Microfluidics single-cell encapsulation reveals that poly-l-lysine-mediated stem cell adhesion to alginate microgels is crucial for cell-cell crosstalk and its self-renewal.

Microfluidic cell encapsulation has provided a platform for studying the behavior of individual cells and has become a turning point in single-cell analysis during the last decade. The engineered microenvironment, along with protecting the immune response, has led to increasingly presenting the results of practical and pre-clinical studies with the goals of disease treatment, tissue engineering, intelligent control of stem cell differentiation, and regenerative medicine. However, the significance of cell-substrate interaction versus cell-cell communications in the microgel is still unclear. In this study, monodisperse alginate microgels were generated using a flow-focusing microfluidic device to determine how the cell microenvironment can control human bone marrow-derived mesenchymal stem cells (hBMSCs) viability, proliferation, and biomechanical features in single-cell droplets versus multi-cell droplets. Collected results show insufficient cell proliferation (234 % and 329 %) in both single- and multi-cell alginate microgels. Alginate hydrogels supplemented with poly-l-lysine (PLL) showed a better proliferation rate (514 % and 780 %) in a comparison of free alginate hydrogels. Cell stiffness data illustrate that hBMSCs cultured in alginate hydrogels have higher membrane flexibility and migration potency (Young's modulus equal to 1.06 kPa), whereas PLL introduces more binding sites for cell attachment and causes lower flexibility and migration potency (Young's modulus equal to 1.83 kPa). Considering that cell adhesion is the most important parameter in tissue engineering, in which cells do not run away from a 3D substrate, PLL enhances cell stiffness and guarantees cell attachments. In conclusion, cell attachment to PLL-mediated alginate hydrogels is crucial for cell viability and proliferation. It suggests that cell-cell signaling is good enough for stem cell viability, but cell-PLL attachment alongside cell-cell signaling is crucial for stem cell proliferation and self-renewal.

Predicting Rheumatoid Arthritis Development Using Hand Ultrasound and Machine Learning-A Two-Year Follow-Up Cohort Study.

BACKGROUND: The early diagnosis and treatment of rheumatoid arthritis (RA) are essential to prevent joint damage and enhance patient outcomes. Diagnosing RA in its early stages is challenging due to the nonspecific and variable clinical signs and symptoms. Our study aimed to identify the most predictive features of hand ultrasound (US) for RA development and assess the performance of machine learning models in diagnosing preclinical RA. METHODS: We conducted a prospective cohort study with 326 adults who had experienced hand joint pain for less than 12 months and no clinical arthritis. We assessed the participants clinically and via hand US at baseline and followed them for 24 months. Clinical progression to RA was defined according to the ACR/EULAR criteria. Regression modeling and machine learning approaches were used to analyze the predictive US features. RESULTS: Of the 326 participants (45.10 ± 11.37 years/83% female), 123 (37.7%) developed clinical RA during follow-up. At baseline, 84.6% of the progressors had US synovitis, whereas 16.3% of the non-progressors did (p < 0.0001). Only 5.7% of the progressors had positive PD. Multivariate analysis revealed that the radiocarpal synovial thickness (OR = 39.8), PIP/MCP synovitis (OR = 68 and 39), and wrist effusion (OR = 12.56) on US significantly increased the odds of developing RA. ML confirmed these US features, along with the RF and anti-CCP levels, as the most important predictors of RA. CONCLUSIONS: Hand US can identify preclinical synovitis and determine the RA risk. The radiocarpal synovial thickness, PIP/MCP synovitis, wrist effusion, and RF and anti-CCP levels are associated with RA development.

Royal jelly induces ROS-mediated apoptosis in acute lymphoblastic leukemia (ALL)-derived Nalm-6 cells: Shedding light on novel therapeutic approaches for ALL.

