Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Vanillin and IGF1-loaded dual-layer multifunctional wound dressing with micro-nanofibrous structure for full-thickness wound healing acceleration
No full textMultifunctional dual-layer wound dressings hold significant promise for comprehensive full-thickness wound management by closely mimicking the native skin structure and features. Herein, we employed an innovative approach utilizing electrospinning techniques to develop a dual-layer dressing comprising a microfibrous Ecoflex (R)-Vanillin (Ex-Vnil) top layer (TL) and a nanofibrous Soluplus (R)-Insulin-like growth factor-1 (Sol-IGF1) bottom layer (BL). The tensile properties of dual-layer wound dressings were within the standard range for use in skin tissue regeneration. The TL exhibited hydrophobic properties with a contact angle value of 92.4 degrees and significant antibacterial activity, mimicking the epidermis of the skin, thereby preventing fluid and bacterial penetration. Moreover, the dual-layer wound dressing demonstrated standard water vapour transmission rate, with 91.2 release of IGF1 and 66.8 release of Vnil within 5 days. Notably, the fabricated dual-layer dressing promoted cell behaviour and exhibited a significant angiogenesis effect and accelerated healing of full-thickness wound, achieving 96.4 closure after 14 days, attributed to reduced inflammation, early blood vessel formation, and enhanced collagen density. Our findings underscore the potential of the fabricated dual-layer dressing as an innovative solution in full-thickness wound care
Glioblastoma multiforme: insights into pathogenesis, key signaling pathways, and therapeutic strategies
No full textGlioblastoma multiforme (GBM) is the most prevalent and aggressive primary brain tumor in adults, characterized by a poor prognosis and significant resistance to existing treatments. Despite progress in therapeutic strategies, the median overall survival remains approximately 15 months. A hallmark of GBM is its intricate molecular profile, driven by disruptions in multiple signaling pathways, including PI3K/AKT/mTOR, Wnt, NF-kappa B, and TGF-beta, critical to tumor growth, invasion, and treatment resistance. This review examines the epidemiology, molecular mechanisms, and therapeutic prospects of targeting these pathways in GBM, highlighting recent insights into pathway interactions and discovering new therapeutic targets to improve patient outcomes
Evaluation of accuracy of deep learning and conventional neural network algorithms in detection of dental implant type using intraoral radiographic images: A systematic review and meta-analysis
No full textStatement of problem. With the growing importance of implant brand detection in clinical practice, the accuracy of machine learning algorithms in implant brand detection has become a subject of research interest. Recent studies have shown promising results for the use of machine learning in implant brand detection. However, despite these promising findings, a comprehensive evaluation of the accuracy of machine learning in implant brand detection is needed. Purpose. The purpose of this systematic review and meta-analysis was to assess the accuracy, sensitivity, and specificity of deep learning algorithms in implant brand detection using 2-dimensional images such as from periapical or panoramic radiographs. Material and methods. Electronic searches were conducted in PubMed, Embase, Scopus, Scopus Secondary, and Web of Science databases. Studies that met the inclusion criteria were assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Meta-analyses were performed using the random-effects model to estimate the pooled performance measures and the 95 confidence intervals (CIs) using STATA v.17. Results. Thirteen studies were selected for the systematic review, and 3 were used in the meta-analysis. The meta-analysis of the studies found that the overall accuracy of CNN algorithms in detecting dental implants in radiographic images was 95.63, with a sensitivity of 94.55 and a specificity of 97.91. The highest reported accuracy was 99.08 for CNN Multitask ResNet152 algorithm, and sensitivity and specificity were 100.00 and 98.70 respectively for the deep CNN (Neuro-T version 2.0.1) algorithm with the Straumann SLActive BLT implant brand. All studies had a low risk of bias. Conclusions. The highest accuracy and sensitivity were reported in studies using CNN Multitask ResNet152 and deep CNN (Neuro-T version 2.0.1) algorithms. (J Prosthet Dent 2025;133:137-146
Diagnostic Value of Chest Computed Tomography Scan for Identification of Foreign Body Aspiration in Children: A Systematic Review and Meta-analysis
No full textIntroduction: Foreign body aspiration (FBA) is a common, life-threatening pediatric emergency and was shown to be associated with high risk of morbidity and mortality. This systematic review and meta-analysis aimed to investigate the diagnostic value of chest computed tomography (CT) scan for identification of FBA in children. Methods: From inception to May 2024, a systematic search was carried out across multiple databases including Medline, Scopus, and Web of Science, considering published papers in English language. Quality assessment of the included studies was performed using seven domains of Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Results: The systematic literature search yielded 7203 articles. The pooled sensitivity and specificity of chest CT scan for identification of FBA were 0.99 (95 CI: 0.98-0.99) and 0.97 (95 CI: 0.96-0.98), respectively. The pooled positive likelihood ratio was 10.12 (95 CI: 4.59-22.20), and pooled negative likelihood ratio was 0.05 (95 CI: 0.02-0.1). Furthermore, the area under the summarized receiver operating characteristic (SROC) curve was 0.98. Conclusions: Our meta-analysis revealed that despite high heterogeneity, in the diagnostic characteristics of chest CT scan among studies, it has high diagnostic value in identifying FBA in suspected pediatric cases
