anterolateral ligament, is emphasized, underscoring their importance in knee integrity and function. MRI emerges as a key tool in detecting KFs, with varying visibility and prevalence of injuries. The review discusses the development of MRI criteria for accurate diagnosis, highlighting the need for further research to refine these criteria and understand the interplay between KF injuries, anterior cruciate ligament (ACL) ruptures, and associated knee pathologies. The review covers various lateral extra-articular tenodesis (LET) techniques used to address residual laxity and instability following ACL reconstruction. Among them, the modified Lemaire technique, which resembles the anatomical and functional characteristics of distal KFs, shows effectiveness in reducing internal rotation and residual laxity. The review emphasizes the need for further research to understand the healing dynamics of KF injuries and the efficacy of different LET techniques. It suggests that a comprehensive approach, considering both biomechanical and clinical aspects, is crucial for advancing knee joint health and rehabilitation.

According to a NIH study, Lung cancer among individuals who have never smoked is more prevalent in women and occurs at an earlier age than in smokers. The rise in lung cancer rates among female non-smokers might be linked to radon inhalation and should be further investigated. Our theory is based on the differences in radon exposure between males and females, which can be attributed to the variations in time spent indoors versus outdoors. Over the past few years, the smoking rates have shown a steady decline in the United States and other developed countries. This decrease in smoking prevalence has led to a new shift in the primary risk factors associated with lung cancer. Although tobacco smoke historically served as the primary cause of lung cancer, the reduction in smoking rates has allowed other risk factors, such as radon exposure, to come to the forefront. Given that women in certain countries, on average, might spend more time indoors compared to men, they are potentially exposed to higher levels of radon. This increased exposure could explain the rising rates of lung cancer among female non-smokers. The theory is still in its nascent stages and requires further research and validation. However, if proven correct, it could significantly alter our understanding of lung cancer risk factors and lead to new prevention. It is therefore crucial to expedite the review and publication of this theory, given its potential implications for public health.

Humans have generally evolved some adaptations to protect against UV and different levels of background ionizing radiation. Similarly, elephants and whales have evolved adaptations to protect against cancer, such as multiple copies of the tumor suppressor gene p53, due to their large size and long lifespan. The difference in cancer protection strategies between humans and elephants/whales depends on genetics, lifestyle, environmental exposures, and evolutionary pressures. In this paper, we discuss how the differences in evolutionary adaptations between humans and elephants could explain why elephants have evolved a protective mechanism against cancer, whereas humans have not. Humans living in regions with high levels of background radiation, e.g. in Ramsar, Iran where exposure rates exceed those on the surface of Mars, seem to have developed some kind of protection against the ionizing radiation. However, humans in general have not developed cancer-fighting adaptations, so they instead rely on medical technologies and interventions. The difference in cancer protection strategies between humans and elephants/whales depends on genetics, lifestyle, environmental exposures, and evolutionary pressures. In this paper, we discuss how the differences in evolutionary adaptations between humans and elephants could explain why elephants have evolved a protective mechanism against cancer, whereas humans have not. Studying elephant adaptations may provide insights into new cancer prevention and treatment strategies for humans, but further research is required to fully understand the evolutionary disparities.

Research conducted over the years has established that artificial light at night (ALAN), particularly short wavelengths in the blue region (~400–500 nm), can disrupt the circadian rhythm, cause sleep disturbances, and lead to metabolic dysregulation. With the increasing number of people spending considerable amounts of time at home or work staring at digital screens such as smartphones, tablets, and laptops, the negative impacts of blue light are becoming more apparent. While blue wavelengths during the day can enhance attention and reaction times, they are disruptive at night and are associated with a wide range of health problems such as poor sleep quality, mental health problems, and increased risk of some cancers. The growing global concern over the detrimental effects of ALAN on human health is supported by epidemiological and experimental studies, which suggest that exposure to ALAN is associated with disorders like type 2 diabetes, obesity, and increased risk of breast and prostate cancer. Moreover, several studies have reported a connection between ALAN, night-shift work, reduced cognitive performance, and a higher likelihood of human errors. The purpose of this paper is to review the biological impacts of blue light exposure on human cognitive functions and vision quality. Additionally, studies indicating a potential link between exposure to blue light from digital screens and increased risk of breast cancer are also reviewed. However, more research is needed to fully comprehend the relationship between blue light exposure and adverse health effects, such as the risk of breast cancer.

Recent studies offer valuable insights into viral inactivation for vaccine development. Schulze et al. have demonstrated the potential of heavy ion beam irradiation to create effective vaccines, which is particularly relevant in the context of airborne pandemics. Notably, the success in immunizing mice via intranasal administration with the inactivated influenza virus is encouraging, especially given the genetic similarities between influenza and SARS-CoV-2. However, the study raises important considerations. While heavy ion treatment shows advantages, there are concerns about viral inactivation completeness and the potential for surviving viruses, albeit at extremely low levels. Prolonged irradiation times and the risk of selective pressure leading to the evolution of resistant variants are highlighted. Biosafety concerns regarding accidental lab escape of resistant strains are crucial, emphasizing the need for caution during experiments. Moreover, limitations in Monte Carlo simulations of virus irradiation are discussed, pointing out the need for more comprehensive studies to assess the impact of secondary particles on virus inactivation under realistic irradiation conditions. Given these considerations, while the study presents a promising approach for vaccine development, further research is essential to address potential drawbacks and optimize the method for safe and effective application.

Professor John Roderick Cameron (1922–2005) stands out as a trailblazer in the field of medical physics, whose innovative work has deeply influenced radiation protection and the broader medical radiation field through sound technical judgment and insight. Best known for inventing the bone densitometry device, his pioneering efforts have reshaped modern medical practices far beyond his initial breakthroughs. Cameron’s explorations extended into the realms of space biomedical science and models of terrestrial radiation, areas where his insights continue to resonate today. As the Emeritus Professor of Medical Physics at the University of Wisconsin-Madison and a founding member of the American Association of Physicists in Medicine, Cameron laid crucial groundwork for safety standards in environments with high natural radiation levels. His leadership was instrumental in advancing thermoluminescence dosimetry, radiation measurement, and image quality assurance, driving progress in both academia and clinical practices. Moreover, through establishing Medical Physics Publishing, Cameron played a pivotal role in spreading vital research and educational materials across the fields of health physics and medical physics. This commentary reflects on Cameron’s far-reaching contributions, highlighting his critical work in space radiation research and terrestrial radiation models-key to the future of interplanetary travel and potential human settlement on planets like Mars. His research in areas of high background radiation, like Ramsar, Iran, has been fundamental in developing strategies for biological protection in space, which are essential for ensuring astronaut safety during long-duration space missions. We honor Professor Cameron’s profound legacy, celebrating his visionary spirit and the lasting impact of his contributions on generations of scientists in radiation science.

