The fundamental skin role is to supply a supportive barrier to protect body against harmful agents and injuries. Three layers of skin including epidermis, dermis and hypodermis form a sophisticated tissue composed of extracellular matrix (ECM) mainly made of collagens and glycosaminoglycans (GAGs) as a scaffold, different cell types such as keratinocytes, fibroblasts and functional cells embedded in the ECM. When the skin is injured, depends on its severity, the majority of mentioned components are recruited to wound regeneration. Additionally, different growth factors like fibroblast growth factor (FGF), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF) are needed to orchestrated wound healing process. In case of large surface area wounds, natural wound repair seems inefficient. Inspired by nature, scientists in tissue engineering field attempt to engineered constructs mimicking natural healing process to promote skin restoration in untreatable injuries. There are three main types of commercially available engineered skin substitutes including epidermal, dermal, and dermoepidermal. Each of them could be composed of scaffold, desired cell types or growth factors. These substitutes could have autologous, allogeneic, or xenogeneic origin. Moreover, they may be cellular or acellular. They are used to accelerate wound healing and recover normal skin functions with pain relief. Although there are a wide variety of commercially available skin substitutes, almost none of them considered as an ideal equivalents required for proper wound healing.

Purpose: Computed tomography (CT) scan is a commonly used tool for the diagnosis of the novel coronavirus disease 2019 , similarly to reverse transcription-polymerase chain reaction (RT-PCR). Because of the limitations of RT-PCR, there is growing interest in the usability of the CT scan. The present systematic review and meta-analysis aims to summarize the available data on the CT scan features of COVID-19. Material and methods:We conducted a systematic search in electronic databases to find eligible studies published between 1 December 2019 and 4 April 2020, which investigated the computed tomographic features of patients with COVID-19. All preprint and peer-reviewed articles were included. No language limitation was applied. For proportional data, pooled prevalence was calculated using a Freeman-Tukey double arcsine transformation, with a 95% confidence interval (CI). Results:Eighty-six studies were eligible to be included in the meta-analysis. For 7956 patients, the most common CT findings were bilateral pattern of involvement (78%; 95% CI: 0.73-0.82; p < 0.001), involvement of more than 1 lobe (75%; 95% CI: 0.68-0.82; p < 0.001), ground-glass opacities (GGO) (73%; 95% CI: 0.67-0.78; p < 0.001), and periphe ral distribution of signs (69%; 95% CI: 0.61-0.76; p < 0.001). Only 5% of patients had a normal CT scan (95% CI: 0.03-0.07; p < 0.001). The proportion of paediatric patients (age < 18 years) with unremarkable CT findings was higher (40%; 95% CI: 0.27-0.55; p < 0.001). Subgroup analysis showed that patients with the severe or critical type of COVID-19 were more likely to have pleural effusion (RR 7.77;; p < 0.001) and consolidation (RR 3.13; 95% CI: 1.57-6.23; p < 0.001). CT results in patients with COVID-19 were comparable with those of people having pneumonia from other causes, except for the lower incidence of consolidation (RR 0.81; 95% CI: 0.71-0.91; p < 0.001) and higher risk of showing GGO (RR 1.45; 95% CI: 1.13-1.86; p < 0.001). The mortality rate was slightly higher in patients with bilateral involvement (RR 3.19; 95% CI: 1.07-9.49; p = 0.04). Conclusions:Our study results show that COVID-19 shares some features with other viral types of pneumonia, despite some differences. They commonly present as GGO along with vascular thickening, air bronchogram and consolidations. Normal CT images, lymphadenopathies, and pleural effusions are not common. Consolidations and pleural effusions correlate with more severe disease. CT features are different between COVID-19 and non-COVID-19 pneumonia. Also, they differ by age, disease severity, and outcomes within COVID-19 patients.

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AimThe main aim of this study was to investigate the additional effects of L‐theanine, an amino acid in tea and an analog of glutamate with neuroprotective and anti‐depressant properties, on obsessive–compulsive disorder (OCD) symptoms in combination with fluvoxamine.MethodsPatients from either sex aged between 18 and 60 years diagnosed with OCD, based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5), who had a Yale‐Brown Obsessive Compulsive Scale (Y‐BOCS) score of more than 21 were enrolled in a double‐blinded, parallel‐group, placebo‐controlled, clinical trial of 10 weeks to receive either L‐theanine (100 mg twice daily) and fluvoxamine (100 mg daily initially followed by 200 mg daily after week 5) or placebo and fluvoxamine. The primary outcome of interest in this study was the Y‐BOCS total score decrease from baseline.ResultsFrom a total of 95 evaluated patients, 50 completed our study; 30 were randomly assigned to each group. Multivariate analysis (ANOVA) showed a significant effect of time treatment for L‐theanine in obsession subscale (F = 5.51, P = 0.008) of the Y‐BOCS score but not in the total and compulsion scores. Our results showed significantly more improvement in obsession subscale scores in L‐theanine compared to placebo group (P = 0.007, Cohen's d = 0.82). Also, total Y‐BOCS scores were lower in L‐theanine compared to placebo group at week 5 (P = 0.039, Cohen's d = 0.60) and 10 (P = 0.008, Cohen's d = 0.80). However, there was no significant between‐group differences in compulsion subscale scores. Complete response was also more frequent in the L‐theanine group (P = 0.0001).ConclusionFindings in this study suggest L‐theanine as a relatively safe and effective adjuvant therapy for moderate to severe OCD.