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Byline: J. P. Lhomme (1), R. Mougou (2), M. Mansour (3) Abstract: The potential effect of climate change on durum wheat in Tunisia is assessed using a simple crop simulation model and a climate projection for the 2071--2100 period, obtained from the Meteo-France ARPEGE-Climate atmospheric model run under the IPCC (International Panel on Climate Change) scenario A1B. In the process-oriented crop model, phenology is estimated through thermal time. Water balance is calculated on a daily basis by means of a simple modelling of actual evapotranspiration involving reference evapotranspiration, crop coefficients and some basic soil characteristics. The impact of crop water deficit on yield is accounted for through the linear crop-water production function developed by the FAO (Food and Agriculture Organization of the United Nations). Two stations are chosen to study the climate change effect. They are representative of the main areas where cereals are grown in Tunisia: Jendouba in the northern region and Kairouan in the central region. In the future scenario, temperature systematically increases, whereas precipitation increases or decreases depending on the location and the period of the year. Mean annual precipitation declines in Jendouba and raises in Kairouan. Under climate change, the water conditions needed for sowing occur earlier and cycle lengths are reduced in both locations. Crop water deficit and the corresponding deficit in crop yield happen to be slightly lower in Kairouan conversely, they become higher in Jendouba. Author Affiliation: (1) IRD (UR060), CEFE-CNRS, 1919 route de Mende, 34293, Montpellier cedex 5, France (2) INRGREF, BP 10, Ariana, 2080, Tunisia (3) CRRHAB, Chott Mariem, 4042, Tunisia Article History: Registration Date: 13/02/2009 Received Date: 11/12/2007 Accepted Date: 22/01/2009 Online Date: 01/04/2009

Purpose: Potentially toxic metals can directly induce various adverse effects on reproductive organs or interrupt essential metals' physiological activities. Despite intensive efforts to reduce these metals in the environment, chronic and low-level exposure remains a public health problem. The present study aimed to investigate prenatal metal exposure, including arsenic (As), copper (Cu), lead (Pb), manganese (Mn), rubidium (Rb), selenium (Se), and zinc (Zn), effects on birth weight., Methods: We collected 579 blood samples before the 16th week of gestation from apparently healthy women with singleton pregnancy in Iran ( n  = 193) and Japan ( n  = 386). Blood metal concentrations were measured using inductively coupled plasma-mass spectrometry., Results: Prenatal blood levels of As, Mn, Pb, and Zn were significantly higher, while Cu, Rb, and Se were significantly ( p  < 0.01) lower in Iranian participants than in Japanese. Adjusted linear regression analyses and Bayesian Kernel Machine Regression (BKMR) overall exposure-response functions showed inverse relationships between metals and birth weight., Conclusion: The study findings, using data from geographically diverse countries, suggest prenatal blood metal exposure as a potential risk factor for lower birth weight. Therefore, women of reproductive age should minimize encountering to potentially toxic metals as much as possible., Competing Interests: Conflicts of interestThe authors declare that there are no conflicts of interest in this study. The present study was supported by the Japan Society for the Promotion of Science (JSPS; #L22517)., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2025. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Mesenchymal stem cells (MSCs) may play a pivotal role in shaping the tumor microenvironment (TME), influencing tumor growth. Nonetheless, conflicting evidence exists regarding the distinct impacts of MSCs on tumor progression, with some studies suggesting promotion while others indicate suppression of tumor cell growth. Considering that oxidative stress is implicated in the dynamic interaction between components of the TME and tumor cells, we investigated the contribution of exosomes released by hydrogen peroxide (H 2 O 2 )-treated MSCs to murine mammary tumor growth and progression. Additionally, we aimed to identify the underlying mechanism through which MSC-derived exosomes affect breast tumor growth and angiogenesis. Our findings demonstrated that exosomes released by H 2 O 2 -treated, stress-induced