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Brain dynamics associated with design creativity tasks are largely unexplored. Despite significant strides, there is a limited understanding of the brain-behavior during design creation tasks. The objective of this paper is to review the concepts of creativity and design creativity as well as their differences, and to explore the brain dynamics associated with design creativity tasks using electroencephalography (EEG) as a neuroimaging tool. The paper aims to provide essential insights for future researchers in the field of design creativity neurocognition. It seeks to examine fundamental studies, present key findings, and initiate a discussion on associated brain dynamics. The review employs thematic analysis and a forward and backward snowball search methodology with specific inclusion and exclusion criteria to select relevant studies. This search strategy ensured a comprehensive review focused on EEG-based creativity and design creativity experiments. Different components of those experiments such as participants, psychometrics, experiment design, and creativity tasks, are reviewed and then discussed. The review identifies that while some studies have converged on specific findings regarding EEG alpha band activity in creativity experiments, there remain inconsistencies in the literature. The paper underscores the need for further research to unravel the interplays between these cognitive processes. This comprehensive review serves as a valuable resource for readers seeking an understanding of current literature, principal discoveries, and areas where knowledge remains incomplete. It highlights both positive and foundational aspects, identifies gaps, and poses lingering questions to guide future research endeavors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zangeneh Soroush and Zeng.)

MXenes have demonstrated potential for various applications owing to their tunable surface chemistry and metallic conductivity. However, high temperatures can accelerate MXene film oxidation in air. Understanding the mechanisms of MXene oxidation at elevated temperatures, which is still limited, is critical in improving their thermal stability for high-temperature applications. Here, we demonstrate that Ti[Formula: see text]C[Formula: see text]T[Formula: see text] MXene monoflakes have exceptional thermal stability at temperatures up to 600[Formula: see text]C in air, while multiflakes readily oxidize in air at 300[Formula: see text]C. Density functional theory calculations indicate that confined water between Ti[Formula: see text]C[Formula: see text]T[Formula: see text] flakes has higher removal energy than surface water and can thus persist to higher temperatures, leading to oxidation. We demonstrate that the amount of confined water correlates with the degree of oxidation in stacked flakes. Confined water can be fully removed by vacuum annealing Ti[Formula: see text]C[Formula: see text]T[Formula: see text] films at 600[Formula: see text]C, resulting in substantial stability improvement in multiflake films (can withstand 600[Formula: see text]C in air). These findings provide fundamental insights into the kinetics of confined water and its role in Ti[Formula: see text]C[Formula: see text]T[Formula: see text] oxidation. This work enables the use of stable monoflake MXenes in high-temperature applications and provides guidelines for proper vacuum annealing of multiflake films to enhance their stability., Competing Interests: Competing interests statement:The authors declare no competing interest.

Understanding neural mechanisms in design and creativity processes remains a challenging endeavor. To address this gap, we present two electroencephalography (EEG) datasets recorded in design and creativity experiments. We have discussed the details, similarities, differences, and corresponding cognitive tasks of the two datasets in the following sections. The design dataset (Dataset A) comprises EEG recordings of 27 participants during loosely controlled design creation experiments. Each experiment included six design problems. In each design problem, participants performed five cognitive tasks, including problem understanding, idea generation, rating idea generation, idea evaluation, and rating idea evaluation. The NASA Task Load Index was used in rating tasks. The creativity dataset (Dataset B) includes EEG signals recorded from 28 participants in creativity experiments which were based on a modified variant of the Torrance Test of Creative Thinking (TTCT-F). Participants were presented with three incomplete sketches and were asked to perform three creativity tasks for each sketch: idea generation, idea evolution, and idea evaluation. In both datasets, we structured the experiments into predefined steps, primarily to ensure participants' comfort and task clarity. This was the only control applied to the experiments. All the tasks were loosely controlled: open-ended (up to 3 min) and self-paced. 64-channel EEG signals were recorded at 500 Hz based on the international 10-10 system by the Brain Vision EEG recording system while the participants were performing their assigned tasks. EEG channels were pre-processed and finally referenced to the Cz channel to remove artifacts. EEGs were pre-processed using popular pipelines widely used in previous studies. Preprocessed EEG signals were finally segmented according to the tasks to facilitate future analyses. The EEG signals are stored in the .mat format. While the present paper mainly addresses pre-processed datasets, it also cites raw EEG recordings in the following sections. We aim to promote research and facilitate the development of experimental protocols and methodologies in design and creativity cognition by sharing these resources. There exist important points regarding the datasets which are worth mentioning. These datasets represent a novel contribution to the field, offering insights into design and creativity neurocognition. To our knowledge, publicly accessible datasets of this nature are scarce, and, to the best of our knowledge, our datasets are the first publicly available ones in design and creativity. Researchers can utilize these datasets directly or draw upon the considerations and technical insights provided to inform their studies. Furthermore, we introduce the concept of loosely controlled cognitive experiments in design and creativity cognition. These experiments strike a balance between flexibility and control, allowing participants to incubate creative ideas over extended response times while maintaining structured experimental sections. Such an approach fosters more natural data recording procedures and holds the potential to enhance the accuracy and reliability of future studies. The loosely controlled approach can be employed in future cognitive studies. This paper also conducts a comparative analysis of the two datasets, offering a holistic view of design and creativity tasks. By exploring various aspects of these cognitive processes, we provide an understanding for future researchers., (© 2023 The Author(s).)

