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Erectile dysfunction (ED) is associated with cardiovascular events, and a significant proportion of men with coronary artery disease (CAD) exhibit early signs of ED. Moreover, both of these disorders shared common risk factors in previous studies. This study was conducted to determine which risk factors and conditions in CAD patients might contribute to the occurrence of ED. This analytical cross-sectional study was conducted in the North of Iran from October 2016 to September 2017. 316 patients with coronary artery disease were enrolled. Demographic information were collected using a checklist, and the International Index of Erectile Function (IIEF-15) questionnaire was used to determine the participant's ED status. Univariate and multivariate logistic regression were used to investigate associated factors. The mean age of the participants was 56.51±9.88 years. About 55.1% of the patients had ED. Moreover, the severity of CAD was independently associated with an increased risk of ED (OR=4.11, 95%CI=1.69-9.97), with patients having more than one involved coronary artery and greater coronary artery stenosis had a higher risk of developing ED occurrence (OR=3.74, 95%CI=1.72-8.09). Besides, age (OR=1.23, 95%CI=1.18-1.29) and BMI (OR=1.26, 95%CI=1.13-1.41) were independent predictors of ED occurrence in CAD patients. Higher CAD severity, older age, and higher BMI were all independent predictors of ED occurrence in CAD patients. While, diabetes mellitus, dyslipidemia, and smoking were not independent risk factors, they could contribute to the development of ED when combined with other risk factors.

This paper presents the design and fabrication of a slant-polarized monopulse array antenna featuring a cosecant-squared radiation pattern for accurate target tracking. The proposed 2 × 8 microstrip array employs a modified proximity coupling scheme and incorporates metallic walls to reduce mutual coupling. A strategically placed ground plane enhances the gain, suppresses the back lobe, and improves isolation from the surrounding environment. The amplitude and phase excitations are optimized with a genetic algorithm that accounts for mutual coupling to synthesize the desired cosecant-squared pattern. A rectangular 180-degree hybrid coupler is integrated to enable monopulse operation in the azimuth plane, thereby improving tracking performance. Measurement results of the fabricated prototype demonstrate a 34% impedance bandwidth (3.8–5.4 GHz), a peak gain of 13.05 dBi, a sidelobe level of 13 dB, a null depth of 24 dB, and an elevation plane beamwidth of 24° at the center frequency, all of which align closely with simulation results. The measured radiation pattern accurately follows the ideal cosecant-squared curve.

Background and AimsThe occurrence of hypothermia increases complications during and after surgery.This study was conducted with the aim of comparing the effect of lavage fluid temperature in terms of the incidence of hypothermia in TURP surgery candidates under spinal anesthesia.Methods70 patients candidates for elective TURP were randomly divided into two groups. The first group (37) received irrigation fluid at room temperature and second group(33) received irrigation fluid heated to 37 degrees Celsius for surgery.Parameters of patients were initially measured upon entering the operating room, after spinal, at the beginning of the operation, at the end of the operation and also during recovery.ResultsThe drop in the body temperature in the control group was more than the intervention group (p=0.04). There was no statistically significant difference between two groups in the analysis of changes in mean arterial blood pressure and heart rate (p>0.05). There was no statistically significant difference between the two groups in terms of the average volume of lavage serum consumed during the operation, the comparison of hemoglobin before and after the operation, the incidence and severity of shivering and the duration of recovery and hospitalization. However, in terms of the need for blood transfusion and the number of blood units consumed during the operation, there was a statistically significant difference between the two groups (p<0.05).Abstract EP241 Figure 1(Chart 2) Changes in average mean heart rate(HR) in patients of two groupsConclusionsUse of heated irrigation fluid to body temperature is associated with less occurrence of hypothermia, shivering and less need for blood transfusion than the group receiving washing solution at room temperature.Research Ethics hypothermia in TURP