Objectives: Until recently, a conventional chemotherapy regimen for Acute lymphoblastic leukemia (ALL) is considered an efficient therapeutic method in children. However, suboptimal long-term survival rates in adults, disease relapse, and drug-induced toxicities require novel therapeutic agents for ALL treatments. Today, natural products with pharmacological benefits play a significant role in treating different cancers. Among the most valued natural products, honey bees' royal jelly (RJ) is one of the most appreciated which has revealed anti-tumor activity against different human cancers. This study aimed to evaluate anti-leukemic properties and the molecular mechanisms of RJ cytotoxicity on ALL-derived Nalm-6 cells. Materials and Methods: The metabolic activity was measured by MTT assay. Apoptosis, cell distribution in the cell cycle, and intracellular reactive oxygen species (ROS) level were investigated using flow cytometry analysis. Moreover, quantitative real-time PCR (qRT-PCR) was performed to scrutinize the expression of various regulatory genes. Results: RJ significantly decreased the viability of Nalm-6 cells but had no cytotoxic effect on normal cells. In addition, RJ induced ROS-mediated apoptosis by up-regulating pro-apoptotic genes while decreasing anti-apoptotic gene expression. The results outlined that ROS-dependent up-regulation of FOXO4 and Sirt1 inhibits the cells' transition to the S phase of the cell cycle through p21 up-regulation. The qRT-PCR analysis of autophagy-related gene expression also demonstrated that RJ induced BECN1 mediated autophagy in Naml-6 cells. Conclusion: Taken together, this study showed that RJ can be utilized as a potent natural substance to induce ALL cells' programmed cell death. However, further studies are required to examine this compound's pharmaceutical application.

Protein C and S activities in COVID-19: A systematic review and meta-analysis.

COVID-19 has been associated with alterations in coagulation. Recent reports have shown that protein C and S activities are altered in COVID-19. This may affect the complications and outcome of the disease. However, their exact role in COVID-19 remains uncertain. The aim of the current study was therefore to analyze all papers in the literature on protein C and S activities in COVID-19. We searched three medical electronic databases. Of the 2442 papers, 28 studies were selected for the present meta-analysis. For the meta-analysis, means ± standard deviations with 95% confidence intervals (CI) for protein C and S activities were extracted. Pooled p values were calculated using STATA software. Protein C and S activities were significantly lower in COVID-19 patients than in healthy controls (pooled p values: 0.04 and 0.02, respectively). Similarly, protein C activities were considerably lower in nonsurviving patients (pooled p value = 0.00). There was no association between proteins C or S and thrombosis risk or ICU admission in COVID-19 patients (p value > 0.05). COVID-19 patients may exhibit lower activities of the C and S proteins, which might affect disease outcome; however, additional attention should be given when considering therapeutic strategies for these patients.

A comparative survey between cascade correlation neural network (CCNN) and feedforward neural network (FFNN) machine learning models for forecasting suspended sediment concentration.

Suspended sediment concentration prediction is critical for the design of reservoirs, dams, rivers ecosystems, various operations of aquatic resource structure, environmental safety, and water management. In this study, two different machine models, namely the cascade correlation neural network (CCNN) and feedforward neural network (FFNN) were applied to predict daily-suspended sediment concentration (SSC) at Simga and Jondhara stations in Sheonath basin, India. Daily-suspended sediment concentration and discharge data from 2010 to 2015 were collected and used to develop the model to predict suspended sediment concentration. The developed models were evaluated using statistical indices like Nash and Sutcliffe efficiency coefficient (NES), root mean square error (RMSE), Willmott's index of agreement (WI), and Legates-McCabe's index (LM), supplemented by a scatter plot, density plots, histograms and Taylor diagram for graphical representation. The developed model was evaluated and compared with CCNN and FFNN. Nine input combinations were explored using different lag-times for discharge (Qt-n) and suspended sediment concentration (St-n) as input variables, with the current suspended sediment concentration as the desired output, to develop CCNN and FFNN models. The CCNN4 model with 4 lagged inputs (St-1, St-2, St-3, St-4) outperformed the other developed models with the lowest RMSE = 95.02 mg/l and the highest NES = 0.0.662, WI = 0.890 and LM = 0.668 for the Jondhara Station while the same CCNN4 model secure as the best with the lowest RMSE = 53.71 mg/l and the highest NES = 0.785, WI = 0.936 and LM = 0.788 for the Simga Station. The result shows the CCNN model was better than the FFNN model for predicting daily-suspended sediment at both stations in the Sheonath basin, India. Overall, CCNN showed better forecasting potential for suspended sediment concentration compared to FFNN at both stations, demonstrating their applicability for hydrological forecasting with complex relationships.

