Benefits and harms of perioperative high fraction inspired oxygen for surgical site infection prevention: a protocol for a systematic review and meta-analysis of individual patient data of randomised controlled trials.

INTRODUCTION The use of high fraction of inspired oxygen (FiO2) intraoperatively for the prevention of surgical site infection (SSI) remains controversial. Promising results of early randomised controlled trials (RCT) have been replicated with varying success and subsequent meta-analysis are equivocal. Recent advancements in perioperative care, including the increased use of laparoscopic surgery and pneumoperitoneum and shifts in fluid and temperature management, can affect peripheral oxygen delivery and may explain the inconsistency in reproducibility. However, the published data provides insufficient detail on the participant level to test these hypotheses. The purpose of this individual participant data meta-analysis is to assess the described benefits and harms of intraoperative high FiO2compared with regular (0.21-0.40) FiO2 and its potential effect modifiers. METHODS AND ANALYSIS Two reviewers will search medical databases and online trial registries, including MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov and WHO regional databases, for randomised and quasi-RCT comparing the effect of intraoperative high FiO2 (0.60-1.00) to regular FiO2 (0.21-0.40) on SSI within 90 days after surgery in adult patients. Secondary outcome will be all-cause mortality within the longest available follow-up. Investigators of the identified trials will be invited to collaborate. Data will be analysed with the one-step approach using the generalised linear mixed model framework and the statistical model appropriate for the type of outcome being analysed (logistic and cox regression, respectively), with a random treatment effect term to account for the clustering of patients within studies. The bias will be assessed using the Cochrane risk-of-bias tool for randomised trials V.2 and the certainty of evidence using Grading of Recommendations, Assessment, Development and Evaluation methodology. Prespecified subgroup analyses include use of mechanical ventilation, nitrous oxide, preoperative antibiotic prophylaxis, temperature (2.5 hour). ETHICS AND DISSEMINATION Ethics approval is not required. Investigators will deidentify individual participant data before it is shared. The results will be submitted to a peer-review journal. PROSPERO REGISTRATION NUMBER CRD42018090261

Human monkeypox: history, presentations, transmission, epidemiology, diagnosis, treatment, and prevention

Human monkeypox is a zoonotic infection that is similar to the diseases caused by other poxviruses. It is endemic among wild rodents in the rainforests of Central and Western Africa, and can be transmitted via direct skin contact or mucosal exposure to infected animals. The initial symptoms include fever, headache, myalgia, fatigue, and lymphadenopathy, the last of which is the main symptom that distinguishes it from smallpox. In order to prevent and manage the disease, those who are infected must be rapidly diagnosed and isolated. Several vaccines have already been developed (e.g., JYNNEOS, ACAM2000 and ACAM3000) and antiviral drugs (e.g., cidofovir and tecovirimat) can also be used to treat the disease. In the present study, we reviewed the history, morphology, clinical presentations, transmission routes, diagnosis, prevention, and potential treatment strategies for monkeypox, in order to enable health authorities and physicians to better deal with this emerging crisis

The Precision nEDM Measurement with UltraCold Neutrons at TRIUMF

The TRIUMF Ultra-Cold Advanced Neutron (TUCAN) collaboration aims at a precision neutron electric dipole moment (nEDM) measurement with an uncertainty of $10^{-27}\,e\cdot\mathrm{cm}$, which is an order-of-magnitude better than the current nEDM upper limit and enables us to test Supersymmetry. To achieve this precision, we are developing a new high-intensity ultracold neutron (UCN) source using super-thermal UCN production in superfluid helium (He-II) and a nEDM spectrometer. The current development status of them is reported in this article.Comment: Proceedings of the 24th International Spin Symposium (SPIN 2021), 18-22 October 2021, Matsue, Japa

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

D, L-Sulforaphane loaded Fe3O4@ gold core shell nanoparticles: A potential sulforaphane delivery system

A novel design of gold-coated iron oxide nanoparticles was fabricated as a potential delivery system to improve the efficiency and stability of d, l-sulforaphane as an anticancer drug. To this purpose, the surface of gold-coated iron oxide nanoparticles was modified for sulforaphane delivery via furnishing its surface with thiolated polyethylene glycol-folic acid and thiolated polyethylene glycol-FITC. The synthesized nanoparticles were characterized by different techniques such as FTIR, energy dispersive X-ray spectroscopy, UV-visible spectroscopy, scanning and transmission electron microscopy. The average diameters of the synthesized nanoparticles before and after sulforaphane loading were obtained ∼ 33 nm and ∼ 38 nm, respectively, when ∼ 2.8 mmol/g of sulforaphane was loaded. The result of cell viability assay which was confirmed by apoptosis assay on the human breast cancer cells (MCF-7 line) as a model of in vitro-cancerous cells, proved that the bare nanoparticles showed little inherent cytotoxicity, whereas the sulforaphane-loaded nanoparticles were cytotoxic. The expression rate of the anti-apoptotic genes (bcl-2 and bcl-xL), and the pro-apoptotic genes (bax and bak) were quantified, and it was found that the expression rate of bcl-2 and bcl-xL genes significantly were decreased when MCF-7 cells were incubated by sulforaphane-loaded nanoparticles. The sulforaphane-loaded into the designed gold-coated iron oxide nanoparticles, acceptably induced apoptosis in MCF-7 cells