Radiation protection is an essential issue in diagnostic radiology to ensure the safety of patients, healthcare professionals, and the general public. Lead has traditionally been used as a shielding material due to its high atomic number, high density, and effectiveness in attenuating radiation. However, some concerns related to the long-term health effects of toxicity, environmental disease as well as heavy weight of lead have led to the search for alternative lead-free shielding materials. Lead‑free multilayered polymer composites and non-lead nano-composite shields have been suggested as effective shielding materials to replace conventional lead-based and single metal shields. Using several elements with high density and atomic number, such as bismuth, barium, gadolinium, and tungsten, offer significant enhancements in the shielding ability of composites. This review focuses on the development and use of lead-free materials for radiation shielding in medical settings. It discusses the drawbacks of traditional lead shielding, such as toxicity, weight, and recycling challenges, and highlights the benefits of lead-free alternatives.

IntroductionThis study presents the development and validation of a Deep Learning Convolutional Neural Network (CNN) model for estimating acetabular version (AV) from native hip plain radiographs.MethodsUtilizing a dataset comprising 300 participants with unrelated pelvic complaints, the CNN model was trained and evaluated against CT-Scans, considered the gold standard, using a 5-fold cross-validation.ResultsNotably, the CNN model exhibited a robust performance, demonstrating a strong Pearson correlation with CT-Scans (right hip: r = 0.70, p < 0.001; left hip: r = 0.71, p < 0.001) and achieving a mean absolute error of 2.95°. Remarkably, over 83% of predictions yielded errors ≤5°, highlighting the model's high precision in AV estimation.DiscussionThe model holds promise in preoperative planning for hip arthroplasty, potentially reducing complications like recurrent dislocation and component wear. Future directions include further refinement of the CNN model, with ongoing investigations aimed at enhancing preoperative planning potential and ensuring comprehensive assessment across diverse patient populations, particularly in diseased cases. Additionally, future research could explore the model's potential value in scenarios necessitating minimized ionizing radiation exposure, such as post-operative evaluations.

This article discusses a case of ochronotic arthropathy, a manifestation of alkaptonuria. Alkaptonuria is characterized by the accumulation of homogentisic acid [HGA] in tissues, leading to a distinctive blue-black pigmentation and early joint degeneration. A 68-year-old female patient, with a history of alkaptonuria, presented with progressive hip pain and was eventually treated with an elective total hip replacement. Due to vertebral calcifications, the operation was performed under general anesthesia. Pre- and post-operative care was guided by the patient’s comorbidities and potential complications related to alkaptonuria, including potential cardiac and respiratory issues. Following surgery, the patient exhibited significant improvements in hip joint functionality. The paper also discusses the challenges in diagnosing alkaptonuria, the absence of definitive treatment, and the potential of dietary restrictions and symptomatic treatments. Moreover, it addresses surgical considerations for ochronotic arthropathy and emphasizes the role of regular calcium and vitamin D intake in maintaining bone quality. The success of the hip replacement surgery in this case suggests a potential intervention for managing ochronotic arthropathy in alkaptonuria patients.

Background: As the use of electronic devices such as mobile phones, tablets, and computers continues to rise globally, concerns have been raised about their potential impact on human health. Exposure to high energy visible (HEV) blue light, emitted from digital screens, particularly the so-called artificial light at night (ALAN), has been associated with adverse health effects, ranging from disruption of circadian rhythms to cancer. Breast cancer incidence rates are also increasing worldwide.Objective: This study aimed at finding a correlation between breast cancer and exposure to blue light from mobile phone.Material and Methods: In this retrospective matched case-control study, we aimed to investigate whether exposure to blue light from mobile phone screens is associated with an increased risk of female breast cancer. We interviewed 301 breast cancer patients (cases) and 294 controls using a standard questionnaire and performed multivariate analysis, chi-square, and Fisher’s exact tests for data analysis.Results: Although heavy users in the case group of our study had a statistically significant higher mean 10-year cumulative exposure to digital screens compared to the control group (7089±14985 vs 4052±12515 hours, respectively, P=0.038), our study did not find a strong relationship between exposure to HEV and development of breast cancer. Conclusion: Our findings suggest that heavy exposure to HEV blue light emitted from mobile phone screens at night might constitute a risk factor for promoting the development of breast cancer, but further large-scale cohort studies are warranted.

Background: Hip hemiarthroplasty (HA) and total hip arthroplasty (THA) are common treatments for femoral neck fractures in elderly patients. Despite HA's advantages of shorter operative times, less blood loss, and lower initial costs compared to primary THA, it may lead to conversion THA (cTHA). Our objectives are to evaluate the impact of conversion from HA to THA on Harris hip scores (HHS), compare complication rates between cTHA, revision THA, and primary THA, and assess the rates and types of complications following cTHA. Methods: A systematic review and meta-analysis were performed, evaluating studies published until 2023, with inclusion criteria entailing studies that explored outcomes and complications following cTHA of failed HA. Data extraction focused on variables such as postoperative HHS and complication rates, including periprosthetic joint infection, periprosthetic fracture, dislocation, stem loosening, acetabular loosening, and overall revision. Results: This study included 28 retrospective studies (4699 hips), showing a mean increase in HHS by 39.1 points, indicating a significant improvement from preoperative levels. Complication rates were detailed, with a 6.4% rate of periprosthetic joint infection, 2.2% for periprosthetic fracture, 7.6% dislocation, 1.6% stem loosening, 1.9% acetabular loosening, and an overall re-revision rate of 8.7%. Conclusions: Conversion from HA to THA generally results in improved functional outcomes, as evidenced by HHS improvements. Despite the positive impact on HHS, cTHAs are associated with notable risks of complications and the need for further revision surgeries. Level of Evidence: IV.

Evaluating the Strength of a Hypothesis on How Terrestrial Organisms Overcame the Loss of Water’s Protective Shield Evaluating the Strength of a Hypothesis on How Terrestrial Organisms Overcame the Loss of Water’s Protective Shield Evaluating the Strength of a Hypothesis on How Terrestrial Organisms Overcame the Loss of Water’s Protective Shield Evaluating the Strength of a Hypothesis on How Terrestrial Organisms Overcame the Loss of Water’s Protective Shield

Abstract Background Osteonecrosis is a major cause of morbidity for patients with systemic lupus erythematosus (SLE). Although core decompression is an approved and trusted technique to prevent further joint deterioration, this surgical method seems to be less beneficial for SLE patients. We aimed to evaluate the outcomes of core decompression in SLE patients with primary stages of femoral head osteonecrosis. Methods In this study, 23 patients (39 affected hip joints) with osteonecrosis of the femoral head with stage II of the disease, based on the Ficat-Arlet classification system, underwent core decompression. Also, patients demographic characteristics, clinical data, medication history, comorbidities, immunological findings, hip plain radiographs, history of total hip arthroplasty after core decompression, and patients satisfaction with joint function according to the Oxford hip score questionnaire were obtained. Results In the study, 53.8% of affected joints showed signs of radiographic deterioration in follow-up imaging. Sixty-one and a half percent (61.5%) of patients had unsatisfactory joint performance. A third (33.3%) of affected hip joints underwent total hip arthroplasty up to 5 years from core decompression. SLE patients with a history of receiving bisphosphonate were 83.2% less dissatisfied with their joint function than patients without a history of bisphosphonate use (P

Abstract Background Severe ankylosing spondylitis (AS) frequently involves hip joints and, occasionally, presents with concurrent spinal deformities, such as kyphoscoliosis, creating complex challenges for surgical management. Case presentation We present a 26-year-old Persian male with a history of AS and severe kyphoscoliosis, leading to bilateral hip fusion and immobility. Following spinal deformity correction, a one-stage bilateral conversion to total hip arthroplasty (THA) was conducted through the direct anterior approach. Conclusion Primary correction of spinal deformities allows for extended surgical procedures under general anesthesia. Single stage bilateral hip conversion arthroplasty via the direct anterior approach enhances postoperative mobilization, reduce the risk of re-ankylosis, and improve the overall quality of life for AS patients with this unique presentation.

