Recent advances in smart wearable sensors as electronic skin.

Flexible and multifunctional electronic devices and soft robots inspired by human organs, such as skin, have many applications. However, the emergence of electronic skins (e-skins) or textiles in biomedical engineering has made a great revolution in a myriad of people's lives who suffer from different types of diseases and problems in which their skin and muscles lose their appropriate functions. In this review, recent advances in the sensory function of the e-skins are described. Furthermore, we have categorized them from the sensory function perspective and highlighted their advantages and limitations. The categories are tactile sensors (including capacitive, piezoresistive, piezoelectric, triboelectric, and optical), temperature, and multi-sensors. In addition, we summarized the most recent advancements in sensors and their particular features. The role of material selection and structure in sensory function and other features of the e-skins are also discussed. Finally, current challenges and future prospects of these systems towards advanced biomedical applications are elaborated.

Cosmetic Breast Implants and the Risk of Suicide: A Systematic Review and Meta-Analysis.

Objective: Having cosmetic breast implants increases a woman's chance of suicide, which is now a global challenge. This systematic review evaluated the possible risk of suicide among women who undergo cosmetic breast implants. Method : This meta-analysis was done based on Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). In the current systematic review and meta-analysis, we systematically searched for all articles written in both English or Persian that estimated the prevalence of suicidal ideation in women who had cosmetic breast implants. We systematically searched different databases, including MEDLINE (PubMed), Web of Science, Embase, Cochrane, Library ProQuest, Scopus, and Google Scholar, from inception to March 2021. There was also a search for references. Suicidal ideation, a suicide plan, or suicide attempts were the outcomes. In order to determine the total pooled prevalence of suicidal ideation, we utilized a random-effects model. To examine the risks of bias in each study, we applied the Joanna Briggs Institute Critical Appraisal method. Results: We identified 218 citations in our initial search. After omitting duplicated citations and excluding irrelevant studies according to the title and abstract selection, 42 studies were chosen for the full text analysis. Finally, 11 research, examining a total of 324,332 women were incorporated into the systematic review and critical appraisal assessment. Eight of these studies were found to be eligible for meta-analysis. The frequency of suicide in women with cosmetic breast implant was 0.2% (95% CI: 0.1% to 0.4%; P < 0.001) (Q-value: 168.143, I2:95.83). Most of the included studies had moderate quality. Conclusion: There might be a correlation between cosmetic breast implants and suicide risk, which could be stronger in the presence of a history of mental illnesses. The evidence about the possible effects of breast implants on the risk of suicide is still inconclusive, and there is a need for future well-designed studies on this topic.

The Impact of Single Nucleotide Polymorphisms on the Pharmacokinetics of Tacrolimus in Kidney Allograft Recipients of Northern-West, Iran.

Purpose: Calcineurin inhibitors (CNIs) such as tacrolimus are a major immunosuppressive therapy after renal transplantation, which inhibit cytokine expression. The pharmacokinetics of such drugs is influenced by cytochrome P450 (CYP) enzymes, multi-drug resistance-1 (MDR-1), and C25385T pregnane X receptor (PXR). This study aimed to investigate the impact of single nucleotide polymorphisms (SNP) in these genes on the ratio of tacrolimus level per drug dosage (C/D ratio), acute graft rejection, and viral infections. Methods: Kidney transplantation recipients (n=65) under similar immunosuppressive treatment were included. Amplification refractory mutation systempolymerase chain reaction (ARMS-PCR) method was applied to amplify the loci containing the SNPs of interest. Results: Overall, 65 patients with a male/female ratio of 37/28 were included. The mean age was 38±1.75 years. The variant allele frequencies of CYP3A5*3, MDR-1 C3435T, and PXR C25385T were 95.38, 20.77, and 26.92%, respectively. No significant correlations were found between the studied SNPs and the tacrolimus C/D ratios. However, there was a significant difference in the C/D ratios at 2 and 8 weeks in homozygote CYP3A5 *3/*3 carriers (P=0.015). No significant association was found between the studied polymorphisms and viral infections and acute graft rejection (P>0.05). Conclusion: Homozygote CYP3A5 *3/*3 genotype could influence the tacrolimus metabolism rate (C/D ratio).