Janus structures have unique properties due to their distinct functionalities on opposing faces, but have yet to be realized with flowing liquids. We demonstrate such Janus liquids with a customizable distribution of nanoparticles (NPs) throughout their structures by joining two aqueous streams of NP dispersions in an apolar liquid. Using this anisotropic integration platform, different magnetic, conductive, or non-responsive NPs can be spatially confined to opposite sides of the original interface using magnetic graphene oxide (mGO)/GO, Ti 3 C 2 T x /GO, or GO suspensions. The resultant Janus liquids can be used as templates for versatile, responsive, and mechanically robust aerogels suitable for piezoresistive sensing, human motion monitoring, and electromagnetic interference (EMI) shielding with a tuned absorption mechanism. The EMI shields outperform their current counterparts in terms of wave absorption, i.e., SE T  ≈ 51 dB, SE R  ≈ 0.4 dB, and A = 0.91, due to their high porosity ranging from micro- to macro-scales along with non-interfering magnetic and conductive networks imparted by the Janus architecture., (© 2023. The Author(s).)

MXenes, a family of 2D transition-metal carbides and nitrides, have excellent electrical conductivity and unique optical properties. However, MXenes oxidize in ambient conditions, which is accelerated upon heating. Intercalation of water also causes hydrolysis accelerating oxidation. Developing new tools to readily characterize MXenes' thermal stability can enable deeper insights into their structure-property relationships. Here, in situ spectroscopic ellipsometry (SE) is employed to characterize the optical properties of three types of MXenes (Ti 3 C 2 T x , Mo 2 TiC 2 T x , and Ti 2 CT x ) with varied composition and atomistic structures to investigate their thermal degradation upon heating under ambient environment. It is demonstrated that changes in MXene extinction and optical conductivity in the visible and near-IR regions correlate well with the amount of intercalated water and hydroxyl termination groups and the degree of oxidation, measured using thermogravimetric analysis. Among the three MXenes, Ti 3 C 2 T x and Ti 2 CT x , respectively, have the highest and lowest thermal stability, indicating the role of transition-metal type, synthesis route, and the number of atomic layers in MXene flakes. These findings demonstrate the utility of SE as a powerful in situ technique for rapid structure-property relationship studies paving the way for the further design, fabrication, and property optimization of novel MXene materials., (© 2023 Wiley-VCH GmbH.)

Modern materials science has witnessed the era of advanced fabrication methods to engineer functionality from the nano- to macroscales. Versatile fabrication and additive manufacturing methods are developed, but the ability to design a material for a given application is still limited. Here, a novel strategy that enables target-oriented manufacturing of ultra-lightweight aerogels with on-demand characteristics is introduced. The process relies on controllable liquid templating through interfacial complexation to generate tunable, stimuli-responsive 3D-structured (multiphase) filamentous liquid templates. The methodology involves nanoscale chemistry and microscale assembly of nanoparticles (NPs) at liquid-liquid interfaces to produce hierarchical macroscopic aerogels featuring multiscale porosity, ultralow density (3.05-3.41 mg cm -3 ), and high compressibility (90%) combined with elastic resilience and instant shape recovery. The challenges are overcome facing ultra-lightweight aerogels, including poor mechanical integrity and the inability to form predefined 3D constructs with on-demand functionality, for a multitude of applications. The controllable nature of the coined methodology enables tunable electromagnetic interference shielding with high specific shielding effectiveness (39 893 dB cm 2 g -1 ), and one of the highest-ever reported oil-absorption capacities (487 times the initial weight of aerogel for chloroform), to be obtained. These properties originate from the engineerable nature of liquid templating, pushing the boundaries of lightweight materials to systematic function design and applications., (© 2023 The Authors. Advanced Materials published by Wiley-VCH GmbH.)

