Aim
The aim of this study was to evaluate the short‐term and long‐term effects of routine repetitive transcranial magnetic stimulation (rTMS) on the sleep duration, depressive symptoms, and quality ...of life of patients with treatment‐resistant depression (TRD).
Methods
In this prospective cohort study, 25 participants with TRD were assessed using the Insomnia Severity Index (ISI) and four sleep duration components of the Pittsburgh Sleep Quality Index (PSQI). Depression severity was measured with Hamilton's Depression Rating Scale (HDRS) and Beck's Depression Inventory (BDI‐II), and patient‐perceived quality of life with the 36‐Item Short‐Form Survey (SF‐36). All of these measures were evaluated at baseline (T0), and immediately (T1), 6 weeks (T2), and 12 weeks (T3) after the end of intervention.
Results
At T1 endpoint, HDRS, BDI, SF‐36, ISI, and three PSQI items (time to wake up, time taken to fall asleep, and Real Sleep Time) significantly improved, though these gains were reduced at follow‐up endpoints (T2 and T3). Adjusting for confounders (age, sex, occupational status, BMI, and hypnotic medication) revealed that only improvements in HDRS, BDI, and time taken to fall asleep at T1 remained statistically significant. Linear regression analyses showed no significant association between reduced time taken to fall asleep and depression symptoms, suggesting rTMS can independently enhance this parameter, irrespective of depression resolution.
Conclusion
Routine rTMS therapy can potentially enhance sleep duration in TRD individuals, alongside improved depressive symptoms and quality of life. However, these benefits tend to decrease over long‐term follow‐up, emphasizing a more pronounced short‐term efficacy of rTMS.
In this study, 25 patients with treatment‐resistant depression (TRD) received 25 daily sessions of repetitive transcranial magnetic stimulation (rTMS), alongside their ongoing medical treatment. Assessment of sleep duration (Insomnia Severity Index and Pittsburgh Sleep Quality Index), depression severity (Hamilton's Depression Rating Scale and Beck's Depression Inventory), and quality of life (36‐Item Short‐Form Survey) revealed a significant improvement in depressive symptoms and quality of life, as well as sleep duration in TRD patients immediately after the intervention. However, a diminishing trend was observed for all variables over time, suggesting a short‐term beneficial effect of rTMS on both sleep status and depressive symptoms.
The emergence of three-dimensional (3D) printing promises a disruption in the design and on-demand fabrication of smart structures in applications ranging from functional devices to human organs. ...However, the scale at which 3D printing excels is within macro- and microlevels and principally lacks the spatial ordering of building blocks at nanolevels, which is vital for most multifunctional devices. Herein, we employ liquid crystal (LC) inks to bridge the gap between the nano- and microscales in a single-step 3D printing. The LC ink is prepared from mixtures of LCs of nanocellulose whiskers and large sheets of graphene oxide, which offers a highly ordered laminar organization not inherently present in the source materials. LC-mediated 3D printing imparts the fine-tuning required for the design freedom of architecturally layered systems at the nanoscale with intricate patterns within the 3D-printed constructs. This approach empowered the development of a high-performance humidity sensor composed of self-assembled lamellar organization of NC whiskers. We observed that the NC whiskers that are flat and parallel to each other in the laminar organization allow facile mass transport through the structure, demonstrating a significant improvement in the sensor performance. This work exemplifies how LC ink, implemented in a 3D printing process, can unlock the potential of individual constituents to allow macroscopic printing architectures with nanoscopic arrangements.
