Intelligent modelling for the elimination of lanthanides (La3+, Ce3+, Nd3+ and Eu3+) from aqueous solution by magnetic CoFe2O4 and CoFe2O4-GO spinel ferrite nanocomposites.

In this research, a novel CoFe2O4-GO (Graphen Oxide) resulting from the combination of high applicable magnetic and organic base materials and synthesized with a simple and fast co-precipitation route was synthesized for the REEs (Rare Earth Elements) extraction. This adsorbent could remove the La3+, Ce3+, Nd3+ and Eu3+ by maximum adsorption capacity of 625, 626, 714.2, 1111.2 mg/g at optimized pH = 6, respectively. A data-driven model was obtained using Group Method of Data Handling (GMDH)-based Neural Network to estimate the adsorption capacity of these LREEs as a function of time, pH, temperature, adsorbent ζ (zeta)- potential, initial concentration of lanthanides ions, and ε which is defined by the physico-chemical properties of lanthanides. The results clearly indicated that the model estimate the experimental values with good deviation (mostly less than 10%) and it can be used for the prediction of the results from other similar researches with less than 25% deviation. The results of sensitivity analysis indicated that the adsorption capacity is more sensitive to pH of the solution, temperature, and ε. Finally, the desorption studies showed an excellent removal efficiency (97%) at least for three adsorption-desorption cycles. These results claimed that the CoFe2O4-GO is a highly efficient adsorbent for the REEs extraction.

Overminus Lens Therapy in the Management of Children with Intermittent Exotropia.

PURPOSE: To evaluate the results of overminus lens therapy in the management of children with intermittent exotropia or X(T). METHODS: In this retrospective study, 163 consecutive patients with X(T) who were treated with overminus spectacles with at least 12 months of follow-up were included in the study. The outcome measures were the level of X(T) control evaluated using the Jampolsky's qualitative assessment method and refractive error changes under overminus lens treatment. RESULTS: The mean angle of deviation at the initial visit was 24.7 ± 15.1 prism diopters (PD) that improved to 10.6 ± 4.2 PD with overminus glasses with a median follow-up of 38 months (P = 0.02). One hundred and nine patients (66.8%) achieved good controlled X(T) or orthotropia by overminus lens therapy after 1 year. Three patients progressed to esotropia, which disappeared after discontinuing overminus lens therapy. Overminus lens therapy did not have a statistically significant effect on the mean spherical equivalent of cycloplegic refraction in each eye (right eye: P = 0.13; left eye: P = 0.15). CONCLUSIONS: Overminus lens therapy can be effective for improving the control of X(T) in young children. It can defer the requirement for surgery or decrease the rate of surgical intervention.

Comparing Two Inferior Oblique Weakening Procedures: Disinsertion versus Myectomy.

PURPOSE: To compare two methods for treating inferior oblique overaction (IOOA): disinsertion versus myectomy of the muscle. METHODS: In this prospective interventional case series, patients were randomly assigned to undergo either IO myectomy or disinsertion. The changes in vertical and horizontal deviations following these two surgical procedures were evaluated. The postoperative IO function of grade 0 or +1 and the fundus extorsion of grade 0 or +1 was considered as the successful outcome. RESULTS: Thirty-six patients (50 eyes) with a mean age of 12.67 ± 4.05 years were included. In the myectomy group, the mean preoperative hyperdeviation in adduction was 29.5 ± 9.32 prism diopter (PD), which decreased to 9.15 ± 7.86 PD after surgery (P = 0.001). In the disinsertion group, these measurements were 32.73 ± 12.42 and 12.65 ± 9.34 PD before and after the surgery, respectively (P = 0.001). The success rate of surgery based on the IOOA grading was 87.4% and 92.3% in the myectomy and disinsertion groups, respectively (P = 0.780). The successful correction rate of abnormal fundus torsion was 91.6% in the myectomy and 88.4% in the disinsertion group (P = 0.821). In comparison, 48% of the cases in the myectomy group and 50% in the disinsertion group were within the normal range of torsional position postoperatively (P = 0.786). There was no statistically significant difference in terms of changes in the horizontal or vertical deviations, V-pattern, and dissociated vertical deviation between the two groups. CONCLUSION: Both surgical techniques seem to be effective for treatment of inferior oblique muscle overaction.