A handheld bioprinter for multi-material printing of complex constructs.

In situbioprinting-the process of depositing bioinks at a defected area, has recently emerged as a versatile technology for tissue repair and restorationviasite-specific delivery of pro-healing constructs. The ability to print multiple materialsin situis an exciting approach that allows simultaneous or sequential dispensing of different materials and cells to achieve tissue biomimicry. Herein, we report a modular handheld bioprinter that deposits a variety of bioinksin situwith exquisite control over their physical and chemical properties. Combined stereolithography 3D printing and microfluidic technologies allowed us to develop a novel low-priced handheld bioprinter. The ergonomic design of the handheld bioprinter facilitate the shape-controlled biofabrication of multi-component fibers with different cross-sectional shapes and material compositions. Furthermore, the capabilities of the produced fibers in the local delivery of therapeutic agents was demonstrated by incorporating drug-loaded microcarriers, extending the application of the printed fibers to on-demand, temporal, and dosage-control drug delivery platforms. Also, the versatility of this platform to produce biosensors and wearable electronics was demonstrated via incorporating conductive materials and integrating pH-responsive dyes. The handheld printer's efficacy in generating cell-laden fibers with high cell viability for site-specific cell delivery was shown by producing single-component and multi-component cell-laden fibers. In particular, the multi-component fibers were able to model the invasion of cancer cells into the adjacent tissue.

Tissue-engineered heart chambers as a platform technology for drug discovery and disease modeling.

Current drug screening approaches are incapable of fully detecting and characterizing drug effectiveness and toxicity of human cardiomyocytes. The pharmaceutical industry uses mathematical models, cell lines, and in vivo models. Many promising drugs are abandoned early in development, and some cardiotoxic drugs reach humans leading to drug recalls. Therefore, there is an unmet need to have more reliable and predictive tools for drug discovery and screening applications. Biofabrication of functional cardiac tissues holds great promise for developing a faithful 3D in vitro disease model, optimizing drug screening efficiencies enabling precision medicine. Different fabrication techniques including molding, pull spinning and 3D bioprinting were used to develop tissue-engineered heart chambers. The big challenge is to effectively organize cells into tissue with structural and physiological features resembling native tissues. Some advancements have been made in engineering miniaturized heart chambers that resemble a living pump for drug screening and disease modeling applications. Here, we review the currently developed tissue-engineered heart chambers and discuss challenges and prospects.

Maternal deprivation effect on morphine-induced CPP is related to changes in opioid receptors in selected rat brain regions (hippocampus, prefrontal cortex, and nucleus accumbens).

Early-life environmental conditions affect offspring's development. Maternal deprivation (MD) can induce persistent changes that give rise to neuropsychiatric diseases including substance abuse disorders. However, long-lasting mechanisms that determine vulnerability to drug addiction remain unknown. We hypothesized that MD could induce changes in Opioid system, HPA (hypothalamic-pituitary-adrenal) axis, and BDNF (brain-derived neurotrophic factor), so may be involved in the drug abuse in later life. Male offspring of Wistar rats (n = 8 per group) were subjected to 3 h of daily MD during postnatal days 1-14. In adulthood, morphine-induced CPP (conditioned place preference) was investigated using two doses of morphine (3 and 5 mg/kg). Serum corticosterone level was measured by ELISA method. The expression level of genes in selected brain regions (hippocampus, prefrontal cortex, and nucleus accumbens) was determined by qPCR (quantitative PCR). A greater morphine-induced CPP was observed in MD rats with 3 and 5 mg/kg morphine compared to controls. MD group had a higher corticosterone level. A significant decrease was observed in the expression of BDNF gene (in all of the selected brain regions) and GR (glucocorticoid receptor) gene (in the hippocampus and nucleus accumbens) in MD rats. Also, a significant increase in the expression of µ Opioid receptor (in all of the selected brain regions) and κ Opioid receptor (in the prefrontal cortex and nucleus accumbens) was observed in MD rats. Our results suggest that MD induces alterations in the HPA axis function, BDNF level, and Opioid receptors system that enhance vulnerability to morphine at adulthood.