Background: Smartphone users frequently connect to the Internet via mobile data or Wi-Fi. Over the past two decades, the worldwide percentage of people who connect to the Internet using their mobile phones has increased drastically.Objective: This study aimed to evaluate the potential link between mobile cellular data/ and Wi-Fi use and adverse health effects.Material and Methods: This cross-sectional study was conducted on 2,796 employees (52% female and 48% male) of Shiraz University of Medical Sciences (SUMS), Shiraz, Iran. The sociodemographic data (e.g., gender, age, nationality, and education level) were collected for all the participants. They were also requested to provide information about their smartphone use including the characteristics of the connection to the Internet using their smartphones (mobile data and Wi-Fi). In addition, the participants’ history of diabetes, hypertension, cardiac ischemia, myocardial infarction, renal failure, fatty liver, hepatitis, chronic lung disease, thyroid disease, kidney stone, gall bladder stone, rheumatoid disease, epilepsy, and chronic headache was recorded through face-to-face interviews.Results: 94% of people participating in this study reported using mobile/Wi-Fi internet. The mean (±SD) Internet usage per day was 117.85±122.70 minutes including 76±98 minutes of mobile data and 42±81 minutes of Wi-Fi use. Conclusion: Our findings showed no link between mobile phone Internet usage and the risk of the above-mentioned health problems. As in 2021, the global average daily time spent on the Internet using mobile phones was 155 minutes, the participants’ lower use time could explain the failure to show any detrimental effects. Considering the study limitations, further large-scale studies are warranted.

The Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern LifeThe Critical Role of Radiation Protection in Modern Life

Objectives: This study aimed to evaluate radiofrequency-induced heating of different amalgam restorations and dental implants during 1.5T magnetic resonance imaging (MRI). Materials and Methods: Standardized class I cavities (5 mm long, 3 mm wide, and 3 mm deep) were prepared on the occlusal surface of 45 extracted human third molars. The samples were restored by three different types of amalgam including Cinalux amalgam (non-gamma-2, spherical), GS-80 (non-gamma-2, admix), and GK-110 amalgam (non-gamma-2, admix in silver). As a separate intervention group (G4), five titanium mini drive-lock implants with 2mm diameter and 10mm length were also selected and mounted to the base of the Eppendorf tube with 3mm of the implants extending above the mounting putty. The box containing the specimens was placed parallel to the long axis of the standard head and neck coil of the MRI device (64MHz radio-frequency energy with 25kW amplifier, 1.5T). Temperature fluctuations of the metallic materials in each group were monitored during MRI scans using a calibrated thermometer. One-way ANOVA was used to compare temperature changes among the amalgam groups (P

Background: Substantial data indicate that genetic and environmental factors play a key role in determining the risk of Alzheimer’s disease (AD). Moreover, it is known that having relatives with AD increases the risk of developing this disease.Objective: This study is aimed at investigating whether having a family history of AD, may increase the risk of COVID-19 in a cohort-based study.Material and Methods: Participants of this retrospective cohort study were previously enrolled in the SUMS Employees Cohort (SUMSEC). All participants including those whose SARS-CoV-2 infection was confirmed by positive PCR test and chest CT scan were requested to respond to interviewer-administered questionnaires. Moreover, AD was diagnosed via memory and thinking impairment, concentration problems, confusion with location, and problems in finishing daily tasks.Results: The total numbers of female and male participants with a family history of AD were 463 and 222 individuals, respectively. When all types of family history of AD were considered, a 51.3% increase was found in the relative frequency of the participants with both family history of AD and confirmed COVID-19 compared with those only with a family history of AD. Conclusion: Despite the limitations of our study, and from a broader perspective, our findings can further support the concept that AD risk haplotypes including APOE are linked to the same morbidities from cardiovascular disease and obesity that increase vulnerability to COVID-19. Given this consideration, millions of APOE ε4 carriers around the globe should be advised to take additional precautions to prevent life-threatening diseases such as COVID-19.

Abstract Background After the Coronavirus pandemic, many educational routines were stopped for the safety of medical staff. To achieve educational goals, we have implemented new policies in our hospitals. In this study, we aimed to evaluate the effect of such strategies. Method This survey-based study uses questionnaires to assess newly implemented educational strategies. We surveyed 107 medical staff of the orthopedic department of Tehran University of Medical Sciences, including faculty members, residents, and students. The survey contained three series of questionnaires for these groups. Results The maximum satisfaction for all three groups was observed in the platform and facilities for using e-classes, and the cost- and time-saving capabilities (Respectively, faculty members (FM): 81.8%, residents (R): 95.2%, students/interns (S/I): 87.0%; FM: 90.9%, R: 88.1%, S/I: 81.5%). The new policies have been shown to reduce the stress level of most trainees, increase the quality of knowledge-based education, increase the opportunity for reexamining educational content, expand discussion and research opportunities, and improve work conditions. There was a broad acceptance of the virtual journal clubs and morning reports. However, there were discrepancies between residents and faculty members on issues such as the evaluation of trainees, the new educational curriculum, and flexible shift schedules. Our strategies failed to improve skill-based education and patient treatment status. Most participants indicated that e-learning should be used with face-to-face training post-pandemic (FM: 81.8%, R: 83.3%, S/I: 75.9%). Conclusion Our efforts to optimize the educational system during this crisis have generally improved trainees’ work conditions and educational experience. Most participants believed that e-learning and virtual methods should be used alongside traditional training as a complementary component after the pandemic.

The ability of human cells to adapt to space radiation is essential for the well-being of astronauts during long-distance space expeditions, such as voyages to Mars or other deep space destinations. However, the adaptation of the microbiomes should not be overlooked. Microorganisms inside an astronaut’s body, or inside the space station or other spacecraft, will also be exposed to radiation, which may induce resistance to antibiotics, UV, heat, desiccation, and other life-threatening factors. Therefore, it is essential to consider the potential effects of radiation not only on humans but also on their microbiomes to develop effective risk reduction strategies for space missions. Studying the human microbiome in space missions can have several potential benefits, including but not limited to a better understanding of the major effects space travel has on human health, developing new technologies for monitoring health and developing new radiation therapies and treatments. While radioadaptive response in astronauts’ cells can lead to resistance against high levels of space radiation, radioadaptive response in their microbiome can lead to resistance against UV, heat, desiccation, antibiotics, and radiation. As astronauts and their microbiomes compete to adapt to the space environment. The microorganisms may emerge as the winners, leading to life-threatening situations due to lethal infections. Therefore, understanding the magnitude of the adaptation of microorganisms before launching a space mission is crucial to be able to develop effective strategies to mitigate the risks associated with radiation exposure. Ensuring the safety and well-being of astronauts during long-duration space missions and minimizing the risks linked with radiation exposure can be achieved by adopting this approach.