Alzheimer's disease (AD) is associated with severe cognitive impairments as well as some metabolic defects. Scant studies in animal models indicate a link between probiotics and cognitive function. This randomized, double-blind, and controlled clinical trial was conducted among 60 AD patients to assess the effects of probiotic supplementation on cognitive function and metabolic status. The patients were randomly divided into two groups ( = 30 in each group) treating with either milk (control group) or a mixture of probiotics (probiotic group). The probiotic supplemented group took 200 ml/day probiotic milk containing , and (2 × 10 CFU/g for each) for 12 weeks. Mini-mental state examination (MMSE) score was recorded in all subjects before and after the treatment. Pre- and post-treatment fasting blood samples were obtained to determine the related markers. After 12 weeks intervention, compared with the control group (-5.03% ± 3.00), the probiotic treated (+27.90% ± 8.07) patients showed a significant improvement in the MMSE score ( <0.001). In addition, changes in plasma malondialdehyde (-22.01% ± 4.84 vs. +2.67% ± 3.86 μmol/L, <0.001), serum high-sensitivity C-reactive protein (-17.61% ± 3.70 vs. +45.26% ± 3.50 μg/mL, <0.001), homeostasis model of assessment-estimated insulin resistance (+28.84% ± 13.34 vs. +76.95% ± 24.60, = 0.002), Beta cell function (+3.45% ± 10.91 vs. +75.62% ± 23.18, = 0.001), serum triglycerides (-20.29% ± 4.49 vs. -0.16% ± 5.24 mg/dL, = 0.003), and quantitative insulin sensitivity check index (-1.83 ± 1.26 vs. -4.66 ± 1.70, = 0.006) in the probiotic group were significantly varied compared to the control group. We found that the probiotic treatment had no considerable effect on other biomarkers of oxidative stress and inflammation, fasting plasma glucose, and other lipid profiles. Overall, the current study demonstrated that probiotic consumption for 12 weeks positively affects cognitive function and some metabolic statuses in the AD patients. http://www.irct.ir/, IRCT201511305623N60.

Varicocele is one of the most common treatable causes of male infertility, and its treatment may be beneficial for fertility. This study aimed to evaluate fertility rate and DNA fragmentation index (DFI) following varicocelectomy in primary infertile men with clinical varicocele. This prospective longitudinal study was conducted on primary infertility men, in a tertiary center from December 2018 to December 2019 with one-year follow-up. Data of the semen parameters, DFI (%), and fertility rate were gathered before, as well as 4 and 12 months after undergoing varicocelectomy. For data analysis, SPSS software and analytical test were used. Out of 76 patients who were analyzed, 22 (29%) became fertile and 54 (71%) remained infertile. Semen parameters and DFI (%) were improved significantly following varicocelectomy (P<0.001). Smoking history, occupational heated exposure, body mass index (BMI), and infertility duration were determined as predictors associated with fertility status (P<0.05). Although varicocele repair improved the DFI, the fertility rate was achieved in less than one-third of patients; it seems that the other parameters, such as the history of smoking, occupational heated exposure, overweight, and duration of infertility should be considered as predictors of fertility status, in primary infertile men who are a candidate for varicocelectomy.