The Relationship between "Self-Care Ability" and Psychological Changes among Hemodialysis Patients.

AIM: The study investigates and analyzes the relationship among the concepts of demoralization, posttraumatic growth, and self-care ability in patients undergoing hemodialysis. METHODS: The cross-sectional descriptive correlational study was conducted in 2017 on 150 hemodialysis patients selected through census in Buali Hospital, Ardabil, Iran. Demoralization scale, the posttraumatic growth inventory, and self-care questionnaire were used for cross-sectional data collection. Data were analyzed using descriptive statistics, Pearson and Spearman correlation coefficient. RESULTS: The mean and standard deviation of demoralization, posttraumatic growth, and self-care were 36.25 ± 18.84, 63.17 ± 17.71, and 33.89 ± 6.40, respectively. Self-care ability was positively associated with posttraumatic growth (r = 0.287) and negatively related to demoralization (r = -0.168). Self-care ability was also found to be desirable in 84.7% of the patients. CONCLUSIONS: Hemodialysis patients can experience both positive and negative psychological changes. Self-care ability is associated with reductions in negative psychological problems and increases in positive psychological changes. Health-care providers can, therefore, help hemodialysis patients to improve their psychological conditions by making plans for improving self-care abilities.

The effects of photobiomodulation therapy for treatment of alveolar osteitis (Dry Socket): Systematic review and meta-analysis.

INTRODUCTION: Dry socket (alveolar osteitis) is one of the most common complications that occur after the extraction of permanent teeth. The aim of this review was to evaluate and compare the effectiveness of photobiomodulation (PBT) with other treatment methods on alveolar osteitis. METHODS AND MATERIALS: MEDLINE, Web of Science, EMBASE, Scopus and Cochrane's CENTRAL online databases were searched based on the search strategy. Also, the prominent laser journals and the references of relevant studies were hand searched for eligible studies and then the data were extracted from the retrieved studies were extracted using piloted custom forms. The data were combined and analyzed using inverse-variance random-effect meta-analysis. RESULTS: For the treatment of dry socket, pain perception based on the VAS score, PBT on average has a 3.41 higher pain level reduction compared to alveogyl which seems to be both statistically and clinically significant. In addition, based on the GRADE score, the evidence seems to be of moderate quality. Also, in the individual studies which were included in this systematic review, PBT seems to be more effective than other methods (Salicept, zinc-oxide eugenol, ozone, and photodynamic therapy) in pain reduction of patients with alveolar osteitis. CONCLUSIONS: PBT, in general, has a higher ability in decreasing pain levels for patients with alveolar osteitis (dry socket) compared to alveogyl. Therefore, PBT could be used as an appropriate method for treatment and controlling the signs of dry socket.

Quantification of mortality and morbidity attributed to the ambient air criteria pollutants in Shiraz city, Iran.

According to the epidemiological surveys, ambient air pollution has directly related to mortality and different diseases such as cardiovascular and respiratory defects. Among the atmospheric contaminants, criteria air ones (NO2, O3, PM2.5/10, SO2) demonstrated that have particular importance in the community disease. The overall goal of this paper was to study the impact of criteria air contaminants on the health of the inhabitants of Shiraz city, Iran. To accomplish this, the AirQ2.2.3 software was applied. The results of the study revealed that the annual average NO2, SO2, PM2.5, PM10, and O3 concentrations are 39.98, 27.6, 14.35, 46.16, and 120.03 µg/m3 in 2016 and 30.27, 23.97, 16.45, 51.65, and 52.58 µg/m3 in 2017. The total International Classification of Diseases (ICD), cardiovascular, and respiratory mortalities caused by air contaminants in Shiraz was predicted as 911, 628, and 182 cases in 2016, and 346, 370, and 82 cases in 2017, respectively. Sulfur dioxide (SO2) had the greatest rate of total mortality with the attributable equivalent of 4.3% in 2016, but this value has been decreased to 0.42% in 2017. The findings of this research revealed that air contamination has caused problems in Shiraz city according to the predicted results. The findings of this work provide useful data for regional and national health policymakers, who should take decisions to develop strategies for control air contaminants and estimate the cost-effectiveness of interventions.