The anterior cruciate ligament (ACL) is often vulnerable to sports-related injuries, leading to numerous ACL reconstructions (ACLRs) annually in the United States. Although largely successful, these procedures face the risk of recurrent instability due to graft failure. ACLR failures are typically attributed to technical errors and patient-related factors, with improper positioning of the tibial and femoral tunnels as the most common technical mistake. Current 2-stage revision techniques involve primary bone grafting followed by secondary tendon graft placement, resulting in increased costs and extended rehabilitation times. This article proposes a single-stage revision strategy involving simultaneous tunnel grafting and ACLR revision. The method employs double suspensory fixation by adjustable loop buttons, thereby eliminating the dependence on metaphyseal bone stock for stable graft fixation. This new procedure may offer a more efficient and cost-effective approach, reducing the need for a second surgery and potentially allowing patients to return to normal activities more quickly.

Background: Substantial evidence indicates that exposure to extremely low frequency-electromagnetic fields (ELF-EMFs) affects male reproductive system. Objective: The goal of this study was to evaluate the effects of long-term irradiation with ELF-EMF on sperm quality and quantity and testicular structure.Material and Methods: In this case-control study, sixty male Sprague-Dawley rats were randomly divided into six groups. Experimental groups were exposed to ELF-EMF (50 Hz EMF, 100 µT) for either 1 h/day for 52 days (Group 1), 4 h/day for 52 days (Group 3), 1 h/day for 5 days (Group 5), 4 h/day for 52 days (Group 7). Groups 2, 4, 6 and 8 were only sham exposed at durations equal to Groups 1, 3, 5 and 7, respectively. Results: Both count and motility of sperms were significantly decreased in animals exposed to ELF-EMF (1 h/day for 52 days, 4 h/day for 52 day, and 4 h/day for 5 days) compared to the sham-exposed groups (P

Background: Alzheimer’s disease (AD) is one of the most significant public health concerns and tremendous economic challenges. Studies conducted over the past decades show that exposure to radiofrequency electromagnetic fields (RF-EMFs) may relieve AD symptoms. Objective: To determine if exposure to RF-EMFs emitted by cellphones affect the risk of AD.Material and Methods: In this review, all relevant published articles reporting an association of cell phone use with AD were studied. We systematically searched international datasets to identify relevant studies. Finally, 33 studies were included in the review. Our review discusses the effects of RF-EMFs on the amyloid β (Aβ), oxidative stress, apoptosis, reactive oxygen species (ROS), neuronal death, and astrocyte responses. Moreover, the role of exposure parameters, including the type of exposure, its duration, and specific absorption rate (SAR), are discussed. Results: Progressive factors of AD such as Aβ, myelin basic protein (MBP), nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, and neurofilament light polypeptide (NFL) were decreased. While tau protein showed no change, factors affecting brain activity such as glial fibrillary acidic protein (GFAP), mitogen-activated protein kinases (MAPKs), cerebral blood flow (CBF), brain temperature, and neuronal activity were increased. Conclusion: Exposure to low levels of RF-EMFs can reduce the risk of AD by increasing MAPK and GFAP and decreasing MBP. Considering the role of apoptosis in AD and the effect of RF-EMF on the progression of the process, this review indicates the positive effect of these exposures.

Lead is the most widely used material for radiation protection in diagnostic radiology because its ability to attenuate x-rays is superior to other materials due to its high atomic number, high density, and its higher economic affordability. However, lead shields have serious disadvantages, such as high toxicity, heavy weight, poor flexibility, and low chemical stability. These disadvantages have oriented extensive research toward the use of non-lead composite shields. This study aims to review the materials and compounds proposed as alternatives to lead in x-ray shields and investigate their effectiveness in removing the limitations of standard lead shields. In total, 83 articles were reviewed using databases such as Google Scholar, Medline, Web of Science, Scopus, and Embase with the keywords of radiation protection, lead-free shields, and dianostic radiology. Since a wide range of materials can be used as radiation shields, the results show that in addition to the atomic number, the size of the particles can also be effective in increasing the radiation attenuation efficiency to the extent that the nano-sized non-lead shields have been more effective in radiation protection. Also, compared to common single and combined materials, multilayer polymer composites have better photon attenuation capability and reduce the possibility of x-ray penetration more effectively. Research to find appropriate alternative materials for lead and the optimization of the efficacy of radiation shields, should be continued, as it is difficult to achieve a light, flexible, low cost shield with a high x-ray attenuation in the entire range of diagnostic photon energies.

Background: Nowadays, there is a growing global concern over rapidly increasing screen time (smartphones, tablets, and computers). An accumulating body of evidence indicates that prolonged exposure to short-wavelength visible light (blue component) emitted from digital screens may cause cancer. The application of machine learning (ML) methods has significantly improved the accuracy of predictions in fields such as cancer susceptibility, recurrence, and survival. Objective: To develop an ML model for predicting the risk of breast cancer in women via several parameters related to exposure to ionizing and non-ionizing radiation.Material and Methods: In this analytical study, three ML models Random Forest (RF), Support Vector Machine (SVM), and Multi-Layer Perceptron Neural Network (MLPNN) were used to analyze data collected from 603 cases, including 309 breast cancer cases and 294 gender and age-matched controls. Standard face-to-face interviews were performed using a standard questionnaire for data collection. Results: The examined models RF, SVM, and MLPNN performed well for correctly classifying cases with breast cancer and the healthy ones (mean sensitivity> 97.2%, mean specificity >96.4%, and average accuracy >97.1%). Conclusion: Machine learning models can be used to effectively predict the risk of breast cancer via the history of exposure to ionizing and non-ionizing radiation (including blue light and screen time issues) parameters. The performance of the developed methods is encouraging; nevertheless, further investigation is required to confirm that machine learning techniques can diagnose breast cancer with relatively high accuracies automatically.