Tarlatamab is a delta-like ligand 3 (DLL3)-directed bispecific T-cell engager immunotherapy that has improved survival in patients with previously treated small-cell lung cancer (SCLC). We evaluated the safety and activity of tarlatamab in combination with atezolizumab or durvalumab as first-line maintenance therapy in patients with extensive-stage (ES)-SCLC. In this multicentre, non-randomised, phase 1b study, patients aged 18 years and older, with Eastern Cooperative Oncology Group performance status of 0–1 and without disease progression after four to six cycles of platinum–etoposide chemotherapy plus a programmed cell death ligand 1 (PD-L1) inhibitor (if available), received tarlatamab 10 mg intravenously once every 2 weeks, after an initial tarlatamab 1 mg dose, with atezolizumab intravenously (1680 mg once every 4 weeks) or durvalumab intravenously (1500 mg once every 4 weeks) as maintenance until disease progression. Patients were enrolled from 30 centres in 13 countries. The primary objective was to evaluate safety and to determine the recommended phase 2 dose or maximum tolerated dose of tarlatamab in combination with a PD-L1 inhibitor through assessment of dose-limiting toxicities, treatment-emergent adverse events, treatment-related adverse events, and changes in vital signs, electrocardiograms, and clinical laboratory tests. All patients who received at least one dose of tarlatamab were included in the analyses. Because overall survival data were immature at the primary analysis, in this Article, we report a non-specified interim analysis to provide an updated examination of overall survival and longer-term safety. This study is registered with ClinicalTrials.gov, NCT05361395; the EU Clinical Trials registry, 2021-005462-17; and EudraCT, 2024-511021-58. Between Aug 31, 2022, and Jan 30, 2024, 88 patients received tarlatamab with atezolizumab or durvalumab after standard-of-care first-line chemo-immunotherapy. The median time from start of standard-of-care first-line chemo-immunotherapy to start of tarlatamab maintenance was 3·6 months (IQR 3·2–4·3). The median follow-up from the start of maintenance was 18·4 months (15·2–23·0) and the median exposure to tarlatamab was 35 weeks (8–75). The most common grade 3–4 adverse events were hyponatraemia (nine [10%] of 88 patients), anaemia (seven [8%] of 88 patients), and neutropenia (six [7%] of 88 patients). Serious adverse events occurred in 50 (57%) of 88 patients. The most common serious adverse events were cytokine release syndrome (21 [24%] of 88 patients), pyrexia (six [7%] of 88 patients), immune effector cell-associated neurotoxicity syndrome (four [5%] of 88 patients), and pneumonia (four [5%] of 88 patients). There were no deaths due to treatment-related adverse events. Median overall survival was 25·3 months (95% CI 20·3–not estimable). Tarlatamab plus a PD-L1 inhibitor as maintenance after first-line chemo-immunotherapy showed a manageable safety profile with promising anticancer activity, supporting the ongoing phase 3 trial (NCT06211036). Amgen.

There is an urgent need for an effective tuberculosis (TB) vaccine. Heterologous prime-boost regimens induce potent cellular immunity. MVA85A is a candidate TB vaccine. This phase I clinical trial was designed to evaluate whether alternating aerosol and intradermal vaccination routes would boost cellular immunity to the Mycobacterium tuberculosis antigen 85A (Ag85A). Between December 2013 and January 2016, 36 bacille Calmette-Guérin-vaccinated, healthy UK adults were randomised equally between 3 groups to receive 2 MVA85A vaccinations 1 month apart using either heterologous (Group 1, aerosol-intradermal; Group 2, intradermal-aerosol) or homologous (Group 3, intradermal-intradermal) immunisation. Bronchoscopy and bronchoalveolar lavage (BAL) were performed 7 days post-vaccination. Adverse events (AEs) and peripheral blood were collected for 6 months post-vaccination. The laboratory and bronchoscopy teams were blinded to treatment allocation. One participant was withdrawn and was replaced. Participants were aged 21-42 years, and 28/37 were female. In a per protocol analysis, aerosol delivery of MVA85A as a priming immunisation was well tolerated and highly immunogenic. Most AEs were mild local injection site reactions following intradermal vaccination. Transient systemic AEs occurred following vaccination by both routes and were most frequently mild. All respiratory AEs following primary aerosol MVA85A (Group 1) were mild. Boosting an intradermal MVA85A prime with an aerosolised MVA85A boost 1 month later (Group 2) resulted in transient moderate/severe respiratory and systemic AEs. There were no serious adverse events and no bronchoscopy-related complications. Only the intradermal-aerosol vaccination regimen (Group 2) resulted in modest, significant boosting of the cell-mediated immune response to Ag85A (p = 0.027; 95% CI: 28 to 630 spot forming cells per 1 × 106 peripheral blood mononuclear cells). All 3 regimens induced systemic cellular immune responses to the modified vaccinia virus Ankara (MVA) vector. Serum antibodies to Ag85A and MVA were only induced after intradermal vaccination. Aerosolised MVA85A induced significantly higher levels of Ag85A lung mucosal CD4+ and CD8+ T cell cytokines compared to intradermal vaccination. Boosting with aerosol-inhaled MVA85A enhanced the intradermal primed responses in Group 2. The magnitude of BAL MVA-specific CD4+ T cell responses was lower than the Ag85A-specific responses. A limitation of the study is that while the intradermal-aerosol regimen induced the most potent cellular Ag85A immune responses, we did not boost the last 3 participants in this group because of the AE profile. Timing of bronchoscopies aimed to capture peak mucosal response; however, peak responses may have occurred outside of this time frame. To our knowledge, this is the first human randomised clinical trial to explore heterologous prime-boost regimes using aerosol and systemic routes of administration of a virally vectored vaccine. In this trial, the aerosol prime-intradermal boost regime was well tolerated, but intradermal prime-aerosol boost resulted in transient but significant respiratory AEs. Aerosol vaccination induced potent cellular Ag85A-specific mucosal and systemic immune responses. Whilst the implications of inducing potent mucosal and systemic immunity for protection are unclear, these findings are of relevance for the development of aerosolised vaccines for TB and other respiratory and mucosal pathogens. ClinicalTrials.gov NCT01954563.