Assessing the quality and grain yield of winter wheat in the organic farming management under wheat-legume intercropping practice.

Intercropping is an alternative farming method that maximizes crop yield and resource usage effectiveness, especially in low-input agricultural systems. Legume-based intercropping systems can effectively boost the quality and wheat yield by promoting soil functions and microbial activities. However, changes in the types of legumes and field management can alter the response of crop functions. A three-year field study was conducted on intercropping cultivation of winter wheat variety (Butterfly and Lorien) and legume species (faba bean, incarnate clover, spring pea, winter pea) to assess grain yield and wheat quality in organic farming. Based on the results, Butterfly showed higher grain quality but lower grain yield and yield components than Lorien. Mixtures of legume crops with winter wheat did not significantly differ in wheat grain yield, but grain quality variables were significantly affected. Protein content (PC) was significantly higher in wheat and legume mixtures than in sole wheat by 4 %. PC in wheat + winter pea (Wheat + Wi) and wheat + faba bean (Wheat + Fa) were higher than wheat sown alone. Wet gluten (WG) was higher in Wheat + Wi than in sole wheat and wheat + incarnate clover mixtures (Wheat + In). The rheological parameters evaluated by the Mixolab showed greater wheat quality in Butterfly and legume mixtures. Mixed and row-row intercropping of wheat and legume species did not significantly influence rheological properties. To conclude, customizing wheat yield and grain quality under the effect of winter wheat and legume mixtures requires considering the optimal solution based on different cultivates, wheat varieties and legume species to achieve the desired response.

Distinct immunometabolic signatures in circulating immune cells define disease outcome in acute-on-chronic liver failure.

BACKGROUND AIMS: Acute-on-chronic liver failure (ACLF) is a complication of cirrhosis characterized by multiple organ failure and high short-term mortality. The pathophysiology of ACLF involves elevated systemic inflammation leading to organ failure, along with immune dysfunction that heightens susceptibility to bacterial infections. However, it is unclear how these aspects are associated with recovery and non-recovery in ACLF. APPROACH RESULTS: Here we mapped the single-cell transcriptome of circulating immune cells from ACLF-, acute decompensated (AD) cirrhosis patients and healthy individuals. We further interrogate how these findings as well as immunometabolic- and functional profiles associate with ACLF recovery (ACLF-R) or non-recovery (ACLF-NR). Our analysis unveiled two distinct states of classical monocytes (cMon). Hereto, ACLF-R cMons were characterized by transcripts associated with immune- and stress tolerance, including anti-inflammatory genes such as RETN and LGALS1 . Additional metabolomic- and functional validation experiments implicated an elevated oxidative phosphorylation metabolic program as well as an impaired ACLF-R cMon functionality. Interestingly, we observed a common stress-induced tolerant state, oxidative phosphorylation program and blunted activation among lymphoid populations in ACLF-R patients. Conversely, ACLF-NR cMon featured elevated expression of inflammatory- and stress response genes such as VIM , LGALS2 , and TREM1 along with blunted metabolic activity and increased functionality. CONCLUSIONS: This study identifies distinct immuno-metabolic cellular states that contribute to disease outcome in ACLF patients. Our findings provide valuable insights into the pathogenesis of ACLF, shedding light on factors driving either recovery or non-recovery phenotypes which may be harnessed as potential therapeutic targets in the future.

Eye-Related Adverse Events After I-131 Radioiodine Therapy: A Systematic Review of the Current Literature.