Objective: Scholars are exploring novel diagnostic and prognostic biomarkers with higher sensitivity and specificity for systemic lupus erythematosus (SLE). In this regard, DNA methylation alterations have aroused attention. The association between the dysfunction of MMP9 and TNFAIP3 genes and SLE has been previously demonstrated. Therefore, in this study, we investigated the methylation level of MMP9 and TNFAIP3 promoters in peripheral blood mononuclear cells (PBMCs) of SLE patients and healthy controls., Methods: Eighty Iranian SLE patients and 77 healthy individuals were enrolled. The methylation quantification endonuclease-resistant DNA (MethyQESD) method was used to assess methylation levels of MMP9 and TNFAIP3 in extracted DNA of PBMCs. To quantify the diagnostic utility of the promoter methylation level of these genes, the receiver operating characteristic (ROC) curve was constructed., Results: MMP9 promoter was significantly hypomethylated in SLE patients compared with healthy people ( p < 0.001), while there was no significant difference in terms of TNFAIP3 promoter methylation levels ( p = 0.167). Also, this differential MMP9 methylation was observed in patients with renal involvement and patients without renal involvement (42.07 ± 25.73 vs 56.74 ± 29.71, p = 0.007). ROC analyses indicated that the diagnostic power of the MMP9 promoter methylation level for SLE was 0.839 [95% CI (0.781-0.911)]. Moreover, MMP9 methylation level was negatively correlated with creatinine and anti-dsDNA concentration and positively correlated with C3 and C4 levels., Conclusion: The results of this study highlight the application of MMP9 methylation level in PBMCs of SLE patients as a diagnostic biomarker.

Introduction: The COVID-19 pandemic has considerably affected human beings most of whom are healthcare workers (HCWs) combating the disease in the front line., Methods: This cross-sectional study aims to explore the effects of stress and anxiety caused by COVID-19 on the quality of sleep and life in HCWs, including physicians, nurses, and other healthcare staff. In this global study, we asked 1,210 HCWs (620 and 590 volunteers from Iran and European countries, including Germany, the Netherlands, and Italy, respectively), who age 21-70, to participate in the test. Several measures of COVID-related stress, anxiety, sleep, and life quality, including the 12-item General Health Questionnaire (GHQ-12), Fear of COVID-19 scale (FCV-19S), Beck Anxiety Inventory (BAI), the Pittsburgh Sleep Quality Index (PSQI), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) are recorded., Results: Volunteers reported high rates of stress and anxiety and poor sleep quality as well as lower quality of life. The correlation analysis between the measures is reported. According to the results, regardless of the location, HCWs, predominantly female nurses, developed anxiety and stress symptoms which consequently resulted in lower sleep and life quality. Both for Iranian and the European HCWs, significant differences existed between nurses and the other two groups, with the p -values equal to 0.0357 and 0.0429 for GHQ-12, 0.0368, and 0.714 for BAI measure. Even though nurses reported the most stress, anxiety, fear of COVID-19, lower quality of life and sleep in both countries, and also an increase in other measures as well, there existed no statistically significant difference in FCV-19S, PSQI, and WHOQOL-BREF., Discussion: This study helps to expand our knowledge the effects of pandemics on HCWs and also for healthcare management to predict HCW's mental health conditions in similar situations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zangeneh Soroush, Tahvilian, Koohestani, Maghooli, Jafarnia Dabanloo, Sarhangi Kadijani, Jahantigh, Zangeneh Soroush and Saliani.)

Abstract: The objective of this study was to determine ADL (Activity of daily living) in survivors of the Iran-Iraq war with bilateral lower limb amputation. The cross-sectional survey 335 amputees participated in the study (response rate = 58 %) and ADL (KATZ) questionnaire were used. The average age of the patients was 42.05 (SD = 6.33). The majority of the cases 97.6 % (n = 327) were married. The most common type of amputation was both below-knee 37.6 % (n = 126). Two hundred and six subjects (61.5 %) were prosthetic ambulates. Shell and landmine were the most common cause of amputation. The most dependency in ADL was related to transport 26.4% (n=90) which was followed by taking shower 19.6% (n= 67). The results of this study suggest a rehabilitation programs to improve the independency in amputees.