Background: We aimed to determine symptomatic Coronavirus disease 2019 (COVID-19) rates within 1 month of elective arthroplasty for vaccinated individuals and to determine whether vaccination guarantees protection against COVID-19 after arthroplasty (primary outcome). In addition, the 90-day surgical complications were compared to those of an unvaccinated group (secondary outcome). Methods: A prospective cohort study was conducted on elective joint arthroplasty patients at 3 tertiary hospitals in 2 major cities (Tehran and Isfahan) in our country (Iran). The outcomes of the COVID-19-vaccinated group were assessed between October 2021 and March 2022. Ninety-day surgical complications were compared with a historical cohort of unvaccinated patients treated earlier in the pandemic (April 2020-March 2021). Results: The study included 1717 consecutive patients: 962 vaccinated and 755 unvaccinated. In the vaccinated group, 38 patients (3.9%) contracted COVID-19, 4 (10.5%) were hospitalized again, and none required intensive care unit admission. The multivariate logistic regression analysis revealed that COVID-19-positive cases are more likely to be female (odds ratio [OR] = 12.5), to have visitors to their home (OR = 4.7), and to stay longer in the hospital (OR = 1.2) than COVID-19-negative cases. Compared to unvaccinated patients, the postoperative COVID-19 rate was not significantly different (3.9% vs 2.4%, P = .07). The incidence of surgical complications was similar between the 2 groups (P > .05). Conclusions: The vaccination does not provide a guarantee that a patient will not contract COVID-19 following their arthroplasty surgery, especially in a region with a high rate of COVID-19. We believe reasonable perioperative COVID-19 precautions may be warranted even in vaccinated patients.

An accumulating body of evidence shows that various ethnicities are differentially affected by SARS-COV-2 infection. Moreover, some evidence shows that due to the vaccine inequity and millions of people living with HIV, a major catastrophe could occur in African countries that possibly affects the whole world. Given the possibility that Neanderthal genes confer a slight increase in susceptibility, this difference, at least to some extent, might possibly decrease the risk of the emergence of new SARS-CoV-2 variants among black people in Africa. Recent studies show less death and fewer cases among the ethnic group classified as “Black Africans”. Although Neanderthal DNA might explain some differences in morbidity and mortality of COVID-19, a multitude of confounders complicate things to where drawing definite conclusions is hard or even impossible. Using selective-pressure-free treatments (e.g. low dose radiotherapy) for COVID-19 pneumonia would be of crucial importance everywhere, but particularly in sub-Saharan Africa, where “long COVID” in millions of people with HIV paves the road for the more frequent emergence of new variants.

The Omicron variant is spreading at a rate we have never observed with any previous variant. A lot of efforts have been taken to inactivate SARS-CoV-2, especially the omicron variant. Specific wavelength ranges of electromagnetic radiation can be exploited to inactivate coronaviruses. Previous studies show that 222-nm far-Ultraviolet C (far-UVC) light inactivates airborne influenza virus efficiently. Considering the similar genomic sizes of all human coronaviruses, other human coronaviruses, such as SARS-CoV-2, would be expected to be inactivated by far-UVC with a similar efficacy. Taking this into account, it is concluded that exposure to far-UVC can be introduced as a safe method that significantly reduces the ambient level of airborne coronaviruses in crowded places. Biomolecules, particularly proteins, strongly absorb ultraviolet radiation at a wavelength of around 200 nm. Given this consideration, far-UVC has a limited ability to permeate biological materials. Thus, for example, in only around 0.3 mm of tissue, the intensity of 200-nm UV radiation is decreased by half, compared to tissue penetration of about 3 mm at 250 nm. This paper aims to answer the key question of whether far-UVC can penetrate SARS-CoV-2 inside inhalable respiratory droplets (with diameters up to 100 µm).

Background: Some evidence shows that a pre-exposure to RF can mitigate the effects of subsequent exposures to high doses of ionizing radiation.Objective: We aimed to assess the effect of a pre-exposure to non-ionizing RF radiation on survival, weight changes, food consumption, and water intake of lethally irradiated rats.Material and Methods: In this case-control study, we used a commercial mobile phone (GSM, 900/1800 MHz) as well as a 2.4 GHz Wi-Fi router as the sources of pre-exposure to RF radiation. Forty-eight rats were randomly divided into six groups of control, “8 Gy X-rays”, mobile phone, “mobile phone+8 Gy”, Wi-Fi, and “Wi-Fi+8 Gy”. Then, the survival fraction, weight loss, water, and food consumption changes were compared in different groups.Results: The survival analysis indicated that the survival rates in all of the exposed animals (“8 Gy X-rays”, “mobile phone+8 Gy”, “Wi-Fi+8 Gy”) were significantly lower than the control, “Wi-Fi”, and “mobile phone” groups. The changes in survival rates of “mobile+8 Gy”, “Wi-Fi+8 Gy”, and 8 Gy alone were not statistically significant. However, food and water intake were significantly affected by exposure to both RF pre-exposures and exposure to high dose ionizing radiation. Conclusion: To the best of our knowledge, the existence of a dose window for the induction of AR can be the cause of the lack of AR in our experiment. Our findings confirm that in a similar pattern with the adaptive responses induced by pre-exposure to ionizing radiation, the induction of adaptive response by RF-pre-exposures requires a minimum level of damage to trigger adaptive phenomena.

Highlights Collagen gene variations seemed to have an association with anterior cruciate ligament (ACL) injury among professional athletes. This study shows no association of a type of COL1A1 polymorphism ACL injury in a young professional male athlete population. Different genotypes of COL1A1 have similar outcomes in ACL reconstruction surgery.

Abstract Introduction and objective Developmental dysplasia of the hip (DDH) is a musculoskeletal disorder. Genetic and epigenetic changes in C-X3-C motif chemokine receptor 1 (CX3CR1) may lead to disturbance in chondrocyte development and change the labrum dimensions, which indirectly result in hip joint instability. Considering the important role of this gene in cell migration, cell adhesion and bone and cartilage development, we aimed to evaluate the CX3CR1 gene methylation in DDH pathogenesis. Methods Our study comprised of forty-five DDH patients and forty-five healthy control subjects with healthy femoral neck cartilage. The healthy controls had total or hemiarthroplasty for the femoral neck fracture. Samples were collected from the femoral head (cartilage) of DDH patients and healthy controls. Genomic DNA was obtained from the samples, and DNA methylation of CX3CR1 gene was analyzed via metabisulfite method. Results Methylation analysis reveals no significant differences in promoter of CX3CR1 gene in cartilage samples from DDH patients and healthy control subjects (P = 0.33). Conclusion Methylation status of CX3CR1 gene showed no significant difference between the patient and control groups. Our results indicate that DNA methylation may not modulate this gene in this disease and other epigenetic mechanisms such as non-coding RNAs and histone modifications could be implicated.

Accurate and reliable estimation of the pelvic tilt is one of the essential pre-planning factors for total hip arthroplasty to prevent common post-operative complications such as implant impingement and dislocation. Inspired by the latest advances in deep learning-based systems, our focus in this paper has been to present an innovative and accurate method for estimating the functional pelvic tilt (PT) from a standing anterior–posterior (AP) radiography image. We introduce an encoder–decoder-style network based on a concurrent learning approach called VGG-UNET (VGG embedded in U-NET), where a deep fully convolutional network known as VGG is embedded at the encoder part of an image segmentation network, i.e., U-NET. In the bottleneck of the VGG-UNET, in addition to the decoder path, we use another path utilizing light-weight convolutional and fully connected layers to combine all extracted feature maps from the final convolution layer of VGG and thus regress PT. In the test phase, we exclude the decoder path and consider only a single target task i.e., PT estimation. The absolute errors obtained using VGG-UNET, VGG, and Mask R-CNN are 3.04 ± 2.49, 3.92 ± 2.92, and 4.97 ± 3.87, respectively. It is observed that the VGG-UNET leads to a more accurate prediction with a lower standard deviation (STD). Our experimental results demonstrate that the proposed multi-task network leads to a significantly improved performance compared to the best-reported results based on cascaded networks.