The stability and catalytic performance of K-modified molybdena supported on a titanate nanostructured catalyst in the oxidative dehydrogenation of propane.

Titanate nanotube supported molybdena was evaluated as a catalyst in the oxidative dehydrogenation of propane to propylene. The synthesized titanate nanotubes with high specific surface area were prepared by a hydrothermal method. The characterization of pristine nanotubes was performed via XRD, Raman, SEM, TEM and BET. The presence of hydrogen titanate nanostructure was confirmed in the bare support. Incipient wetness impregnation method was used to prepare MoTNT-x (x = 5, 10, and 15 wt% molybdena). The as-prepared catalysts' characterization was investigated using Raman, XRD, SEM, EDS, TEM, BET, TGA, and CHNS. Furthermore, H2-TPR was performed to explore reducibility of the catalysts. XRD and Raman results indicated development of the anatase phase in MoTNT-x catalysts upon calcination, along with specific surface area loss according to BET. Study of the catalytic performance of the samples showed an increase in catalytic activity and a significant drop in propylene selectivity with rising molybdena content. The maximum yield of propylene (about 9.3%) was obtained in 10 wt% of Mo content. The effect of potassium loading as a promoter in K/MoTNT-10 catalyst was also explored through characterization of the surface molybdena species and catalytic performance. Due to the presence of potassium, propylene yield increased from 9.3% to 11.3% at 500 °C. The stabilities of both catalysts were considered for 3000 min and showed only slight drops in propane conversion and propylene selectivity.

Patient and Consumer Safety Risks When Using Conversational Assistants for Medical Information: An Observational Study of Siri, Alexa, and Google Assistant.

BACKGROUND: Conversational assistants, such as Siri, Alexa, and Google Assistant, are ubiquitous and are beginning to be used as portals for medical services. However, the potential safety issues of using conversational assistants for medical information by patients and consumers are not understood. OBJECTIVE: To determine the prevalence and nature of the harm that could result from patients or consumers using conversational assistants for medical information. METHODS: Participants were given medical problems to pose to Siri, Alexa, or Google Assistant, and asked to determine an action to take based on information from the system. Assignment of tasks and systems were randomized across participants, and participants queried the conversational assistants in their own words, making as many attempts as needed until they either reported an action to take or gave up. Participant-reported actions for each medical task were rated for patient harm using an Agency for Healthcare Research and Quality harm scale. RESULTS: Fifty-four subjects completed the study with a mean age of 42 years (SD 18). Twenty-nine (54%) were female, 31 (57%) Caucasian, and 26 (50%) were college educated. Only 8 (15%) reported using a conversational assistant regularly, while 22 (41%) had never used one, and 24 (44%) had tried one "a few times." Forty-four (82%) used computers regularly. Subjects were only able to complete 168 (43%) of their 394 tasks. Of these, 49 (29%) reported actions that could have resulted in some degree of patient harm, including 27 (16%) that could have resulted in death. CONCLUSIONS: Reliance on conversational assistants for actionable medical information represents a safety risk for patients and consumers. Patients should be cautioned to not use these technologies for answers to medical questions they intend to act on without further consultation from a health care provider.

The effects of photodynamic and low-level laser therapy for treatment of oral lichen planus-A systematic review and meta-analysis.