Sarcopenia is more common in the elderly and causes adverse outcomes with increased morbidity and mortality. This prospective cohort study assessed the association of sarcopenia risk with the severity of COVID-19 at the time of admission and during hospitalisation and the length of hospital stay. Two hundred patients (aged ≥ 60 years) who were hospitalised for COVID-19 were enrolled using consecutive sampling between 29 December 2020 and 20 May 2021. The sarcopenia score of the patients was assessed using the Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falls questionnaire. The severity of COVID-19 was determined using the modified National Early Warning Score (m-NEWS) system for 2019 n-CoV-infected patients at admission (T1), day three (T2) and at discharge (T3). Data were analysed using SPSS, version 22 and STATA, version 14. Of the 165 patients included, thirty four (20·6 %) were at risk of sarcopenia. The length of hospital stay was slightly longer in patients with sarcopenia risk, but the difference was not significant ( P = 0·600). The adjusted OR of respiratory rate (RR) > 20 /min at T1 for the sarcopenia risk group was 6·7-times higher than that for the non-sarcopenic group ( P = 0·002). According to generalised estimating equations, after adjusting for confounding factors, the m-NEWS score was 5·6 units higher in patients at risk of sarcopenia ( P < 0·001). Sarcopenia risk could exacerbate COVID-19 severity and increase RR at admission, as well as the need for oxygen therapy at discharge.

Strong light-matter interactions in localized nano-emitters placed near metallic mirrors have been widely reported via spectroscopic studies in the optical far-field. Here, we report a near-field nano-spectroscopic study of localized nanoscale emitters on a flat Au substrate. Using quasi 2-dimensional CdSe/Cd x Zn 1-x S nanoplatelets, we observe directional propagation on the Au substrate of surface plasmon polaritons launched from the excitons of the nanoplatelets as wave-like fringe patterns in the near-field photoluminescence maps. These fringe patterns were confirmed via extensive electromagnetic wave simulations to be standing-waves formed between the tip and the edge-up assembled nano-emitters on the substrate plane. We further report that both light confinement and in-plane emission can be engineered by tuning the surrounding dielectric environment of the nanoplatelets. Our results lead to renewed understanding of in-plane, near-field electromagnetic signal transduction from the localized nano-emitters with profound implications in nano and quantum photonics as well as resonant optoelectronics., (© 2023. The Author(s).)

Urinary tract infection (UTI) is a common bacterial illness in children. Knowledge of the antimicrobial resistance patterns of common uropathogens in children according to local epidemiology is essential for providing clinically appropriate, cost effective therapy for UTI. The aim of this study was to determine the distribution of urinary tract infections in a referral hospital, Children’s Medical Center, and determination of in vitro susceptibility of these organisms to antimicrobial agents. Of the 1231 bacterial isolates the most frequent isolates were Escherichia coli (38.66%), Klebsiella spp. (22.25%), Coagulase-negative staphylococci (10.1%), Pseudomonas spp. (8.7%), enterococci (8.28%), Enterobacter spp. (4.1%), staphylococcus aureus (3.24%), and proteus mirabilis (2.9%). Among Enterobacteriaceae, 79.80% of E. coli were amikacin-sensitive. Of Gram-positive cocci, 66.66% of staphylococcus aureus were vancomycin-sensitive. Our data show the original distribution of uropathogens from UTIs in children referred to Children’s Medical Center in Tehran and the emergence of multidrug resistant strains.

Background: Adult T-cell Leukemia/Lymphoma (ATLL) is a rapidly progressing type of T-cell non-Hodgkin lymphoma that is developed after the infection by human T-cell leukemia virus type 1 (HTLV-1). It could be categorized into four major subtypes, acute, lymphoma, chronic, and smoldering. These different subtypes have some shared clinical manifestations, and there are no trustworthy biomarkers for diagnosis of them., Methods: We applied weighted-gene co-expression network analysis to find the potential gene and miRNA biomarkers for various ATLL subtypes. Afterward, we found reliable miRNA-gene interactions by identifying the experimentally validated-target genes of miRNAs., Results: The outcomes disclosed the interactions of miR-29b-2-5p and miR-342-3p with LSAMP in ATLL&#95;acute, miR-575 with UBN2, miR-342-3p with ZNF280B, and miR-342-5p with FOXRED2 in ATLL&#95;chronic, miR-940 and miR-423-3p with C6orf141, miR-940 and miR-1225-3p with CDCP1, and miR-324-3p with COL14A1 in ATLL&#95;smoldering. These miRNA-gene interactions determine the molecular factors involved in the pathogenesis of each ATLL subtype and the unique ones could be considered biomarkers., Conclusion: The above-mentioned miRNAs-genes interactions are suggested as diagnostic biomarkers for different ATLL subtypes., (© 2023. The Author(s).)