MSCs (St-MSC Exo) promoted breast cancer cell progression by inducing the expression of vascular endothelial growth factor (VEGF) and markers associated with epithelial-to-mesenchymal transition. Further clarification revealed that the promoting effect of St-MSC Exo on VEGF expression may, in part, depend on activating STAT3 signaling in BC cells. In contrast, exosomes derived from untreated MSCs retarded JAK1/STAT3 phosphorylation and reduced VEGF expression. Additionally, our observations revealed that the activation of the transcription factor NF-κB in BC cells, stimulated with St-MSC Exo, occurs concurrently with an increase in intracellular ROS production. Moreover, we observed that the increase in VEGF secretion into the conditioned media of 4T1 BC, mediated by St-MSC Exo, positively influenced endothelial cell proliferation, migration, and vascular behavior in vitro. In turn, our in vivo studies confirmed that St-MSC Exo, but not exosomes derived from untreated MSCs, exhibited a significant promoting effect on breast tumorigenicity. Collectively, our findings provide new insights into how MSCs may contribute to modulating the TME. We propose a novel mechanism through which exosomes derived from oxidative stress-induced MSCs may contribute to tumor progression and angiogenesis., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Forskolin, a diterpenoid found in the roots of Coleus forskohlii, has generated significant interest in the medical field due to its various therapeutic uses. This study aimed to establish an effective system for regenerating C. forskohlii plants, ensuring a year-round supply of plant material and forskolin production. We tested different concentrations of cytokinins, either alone or combined with auxin, to see their impact on shoot multiplication and growth. We found that a medium supplemented with 1.5 mg L -1 of meta-topolin (mT) resulted in the highest number of shoots (~ 12.66) and leaves (~ 20) within about 5 days. When mT (1 mg L -1 ) was combined with a low amount of auxin (0.05 mg L -1 NAA), we obtained an even greater number of leaves (~ 23). The shoot regeneration capacity was consistent over five subculture passages, showing minimal variation in mean shoot length and number. During acclimatization, around 91% of the plantlets grown in vermiculite + sand survived. The photosynthetic pigment concentration in the plantlets modestly increased in the first 10 days and reached its highest level after 30 days. Genetic fidelity assays using inter simple sequence repeats (ISSRs) confirmed the similarity between the in vitro derived plantlets and the mother plant. Micro-morphological features of in vitro and ex-vitro acclimated plantlets also matched those of the mother plant, further confirming genetic accuracy. Histochemical staining with vanillin confirmed the presence of forskolin in the in vitro roots, indicated by the violet coloration in the cells. Forskolin quantification was also validated by HPLC where in vitro derived roots were documented to undergo an almost ~ 1.8-fold in comparison to that of the mother plant. This established protocol can effectively address resource scarcity for commercial-scale forskolin production and sustainable conservation techniques., Competing Interests: Declarations Ethical approval This article does not contain any experiments with human participants or animals performed by any of the authors. Competing interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Objective: Gastric cancer ranks as one of the top five deadliest cancers worldwide and is often diagnosed at late stages. Analysis of saliva may provide a non-invasive approach for detection of malignancies in organs associated with the oral cavity. This research aims to analyze salivary microRNA expression together with clinical and demographic features with the aim of diagnosing gastric cancer., Materials: The study included 19 patients with early-stage gastric cancer and 19 healthy controls. Saliva samples were collected and processed for RNA isolation. Salivary expression of miR-223-3p and miR-21-5p were measured using quantitative reverse-transcription polymerase chain reaction (RT-qPCR). Receiver operating characteristic (ROC) curves were generated to evaluate the accuracy of diagnostic models. Machine learning algorithms, multiple logistic regression, and principal component analysis (PCA) were used to assess the predictive power