Background: During the last decade, people have been dramatically exposed to radiation emitted from widely-used radiofrequency electromagnetic fields (RF-EMF) generating devices. Objective: This study aimed to evaluate the effects of exposure to RF-EMF emitted from smart phones and Wi-Fi routers on the growth rate and antibiotic sensitivity of Enterococcus faecalis (E. faecalis) as a pathogen in the root canals of teeth.Material and Methods: In this experimental study, E. faecalis ATCC 19115 was used, characterized and confirmed by morphological and biochemical tests. Antibiotic susceptibility test was measured for several common antibiotics. To perform antibiotic susceptibility tests, disk diffusion (Kirby-Bauer) method on Mueller-Hinton agar plates was used before and after exposure to RF-EMFs emitted from a commercial Wi-Fi router or a mobile phone simulator. Moreover, we measured the optical density at 625 nm after different exposure times using a calibrated UV-visible spectrophotometer to evaluate the effect of RF-EMF exposure on the bacterial growth rate. Results: Exposure to RF-EMF significantly altered the antimicrobial sensitivity of the E. faecalis. While, the susceptibility of the bacteria decreased significantly after 6 h of exposure, longer exposure time (e.g. exposure for 24 h) increased the susceptibility of the bacteria to all antibiotics. Furthermore, it was found that the bacteria tended to regress to their early state. Moreover, the non-exposed E. faecalis showed a slower growth rate than the bacteria exposed to RF-EMFs. Conclusion: Exposure to RF-EMF emitted by Wi-Fi routers or mobile phone simulator can significantly change the antibiotic susceptibility and growth rate of E. faecalis.

Abstract Background Total hip arthroplasty is a common orthopedic surgery for treating primary or secondary hip osteoarthritis. Bilateral total hip replacement could be performed in a single stage or two separate stages. Each surgical procedure's reliability, safety, and complications have been reported controversially. This study aimed to review the current evidence regarding the outcomes of simultaneous and staged bilateral total hip arthroplasty. Methods We conducted a meta-analysis using MEDLINE, EMBASE, Web of Science, and Scopus databases. Eligible studies compared complications and related outcomes between simultaneous and staged bilateral THA. Two reviewers independently screened initial search results, assessed methodological quality, and extracted data. We used the Mantel–Haenszel method to perform the meta-analysis. Results In our study, we included 29,551 patients undergoing simBTHA and 74,600 patients undergoing stgBTHA. In favor of the simBTHA, a significant reduction in deep vein thrombosis (DVT) and systemic, local, and pulmonary complications was documented. However, we evidenced an increased pulmonary embolism (PE) and periprosthetic fracture risk in simBTHA. In the simBTHA, total blood loss, length of hospital stay, and total cost were lower. Conclusion This meta-analysis shows that simultaneous bilateral THA accompanies fewer complications and lower total cost. Well-designed randomized controlled trials are needed to provide robust evidence.

At the beginning of the COVID-19 emergence, many scientists believed that, thanks to the proofreading enzyme of SARS-CoV-2, the virus would not have many mutations. Our team introduced the concept of radiation at extremely low doses in an attempt to establish selected pressure-free treatment approaches for COVID-19. The capacity of low-dose radiation to modulate excessive inflammatory responses, optimize the immune system, prevent the occurrence of dangerous cytokine storm, regulate lymphocyte counts, and control bacterial co-infections as well as different modalities were proposed as a treatment program for patients with severe COVID-19-associated pneumonia. There is now substantial evidence which indicates that it would be unwise not to further investigate low-dose radiation therapy (LDRT) as an effective remedy against COVID-19-associated pneumonia.

Negative pressure wound therapy (NPWT) is a postoperative wound care method, which has recently become an ongoing field of research in hip and knee arthroplasty. We report the successful management of wound dehiscence and infection after THA in a case of Marfan syndrome by closed-incision negative-pressure wound therapy (ciNPWT). Our patient also developed a rare postoperative neurologic complication, that is, Parsonage-Turner syndrome (PTS). To our knowledge, this is the first report of PTS and ciNPWT use for SSI after THA in a Marfan patient. As wound dehiscence and infection can occur after THA in Marfan patients, we propose ciNPWT as an option to treat or even prevent (prophylactic use) such complications in this rare group of patients.

Background: The safety of continuing total joint arthroplasty (TJA), as an elective procedure, during the pandemic is controversial. The present study aimed to investigate the incidence of symptomatic coronavirus disease 2019 (COVID-19) and its related risk factors in unvaccinated patients after TJA within 1 month after discharge in 2 large cities of our country. Material and methods: The present prospective study included all the patients admitted to 3 hospitals, located in Tehran and Isfahan, 2 highly populated cities of Iran, from April 1, 2020, to April 1, 2021, for elective TJA. Urgent TJA (traumatic fractures) were excluded. The primary outcome was symptomatic COVID-19 within 1 month after discharge that was diagnosed using the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction test. Afterward, the incidence of COVID-19 in the study population was compared with that in the general population to estimate the safety of elective TJA during the pandemic. Results: From the 1007 patients undergoing TJA, 755 patients met the inclusion criteria. None of the patients was vaccinated against COVID-19. Among them, 18 patients (2.4%) developed symptomatic COVID-19 within 1 month after discharge. In the same time interval, the incidence of COVID-19 was 2.2% in the general population of these 2 cities, which was similar to the incidence reported in the study population. Of the patients who were positive for COVID-19, 4 patients were hospitalized, and 3 of them were admitted to an intensive care unit; however, no mortality was reported. Conclusion: The TJA will be a safe elective procedure for the patients during the pandemic if the preventive protocols are followed strictly.

Abstract Background Templating is a preoperative planning procedure that improves the efficiency of the surgical process and reduces postoperative complications of total hip arthroplasty (THA) by improving the precision of prediction of prosthetic implant size. This study aimed to evaluate the accuracy of the preoperative cup and stem size digital 2D templating of THA with mediCAD® software and find the factors that influence the accuracy, such as indication for surgery, patients’ demographics, implant brand, and the assessors’ grade of education. Methods We retrospectively retrieved 420 patient template images of all patients who underwent THA between March 2018 and March 2021. Templating of all included images was processed using mediCAD® software a day before surgery by a newcomer physician to hip arthroplasty course (PGY-2 orthopedic resident or hip surgery fellow). Preoperative templating cup and stem sizes were compared with the actual inserted implant sizes. Result After excluding ineligible patients, this study included 391 patients, 193 (49.4%) males and 198 (50.6%) females with a mean age of 43.3 ± 14.9. The average cup sizes predicted before and after surgery were 52.12 ± 14.28 and 52.21 ± 15.05 respectively, and the mean delta cup size (before and after surgery) was 2.79 ± 2.94. The delta stem size before and after surgery has a mean value of 1.53 ± 1.49. The acetabular cup components, measured within ± 0, ± 1, and ± 2 sizes, were 28.9%, 63.9%, 83.1% accurate, respectively. The femoral stem design component measured within ± 0, ± 1, and ± 2 sizes were 27.2%, 61.0%, 78.6% accurate, respectively. Wagner Cone® stem brand, DDH patients, and females showed significantly higher accuracy of stem size templating. Revision THA has the lowest accuracy in terms of cup size templating. The compression of accuracy rate between resident and fellow revealed no significant differences. Also, no significant difference was detected between the accuracy of templating performed in the first months with the second months of the arthroplasty course period. Conclusion Our study showed that under mentioned condition, templating using mediCAD® has acceptable accuracy in predicting the sizes of femoral and acetabular components in THA patients. Digital software like mediCAD® remains favorable because of the short learning curve, user-friendly features, and low-cost maintenance, leading to level-up patient care and THA efficacy. Further studies are necessary for clarifying the role of the assessor’s experience and expertise in THA preoperative templating. Level of evidence Level III (retrospective observational study).