In this multicentre study, we compared the status of antibody production in healthcare personnel (HCP) before and after vaccination using different brands of COVID-19 vaccines between March 2021 and September 2021. Out of a total of 962 HCP enrolled in our study, the antibody against the S1 domain of SARS-CoV-2 was detected in 48.3%, 95.5% and 96.2% of them before, after the first and the second doses of the vaccines, respectively. Our results showed post-vaccination infection in 3.7% and 5.9% of the individuals after the first and second doses of vaccines, respectively. The infection was significantly lower in HCP who presented higher antibody titres before the vaccination. Although types of vaccines did not show a significant difference in the infection rate, a lower infection rate was recorded for AstraZeneca after the second vaccination course. This rate was equal among individuals receiving a second dose of Sinopharm and Sputnik. Vaccine-related side effects were more frequent among AstraZeneca recipients after the first dose and among Sputnik recipients after the second dose. In conclusion, our results showed diversity among different brands of COVID-19 vaccines; however, it seems that two doses of the vaccines could induce an antibody response in most of HCP. The induced immunity could persist for 3-5 months after the second vaccination course.

An immunosensor based on gold nanorods (AuNRs) etchant activity of a metal-organic framework (MOF): MIL-88B(Fe)-reduced graphene oxide (rGMOF) was developed for the determination of prostate-specific antigen (PSA). Several techniques, including FTIR, UV-Vis spectrophotometry, XRD, and electron microscopy, were employed to characterize the MOFs containing iron-oxygen clusters on the surface of reduced graphene oxide. Enzyme mimetic activity of rGMOF before and after bioconjugation with antibodies was calculated as 8.4 and 2.5 U mg -1 , respectively. The primary anti-PSA was conjugated to a magnetic bead and used as PSA-specific capturing. Then, the secondary anti-PSA was grafted to the rGMOF. In the presence of antigen, an immuno-sandwich was formed between the conjugations mentioned above. Afterward, AuNRs were etched by rGMOF, and the related spectrum was recorded in the wavelength range 350 to 900 nm. By progressing the etching procedure, the longitudinal LSPR peak of AuNRs was gradually blue-shifted with a linear correlation with the PSA concentration from 0.1 pg mL -1 to 100 ng mL -1 . The detection limit was 0.09 pg mL -1 . The proposed immunosensor was successfully employed to determine PSA levels in real samples. Since the obtained results showed an excellent correlation with those acquired by the chemiluminescence gold standard method, it has the potential for PSA determination in clinical assays., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

We designed a magneto-plasmonic biosensor for the immunodetection of antigens in minute sample volume. Both spherical gold nanoparticles (AuNP) and magnetic beads (MB) were conjugated to goat anti-rabbit IgG antibody (Ab) capable of recognizing a model target, rabbit IgG (rIgG). The AuNP bioconjugate was used as the optical detection probe while the MB one was used as the capture probe. Addition of the target analyte followed by detection probe resulted in the formation of a sandwich immunocomplex which was separated from the unbound AuNP-Ab conjugate by application of an external magnetic field. The readout was executed either in a direct or in indirect way by measuring the UV-Visible spectrum of each fraction in a specially designed microcell. Dose-response curves were established from the optical signal of the immunocomplex and unbound AuNP-Ab conjugate fractions. Finally, the assay was transposed to a microfluidic cell specially designed to enable easy separation of the immunocomplex and AuNP-Ab conjugate fractions and subsequent analysis of the latter fraction and achieve the quantification of the analyte in the ng/mL concentration range.