OBJECTIVE: Although I-131 is relatively safe, there is limited focus on probable eye-related side effects after radioactive iodine (RAI) therapy. Thus, we aimed to provide evidence for the adverse outcomes of I-131, exclusively in patients with thyroid cancer. METHODS: A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was designed to examine the ocular complications of RAI therapy. Databases including PubMed, Scopus, and Web of Science were searched until October 2023 with specific thyroid neoplasms, ophthalmology and iodine terms. After thorough screening and review, relevant data were extracted. RESULTS: The database search yielded 3434 articles, which resulted in the final 28 eligible studies. These studies investigated ophthalmic symptoms following RAI therapy, classifying them as obstructive diseases (for example, nasolacrimal duct obstruction; median incidence rate: 6.8%), inflammatory symptoms (median incidence rate: 13%), and cataracts (median incidence rate: 2.5 and 5%). The most common time interval between RAI therapy and the onset of symptoms was within the first 12 months and then declined in the preceding years. A strong positive correlation was observed between higher I-131 doses of more than 100 to 150 mCi (3.7-5.55 GBq) and the risk of symptom development. Ages older than 45 also showed a significant association with nasolacrimal duct obstruction. CONCLUSION: The risk of ophthalmic complications is associated with various factors, including the administration of high I-131 doses, age of more than 45 years, and time to event within the first 12 months. Considering these conditions may help enhance patient care and prevent adverse outcomes that may limit patients' quality of life.

Composite alginate-based hydrogel delivery of antioxidant pumpkin protein hydrolysate in simulated gastrointestinal condition.

Pumpkin seeds are rich in protein (24-36.5%). Some of them are consumed as nuts, while others are regarded as waste and used for feeding animals. Protein hydrolysates from pumpkin seeds possess some bioactive properties, such as anti-oxidant activity. In this work, various composite alginate hydrogels contain Aloe vera, CMC, and tragacanth have been employed to protect PSPH against degradation in simulated gastrointestinal digestion (SGI) and regulate its release rate. The encapsulation efficiency of PSPH in plain alginate and beads with Aloe vera, CMC, and tragacanth combinations was 71.63, 75.63, 85.07, and 80.4%, respectively. The release rate of the plain alginate beads was %30.23 in the SGF and %52.26 in the SIF, and decreased in the composite-based beads. The highest decreasing rate in the antioxidant activity during SGI was observed in free PSPH, and the decreasing rate slowed down in the alginate-based composites. The swelling rate in plain alginate was %-23.43 and %25.43 in the SGF and SIF, respectively, and increased in the composite-based beads. The FTIR spectra of hydrogels before and after loading with PSPH showed identical absorption patterns and were similar to each other. Based on the data for SEM, it was revealed that substituting other polymers in polymer combinations with alginates resulted in a porosity reduction of the beads and smoother and more uniform surfaces. Based on the results, the combination of polysacchared with alginate could protect and increase the applicability of PSPH as a functional component in the food industry.

The Importance of Pseudo Thrombocytopenia Due to Platelet Cold Agglutination before Surgery, What Should We Do? A Case Report.

Platelet cold agglutination (PCA) is a rare in-vitro phenomenon caused by Immunoglobulin M (IgM) autoantibodies, which results in Ethylenediaminetetraacetic Acid (EDTA) independent pseudo thrombocytopenia (PTCP). Its diagnosis is made based on the peripheral blood smear (PBS) examination and pre-test warming blood sample. Here, a case of PTCP secondary to PCA is presented. He was first admitted for pre-surgical tests but his platelet count was low. His blood was taken with EDTA and sodium citrate anticoagulant to rule pre-analytical error out. Then his sample warmed up and the test was run again with Mindray BC-6000 automated cell counter. Moreover, the rheumatologic tests were done for him. His platelet count was 23×109/L at first, and PBS showed many platelet aggregates. The low platelet count was not correct with Sodium Citrate or re-sampling with EDTA so platelet satellitism and improper sampling were ruled out. By warming the sample up to 37⸰C, the Platelet count rose to 216×109 / L. The rheumatologic tests were negative except for HLA-B27 which was positive. Finally, he was diagnosed with PCA which is due to a cold antibody (clinically insignificant). This diagnosis is important for the prevention of recurrent tests, unnecessary platelet transfusion, and other problems. Here these conditions will be discussed.