We have previously reported that during future space missions the risk of severe COVID-19 infection will be a cardinal issue that needs careful attention. Our studies show that even with the most reliable pre-mission screening and quarantine strategies, astronauts with a latent (hidden, inactive, or dormant) SARS-CoV-2 infection might be sent to space. Given this consideration, an asymptomatic individual with dormant SARS-CoV-2 infection may successfully pass all the pre-launch medical tests. Then during a space mission such as a journey to Mars or beyond, when the immune system of these astronauts starts to weaken, the dormant infection may progress to a severe infection that possibly affects the chance of the mission’s success. The effects of microgravity and the elevated space radiation are two key factors that should be evaluated. Furthermore, the limited size of the spacecraft, the proximity of crew members during flight operations, spacecraft atmospheric composition, limited exercise capability, effects of viral response to space radiation, and uncertainty in the likelihood of the virus to mutate and evolve during a space mission merit additional study.

Background: The effects of radiation on the cellular compartments of the tumor microenvironment (TME) might be essential in radiotherapy outcomes. Objective: We aimed to assess the effects of the different doses of gamma irradiation on viability, ABCA1 and MMP-9 expression in adipose-derived mesenchymal stem cells (ASCs) as a critical part of TME.Material and Methods: In this experimental study, ASCs were extracted from five healthy donors and irradiated with different doses of 5, 10 and 30 Gy of gamma. Then, RNA was extracted from irradiated ASCs and cDNA was synthesized. The viability of ASCs was determined at 24, 48, 72 and 168 h after irradiation using trypan blue staining. The expression of ABCA1 was checked by quantitative real-time (qRT)-PCR technique and the expression of MMP-9 protein was evaluated by western-blot. Results: Based on our findings, 10 Gy and 30 Gy but not 5 Gy of gamma irradiation significantly decreased the viability of ASCs after 24, 48, 72 and 168 h compared to the non-irradiated cells (p < 0.05). However, a dose of 5 Gy increased ABCA1 in ASCs significantly compared to 10 Gy and 30 Gy (P=0.01 and P=0.02, respectively). In addition, the analysis of western blot data showed that 5 Gy of gamma irradiation significantly increased the expression of MMP-9 in ASCs (P=0.019). Conclusion: It is concluded that various doses of gamma radiation elicit differential ASCs responses that may lead to different tumor cell reactions to the radiotherapy through bystander effects.

Background: We examined the effect of low-level laser therapy (LLLT) and Bioptron light therapy on pain and function following primary total knee arthroplasty. Methods: A single-center, single-surgeon, prospective randomized clinical trial was performed with 3 groups of 15 patients: LLLT (804 nm), light (Bioptron; Bioptron AG, Wollerau, Switzerland), and controls. Range of motion (ROM), visual analog scale pain, opiate consumption (oxycodone in milligrams), knee swelling, and the Knee Society Score (KSS) were assessed before the surgery and on postoperative day 2, postoperative day 3, month 3, and month 12 after the operation. Results: The preoperative scores were similar between groups. A higher ROM was observed with the LLLT group at all follow-ups except at the 12-month follow-up (3-month ROM: 116.8° vs 104.0° vs 92.3°; P < .001). The knee swelling at 3 months was similar between the LLLT and light groups (2.1 cm), which was lower than that in controls (2.1 cm, P < .001). Furthermore, visual analog scale pain decreased more in the LLLT group than in other groups (8.5 vs 7.2 vs 6.0 points) at 3 months (P = .04) but was similar at 12 months (P > .05). Also, the LLLT group consumed fewer opiate painkillers during the first month (48.3 vs 60.3 mg of oxycodone, P = .02). In the LLLT group, the KSS at 3 and 12 months and the KSS function score at 3 months exceeded minimally clinically important differences (P < .05). Conclusions: In the early stages of recovery after total knee arthroplasty, LLLT and Bioptron light therapy could be helpful to control immediate and acute knee pain and swelling, reduce the need for opioids, improve ROM and functional scores, and improve recovery. Level of Evidence: Therapeutic level I.

Abstract Purpose Pelvic obliquity (PO) has not been extensively investigated, and there is no gold standard for measurement. The PO is essential for surgeons in planning hip arthroplasty, which includes the restoration of leg length discrepancy (LLD). We aimed to establish a normative range of PO angles by measuring healthy individuals without musculoskeletal disorders. Methods Our study included 134 consecutive cases (70 females) referred to our institution between April 2020 and September 2021 for non‐orthopedic problems. Patients were screened for normal gait and posture using the visual observation method (VOM) and the Modified Gait Abnormality Rating Scale (GARS‐M). In standing standard radiographs, the PO angle was measured as the angle between the horizontal plane and the inter‐teardrop line. Results Patients' mean age and Body Mass Index (BMI) were 39.7 ± 16.8 and 22.3 ± 3.1, respectively. PO angles did not follow a normal distribution, with a median (IQR) of 2.0° (0.9°—3.1°). According to the Wilcoxon one‐sample test, the median PO angle differed significantly from zero (P

During deep space missions, astronauts are exposed to highly ionizing radiation, incl. neutrons, protons and heavy ions from galactic cosmic rays (GCR), solar wind (SW) and solar energetic particles (SEP). This increase the risks for cancerogenisis, damages in central nervous system (CNS), cardiovascular diseases, etc. Large SEP events can even cause acute radiation syndrome (ARS). Long term manned deep space missions will therefor require unique radiation protection strategies. Since it has been shown that physical shielding alone is not sufficient, this paper propose pre-flight screening of the aspirants for evaluation of their level of adaptive responses. Methods for boosting their immune system, should also be further investigated, and the possibility of using radiation effect modulators are discussed. In this paper, especially, the use of vitamin C as a promising non-toxic, cost-effective, easily available radiation mitigator (which can be used hours after irradiation), is described. Although it has previously been shown that vitamin C can decrease radiation-induced chromosomal damage in rodents, it must be further investigated before any conclusions about its radiation mitigating properties in humans can be concluded.