Blind source separation (BSS) methods have received a great deal of attention in electroencephalogram (EEG) artifact elimination as they are routine and standard signal processing tools to remove artifacts and reserve desired neural information. On the other hand, a classifier should follow BSS methods to automatically identify artifactual sources and remove them in the following steps. In addition, removing all detected artifactual components leads to loss of information since some desired information related to neural activity leaks to these sources. So, an approach should be employed to detect and suppress the artifacts and reserve neural activity. This study introduces a novel method based on EEG and Poincare planes in the phase space to detect artifactual components estimated by second-order blind identification (SOBI). Artifacts are detected using a mixture of well-known conventional classifiers and were removed employing stationary wavelet transform (SWT) to reserve neural information. The proposed method is a combination of signal processing techniques and machine learning algorithms, including multi-layer perceptron (MLP), K-nearest neighbor (KNN), naïve Bayes, and support vector machine (SVM) which have significant results while applying our proposed method to different scenarios. Simulated, semi-simulated, and real EEG signals are employed to evaluate the proposed method, and several evaluation criteria are calculated. We achieved acceptable results, for example, 98% average accuracy and 97% average sensitivity in artifactual EEG component detection or about 2% as mean square error in EEG reconstruction after artifact removal. Results showed that the proposed method is effective and can be used in future studies as we have considered different real-world scenarios to evaluate it., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zangeneh Soroush, Tahvilian, Nasirpour, Maghooli, Sadeghniiat-Haghighi, Vahid Harandi, Abdollahi, Ghazizadeh and Jafarnia Dabanloo.)

Water supplies contaminated with heavy metals are a worldwide concern. MXenes have properties that make them attractive for the removal of metal ions from water. This work presents a simple one-step method of Ti 3 C 2 T x carboxylation that involves the use of a chelating agent with a linear structure, providing strong carboxylic acid groups with high mobility. The carboxylation decreases the zeta-potential of Ti 3 C 2 T x by ~16 to ~18 mV over a pH range of 2.0-8.5 and improves Ti 3 C 2 T x stability in the presence of molecular oxygen. pH in the range of 2-6 has a negligible effect on the adsorption capacity of Ti 3 C 2 T x and COOH-Ti 3 C 2 T x . Compared to Ti 3 C 2 T x , COOH-Ti 3 C 2 T x has a slightly higher and much faster mercury uptake, and the concentration of mercury ions leached out from COOH-Ti 3 C 2 T x is lower. For both Ti 3 C 2 T x and COOH-Ti 3 C 2 T x , the leached mercury ion concentration is far below the U.S.-EPA maximum level. At an initial Hg 2+ concentration of 50 ppm and pH of 6, COOH-Ti 3 C 2 T x has the equilibrium adsorption capacity of 499.7 mg/g and removes 95% of Hg 2+ in less than 1 min. Moreover, it has an equilibrium time of 5 min, which is significantly shorter than that of Ti 3 C 2 T x (~ 60 min). Finally, its mercury-ion uptake capacity is higher than commercially available adsorbents reported in the literature. Its mercury removal is mainly via chemisorption and monolayer adsorption., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background/objective: Osteoporosis is a global health concern with an increasing prevalence worldwide. Denosumab is an antiresoptive agent that has been demonstrated to be effective and safe in osteoporotic patients. This study aimed to compare the efficacy and safety of the biosimilar denosumab candidate (Arylia) to the originator product (Prolia®) in postmenopausal osteoporotic patients., Methods: In this randomized, double-blind, active-controlled, noninferiority trial, postmenopausal osteoporotic patients received 60 mg of subcutaneous Arylia or Prolia® at months 0, 6, and 12 and were followed up for 18 months. The primary endpoint was the noninferiority of the biosimilar product to the reference product in the percentage change of bone mineral density (BMD) in 18 months at the lumbar spine (L 1 -L 4 ), total hip, and femoral neck. The secondary endpoints were safety assessment, the incidence of new vertebral fractures, and the trend of bone turnover markers (BTMs)., Results: A total of 190 patients were randomized to receive either biosimilar (n = 95) or reference (n = 95) denosumab. In the per-protocol (PP) analysis, the lower limits of the 95% two-sided confidence intervals of the difference between Arylia and Prolia® in increasing BMD were greater than the predetermined noninferiority margin of - 1.78 at the lumbar spine, total hip, and femoral neck sites (mean differences [95% CIs] of 0.39 [- 1.34 to 2.11], 0.04 [- 1.61 to 1.69], and 0.41 [- 1.58 to 2.40], respectively). The two products were also comparable in terms of safety, new vertebral fractures, and trend of BTMs., Conclusion: The efficacy of the biosimilar denosumab was shown to be noninferior to that of the reference denosumab, with a comparable safety profile at 18 months., Trial Registration: ClinicalTrials.gov, NCT03293108 ; Registration date: 2017-09-19., (© 2022. The Author(s).)