Evaluating the Performance of Agreement Metrics in a Delphi Study on Chemical, Biological, Radiological and Nuclear Major Incidents Preparedness Using Classical and Machine Learning Approaches
No full textDelphi studies in disaster medicine lack consensus on expert agreement metrics. This study examined various metrics using a Delphi study on chemical, biological, radiological, and nuclear (CBRN) preparedness in the Middle East and North Africa region. Forty international disaster medicine experts evaluated 133 items across ten CBRN Preparedness Assessment Tool themes using a 5-point Likert scale. Agreement was measured using Kendall's W, Intraclass Correlation Coefficient, and Cohen's Kappa. Statistical and machine learning techniques compared metric performance. The overall agreement mean score was 4.91 +/- 0.71, with 89.21 average agreement. Kappa emerged as the most sensitive metric in statistical and machine learning analyses, with a feature importance score of 168.32. The Kappa coefficient showed variations across CBRN PAT themes, including medical protocols, logistics, and infrastructure. The integrated statistical and machine learning approach provides a promising method for understanding expert consensus in disaster preparedness, with potential for future refinement by incorporating additional contextual factors
Drug- and Vaccine-Induced Cutaneous T-Cell Lymphoma: A Systematic Review of the Literature
No full textCutaneous T-cell lymphomas (CTCLs) are a type of non-Hodgkin lymphoma that usually involves the skin. It has different subtypes including mycosis fungoides (MFs), Sezary syndrome (SS), primary cutaneous anaplastic large lymphoma (PC-ALCL), lymphomatoid papulosis (LyP), and subcutaneous panniculitis-like T-cell lymphoma (SPTCL). There are several reports of incidence, relapse, or progression of CTCLs by using specific drugs. We aim to identify drug- and vaccine-induced CTCL characteristics. A systematic search was conducted using MeSH terms/keywords: CTCL and drug-induced or drug-associated or vaccine-associated or vaccine induced through PubMed/Medline, Scopus, Web of Science, and Embase until May 10, 2024. Out of 14,031 papers, 60 articles were included, involving 71 patients with a mean age of 53.5 +/- 17 years. Among them, 52.1 were male. Medications were categorized into four groups: conventional, biologics, small molecules, and vaccines. The most frequently reported medications in the first group were fingolimod (n = 8) and methotrexate (n = 7). Infliximab (n = 6) and etanercept (n = 5) were the most commonly reported biologics. Pfizer-BioNTech (n = 11) vaccine and JAK inhibitors (n = 3) were the most reported vaccine and small molecules. LyP (n = 17) was the most frequently reported type of CTCL, followed by PC-ALCL (n = 13), MF (n = 11), SS (n = 8), and SPTCL (n = 8). The most common underlying conditions were rheumatoid arthritis (n = 15) and multiple sclerosis (n = 10). Twenty patients (28) experienced disease regression after discontinuing the drug, with a mean +/- SD of 8.6 +/- 8.8 weeks. In 14 patients (20), chemotherapy and/or radiotherapy were initiated. Six patients passed away after being diagnosed with CTCL: two because of CTCL recurrence and four because of other complications. It is important recognizing CTCL as a possible, although rare, adverse effect of certain drugs and vaccines, and taking a history of vaccinations, especially COVID-19 vaccines, and immunosuppressive drugs such as fingolimod, TNF-a inhibitors, and methotrexate
Melatonin as a treatment for atherosclerosis: focus on programmed cell death, inflammation and oxidative stress
No full textDelaying the development of atherosclerosis (AS) and decreasing cardiac ischemia-reperfusion damage remain serious challenges for the medical community. Chronic arterial disease, i.e., AS, is frequently linked to oxidative stress and inflammation as significant contributing causes. AS risk factors, such as hyperlipidemia, high blood pressure, age, hyperglycemia, smoking, high cholesterol, and irregular sleep patterns, can exacerbate AS in the carotid artery and further shrink its lumen. Finding new approaches that support plaque inhibition or stability is an ongoing problem. The last ten years have shown us that melatonin (MLT) affects the cardiovascular system, although its exact mechanisms of action are yet unknown. MLT's direct free radical scavenger activity, its indirect antioxidant qualities, and its anti-inflammatory capabilities all contribute to its atheroprotective effects on several pathogenic signaling pathways. Herein, we examine the evidence showing that MLT treatment has significant protective effects against AS and AS-related cardiovascular diseases. The numerous pieces of the puzzle that have been as for epigenetic and biogenetic targets for prevention and therapy against the atherosclerotic pathogenic processes are identified