Multi-layer encapsulation of pumpkin (Cucurbita maxima L.) seed protein hydrolysate and investigating its release and antioxidant activity in simulated gastrointestinal digestion.

Because of their high protein content, easy access and low cost, pumpkin seeds are a valuable raw material for the preparation of antioxidant protein hydrolysates. Micro-coating is an effective method to protect bioactive compounds against destruction. In order to strengthen the alginate hydrogel network loaded with pumpkin seed protein hydrolysate (PSPH), CMC was added as part of its formulation in the first step, and chitosan coating was used in the second step. Then, swelling amount, release in the simulated gastrointestinal environment (SGI), antioxidant activity after SGI, Fourier transform infrared spectroscopy (FTIR), zeta potential, dynamic light scattering (DLS), polydispersity index (PDI) and scanning electron microscopy (SEM) of the samples were evaluated. The results showed that, the swelling amount of the chitosan-alginate hydrogel was lower than the chitosan-alginate-CMC sample, and with the increase in chitosan concentration, the swelling amount decreased. The release amount in the chitosan-alginate sample was higher than that in the chitosan-alginate-CMC sample, and with the increase in chitosan concentration, the release rate decreased. Also, the amount of release increased with the passage of time. The highest antioxidant activity belonged to the chitosan-alginate sample in SGI, and it increased with increasing the chitosan concentration. All findings demonstrated that the use of multi-component hybrid systems is a useful method for the protection of bioactive compounds against destruction, their antioxidant activities and their release behavior.

Tranexamic acid in total hip arthroplasty: An umbrella review on efficacy and safety.

Purpose: This comprehensive review was conducted to assess the effects of tranexamic acid (TXA) on blood loss, venous thromboembolism (VTE) risk, and wound complications following total hip arthroplasty (THA). Additionally, it sought to evaluate the effects of various TXA dosages, modes of administration, and combinations with other antifibrinolytic drug. Methods: In search of systematic reviews and meta-analyses on the use of TXA in THA patients, we searched extensively through databases including Scopus, the Cochrane Library, Embase, Medline, the Web of Science, PubMed, and Google Scholar. We discovered 23 meta-analyses covering 32,442 patients overall that fulfilled our study criteria, spanning the period from the creation of these databases until May 2023. Results: This comprehensive review's meta-analyses, which together examined over 35,000 patients, repeatedly demonstrated how TXA administration during THA successfully lowers perioperative blood loss and the need for transfusions. TXA reduced total blood loss by an average of 151-370 ml, postoperative hemoglobin levels by 0.5-1.1 g/dL, and transfusion rates by 19-26% on average when compared to control groups. The information gathered did not indicate that using TXA significantly increased the risk of VTE or wound complications. When comparing different TXA doses, administration techniques, or its use in conjunction with other anti-fibrinolytic therapies, no discernible differences were found in terms of efficacy or safety outcomes. Conclusion: The comprehensive review clearly indicates that TXA improves THA outcomes without increasing the risk of adverse events by lowering blood loss and the requirement for transfusions. This insightful information can help surgeons decide whether to use TXA during THA procedures.

Environmental Assessment of Dryland and Irrigated Winter Wheat Cultivation under Compost Fertilization Strategies.