of miRNAs in conjunction with clinical-demographic features., Results: Significant upregulation of miR-223-3p and downregulation of miR-21-5p in saliva were observed in patients with gastric cancer. The area under ROC curve (AUC) values for salivary miR-21-5p, salivary miR-223-3p, and their multiple logistic regression were determined to be 0.723, 0.791, and 0.850, respectively. The AUC for multiple logistic regression model was 0.919. The PCA model led to the highest diagnostic odds ratio (DOR) of 134.33 (sensitivity = 0.785, specificity = 1.00, AUC = 903). Application of machine learning methods, and in particular a random forest algorithm, showed high accuracy in diagnosing patients with gastric cancer (sensitivity = 1.00, specificity = 0.857, AUC = 0.93)., Conclusion: The application of validated salivary diagnostics in clinical practice could help facilitate earlier diagnosis of gastric cancer and improve medical outcome. Expression of miR-21 and miR-223-3p in saliva together with clinical and demographic features, appears promising in screening for GC., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This work investigates the use of Aspergillus brasiliensis, this particular species of Aspergillus, as a biosorbent for the first time. It is employed to biosorption Zn(II), Cd(II), and Pb(II) and combines the biosorption experiments with electrochemical measurements for in situ analysis. For the experiments, a batch system was employed with the dead biomass. In order to determine the biosorption capacity, the impact of several operational parameters was examined, including pH, temperature, agitation speed, contact time, and initial metal concentration, and the optimum values were 5, 30 °C, 150 rpm, 2 h, and 150 ppm, respectively. Using 0.2 g biomass in 100 mL solution, the maximal uptake of Zn(II), Cd(II), and Pb(II) at ideal conditions was determined to be 33.67, 24.51, and 36.76, respectively. The Langmuir and Freundlich isotherm model was studied for the biosorption process. An electrochemical sensor using nanomaterials is designed and constructed to monitor the concentration of these metals. The silver nanoparticles functionalized with thiosemicarbazide and 6-mercaptohexanoic acid (mercaptohexanoylhydrazinecarbothioamide-coated silver nanoparticles, MHHC-AgNPs) linked to the carboxylated multi-walled carbon nanotubes (MWCNTs) were utilized for glassy carbon electrode modification (MHHC-AgNPs/MWCNTs/GCE). The concentration range of Zn(II) is 0.7-173 µg/L, Cd(II) is 1.18-293 µg/L, and Pb(II) is 2.17-540 µg/L. The detection limits for Zn(II), Cd(II), and Pb(II) are 0.036 µg/L, 0.15 µg/L, and 0.16 µg/L, respectively. Under optimized conditions, these results were obtained using the differential pulse anodic stripping voltammetry method (DPASV). The successful detection of Zn(II), Cd(II), and Pb(II) was achieved by effectively preventing interference from other common ions. It was effectively employed for measuring ions in industrial wastewater, and the results obtained aligned with those acquired from an atomic absorption spectrometer (AAS). Thus, Aspergillus brasiliensis species, along with this electrochemical sensor, can be used to remediate and monitor environmental pollution, Zn(II), Cd(II), and Pb(II), successfully., Competing Interests: Declarations. Ethical approval: Not applicable to this specific section. Consent to participate: All authors whose names appear on this submission, Reza Zarei, Azar Sabokbar, Bahareh Rahimian Zarif, Mansour Bayat, Nahid Haghnazari, and Elahe Ahmadi, 1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work 2) drafted the work or revised it critically for important intellectual content 3) approved the version to be published 4) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved Consent for publication: All authors agreed with the content and that all gave explicit consent to submit and publish. They obtained consent from the responsible authorities at the Islamic Azad University where the work has been carried out. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Cardioneuroablation (CNA) is an emerging treatment for cardioinhibitory syncope and functional AV block. This study aimed to evaluate the safety and efficacy of a fluoroless CNA approach using three-dimensional mapping and extracardiac vagal stimulation (ECVS)., Methods: This prospective observational study included 22 patients (mean age 21 years) with clinically significant functional bradycardia who underwent fluoroless CNA. Procedural success was defined as elimination or significant attenuation of the vagal response to ECVS., Results: CNA was successfully performed in all patients with a mean procedure time of 251 min. Fluoroscopy was avoided in 91% of cases. At a mean follow-up of 11.4 months, 77% of patients remained symptom-free. Among pacemaker patients, 90% did not require further pacing, and 6/10 (60%) have had their pacemakers turned off. No complications were seen during the procedure., Conclusions: Fluoroscopy-free CNA is a safe and effective treatment for functional bradycardia, offering high procedural success rates and favorable symptom-free outcomes while minimizing radiation exposure., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Hemoglobinopathies are among the most prevalent inherited disorders globally, with carrier prevalence varying significantly across regions. In Saudi Arabia, high rates of consanguineous marriages amplify the risk of these disorders., Aim: This study aims to assess the burden of hemoglobinopathies by evaluating the prevalence and regional distribution of beta-hemoglobin variants, including rare variants, among couples participating in the national premarital screening program., Methods: Data were collected from the premarital genetic screening program and entered into the SEHA platform, covering the 13 administrative regions of Saudi Arabia. Blood samples underwent various screening tests for infectious and genetic diseases. Hemoglobin electrophoresis samples were analyzed using capillary electrophoresis, High-Performance Liquid Chromatography (HPLC), or a combination of both methods., Results: From 2011 to 2018, 1,871,184 individuals were included in the study, with 49.8% male and 50.2% female. The average age was 30.2 years. Hemoglobin S (HbS) was identified in 88,431 individuals (4.7% of the tested population and 78.5% of abnormal screening results), primarily as a sickle cell trait. β-thalassemia was the second most common disorder, identified in 22,420 individuals (1.2% of the population and 19.9% of hemoglobin disorders). HbC and HbD were each detected in 0.04% of cases, while HbO-Arab was identified in 0.007% and HbG in 0.006%. Hemoglobin E and hemoglobin Lepore were found to be extremely rare., Conclusion: The study demonstrates regional variation in the prevalence of hemoglobin genetic variants in Saudi Arabia. To effectively mitigate this risk, it is imperative to strengthen public education and awareness, particularly focusing on genetic screening and counseling., (© 2024. The Author(s).)

Background: Developmental dysplasia of the hip (DDH) leads to pain, joint instability, and early degenerative joint disease. Incidence, prevalence, and management strategies of DDH have been well-documented in several countries, but not in Saudi Arabia., Objective: We synthesized the current evidence regarding incidence, prevalence, risk factors, and clinical treatment for children with DDH in Saudi Arabia., Methods: We searched 3 databases to locate studies. Studies that included children with DDH in Saudi Arabia; reported either incidence rate, prevalence, risk factors, and/or clinical practice; and were available in English or Arabic were included. We excluded reviews, case studies, or animal studies. Two independent authors reviewed potential studies and assessed study's quality., Results: Our search yielded 67 potential studies, of which 16 studies were included (total DDH sample = 3,127; age range = 2.5 to 86.4 months). Three studies reported incidence rates ranging from 3.1 to 4.9 per 1000 births, and 3 studies reported prevalence ranging from 6 to 78%. Nine studies reported that female sex, breech position, family history, and age less than 3 years were risk factors associated with DDH. Four studies reported that brace applications and closed reduction were conservative treatments, and 9 studies reported that open hip reduction, adductor tenotomy, and/or pelvic osteotomy were surgical approaches to treat DDH., Conclusions: In Saudi Arabia, the Incidence and prevalence rates of DDH are 3.1 to 4.9 per 1,000 births, and 6-78%, respectively (differ from what has been reported in other countries), but the risk factors of DDH in Saudi Arabia appear to be similar in comparison to other countries (female, breech presentation, family history of DDH)., (© 2024. The Author(s).)