IFI27 transcription is an early predictor for COVID-19 outcomes, a multi-cohort observational study

PurposeRobust biomarkers that predict disease outcomes amongst COVID-19 patients are necessary for both patient triage and resource prioritisation. Numerous candidate biomarkers have been proposed for COVID-19. However, at present, there is no consensus on the best diagnostic approach to predict outcomes in infected patients. Moreover, it is not clear whether such tools would apply to other potentially pandemic pathogens and therefore of use as stockpile for future pandemic preparedness.MethodsWe conducted a multi-cohort observational study to investigate the biology and the prognostic role of interferon alpha-inducible protein 27 (IFI27) in COVID-19 patients.ResultsWe show that IFI27 is expressed in the respiratory tract of COVID-19 patients and elevated IFI27 expression in the lower respiratory tract is associated with the presence of a high viral load. We further demonstrate that the systemic host response, as measured by blood IFI27 expression, is associated with COVID-19 infection. For clinical outcome prediction (e.g., respiratory failure), IFI27 expression displays a high sensitivity (0.95) and specificity (0.83), outperforming other known predictors of COVID-19 outcomes. Furthermore, IFI27 is upregulated in the blood of infected patients in response to other respiratory viruses. For example, in the pandemic H1N1/09 influenza virus infection, IFI27-like genes were highly upregulated in the blood samples of severely infected patients.ConclusionThese data suggest that prognostic biomarkers targeting the family of IFI27 genes could potentially supplement conventional diagnostic tools in future virus pandemics, independent of whether such pandemics are caused by a coronavirus, an influenza virus or another as yet-to-be discovered respiratory virus

The Educational-mystical Role of Intermediate Centers (Ribat) Along the Silk Road From China to Iran

The silk road path to the northern part from China to Europe and from southern paths to lateral paths of Iran- Mesopotamia to Antioch and Mediterranean, had been the place of construction the historical monuments and works such as castles, towers, mills, graves, and intercity Ribats. Sufi Ribats as the mystical orientation and educational centers had a special place in the Silk Road, these intermediate buildings are buildings that functioned militarily in the first centuries of Islam (8th, 9th, and 10th centuries AD), and over time have been used to mean monasteries. The architectural style of the Ribats was similar to that of a military castle, and most of them consisted of a rectangular building with four watchtowers. Examining the Ribats of the Silk Road, it will become clear that the architectural form and plan of the Ribats are very similar to those of religious schools and Caravanserais. The Sufi historians and researchers have recorded many reports over these Ribats, have investigated the introduction, application, and position of Ribats in detail and have left fairly invaluable information to the futures. In this regard, the historical books and Sufi educational books and mystical literature are endowed with reports over intra-city and intercity Ribats built mainly on the way of main paths, particularly the main path of the Silk Road and its lateral ways. In this article, these Ribats have been described in detail as well as their role on the Silk Road

The Effect of Continuous Care Model on Sleep Quality in Patients with Multiple Sclerosis

Multiple sclerosis is a chronic and unpredictable disease and is a growing trend and, like other chronic diseases, affects one's quality of life and since sleep quality is one of the dimensions of quality of life, this study aimed to investigate the effect of applying continuous care model on sleep quality of patients with MS in 2013. This clinical trial study was performed on 80 patients with multiple sclerosis who were randomly assigned to experimental and control groups. Data collection tools included demographic information questionnaire, PSQI questionnaire and model implementation in four stages (familiarization, sensitization, control, evaluation). Model stages were performed individually and in groups for three weeks according to patients' educational needs (sleep, activity, medication and nutrition) and after two months follow up, control and evaluation were performed. Data were analyzed using Chi-square test, independent t-test and repeated measures ANOVA and spss16 software. Statistical analysis of variance (ANOVA) with repeated measures showed a significant difference between the mean of total score and the scores of sleep quality dimensions in three times between the two groups (p<0.05). It can be concluded that the implementation of continuous care model causes a significant difference in the sleep quality of patients with MS