Latest Advances in 3D Bioprinting of Cardiac Tissues.

Cardiovascular diseases (CVDs) are known as the major cause of death worldwide. In spite of tremendous advancements in medical therapy, the gold standard for CVD treatment is still transplantation. Tissue engineering, on the other hand, has emerged as a pioneering field of study with promising results in tissue regeneration using cells, biological cues, and scaffolds. Three-dimensional (3D) bioprinting is a rapidly growing technique in tissue engineering because of its ability to create complex scaffold structures, encapsulate cells, and perform these tasks with precision. More recently, 3D bioprinting has made its debut in cardiac tissue engineering, and scientists are investigating this technique for development of new strategies for cardiac tissue regeneration. In this review, the fundamentals of cardiac tissue biology, available 3D bioprinting techniques and bioinks, and cells implemented for cardiac regeneration are briefly summarized and presented. Afterwards, the pioneering and state-of-the-art works that have utilized 3D bioprinting for cardiac tissue engineering are thoroughly reviewed. Finally, regulatory pathways and their contemporary limitations and challenges for clinical translation are discussed.

Uniform Partitioning of Data Grid for Association Detection.

Inferring appropriate information from large datasets has become important. In particular, identifying relationships among variables in these datasets has far-reaching impacts. In this article, we introduce the uniform information coefficient (UIC), which measures the amount of dependence between two multidimensional variables and is able to detect both linear and non-linear associations. Our proposed UIC is inspired by the maximal information coefficient (MIC) [1].; however, the MIC was originally designed to measure dependence between two one-dimensional variables. Unlike the MIC calculation that depends on the type of association between two variables, we show that the UIC calculation is less computationally expensive and more robust to the type of association between two variables. The UIC achieves this by replacing the dynamic programming step in the MIC calculation with a simpler technique based on the uniform partitioning of the data grid. This computational efficiency comes at the cost of not maximizing the information coefficient as done by the MIC algorithm. We present theoretical guarantees for the performance of the UIC and a variety of experiments to demonstrate its quality in detecting associations.

The therapeutic effect of cerium oxide nanoparticle on ischaemia/reperfusion injury in rat testis.

Testicular torsion is a dangerous urogenital disorder which is caused by twisting of spermatic cord, and unless immediate treatments happen at a proper time, oxidative stress, occurred during ischaemia reperfusion, finally leads to irreversible disintegration of testicular tissue. One of the first preventive lines is to administrate antioxidant factors. In the present study, we investigate the therapeutic effect of cerium oxide nanoparticle on the injury. We divided 45 rats into nine groups, subjected eight groups to testicular torsion-detorsion, injected different doses of cerium oxide nanoparticle into the peritoneum of six groups and analysed all the groups regarding spermatogenetic indices including sperm count, sperm viability and Johnson mean. Our results showed that cerium oxide nanoparticle can alleviate oxidative stress in testis, and this alleviation promotes the reproductive indices as the concentration of cerium oxide nanoparticles increases. The catalase-mimetic and superoxide dismutase-mimetic activities of cerium oxide nanoparticle are the most probable theories to explain the antioxidant effect of the nanoparticle.

Biohybrid oxidized alginate/myocardial extracellular matrix injectable hydrogels with improved electromechanical properties for cardiac tissue engineering.

Injectable hydrogels which mimic the physicochemical and electromechanical properties of cardiac tissue is advantageous for cardiac tissue engineering. Here, a newly-developed in situ forming double-network hydrogel derived from biological macromolecules (oxidized alginate (OA) and myocardial extracellular matrix (ECM)) with improved mechanical properties and electrical conductivity was optimized. 3-(2-aminoethyl amino) propyltrimethoxysilane (APTMS)-functionalized reduced graphene oxide (Amine-rGO) was added to this system with varied concentrations to promote electromechanical properties of the hydrogel. Alginate was partially oxidized with an oxidation degree of 5% and the resulting OA was cross-linked via calcium ions which was reacted with amine groups of ECM and Amine-rGO through Schiff-base reaction. In situ forming hydrogels composed of 4% w/v OA and 0.8% w/v ECM showed appropriate gelation time and tensile Young's modulus. The electroactive hydrogels showed electrical conductivity in the range of semi-conductors and a suitable biodegradation profile for cardiac tissue engineering. Cytocompatibility analysis was performed by MTT assay against human umbilical vein endothelial cells (HUVECs), and the optimal hydrogel with 25 µg/ml concentration of Amine-rGO showed higher cell viability than that for other samples. The results of this study present the potential of OA/myocardial ECM-based hydrogel incorporated with Amine-rGO to provide a desirable platform for cardiac tissue engineering.