The effect of the gap between the cast post and residual gutta-percha and cement type on microleakage of endodontically treated teeth using the fluid filtration method
No full textBACKGROUND: The aim of this study was to investigate the impact of the distance between the gutta-percha and the post, as well as the type of cement used, on the incidence of microleakage in endodontically treated teeth. MATERIALS AND METHODS: This experimental-laboratory study involved 72 single-canal, single-rooted teeth, which were randomly sorted into six study groups and two control groups, each containing nine teeth. The six groups were further divided based on the distance between gutta-percha and post (0 mm, 0-2 mm, and >2 mm) and then categorized by cement type into glass ionomers and resins. Microleakage was evaluated using the fluid filtration method at 15 and 30 days. Data were analyzed using SPSS software, employing between-subjects effects and post hoc Tukey tests at a 5 significance level. RESULTS: Cement type did not significantly affect microleakage (P = 0.598). However, microleakage increased significantly with larger gaps between the post and remaining gutta-percha (P = 0.002). No significant difference in microleakage was observed between the gapless and 2 mm groups did not show any notable difference (P = 0.054). However, the difference in microleakage between the gapless group and the >/=2 mm gap group was significant (P = 0.001). CONCLUSION: This study found no significant difference in microleakage between glass ionomers and resin cements. Only gaps >2 mm significantly affected microleakage
Compare the Efficacy of Bolus Low Dose Ketamine Versus Bolus plus Infusion Low Dose Ketamine on Pain Management in Emergency Department: A randomized clinical trial
No full textBACKGROUND: Ketamine is a promising drug for analgesia in emergency medicine, but a high rate of side effects is a barrier to whispered usage. We hypothesized that ketamine bolus followed by ketamine infusion would provide a more even and longer duration of analgesia and lower rates of side effects in comparison to bolus-only administration. METHODS: This was a double-blinded, clinical trial. Eligible traumatic patients were randomly allocated with the Numerical Rating Scale (NRS) >/=6 in two study groups. The first group received a dose of 0.3 mg/kg of ketamine over 1 minute, followed by an infusion of saline 0.9 over the next 30 minutes (bolus only group). The second group was given 0.15 mg/kg of ketamine over 1 minute, followed by an infusion of 0.15 mg/kg over the next 30 minutes (bolus and infusion group). The primary outcome was to measure the average reduction in pain scores. RESULTS: 80 patients were recruited. Of these, 77 patients were analyzed. Both groups achieved a statistically significant decrease in pain scores (All p-values<0.001). After 30 minutes, patients in the bolus and infusion group reported lower pain scores in all intervals with lower rates of need for rescue analgesia but this difference was not statistically significant. Vital signs remained stable during the study in both groups. No statistically significant difference was observed between study groups in any side effect (p-value< 0.05). CONCLUSION: Both administration protocols resulted in significant pain control. No statistically significant difference was observed between study groups in terms of analgesic efficacy and side effects
Tacrolimus, Cytochrome P450, Interactions with Food Variables in Organ Transplant Recipients; A Current and Comprehensive Review
No full textThe well-established calcineurin inhibitor, tacrolimus, as an immunosuppressive agent, is widely prescribed after organ transplantation. Cytochrome P450 (CYP 450) isoforms are responsible for the metabolism of many features associated with food parameters like phytochemicals, juices, and fruits. This review article summarizes the findings of previous studies to help predict the efficacy or side effects of tacrolimus in the presence of food variables. From the commencement of databases associated with the topic of interest to 26 October 2024, all relevant articles were searched through PubMed, Scopus, and Web of Science. The suggested therapeutic range for tacrolimus trough concentration (C(0) ) was reported as 5-15 ng/ml blood. Tacrolimus interaction with food variables could significantly change C(0) after organ transplantation. For example, grapefruit juice could increase tacrolimus C(0) due to CYP enzyme inhibition. Toxicity such as nephrotoxicity could result from turmeric and other herbal or food products. By inhibiting tacrolimus-metabolizing enzymes and transporters, a high intake of vegetables could increase the risk of adverse effects. Secondary metabolites of vegetables could lead to toxicity in patients with tacrolimus. Furthermore, grapefruit juice, citrus fruits, turmeric, and pomegranate juice could change clinical pharmacokinetics parameters such as T(max), C(max), AUC, and C(0) of tacrolimus after organ transplantation. Bioavailability of tacrolimus might be decreased by induction of the CYP450 system and P-gp efflux pump due to cranberry, rooibos tea, and boldo. Increased inhibitory effect on CYP450 system and/or P-gp efflux pump by grapefruit juice, schisandra, berberine, turmeric, pomegranate juice, pomelo, and ginger could increase bioavailability of tacrolimus. A vigilant immunosuppressive strategy accompanied by scheduled therapeutic drug monitoring is recommended before and after transplant surgery