Background:. The aim of this study was to compare the efficacy of 3 methods of intraoperative analgesic cocktail injection during total knee arthroplasty (TKA)—intra-articular (IA), periarticular (PA), and combined intra-articular and periarticular (IA+PA)—on controlling early postoperative pain. Methods:. This was a prospective double-blinded parallel randomized clinical trial. A total of 153 patients scheduled for TKA were allocated to IA, PA, or IA+PA (51 patients each) by block randomization. The primary outcome was morphine consumption. Secondary outcomes were visual analogue scale (VAS) pain, knee flexion, straight leg raising, Knee Society Score (KSS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results:. The morphine consumption was lowest in the PA group (median = 0, interquartile range [IQR] = 5) and highest in the IA group (median = 10, IQR = 5). The PA group had significantly lower VAS pain at rest than either IA (mean difference = −0.70; 95% confidence interval [CI] = −0.93 to −0.46; p < 0.001) or PA+IA (mean difference = −0.41; 95% CI = −0.65 to −0.18; p < 0.001). The PA group had also lower VAS pain during activity compared with IA (mean difference = −0.63; 95% CI = −0.85 to −0.40; p < 0.001) and IA+PA (mean difference = −0.38; 95% CI = −0.61 to −0.16; p < 0.001). The PA group had significantly greater active knee flexion compared with IA (mean difference = 9.68°; 95% CI = 5.50° to 13.86°; p < 0.001) and IA+PA (mean difference = 5.13°; 95% CI = 0.95° to 9.31°; p = 0.010). Passive knee flexion was greater for PA than IA (mean difference = 7.85°; 95% CI = 4.25° to 11.44°; p < 0.001). Other outcome variables were not significantly different among the 3 groups. The only complications were wound drainage (1 each in the IA and IA+PA groups) and deep venous thrombosis (1 in the IA group). Conclusions:. PA was associated with less early postoperative pain and greater active knee flexion compared with the other 2 analgesic methods. Level of Evidence:. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Background: Forgotten Joint Score (FJS) is a patient-reported outcome measurement that evaluates patients' ability to forget the replaced joint (knee or hip) in everyday activity. This study aimed to evaluate the validity and reliability of the Persian version of this questionnaire in Iranian patients who underwent total hip arthroplasty. Methods: A team of specialists reviewed this questionnaire and voted for its clarity and content validity. Then, the FJS was filled out by 100 randomly selected total hip arthroplasty patients between 2019 and 2021 with at least 6 months of follow-up. The reliability coefficient (Cronbach's alpha) was calculated. Results: A total of 95 patients who met the inclusion criteria, with the mean age 59.9 ± 11.6 years and 26.6% being female, participated in the study. Patients had no difficulty with the content and linguistic format of the Persian FJS-12. The mean FJS for these patients was 50.8 ± 4.6. The Cronbach's alpha was measured at 0.87. The mean content validity index was 0.93. Conclusion: FJS-12 can discriminate even patients with eximious pain and functional outcomes after joint reconstruction surgery. The Persian format of FJS-12 showed acceptable internal consistency using Cronbach's alpha and acceptable content validity. Therefore, it can be utilized in the Iranian population for future research studies.

Objective: The interaction of tumor cells with surrounding stem cells such as adipose-derived mesenchymal stem cells (ASCs) would be a crucial mechanism of tumor progression. It has been shown that irradiation can affect tumor microenvironment through different mechanisms. Given that, we aimed to examine the bystander radiation-induced effects of ASCs on different cancer cell lines. Materials and Methods: In this experimental study, ASCs were extracted from five healthy donors, cultured and then irradiated with a 5Gy of gamma radiation. Following 72 hours of incubation, irradiated ASCs-conditioned media (IACM) and non-irradiated ASCs-conditioned media (NIACM) were collected. Following incubation of different cell lines, Jurkat, LNCaP, U87-MG, MDA-MB-231 and MCF-7, in different media, DMEM, NIACM, and IACM, ALDEFLUOR assay and wound healing assays, were conducted. Using quantitative real-time polymerase chain reaction (qRT-PCR), the expression of ATP-binding cassette transporter genes, ABCA1 and ABCG2, was measured in these cell lines. Results: NIACM significantly increased ALDH activity in MDA-MB-231 cell (P=0.02), while IACM was associated with significant decrease in the LNCaP and MCF-7 cell lines, respectively P=0.02, P=0.03, compared to DMEM as the control. The area of the scratch site was significantly reduced in MDA-MB-231 cells cultured with NIACM compared to DMEM (P=0.04). Furthermore, ABCA1 mRNA expression was considerably decreased in IACM- but not in DMEMtreated LNCaP line (P=0.01). Conclusion: It seems, after exposing to radiation, ASCs modify to prevent tumor development and metastasis through their radiation-induced bystander effects. Therefore, a better understanding of ASCs function in the tumor microenvironment may provide new insights into therapeutic strategies to surmount radio-resistance in cancer treatment.

The ongoing COVID-19 pandemic is of great concern for the whole world, and finding an effective treatment for the disease caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is, therefore, a global race. In particular, treatment options for elderly patients and patients with genetic risk factors with COVID-19-associated pneumonia are limited, and many patients die. Low-dose radiotherapy (LDRT) of lungs was used to treat pneumonia many decades ago. Since the first report on the potential efficacy of LDRT for COVID-19-associated pneumonia was published on 1 April, 2020, tens of papers have addressed the importance of this treatment. Moreover, the findings of less than 10 clinical trials conducted to date are now available. We performed a detailed search of PubMed/MEDLINE, Web of Science, Google Scholar, and Scopus and selected the nine most relevant articles. A review of these articles was conducted. The available data indicate that in oxygen-dependent elderly patients with COVID-19-associated pneumonia, whole-lung radiation at doses of 0.5–1.5 Gy can lead to accelerated recovery and progress in clinical status, encephalopathy, and radiographic consolidation without any detectable acute toxicity. Although data collected so far show that LDRT could be introduced as a treatment with promising efficacy, due to limitations such as lack of randomization in most studies, we need further large-scale randomized studies, especially for elderly patients who are at greater risk of mortality due to COVID-19. However, more preclinical work and clinical trials are needed before any clear conclusion can be made.

More than a decade before the COVID-19 crisis, it was reported that the rapid growth in ionizing radiation-based imaging procedures had caused a significant increase in the collective dose by more than 700% and an increase in the annual per-capita dose by almost 600%, as estimated by the US NCRP [1, 2]. Scientist around the globe discussed that such a rapid growth could be associated with significant effect on public health. Most of the exponential growth of cardiovascular computed tomography (CT) scan and nuclear Imaging, which require larger radiation doses than traditional x-ray imaging. Brenner and Hall in their review article published in the New England Journal of Medicine reported that CT scans increased from ~ 3 million in 1980 to an estimated 62 million in 2006 (20.67 x growth in 26 years) [3]. While imaging technological advances such as adaptive, statistical, iterative image reconstruction techniques have been linked to a significant radiation dose reduction [4], reports show that in countries such as the US most of the increased exposures were due to CT scans and nuclear medicine imaging which need much larger radiation doses compared to those of traditional X-ray imaging procedures.