BACKGROUND: Oral lichen planus (OLP) is a chronic immune-mediated disorder that inflicts oral mucosa in 0.5-2% of the population. Surgery, photodynamic therapy, laser therapy and most commonly pharmacological therapy (like corticosteroids) has been used for treating OLP. New phototherapy approaches have been shown to have positive effects on treating some oral lesions and the aim of our study was to assess the effects of different phototherapy treatments on OLP. METHODS: We conducted a comprehensive electronic search using the determined search strategy in MEDLINE, EMBASE and CENTRAL electronic databases. A hand search of the reference list of the relevant studies and related systematic reviews was also performed. RESULTS: For low-level laser therapy, before and after studies showed a significant difference in pain (MD = -4.39, CI = 95% -4.83, -3.96) and sign score (MD = -1.86, CI = 95% -2.53, -1.19) after treatment. The comparison between corticosteroid therapy and LLLT also showed a significant difference in their effects for severity (MD = 0.57, CI = 95% 0.04, 1.09), but no differences in sign (MD = 0.21, CI = 95% -0.83, 1.24)and pain (MD = -0.10, CI = 95% -0.57,0.38) score was found between these two methods. Before and after studies of photodynamic therapy did not reveal any differences in lesion size. (MD = -1.95, CI = 95% -4.39, 0.490). CONCLUSION: Low-level laser therapy seems to be a reliable alternative to corticosteroids for treating OLP without the adverse effects associated with the pharmacological method. No conclusive evidence for the effectiveness of photodynamic therapy in treating OLP lesion exists.

General health literacy assessment of Iranian women in Mashhad.

BACKGROUND: In women's health, literacy determines their participation in self and family health promotion. Low health literacy is as barrier for understanding medical recommendations, disease prevention and health care. AIM: To assess women's health literacy and relative factors in Mashhad (Iran). METHODS: Women referring to healthcare centers in Mashhad in 2012 and 2013, participated in this cross-sectional study by stratified sampling method. The validated Persian version of Rapid Estimate of Adult Literacy in Medicine-revised questionnaire was used. Vocabulary comprehension and reading scores of health literacy was assessed. Comparisons were done in demographic subgroups by ANOVA, Mann-Whitney U, Kruskal-Wallis, Pearson correlation coefficient, and Chi-Square tests. RESULTS: In total, 250 women with a mean age of 32.1±10.23 years and the mean education level of 10.58±3.67 years were studied. The mean reading score was 11.58±2.51 and the mean vocabulary comprehension score was 17.24±4.73. Participants' health literacy score had positive correlation with age and education, and significant difference in health literacy scores between occupational groups was seen. Housewives' health literacy scores were lower than others (p<0.05). CONCLUSION: Low health literacy was a common problem amongst younger women, especially among women who had less education. These women are at risk of early marriage and child bearing and require more health care. Health care professionals should use effective methods for easier transfer recommendation, also, producing medical information booklets, texts, and videos for different community subgroups through public media or even in cyberspace with clear and common words consisting of essential information.

All-optical sensitive phase shifting based on nonlinear out-of-plane coupling through 1-D slab photonic crystal with a layer of graphene.

We realize all-optical sensitive phase shifting based on nonlinear out-of-plane coupling to a slab waveguide through Fano resonance of a slab 1-D photonic crystal (PhC). We use a graphene layer as the nonlinear material and change its refractive index by the input light intensity through Kerr nonlinear effect to obtain a shift in the Fano resonance frequency. The Fano resonance and self-focusing effect lead to light-intensity enhancement on the graphene in the PhC, reinforcing the nonlinear effect of refractive index in the graphene. Through finite-difference time-domain simulation, we demonstrate that the phase changing sensitivity obtained can be 4 orders higher than that by a single graphene under the same input light intensity. Moreover the threshold pump intensity for all-optical sensitive phase shifting in the coupled light to the waveguide is as low as ~4 MW per square centimeter. The results are applicable in micro optical integrated circuits for phase shifters, phase modulators, power limiters, and phase logic elements for optical computation, digital phase shift keying in communication systems, and non-contact sensitive signal detectors.

Ultrastructural characterization of male and female Physaloptera rara (Spirurida: Physalopteridae): feline stomach worms.