Background Interaction between researchers and policymakers is an essential factor to facilitate the evidence-informed policymaking. One of the effective ways to establish this relationship and promote evidence-informed policymaking is to employ people or organizations that can play the role of knowledge brokers. This study aims to analyze the communication network and interactions between researchers and policymakers in Iran's health sector and identify key people serving as academic knowledge brokers. Methods This study was a survey research. Using a census approach, we administered a sociometric survey to faculty members in the health field in top ten Iranian medical universities to construct academic-policymaker network using social network analysis method. Network maps were generated using UCINET and NetDraw software. We used Indegree Centrality, Outdegree Centrality, and Betweenness Centrality indicators to determine knowledge brokers in the network. Results The drawn network had a total of 188 nodes consisting of 94 university faculty members and 94 policymakers at three national, provincial, and university levels. The network comprised a total of 177 links, with 125 connecting to policymakers and 52 to peers. Of 56 faculty members, we identified four knowledge brokers. Six policymakers were identified as key policymakers in the network, too. Conclusions It seems that the flow of knowledge produced by research in the health field in Iran is not accomplished well from the producers of research evidence to the users of knowledge. Therefore, it seems necessary to consider incentive and support mechanisms to strengthen the interaction between researchers and policymakers in Iran's health sector.

Computational Thinking (CT) pervasively shares its methods, practices, and dispositions across other disciplines as a new way of thinking about problem-solving. Few studies have been carried out studying CT from an Information Systems (IS) perspective. This study elaborates on how systems thinking (ST), an acknowledged theory in the IS field, bonds to CT to address some well-known common issues related to CT such as reductionism and dogmatism, and to supplement the computing nature of CT with behavioral and societal facets involved in its implications. We studied how ST is applied to CT research in the literature. To do so, two primary approaches have been identified that link ST and CT. First, ST is embedded in CT practices meaning that ST is considered as a component of CT. Second, ST and CT are parallelly studied, and ST is considered as a supplementary concept to CT. Correspondingly, we propose a complementary approach that looks at CT from the ST lenses to provide a clearer picture of CT in an educational context. Moreover, we expect this new perspective can help to broaden the development of educational CT concepts and scenarios by including new notions such as framework, interpretation, norms, paradigm, and context.

In recent decades, scholarly investigations have predominantly centered on nanomaterials possessing enzyme-like characteristics, commonly referred to as nanozymes. These nanozymes have emerged as viable substitutes for natural enzymes, offering simplicity, stability, and superior performance across various applications. Inorganic nanoparticles have been extensively employed in the emulation of enzymatic activity found in natural systems. Nanoparticles have shown a strong ability to mimic a number of enzyme-like functions. These systems have made a lot of progress thanks to the huge growth in nanotechnology research and the unique properties of nanomaterials. Our presentation will center on the kinetics, processes, and applications of peroxidase-like nanozymes. In this discourse, we will explore the various characteristics that exert an influence on the catalytic activity of nanozymes, with a particular emphasis on the prevailing problems and prospective consequences. This paper presents a thorough examination of the latest advancements achieved in the domain of peroxidase mimetic nanozymes in the context of cancer diagnosis and treatment. The primary focus is on their use in catalytic cancer therapy, alongside chemotherapy, phototherapy, sonodynamic therapy, radiation, and immunotherapy. The primary objective of this work is to offer theoretical and technical assistance for the prospective advancement of anticancer medications based on nanozymes. Moreover, it is anticipated that this will foster the investigation of novel therapeutic strategies aimed at achieving efficacious tumor therapy.