Aim of the Work: To assess the clinical manifestations, imaging findings and outcomes of corona virus disease 2019 (COVID-19) in patients with rheumatic diseases., Patients and Methods: In a three-center study, patients with rheumatic diseases who developed COVID-19 were included. Patients were classified into two groups, i) inflammatory arthritis including rheumatoid arthritis (RA), spondyloarthritis (SpA) and undifferentiated arthritis, ii) connective tissue diseases (CTDs) including systemic lupus erythematosus (SLE), vasculitis and others. COVID-19 outcomes were assessed based on chest computed tomography severity score (CT-ss), the level of care, the number of patients who died and flare of underlying rheumatic disease., Results: One hundred ninety-six patients with a mean age of 47.9 ± 15.1 years, 73.5% female, were included. Underlying rheumatic diseases were RA (57.7%), SLE and other CTDs (17.9%), SpA (11.2%), vasculitis (11.2%) and undifferentiated arthritis (2%). Myalgia, malaise and fever were the most common clinical manifestations of COVID-19. Pneumonia on computerized tomography (CT), hospitalization, admission in intensive care unit and need to mechanical ventilation were observed in 75.5, 37.2%, 10.7% and 6.6% of patients, respectively. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids, diabetes and underlying pulmonary disease were predictors of moderate to severe pneumonia and hospitalization. Fifteen (7.6%) patients died. Flare of underlying rheumatic disease occurred in 16.3% of patients. Flare of disease in patients with CTDs was significantly more than other rheumatic diseases., Conclusions: In rheumatic patients, treatment with NSAIDs or prednisolone, diabetes and pulmonary disease are risk factors of moderate to high CT-ss and hospitalization during COVID-19., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Egyptian Society for Joint Diseases and Arthritis.)

With the COVID-19 pandemic spreading across the world, its disruptive effect on the provision and utilization of non- COVID related health services have become well-documented. As countries developed mitigation strategies to help continue the delivery of essential health services through the pandemic, they needed to carefully weigh the benefits and risks of pursuing these strategies. In an attempt to assist countries in their mitigation efforts, a Benefit-Risk model was designed to provide guidance on how to compare the health benefits of sustained essential reproductive, maternal, newborn and child (RMNCH) services against the risk of SARS-CoV-2 infections incurred by the countries' populations when accessing these services. This article describes how two existing models were combined to create this model, the field-testing process carried out from November 2020 through March 2021 in six countries and the findings. The overall Benefit-Risk Ratio in the 6 countries analyzed was found to be between 13.7 and 79.2, which means that for every 13.7 to 79.2 lives gained due to increased RMNCH service coverage, there was one loss of a life related to COVID-19. In all cases and for all services, the benefit of maintaining essential health services far exceeded the risks associated with additional COVID-19 infections and deaths. This modelling process illustrated how essential health services can continue to operate during a pandemic and how mitigation measures can reduce COVID-19 infections and restore or increase coverage of essential health services. Overall, this Benefit-Risk analysis underscored the importance and value of maintaining coverage of essential health services even during public health emergencies, including the recent COVID-19 pandemic., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Weissman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The excellent conductivity and versatile surface chemistry of MXenes render these nanomaterials attractive for sensor applications. This mini-review puts recent advances in MXene-based sensors into perspective and provides prospects for the area. It describes the attractive properties and the working principles of MXene-based sensors fabricated from a MXene/polymer nanocomposite or a pristine MXene. The importance of surface modification of MXenes to improve their affinity for polymers and to develop self-healing and durable sensors is delineated. Several novel sensor fabrication methods and their challenges are discussed. Emerging applications of MXene-based sensors including moisture, motion, gas, and humidity detection as well as pressure distribution mapping are critically reviewed. Potential applications of MXene-based sensors in the food industry to monitor food materials and production plants are highlighted., Competing Interests: The authors declare no competing financial interest., (© 2021 The Authors. Published by American Chemical Society.)

Background: Temporary artery clipping facilitates safe cerebral aneurysm management, besides a risk for cerebral ischemia. We developed an artificial neural network (ANN) to predict the safe clipping time of temporary artery occlusion (TAO) during intracranial aneurysm surgery., Method: We devised a three-layer model to predict the safe clipping time for TAO. We considered age, the diameter of the right and left middle cerebral arteries (MCAs), the diameter of the right and left A1 segment of anterior cerebral arteries (ACAs), the diameter of the anterior communicating artery, mean velocity of flow at the right and left MCAs, and the mean velocity of flow at the right and left ACAs, as well as the Fisher grading scale of brain CT scans as the input values for the model., Results: This study included 125 patients: 105 patients from a retrospective cohort for training the model and 20 patients from a prospective cohort for validating the model. The output of the neural network yielded up to 960 s overall safe clipping time for TAO. The input values with the greatest impact on safe TAO were mean velocity of blood at left MCA and left ACA, and Fisher grading scale of brain CT scan., Conclusion: This study presents an axillary framework to improve the accuracy of the estimated safe clipping time interval of temporary artery occlusion in intracranial aneurysm surgery.