Multifunctional Conductive Biomaterials as Promising Platforms for Cardiac Tissue Engineering.

Adult cardiomyocytes are terminally differentiated cells that result in minimal intrinsic potential for the heart to self-regenerate. The introduction of novel approaches in cardiac tissue engineering aims to repair damages from cardiovascular diseases. Recently, conductive biomaterials such as carbon- and gold-based nanomaterials, conductive polymers, and ceramics that have outstanding electrical conductivity, acceptable mechanical properties, and promoted cell-cell signaling transduction have attracted attention for use in cardiac tissue engineering. Nevertheless, comprehensive classification of conductive biomaterials from the perspective of cardiac cell function is a subject for discussion. In the present review, we classify and summarize the unique properties of conductive biomaterials considered beneficial for cardiac tissue engineering. We attempt to cover recent advances in conductive biomaterials with a particular focus on their effects on cardiac cell functions and proposed mechanisms of action. Finally, current problems, limitations, challenges, and suggested solutions for applications of these biomaterials are presented.

Augmentation of morphine-conditioned place preference by food restriction is associated with alterations in the oxytocin/oxytocin receptor in rat models.

BACKGROUND: Studies indicate that food restriction (FR) reinforces the effects of morphine. The exact mechanisms by which FR influences the reward circuitry of morphine have not yet been determined. OBJECTIVES: We hypothesized that the effects of FR on the oxytocin (OXT) system and HPA axis can be associated with substance abuse disorders. In this study, the serum levels of OXT and corticosterone, and the expression of OXT/OXT receptor (OXTR), glucocorticoid receptor (GR), and brain-derived neurotrophic factor (BDNF) in the hippocampus, prefrontal cortex, and nucleus accumbens were investigated in an FR model. METHODS: First, the male rats (n = 8 per group) were subjected to FR for 3 weeks. Then, morphine-induced conditioned place preference (CPP) was observed using two doses of morphine (3 and 5 mg/kg). The serum concentrations of corticosterone and OXT were determined by ELISA and the expression of genes was examined by qPCR. RESULTS: FR induced an enhanced preference in the animals for the 5 mg/kg dose of morphine compared to the controls. Serum corticosterone levels increased after FR but OXT levels decreased. Meanwhile, FR actuated downregulation of GR, BDNF, and OXT genes, while inducing the overexpression of OXTR. CONCLUSION: We propose the inclusion of OXT and OXTR alterations in the enhancement of morphine-induced CPP and addiction vulnerability following FR. Moreover, we conclude that altered BDNF levels and HPA axis activity may be the mechanisms involved in the effects of FR on morphine-induced behavior.

Gastro-Intestinal Tract Cancers Following Bariatric Surgery: a Narrative Review.

The association between obesity and malignancies has been identified epidemiologically. Meanwhile, the increasing global number of bariatric surgeries is reported annually; bariatric surgery's effect on different types of cancers is not well understood. Unfortunately, nonspecific presentations and difficulties regarding investigations make diagnosis challenging. The aim of this study is to compile available data about gastro-intestinal (GI) cancers, occurring after different bariatric surgeries. Although GI cancers are considered a rare complication of obesity surgery, they do exist, and diagnosis needs a high index of suspicion.

An Integrated Model of Patient and Staff Satisfaction Using Queuing Theory.