Introduction: Despite the increasing widespread adoption and experience in minimally invasive liver resections (MILR), open conversion occurs not uncommonly even with minor resections and as been reported to be associated with inferior outcomes. We aimed to identify risk factors for and outcomes of open conversion in patients undergoing minor hepatectomies. We also studied the impact of approach (laparoscopic or robotic) on outcomes., Methods: This is a post-hoc analysis of 20,019 patients who underwent RLR and LLR across 50 international centers between 2004-2020. Risk factors for and perioperative outcomes of open conversion were analysed. Multivariate and propensity score-matched analysis were performed to control for confounding factors., Results: Finally, 10,541 patients undergoing either laparoscopic (LLR; 89.1%) or robotic (RLR; 10.9%) minor liver resections (wedge resections, segmentectomies) were included. Multivariate analysis identified LLR, earlier period of MILR, malignant pathology, cirrhosis, portal hypertension, previous abdominal surgery, larger tumor size, and posterosuperior location as significant independent predictors of open conversion. The most common reason for conversion was technical issues (44.7%), followed by bleeding (27.2%), and oncological reasons (22.3%). After propensity score matching (PSM) of baseline characteristics, patients requiring open conversion had poorer outcomes compared with successful MILR cases as evidenced by longer operative times, more blood loss, higher requirement for perioperative transfusion, longer duration of hospitalization and higher morbidity, reoperation, and 90-day mortality rates., Conclusions: Multiple risk factors were associated with conversion of MILR even for minor hepatectomies, and open conversion was associated with significantly poorer perioperative outcomes., (© 2024. Society of Surgical Oncology.)

Background: Pericardiocentesis offers a definitive diagnostic and a life-saving therapeutic modality through removal of pericardial fluid and relief of high intrapericardial pressure. Percutaneous pericardiocentesis has been performed via different approaches depending on different institutional experiences. In this paper, we present our institutional experience and review the current literature of the different approaches for performing percutaneous pericardiocentesis., Materials and Methods: We evaluated consecutive patients who underwent echocardiographic-guided pericardiocentesis via the apical approach for pericardial effusion between the period of April 1st, 2022, and April 1st, 2023, at University of Arkansas for Medical Sciences (UAMS). Health records were reviewed for clinical presentations, available imaging findings, procedural outcomes, and short-term follow up., Results: A total of eight consecutive cases of pericardiocentesis via the apical approach were found. Seven were successful. No complications were reported. Six patients had evidence of tamponade physiology on echocardiogram., Conclusion: Historically, pericardiocentesis has been most performed via the subxiphoid approach. However, an ultrasound-guided apical approach offers a safe and effective alternative and may be preferable in patients with challenging anatomies., (© 2024. The Author(s).)

Background: N6-methyladenosine (m 6 A) is the most common internal RNA modification and is involved in regulation of RNA and protein expression. AlkB family member 5 (ALKBH5) is a m 6 A demethylase. Given the important role of m 6 A in biological mechanisms, m 6 A and its regulators, have been implicated in many disease processes, including cancer. However, the contribution of ALKBH5 to invasive breast cancer (BC) remains poorly understood. The aim of this study was to evaluate the clinicopathological value of ALKBH5 in BC., Methods: Publicly available data were used to investigate ALKBH5 mRNA alterations, prognostic significance, and association with clinical parameters at the genomic and transcriptomic level. Differentially expressed genes (DEGs) and enriched pathways with low or high ALKBH5 expression were investigated. Immunohistochemistry (IHC) was used to assess ALKBH5 protein expression in a large well-characterised BC series (n = 1327) to determine the clinical significance and association of ALKBH5 expression., Results: Reduced ALKBH5 mRNA expression was significantly associated with poor prognosis and unfavourable clinical parameters. ALKBH5 gene harboured few mutations and/or copy number alternations, but low ALKBH5 mRNA expression was seen. Patients with low ALKBH5 mRNA expression had a number of differentially expressed genes and enriched pathways, including the cytokine-cytokine receptor interaction pathway. Low ALKBH5 protein expression was significantly associated with unfavourable clinical parameters associated with tumour progression including larger tumour size and worse Nottingham Prognostic Index group., Conclusion: This study implicates ALKBH5 in BC and highlights the need for further functional studies to decipher the role of ALKBH5 and RNA m 6 A methylation in BC progression., (© 2024. The Author(s).)