Wheat (Triticum aestivum L.) is a strategic agricultural crop that plays a significant role in maintaining national food security and sustainable economic development. Increasing technical performance considering lowering costs, energy, and environmental consequences are significant aims for wheat cultivation. For drylands, which cover approximately 41% of the world's land surface, water stress has a considerable negative impact on crop output. The current study aimed to assess the environmental aspects of chemical fertilizer in combination with compost in dryland and irrigated winter wheat production systems through life cycle assessment (LCA). The cradle-to-farm gate was considered as the system boundary based on one tone of wheat yield and four strategies: D-C (dryland with compost), D (dryland without compost), I-C (irrigated with compost), and I (irrigated without compost). Based on the results, the highest and lowest amounts of wheat yield were related to the I-C and D strategies with 12.2 and 6.7 ton ha-1, respectively. The LCA result showed that the I strategy in comparison with other strategies had the highest negative impact on human health (49%), resources (59%), ecosystem quality (44%), and climate change (43%). However, the D-C strategy resulted in the lowest adverse effect of 6% on human health, 1% on resources, 10% on ecosystem quality, and 11% on climate change. Utilizing a combination of fertilizer and compost in dryland areas could ensure a higher yield of crops in addition to alleviating negative environmental indicators.

Traumatic middle meningeal artery aneurysm: a case report.

INTRODUCTION: Traumatic intracranial aneurysms are rare, making up about 1% of all intracranial aneurysms. They can happen due to direct injury or blunt force, with the middle cerebral artery being the most frequent site. The middle meningeal artery (MMA) is the main artery that supplies the cranial dura mater, and, because of its location, is susceptible to damage after trauma. This article reported an unusual case of giant post-traumatic MMA pseudoaneurysm. CASE: A 45 year-old man was referred to our department with a history of craniectomy. He complained of non-specific headache, but neurological examination was normal. A follow-up brain CT scan identified a right temporal fossa hyperdense mass. Digital subtraction angiography diagnosed a traumatic MMA aneurysm. The patient was treated with preoperative aneurysm embolization and surgical resection. DISCUSSION: Traumatic MMA aneurysm is a rare presentation after head trauma. It can manifest as epidural hematoma, subdural hematoma or intraparenchymal hematoma, and sometimes resembles the present case, which was discovered incidentally. CONCLUSION: Pseudoaneurysm is a rare complication of MMA trauma, with late presentation. It should be considered in patients with history of traumatic brain injury and temporal fossa extra-axial mass lesion with vascular characteristics.

Application of multi-gene genetic programming to the prognosis prediction of COVID-19 using routine hematological variables.

Identifying patients who may develop severe COVID-19 has been of interest to clinical physicians since it facilitates personalized treatment and optimizes the allocation of medical resources. In this study, multi-gene genetic programming (MGGP), as an advanced artificial intelligence (AI) tool, was used to determine the importance of laboratory predictors in the prognosis of COVID-19 patients. The present retrospective study was conducted on 1455 patients with COVID-19 (727 males and 728 females), who were admitted to Allameh Behlool Gonabadi Hospital, Gonabad, Iran in 2020-2021. For each patient, the demographic characteristics, common laboratory tests at the time of admission, duration of hospitalization, admission to the intensive care unit (ICU), and mortality were collected through the electronic information system of the hospital. Then, the data were normalized and randomly divided into training and test data. Furthermore, mathematical prediction models were developed by MGGP for each gender. Finally, a sensitivity analysis was performed to determine the significance of input parameters on the COVID-19 prognosis. Based on the achieved results, MGGP is able to predict the mortality of COVID-19 patients with an accuracy of 60-92%, the duration of hospital stay with an accuracy of 53-65%, and admission to the ICU with an accuracy of 76-91%, using common hematological tests at the time of admission. Also, sensitivity analysis indicated that blood urea nitrogen (BUN) and aspartate aminotransferase (AST) play key roles in the prognosis of COVID-19 patients. AI techniques, such as MGGP, can be used in the triage and prognosis prediction of COVID-19 patients. In addition, due to the sensitivity of BUN and AST in the estimation models, further studies on the role of the mentioned parameters in the pathophysiology of COVID-19 are recommended.

Powered single hip joint exoskeletons for gait rehabilitation: a systematic review and Meta-analysis.