This paper investigates the connection between patient satisfaction, waiting time, staff satisfaction, and service time. It uses a variety of models to enable improvement against experiential and operational health service goals. Patient satisfaction levels are estimated using a model based on waiting (waiting times). Staff satisfaction levels are estimated using a model based on the time spent with patients (service time). An integrated model of patient and staff satisfaction, the effective satisfaction level model, is then proposed (using queuing theory). This links patient satisfaction, waiting time, staff satisfaction, and service time, connecting two important concepts, namely, experience and efficiency in care delivery and leading to a more holistic approach in designing and managing health services. The proposed model will enable healthcare systems analysts to objectively and directly relate elements of service quality to capacity planning. Moreover, as an instrument used jointly by healthcare commissioners and providers, it affords the prospect of better resource allocation.

Impact of PET and CT in PET/CT studies for staging and evaluating treatment response in bone and soft tissue sarcomas.

PURPOSE: Study impact of F-18 FDG PET/CT on initial staging, restaging, and evaluating treatment response (ETR) in bone and soft tissue sarcomas (BSTS), focusing on discrepancy between CT and PET portions. PATIENTS AND METHODS: Ninety-three BSTS patients having 204 F-18 FDG PET/CT studies were retrospectively reviewed. They were divided into 4 groups. Group I for initial staging included 16 patient studies. The other 3 groups were divided according to the time interval from last treatment received. Group II for ETR up to 2 months included 83 studies. Group III was for early restaging after 2 to 6 months included 45 studies. Group IV was for long-term follow-up after 6 months included 60 studies. All results were confirmed either by pathology, or by clinical follow-up. RESULTS: Sixteen studies for initial staging were concordant in 14 and discordant in 2 patients (48 lesions, 46 concordant, and 2 discordant). PET showed 97.2% sensitivity and 100% specificity versus 100% and 91.6% on CT. Regarding the other 3 groups, 498 lesions were detected; PET and CT were concordant in 436/498 (88%) and discordant in 62/498 (12%). In group II for ETR, PET and CT were concordant in 64/83 (77%) and discordant in 19/83(23%) studies-13 showed excellent to complete response on PET with partial response (PR) or stable disease (SD) on CT; 6 studies in PET showed PR versus SD or progression of disease (PD) on CT. In group III, for early restaging of disease 36/45 (80%) concordant and 9/45 (20%) discordant (3 showed excellent to complete response and 2 PR on PET versus CT SD, 3 PET PR versus CT PD, and 1 PET study showed PD while CT showed SD). In group IV, for long-term restaging, 49/60 (82%) were concordant and 11/60 (18%) were discordant; 9 PET studies were negative for active disease versus CT positive and 2 PET studies showed PD, CT was negative. PET alone showed 94.1% sensitivity and 94.6% specificity versus 97.2% and 63.5% for CT, 100% and 95.9% for PET/CT. CONCLUSIONS: In BSTS for the purpose of initial staging, ETR, short-term, or long-term restaging, FDG-PET is more accurate than CT. Combined PET/CT has higher accuracy than either alone.

Pediatric emergency department assessment of psychological trauma and posttraumatic stress.

OBJECTIVES: This study aimed to describe the kinds of stressors and the extent of symptoms of posttraumatic stress disorder (PTSD) that were reported by children and their parents in a pediatric emergency department and to examine the response rate to an emotional trauma questionnaire in this setting. METHODS: Three self-report questionnaires were given to patients aged eight to 21 years and to their primary caretakers: a brief assessment of service use, the Posttraumatic Stress Reaction Index (PTSRI), and the Impact of Event Scale (IES). RESULTS: Sixty-four of 81 families who were approached agreed to participate (consent rate of 79 percent), and 62 completed the questionnaires. Fifty-six patients reported at least one event that met DSM-IV-TR criteria for emotional trauma. The average number of reported events per child was 3.14 (range, 0 to 7). Eighteen patients met threshold criteria for severity of PTSD symptoms. Twenty-five patients reported that the most distressing traumatic event that they experienced was related to a medical illness. Patients with PTSD reported exposure to more adverse life events than patients without PTSD. IES scores reported by caretakers who identified the same event as their child as the most stressful were as high as those of caretakers who reported a different event as the most stressful. CONCLUSIONS: Exposures to emotionally traumatic events and PTSD symptoms are commonly reported in the pediatric emergency department. Asking children and their parents about their history of emotional trauma when they visit the emergency department is possible and can be well received.