Introduction: In the third millennium, political, economic, geographical, and technological changes have had a profound effect on organizations. The speed of these changes, along with the increase in ...global competition, has forced organizations to reorganize their activities by rethinking new marketing methods (Veynberg et al, 2018). In this regard, sports organizations to increase their competitiveness, need to use various tools to be able to facilitate the achievement of predetermined goals and results (Hautbois, 2019). Among these sports organizations are federations, which play an important role in developing and developed countries. Sports federations operate in a competitive and dynamic environment; An environment in which internal and external variables are constantly changing and it is very difficult to predict these changes (Shamounian et al, 2019). Due to the high sensitivity in the current sports industry and in order to achieve effectiveness in marketing programs, recognizing the dimensions of managerial competencies has become a vital factor in sports success. In fact, strong managerial competencies in contemporary sports management can be a source of significant competitive advantage (Frawley et al, 2018). On the other hand, another component that provides the necessary context for the emergence of managerial competencies is structural capital (Matos et al, 2017). In this regard Swanson et al (2020) in their research, they concluded that managerial competencies have a significant positive effect on knowledge sharing and job performance of employees. Neumeyer & Liu (2021) also concluded that the adoption of new (digital) technologies can significantly contribute to a company's short-term and long-term competitive advantages. In the new era, the professionalization of sports and the performance of sports organizations, along with the increase in organizational and non-organizational areas of sports, has forced managers and employees of sports organizations to seek new processes in their field of performance beyond traditional concepts (Dellitalia, 2018). In addition, sports federations, especially the Karate Federation, have faced many problems in purchasing equipment and supplies, sending their teams to international competitions, holding training camps, holding training competitions, and so on. Given the above, the researcher seeks to answer this question: Is there a relationship between managerial competencies and structural capital with the effectiveness of marketing programs of the Karate Federation of the Islamic Republic of Iran? Methodology: The research is an applied one and in terms of data collection method is a correlational research based on structural equation modeling which was conducted in the field. The statistical population of the study includes all members of the Karate Federation (president, vice president, vice president of women, secretary of the federation, staff of the federation (various committees and staff of other departments) (43 people), members of provincial karate boards (presidents, vice president, finance officer, teachers The provincial karate boards (124 people) and experts in the field of karate included first-class coaches, judges, and national athletes (56 people). All members of the community were identified as a total of 223 people. In this study, the Cutler and Keller (2006) marketing program effectiveness questionnaire, Nwokah, & Ahiauzu (2008) and Shakarian (2013) structural capital questionnaires were used. The face and content validity of the questionnaire was confirmed by 10 professors and the construct validity was confirmed using exploratory and confirmatory factor analysis. Results and Discussion: According to the results of Pearson correlation test, it is observed that between managerial competencies and structural capital (Sig = 0.001, r = 0.873), between managerial competencies and the effectiveness of marketing programs (Sig = 0.001, 0.778). r) And there is a significant positive relationship between structural capital and the effectiveness of marketing programs (Sig = 0.001, r = 0.894). After examining the relationship between research variables, the research model was designed in AMOS software version 24. Conclusion: The results of structural equation modeling showed that managerial competencies have a significant positive effect on the effectiveness of Karate Federation marketing programs. Also, based on the findings of the structural equation model, it was observed that structural capital has a significant positive effect on the effectiveness of the marketing programs of the Karate Federation. The research findings are in line with the results of Neumeyer & Liu (2021) research. In addition, based on the findings of the research model, it was observed that managerial competencies have a significant positive effect on the structural assets of the Karate Federation. This research finding is in line with the results of Swanson et al (2020) research. Based on the results of this research, it is suggested that the marketing director of the Karate Federation coordinate with the director of research, production, procurement, physical and financial distribution, etc., so that different marketing opportunities serve the needs of important marketing departments, territories and presentation. Design services. In addition, it is recommended that the unit manager in the Karate Sports Federation have the appropriate information to plan and properly allocate resources in different markets, products, domains and marketing tools to create effective marketing.
We investigated the role of glial cell line-derived neurotrophic factor (GDNF) in compensating trastuzumab (TZMB)-induced apoptosis in HER2
+
breast cancer (BC) cells using xenograft tumors. We ...generated BC xenografts in nude mice using samples from three patients selected based on their HER2 status and response to TZMB therapy. TZMB treatment resulted in shrinkage of the HER2
+
TZMB-sensitive xenograft tumor but not the HER2
−
or HER2
+
TZMB-resistant ones. GDNF neutralized TZMB activity and induced growth in all tumors. Three distinct cell lines were derived from these tumors and named, respectively, TZMB-sensitive (TSTC), HER2
−
(HNTC), and TZMB-resistant (TRTC). Over 50% of TRTC but 1% of TSTC cells expressed CD44, whereas 84% of TSTC were CD24
+
compared to only 1% of TRTC, despite comparable levels of HER2 detected in both. TZMB induced profound morphological changes toward apoptosis in TSTC but not in TRTC or HNTC. However, GDNF significantly compensated TZMB-mediated TSTC cell loss and promoted growth by 37 and 50%, respectively, in TSTC and TRTC. Inhibition of SRC by Saracatinib (SARC) blocked GDNF function and accelerated TZMB-mediated cell death in TSTC, but GDNF continued promoting TRTC growth. These changes paralleled with expression levels of the key molecules involved in growth and apoptosis. Collectively, we found in our xenograft samples that firstly SRC mediates GDNF pro-survival functions by bridging RET–HER2 crosstalk in TZMB-responsive BC tumors. Secondly, SARC–TZMB interactions can synergistically eradicate such tumor cells; and thirdly, GDNF can support antibody resistance by acting independent from SRC in tumors with poor HER2 response to TZMB therapy.