BACKGROUND: Gait disorders and as a consequence, robotic rehabilitation techniques are becoming increasingly prevalent as the population ages. In the area of rehabilitation robotics, using lightweight single hip joint exoskeletons are of significance. Considering no prior systematic review article on clinical outcomes, we aim to systematically review powered hip exoskeletons in terms of gait parameters and metabolic expenditure effects. METHODS: Three databases of PubMed, Scopus, and Web of science were searched for clinical articles comparing outcomes of gait rehabilitation using hip motorized exoskeleton with conventional methods, on patients with gait disorder or healthy individuals. Of total number of 37 reviewed articles, 14 trials were quantitatively analyzed. Analyses performed in terms of gait spatiotemporal parameters like speed (self-speed and maximum speed), step length, stride length, cadence, and oxygen consumption. RESULTS: Improved clinical outcomes of gait spatiotemporal parameters with hip joint exoskeletons are what our review's findings show. In terms of gait values, meta-analysis indicates that rehabilitation with single hip joint exoskeleton enhanced parameters of maximum speed by 0.13 m/s (0.10-0.17) and step length by 0.06 m (0.05-0.07). For the remaining investigated gait parameters, no statistically significant difference was observed. Regarding metabolic parameters, oxygen consumption was lower in individuals treated with hip exoskeleton (- 1.23 ml/min/kg; range - 2.13 to - 0.32). CONCLUSION: Although the analysis demonstrated improvement with just specific gait measures utilizing powered hip exoskeletons, the lack of improvement in all parameters is likely caused by the high patient condition heterogeneity among the evaluated articles. We also noted in patients who rehabilitated with the hip exoskeleton, the oxygen cost was lower. More randomized controlled trials are needed to verify both the short- and long-term clinical outcomes, including patient-reported measures. LEVEL OF EVIDENCE: Level I (systematic review and meta-analysis).

Soil temperature forecasting using a hybrid artificial neural network in Florida subtropical grazinglands agro-ecosystems.

Soil temperature is a key meteorological parameter that plays an important role in determining rates of physical, chemical and biological reactions in the soil. Ground temperature can vary substantially under different land cover types and climatic conditions. Proper prediction of soil temperature is thus essential for the accurate simulation of land surface processes. In this study, two intelligent neural models-artificial neural networks (ANNs) and Sperm Swarm Optimization (SSO) were used for estimating of soil temperatures at four depths (5, 10, 20, 50 cm) using seven-year meteorological data acquired from Archbold Biological Station in South Florida. The results of this study in subtropical grazinglands of Florida showed that the integrated artificial neural network and SSO models (MLP-SSO) were more accurate tools than the original structure of artificial neural network methods for soil temperature forecasting. In conclusion, this study recommends the hybrid MLP-SSO model as a suitable tool for soil temperature prediction at different soil depths.

Analyzing the influential factors of process safety culture by hybrid hidden content analysis and fuzzy DEMATEL.

Due to the complex nature of safety culture and process industries, several factors influence process safety culture. This paper presents a novel framework that combines the hidden content analysis method with Decision Making Trial and Evaluation Laboratory (DEMATEL) and Fuzzy logic to achieve a comprehensive set of influential factors and their relationship. The proposed methodology consists of two primary stages. Firstly, combined methods of literature review and Delphi study were used to identifying influential factors of process safety culture. Secondly, the Fuzzy-DEMATEL approach is employed to quantify and determine the relationships between different influential factors. A diverse pool of experts' opinions is leveraged to assess the impact of each factor on others and process safety culture. In the first stage, 18 factors identified as influential factors on process safety. The findings of second stage revealed that eight variables were identified as causes, while ten variables were classified as effects. Also, the Organization management's commitment to safety factor had the greatest influence among all of the factors. As well as, the most significant interaction was associated with the risk assessment and management aspect. The integrated approach not only identified the influential factors, but also elucidates the cause-effect relationships among factors. By prioritizing factors and understanding their interconnections, organizations can implement targeted safety measures to improve process safety culture. Its effectiveness in quantifying qualitative data, identifying influential factors, and establishing cause-effect relationships make it a valuable tool for enhancing safety culture in process industries.