Background/aim: This study aimed to evaluate the demographic, clinical, angiographic and prognostic characteristics of Takayasu arteritis (TA) in Iran., Materials and Methods: A total of 75 patients with TA based on the American College of Rheumatology 1990 criteria for TA classification referred to the Rheumatology Centres, were followed-up from 1989 to 2019. Demographic, clinical, angiographic and prognostic characteristics were collected at baseline and last visit., Results: The mean age was 31.9 ± 9.8 years at the disease onset. Female to male ratio was 14. The median latency in diagnosis was 24 months. Pulse discrepancy in the arms, blood pressure discrepancy in the arms, limb claudication, hypertension and constitutional symptoms were the most common clinical features. The most common angiographic type at the time of diagnosis was Type I (42.7%). The most frequent arterial lesion was stenosis (89.4%). Subclavian, carotid and aortic arteries were the most commonly involved arteries. New lesions developed in 28.6% of patients during the 5.25-year follow-up. Vasculitis-induced chronic damage was observed in all patients. Disease activity decreased and vascular damage remained stable throughout the follow-up period., Conclusions: The clinical features and angiographic type of TA in Iran are different from most Asian countries. Differences in angiographic and clinical features may lead to delayed diagnosis. The issue of delay in diagnosis should create awareness among health care providers that TA is not a very rare disease in Iranians and failure to pay attention to warning symptoms may delay the diagnosis., Competing Interests: The authors declare that they have no conflicts of interest., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background: Limited studies have reported epidemiologic data on the impact of Iran-Iraq war. This study examines the war casualties for both combatants and civilians on Iranians at national level., Methods: Databases of Veterans and Martyrs Affair Foundation (VMAF), Janbazan Medical and Engineering Research Center (JMERC) and Ministry of Health were used to collect the data. The prevalence of injuries for both civilians and combatants was presented. Casualties were studied based on conventional and unconventional weapons attacks (1980-2018), separately., Results: The Iran-Iraq war led to 183623 lost lives, 554990 injured and 40240 captured. The mean length of captivity was 45.7 months (1 month-19 years) and 2.7% (n = 575) died in captivity. There were 1439180 war related injuries recorded in databanks, mostly affecting men (98.4%). About 1439180 injuries were recorded, most of them related to conventional weapons (938928 [65.24%]). Remaining artillery and mortar fragmentation in the body (39.5%, n = 371236), psychological disorders (15.9%, n = 228944), and exposure to chemical weapons (11%, n = 158817) were the most prevalent war-related injuries., Conclusion: Human casualties of the Iran-Iraq war on the Iranian side and the health care system are huge even after more than three decades., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: To describe the utilization and out-of-pocket (OOP) payments of war survivors receiving health care services and its determinants., Methods: A cross-sectional study was carried out by systematic random sampling at national level (n = 3079) on healthcare utilization in war survivors on their last received services. A validated questionnaire was used to gather the information of inpatient and outpatient healthcare services and OOP payment. The data were analyzed to indicate the determinants of health utilization and expenses., Results: Health care utilization was reported in 91.6% (n = 2822). The majority (82.5%) received one or two services in their last visits, mostly related to physician visits and medications (65.97%). Health care utilization was higher than general population annually, especially in physician visit (6.6 versus 4.89), medication (5.1 versus 3.6), and hospitalization (0.78 versus 0.15). About 20.2% (n = 599) of the study population paid out of their pocket for their last medical care services. The frequency of OOP payment was greater for physician visit and medication. Payment for hospitalization, imaging, and lab tests were more significantly associated with proceeding to reimburse the expenses ( P <0.001). The median OOP payment was US$10.8 (interquartile range US$20.6). Gender (P=0.003), area of residence ( P =0.01) and being war victims ( P =0.005) were the significant determinants for both OOP payments and reclaiming the expenditure. Higher amount of payments ( P <0.001) and more received health services ( P =0.002) were also important factors in reclaiming the expenditure., Conclusion: Both outpatient services and hospital admission are more frequent among war survivors compared to the general Iranian population. Future studies should attempt to explore the reasons., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)