The research focused on analyzing the UGT gene family in Cannabis sativa , which plays a crucial role in the plant's metabolism and glycosylation of secondary metabolites. The study identified 125 UGTs using conserved plant secondary product glycosyltransferase (PSPG) motif amino acid sequences. These UGT genes were categorized into 17 groups (A-Q) through phylogenetic analysis, showing their distribution across 10 chromosomes in C. sativa . The expansion of the CsUGT gene family was attributed to tandem and duplication events, as suggested by gene duplication analysis. Furthermore, the study found various cis-acting regulatory elements related to phytohormones and stress responses in CsUGT promoter regions. Subcellular localization analysis revealed that CsUGT is present in the cytoplasm, chloroplast, and nucleus. The study revealed that CsUGT plays a significant role in various biological processes, cellular components, and molecular functions as highlighted by Gene Ontology analysis. Additionally, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that some CsUGTs are associated with the biosynthesis of secondary metabolites. This research provides valuable insights into the genomic organization, evolutionary history, and potential regulatory mechanisms of UGT genes in C. sativa . It lays the foundation for further exploration of their specific biological roles and potential applications in the plant's metabolism and stress responses. These findings contribute to a better understanding of the UGT gene family and its relevance to the metabolic pathways in C. sativa ., Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-024-04025-3., Competing Interests: Conflict of interestThe authors declare no conflict of interest., (© King Abdulaziz City for Science and Technology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: As the population ages, more older adults are presenting for surgery. Age-related declines in physiological reserve and functional capacity can result in frailty and poor outcomes after surgery. Hence, optimizing perioperative care in older patients is imperative. Enhanced Recovery After Surgery (ERAS) pathways and Minimally Invasive Surgery (MIS) may influence surgical outcomes, but current use and impact on older adults patients is unknown. The aim of this study was to provide evidence-based recommendations on perioperative care of older adults undergoing major abdominal surgery., Methods: Expert consensus determined working definitions for key terms and metrics related to perioperative care. A systematic literature review and meta-analysis was performed using the PubMed, Embase, Cochrane Library, and Clinicaltrials.gov databases for 24 pre-defined key questions in the topic areas of prehabilitation, MIS, and ERAS in major abdominal surgery (colorectal, upper gastrointestinal (UGI), Hernia, and hepatopancreatic biliary (HPB)) to generate evidence-based recommendations following the GRADE methodology., Result: Older adults were defined as 65 years and older. Over 20,000 articles were initially retrieved from search parameters. Evidence synthesis was performed across the three topic areas from 172 studies, with meta-analyses conducted for MIS and ERAS topics. The use of MIS and ERAS was recommended for older adult patients particularly when undergoing colorectal surgery. Expert opinion recommended prehabilitation, cessation of smoking and alcohol, and correction of anemia in all colorectal, UGI, Hernia, and HPB procedures in older adults. All recommendations were conditional, with low to very low certainty of evidence, with the exception of ERAS program in colorectal surgery., Conclusions: MIS and ERAS are recommended in older adults undergoing major abdominal surgery, with evidence supporting use in colorectal surgery. Though expert opinion supported prehabilitation, there is insufficient evidence supporting use. This work has identified evidence gaps for further studies to optimize older adults undergoing major abdominal surgery., (© 2024. The Author(s).)