Physaloptera rara (Spirurida: Physalopteridae) has been found in dogs, coyotes, raccoons, wolves, foxes, cats, and bobcats in North America. The parasites' developmental cycles involve insects, including beetles, cockroaches, and crickets, as intermediate hosts. The nematodes firmly attach to the wall of the stomach and duodenum, where they feed on the mucosa and suck blood. Frequent movement of these nematodes results in erosions and ulcers in the gastrointestinal tract. The present study reports the morphological features of adult P. rara using scanning electron microscopy. Adult worms were removed from the stomach of an infected domestic cat. Male and female worms measured 25-29 and 27-41 mm, respectively. The worms were stout and the cuticle was reflected over the lips to form a large cephalic collarette with fine transverse striations. The worms possessed two large, simple triangular lateral pseudolabia, each armed with one external tooth, three internal teeth, two submedian cephalic papillae, an amphid, and three porous-like circumscribed regions. The internal margins of the lips had a pair of cuticular folds. At the anterior end of both male and female worms, an excretory pore was located on the ventral side and a pair of lateral ciliated cervical papillae was seen. The vulva was anterior to the middle of the body of female worms. The tail ends of the female worms were stumpy, with two large phasmids near their extremities. The males' tails bore large lateral alae. Ventral ornamentation, in male worms, was composed of three different cuticular patterns; coblestone-like formations, longitudinal cuticular ridges, and rows of bead-like structures. The spicules were unequal and dissimilar; the right spicule had a thick end and the left spicule had a sharp tip. At the posterior end of the males, four pairs of stalked precloacal papillae, three pairs of postcloacal papillae, and two phasmids were present. Three and four sessile papillae were seen directly anterior and posterior to the cloaca, respectively. The middle papilla of the three sessile papillae, directly anterior to cloaca was different in shape and size.

Long-term results of scleral fixation of posterior chamber intraocular lenses in children.

PURPOSE: To evaluate the long-term results of transsclerally fixated posterior chamber intraocular lenses (SF-PCIOLs) in children without adequate capsular support. DESIGN: Noncomparative interventional case series. PARTICIPANTS: Twenty-five eyes of 23 children who underwent primary (6 eyes) or secondary (19 eyes) implantation of SF-PCIOLs. The primary cases included those undergoing surgery for lens subluxation due to Marfan's syndrome, and secondary cases included those after surgery for congenital cataract (3 eyes) or traumatic cataract (16 eyes). All eyes lacked adequate capsular support and, in secondary cases, manifested contact lens intolerance. INTERVENTION: Ab externo transscleral fixation of PCIOLs. MAIN OUTCOME MEASURES: Visual acuity (VA), IOL position, and postoperative complications. RESULTS: The mean age of patients at the time of SF-PCIOL implantation was 79+/-20.2 months (range, 33-120). The mean duration of follow-up after surgery was 81.1+/-46.2 months (range, 12-144). Best-corrected VA improved postoperatively in 12 eyes (48%) by >1 Snellen line. The main cause of reduced vision was corneal and retinal pathologies and amblyopia. Complications included transient intraocular hemorrhage in 13 eyes (52%), transient choroidal effusion in 2 eyes (8%), late endophthalmitis in 1 eye (4%), retinal detachment in 1 eye (4%), and late IOL dislocation due to breakage of polypropylene sutures after 7 to 10 years in 6 eyes (24%). CONCLUSION: Scleral fixation of PCIOLs can be visually rewarding in selected cases, but there is a high rate of complications during a long-term follow-up.

Anteriorization of inferior oblique muscle and downward transposition of medial rectus muscle for lost inferior rectus muscle.

A 6-year-old boy who had been treated with bilateral medial rectus muscle recessions 3 years earlier for congenital esotropia was undergoing bilateral inferior oblique muscle recessions to correct inferior oblique muscle overaction. The right inferior rectus muscle was inadvertently cut during this surgery and was irretrievable. To manage this complication, the medial rectus muscle was transposed toward the inferior rectus insertion and the inferior oblique muscle was anteriorized. At the 1 year follow-up visit, no infraduction deficit was present on downgaze and only 8(delta) of left hypertropia was present in primary position.