Big data analysis applications in the field of medical image processing have recently increased rapidly. Feature reduction plays a significant role in eliminating irrelevant features and creating a ...successful research model for Big Data applications. Fuzzy clustering is used for the segment of the nucleus. Various features, including shape, texture, and color-based features, have been used to address the segmented nucleus. The Modified Dominance Soft Set Feature Selection Algorithm (MDSSA) is intended in this paper to determine the most important features for the classification of leukaemia images. The results of the MDSSA are evaluated using the variance analysis called ANOVA. In the dataset extracted function, the MDSSA selected 17 percent of the features that were more promising than the existing reduction algorithms. The proposed approach also reduces the time needed for further analysis of Big Data. The experimental findings confirm that the performance of the proposed reduction approach is higher than other approaches.
Background Postoperative acute heart failure (AHF) in elderly patients after hip fracture surgery is a common complication. Therefore, this study aimed to identify the risk factor of AHF after hip ...fracture surgery among the older population. Methods This retrospective cohort study was performed on 88 admitted patients whose hip fractures were fixed via internal fixation surgery in a tertiary care hospital in Rawalpindi, Pakistan, from January 2022 to March 2023. Recruitment of patients was made through established inclusion and exclusion criteria. Ethical approval and informed consent were also gained before the data collection. A self-designed form was used to collect data. Data analysis was carried out in the IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). Both descriptive and inferential statistics were applied to compare the attributes of the patients with AHF and patients without AHF. Multivariate logistic regression was used to evaluate the association between the postoperative AHF and its potential risk factors. Results Out of 88 enrolled patients, 12 (13.64%) had developed postoperative AHF. Age ≥ 65 years (OR = 2.606, 95% CI = 1.035~4.160, p = 0.010), anemia (OR = 3.178, 95% CI = 1.847~5.990, p = 0.029), hypertension (OR = 2.019, 95% CI = 1.110~4.034, p = 0.012), diabetes mellitus (OR = 2.003, 95% CI = 1.115~4.012, p = 0.015), hypoalbuminemia (OR = 2.486, 95% CI = 1.218~4.619, p = 0.030), and operation time ≥ 120 minutes (OR = 1.702, 95% CI = 1.099~2.880, p = 0.018), were the risk factors of postoperative AHF in elderly patients after hip fracture surgery. Conclusions In the study population, the incidence of postoperative heart failure was significant and age ≥ 65 years, anemia, hypertension, diabetes mellitus, hypoalbuminemia, and operation time ≥ 120 were significantly involved in the development of it. Preoperative identification and management of AHF risk factors could lead to the prevention of postoperative complications.
Background
Metastases to the bones are a frequent location of metastasis in advanced breast cancer and are responsible for substantial morbidity and healthcare expenses. Imaging has been crucial in ...directing patient therapy for decades, contributing to the staging and response evaluation of the skeleton. This research aimed to assess the diagnostic value of whole-body magnetic resonance imaging with diffusion-weighted imaging added to radionuclide bone scans for early diagnosis of bone metastases in breast cancer patients.
Results
The study was a prospective observational cohort study performed on 20 patients with breast cancer and suspected bone metastases. The patients were evaluated first by obtaining a detailed personal history. Laboratory tests, including CBC, liver, and kidney function tests were assessed. All patients were examined by diffusion-weighted whole-body MRI (DWIBS; diffusion-weighted imaging with background body signal suppression) images and bone scintigraphy after intravenous injection of 20 mci of technetium-99m (
99m
Tc) methylene diphosphonate using a dual head gamma camera. The total number of lesions detected by bone scan was 74, and 75 lesions were seen by DWIBS. Twenty-four lesions were missed by bone scan and detected by DWIBS. Fourteen lesions were detected by bone scan and found free by DWIBS examination in the spine and pelvic bones.