The concentration of various potentially toxic metals (Pb, Cd, As, Ni, Zn, and Cr) in street dust samples collected from Mehran city, Iran, was analyzed. The samples were obtained during normal traffic conditions, NTT, prior to the Arbaeen ceremony, as well as after the pilgrims' return, which corresponds to high traffic time, HTT. Street dust samples were analyzed for HM content using ICP-OES, following acid digestion. The subsequent evaluation of the data involved the application of the geo-accumulation index, enrichment factor, and potential ecological risk index (PER) and health risk assessment. The findings demonstrate a notable increase in the levels of HMs during HTT compared to the NTT. The highest enrichment values for Pb and Cd were observed in Mehran Street dust during the HTT. The mean of PER for all sampling points increased to 138.24, indicating a moderate-potential ecological risk at this time. Based on the health risk assessment, it was found that the hazard index for all samples was below one. The incremental lifetime cancer risk was below 10 -6 . This indicates that the exposed population is not exposed to substantial health risks. Despite the heavy traffic caused by the Arbaeen ceremony in this area and the high enrichment of HMs, along with potential ecological risks, no significant health risks were observed for individuals exposed to street dust. However, it is important to note that the continuation of this trend, in the absence of proper traffic management, could lead to significant environmental and health problems in the future., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Primary Sjögren's syndrome (pSS), a chronic autoimmune condition, has been associated with an increased risk of several cancers. This study aims to delve into the relationship between pSS and the potential development of non-Hodgkin's lymphoma (NHL) utilizing an in-depth systematic review and meta-analysis approach. To thoroughly explore the topic, we conducted a thorough examination of the literature, drawing from reputable databases such as ProQuest, PubMed, Web of Science, Cochrane, and Google Scholar. Our data collection spanned until February 8, 2024, with no time limitation. Data were analyzed with Stata 14 software at a significance threshold of p < 0.05. We examined 15 cohort studies encompassing a total of 50,308 individuals from 1997 to 2023. The findings revealed a substantial link between pSS and the risk of NHL, evident across all demographics. Specifically, the standardized incidence ratio (SIR) was generally 8.78 (95% CI 5.51, 13.99), with similar trends observed in both men (SIR, 6.29; 95% CI 1.93, 20.51) and women (SIR, 9.60; 95% CI 5.89, 15.63). Additionally, the SIR (10.50 (95% CI 7, 15.75)), HR (2.82 (95% CI 1.28, 6.18)), and OR (10.50 (95% CI 3.04, 36.28)) indices further supported this association. Furthermore, the risk of non-NHL associated with pSS was noticeable across different age groups of 40-49 years (SIR, 30.13; 95% CI 14.62, 62.08), 50-59 years (SIR, 9.12; 95% CI 5.13, 16.19), and 60-69 years (SIR, 9; 95% CI 4.68, 17.32). pSS substantively augments the likelihood of NHL manifestation. It notably impacts females and those in earlier stages of adulthood with more acuity than males and older cohorts., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

The A 2B adenosine receptor (A 2B R) is one of the four adenosine-activated G protein-coupled receptors. In addition to adenosine, protein kinase C (PKC) was recently found to activate the A 2B R. The A 2B R is coupled to both G s and G i , as well as G q proteins in some cell types. Many primary cells and cell lines, such as bladder and breast cancer, bronchial smooth muscle, skeletal muscle, and fat cells, express the A 2B R endogenously at high levels, suggesting its potentially important role in asthma, cancer, diabetes, and other conditions. The A 2B R has been characterized as both pro- and anti-inflammatory, inducing cell type-dependent secretion of IL-6, IL-8, and IL-10. Theophylline and enprofylline have long been used for asthma treatment, although it is still not entirely clear if their A 2B R antagonism contributes to their therapeutic effects or side effects. The A 2B R is required in ischemic cardiac preconditioning by adenosine. Both A 2B R and protein kinase C (PKC) contribute to cardioprotection, and both modes of A 2B R signaling can be blocked by A 2B R antagonists. Inhibitors of PKC and A 2B R are in clinical cancer trials. Sulforaphane and other isothiocyanates from cruciferous vegetables such as broccoli and cauliflower have been reported to inhibit A 2B R signaling via reaction with an intracellular A 2B R cysteine residue (C210). A full, A 2B R-selective agonist, critical to elucidate many controversial roles of