Direct Versus Indirect Revascularization for Moyamoya: a Large Multicenter Study.

BACKGROUND: Moyamoya is a chronic occlusive cerebrovascular disease of unknown etiology causing neovascularization of the lenticulostriate collaterals at the base of the brain. Although revascularization surgery is the most effective treatment for moyamoya, there is still no consensus on the best surgical treatment modality as different studies provide different outcomes. OBJECTIVE: In this large case series, we compare the outcomes of direct (DR) and indirect revascularisation (IR) and compare our results to the literature in order to reflect on the best revascularization modality for moyamoya. METHODS: We conducted a multicenter retrospective study in accordance with the Strengthening the Reporting of Observational studies in Epidemiology guidelines of moyamoya affected hemispheres treated with DR and IR surgeries across 13 academic institutions predominantly in North America. All patients who underwent surgical revascularization of their moyamoya-affected hemispheres were included in the study. The primary outcome of the study was the rate of symptomatic strokes. RESULTS: The rates of symptomatic strokes across 515 disease-affected hemispheres were comparable between the two cohorts (11.6% in the DR cohort vs 9.6% in the IR cohort, OR 1.238 (95% CI 0.651 to 2.354), p=0.514). The rate of total perioperative strokes was slightly higher in the DR cohort (6.1% for DR vs 2.0% for IR, OR 3.129 (95% CI 0.991 to 9.875), p=0.052). The rate of total follow-up strokes was slightly higher in the IR cohort (8.1% vs 6.6%, OR 0.799 (95% CI 0.374 to 1.709) p=0.563). CONCLUSION: Since both modalities showed comparable rates of overall total strokes, both modalities of revascularization can be performed depending on the patient's risk assessment.

Characterization of class 1 integrons in metallo-ß-lactamase-producing Acinetobacter baumannii isolates from hospital environment.

BACKGROUND AND OBJECTIVE: The emergence and widespread dissemination of antibiotic resistance in A. baumannii, has become a globally challenge. The increasing hospital outbreaks by multi-drug resistant (MDR) A. baumannii strains, shows the necessity of continuous monitoring to find sources of resistant strains in hospitals. This study aimed to identify the presence of class 1 integrons and metallo-ß-lactamase (MBL) related genes in A. baumannii isolates from hospital environment. METHODS: In order to identify A. baumannii isolates, a total of 297 environmental samples were collected from burn wards and intensive care units (ICUs) of two university hospitals. Resistance to common antibiotics was studied by disk diffusion method and microbroth dilution assay was used to determine the minimum inhibitory concentrations (MICs) of imipenem, colistin and tigecycline. The A. baumannii isolates were studied by polymerase chain reaction (PCR) for the presence of class 1 integrons (intI1, intl CS) and metallo-ß-lactamases (MBLs) (blaIMP, blaVIM, blaNDM) genes. RESULTS: A. baumannii was identified in 68/297 (22.9%) of hospital environment. All A. baumannii strains were multidrug-resistant (MDR), but none of them were resistant to colistin, tigecycline and ampicillin-sulbactam. All (100%) and 38 (95.0%) of A. baumannii isolates from ICUs and burn wards were imipenem resistant respectively. Class 1 integrons was identified in 30/40 (75.0%) and 23/28 (82.1%) isolates from burn wards and ICUs respectively. Two different types of gene cassettes were identified, which included: arr-2, ereC, aadA1, cmlA5 and arr2, cmlA5. MBL genes including blaVIM and blaIMP were detected in 26/28 (92.8%), 27/28(96.4%) and 39/40 (97.5%) and 31/40 (77.5%) of the isolates from the ICUs and the burn wards respectively. None of the isolates contained the blaNDM-1 gene. CONCLUSION: The findings of the present study showed that the isolation rate of MBL producing carbapenem-resistant A. baumannii (CRAB) was relatively high in the environmental surface of burn wards and ICUs, which can be considered as a potential source of outbreaks in hospitalized patients.