Conclusions
Whole body DWIBS seems to be a promising method of imaging in detecting bone metastases from breast cancer that could be used complementary to the traditional bone scan for more accurate diagnosis and staging of the tumor, helping to determine the most appropriate protocol of management.
Background: Children’s Friendship Training (CFT) is a parent-assisted intervention programme that introduces children to basic sets of social rules to help them understand social contexts with ...specific guidance from their parents. It has been reported in several empirical studies that the friendship skills of children with autism spectrum disorder were enhanced after participating in CFT. However, previous studies only focused on the effectiveness of the training without exploring it from the parent’s perspective. As such, the objective of this study is to highlight the parents’ experience in assisting in the implementation of CFT. Purpose: To explore the parents’ experiences with autism spectrum disorder (ASD) in CFT and examine the experiences using the CFT as a theoretical framework. Methodology: In this study, eight parents and their school-aged children with ASD participated in 12 CFT sessions. Upon completing the CFT, the parents participated in a focus group interview. The interview session was video recorded and transcribed with the parents’ consent. Thematic analysis was employed in analysing the collected data as outlined in six different phases. Results: The generated data revealed the similarities and differences in parents’ experiences in the CFT. The current study has identified four main themes: (1) fear and resistance; (2) awareness, learning, and adjustment; (3) change is hard; and (4) identifying support. Conclusions: The findings highlighted the processes that these parents experienced and encountered while attending the CFT programme, it is important to consider these processes based on how they might impact the effectiveness of the programme. The programme’s effectiveness is reliant on the ability to work closely with parents to understand their challenges and explore the type of support they need. This study has analysed the crucial factors that provide an overview of parents’ encounters in their participation in CFT.
Transcranial direct current stimulation (tDCS) has been increasingly applied in fibromyalgia (FM) to reduce pain and fatigue. While results are promising, observed effects are variable, and there are ...questions about optimal stimulation parameters such as target region (e.g., motor vs. prefrontal cortices). This systematic review aimed to provide the latest update on published randomized controlled trials with a parallel-group design to examine the specific effects of active tDCS in reducing pain and disability in FM patients. Using the PRISMA approach, a literature search identified 14 randomized controlled trials investigating the effects of tDCS on pain and fatigue in patients with FM. Assessment of biases shows an overall low-to-moderate risk of bias. tDCS was found effective in all included studies conducted in patients with FM, except one study, in which the improving effects of tDCS were due to placebo. We recommended tDCS over the motor and prefrontal cortices as "effective" and "probably effective" respectively, and also safe for reducing pain perception and fatigue in patients with FM, according to evidence-based guidelines. Stimulation polarity was anodal in all studies, and one single-session study also examined cathodal polarity. The stimulation intensity ranged from 1-mA (7.14% of studies) to 1.5-mA (7.14% of studies) and 2-mA (85.7% of studies). In all of the included studies, a significant improvement in at least one outcome variable (pain or fatigue reduction) was observed. Moreover, 92.8% (13 of 14) applied multi-session tDCS protocols in FM treatment and reported significant improvement in their outcome variables. While tDCS is therapeutically effective for FM, titration studies that systematically evaluate different stimulation intensities, durations, and electrode placement are needed.
The main objective of this study was to record the plant and habitat diversity in the area of Kuh-e Dekel in Mamasani city located in the northwest of Fars province, which is located between 51°32' ...eastern longitude and 30° 8' northern latitude, and in the altitude of 900 to 1350 m above the sea level. A total of 395 samples of vascular plants were collected belonging to 172 genera, 69 families, and 225 species. They were identified and archived in the herbarium of Shiraz University. Dicotyledon plants with 57 families, 142 genera, and 187 species were the most diverse group, followed by monocots with 8 families, 25 genera, and 34 species. Pteridophytes with 3 families, 3 genera, and 3 species and Gymnosperms with 1 family, 1 genus, and 1 species were present in the region. The richest genera in terms of the number of species were Asteraceae (42 species), Fabaceae (23 species), and Poaceae (13 species). The most diverse species in the vegetation of the region were Convolvulus, Plantago, and Trifolium (each with 5 species), and Allium (with 4 species). In terms of chorology, most plants belonged to the Irano-Turanian region. Therophytes were the dominant life form in the area. The most effective ecological factors in the distribution of plants in the area were climatic, topographical, and biological factors.
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