the A 2B R, is still not available, although agonist-bound A 2B R structures have recently been reported., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Background: Real-world data have suggested inconsistent adherence to oral anticoagulation for thromboembolic event (TE) prevention in patients with Non valvular atrial fibrillation (NVAF), yet it remains unclear if event risk is elevated during gaps of non-adherence., Objective: To compare difference in outcomes between direct oral anticoagulant (DOAC) and warfarin based on adherence to the therapy in patients with NVAF., Methods: Using the MarketScan claims data, patients receiving prescription of warfarin or a DOAC for NVAF from January 2015 to June 2016 were included. Outcomes included hospitalization for TE (ischemic stroke or systemic embolism), hemorrhagic stroke, stroke of any kind, and major bleeding. Event rates were reported for warfarin and DOACs at a higher-adherence proportion of days covered (PDC > 80%) and lower-adherence (PDC 40-80%)., Results: The cohort included 83,168 patients prescribed warfarin (51% [n = 42,639]) or DOAC (49% [n = 40,529]). Lower adherence occurred in 36% (n = 15,330) of patients prescribed warfarin and 26% (n = 10,956) prescribed DOAC. As compared to higher-adherence warfarin after multivariable adjustment, the risk of TE was highest in lower-adherence DOAC (HR 1.26; 95% CI, 1.14-1.33), and lowest in higher-adherence DOAC (HR, 0.93; 95% CI, 0.88-0.99). There was a significantly higher risk of hemorrhagic stroke and stroke of any kind in the lower-adherence groups. Major bleeding was more common with lower-adherence DOAC (HR, 1.43, 95% CI, 1.35-1.52) and lower-adherence warfarin (HR, 1.32, 95% CI, 1.26-1.39)., Conclusions: In this large real-world study, low adherence DOAC was associated with higher risk of TE events as compared to high and low adherence warfarin., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: HbC is a common structural hemoglobinopathy especially in West Africa. Prevalence and regional distribution of HbC in Saudi Arabia are widely undocumented. Patients with homozygous HbC disease may have mild hemolytic anemia whereas combination with hemoglobin S (HbS) leads to a clinically severe phenotype., Aim: The current epidemiological study, considered the largest from Saudi Arabia, aimed to evaluate the regional prevalence of the HbC variant among the couples participating in the premarital screening program from 2011 to 2018., Methods: Data from the PMSGC program were obtained for premarital screening and genetic counseling. The collected data were then entered into the SEHA platform, a centralized electronic repository for the 13 designated regions in Saudi Arabia. Hemoglobin electrophoresis samples are analyzed using either HPLC, capillary electrophoresis, or a combination of both methods to confirm the presence of abnormal hemoglobin bands., Results: This study included 1,871,184 individuals from 2011 to 2018. Of those, 49.8% were males and 50.2% were females. 112,618 (6.0%) had an abnormal test. Total number of Hb C cases were 778 (0.04%). HbC trait (HbAC) was detected in 764 participants while homozygous HbC (HbCC) and combined heterozygous (HbSC) were found in 9 and 5 cases, respectively. The regions near the Red Sea have higher rates than the central and eastern regions., Conclusion: HbC is a rare variant in Saudi Arabia with varying regional frequencies. HbC variant is more common in Mecca and Madina regions. The geographic area of HbC distribution differs from the areas with high prevalence of HbS, which explains why HbSC disease cases are overwhelmingly rare., (© 2024. The Author(s).)

Key Message: Nitric oxide functions downstream of the melatonin in adjusting Cd-induced osmotic and oxidative stresses, upregulating the transcription of D4H and DAT genes, and increasing total alkaloid and vincristine contents. A few studies have investigated the relationship between melatonin (MT) and nitric oxide (NO) in regulating defensive responses. However, it is still unclear how MT and NO interact to regulate the biosynthesis of alkaloids and vincristine in leaves of Catharanthus roseus (L.) G. Don under Cd stress. Therefore, this context was explored in the present study. Results showed that Cd toxicity (200 µM) induced oxidative stress, decreased biomass, Chl a, and Chl b content, and increased the content of total alkaloid and vinblastine in the leaves. Application of both MT (100 µM) and sodium nitroprusside (200 µM SNP, as NO donor) enhanced endogenous NO content and accordingly increased metal tolerance index, the content of total alkaloid and vinblastine. It also upregulated the transcription of two respective genes (D4H and DAT) under non-stress and Cd stress conditions. Moreover, the MT and SNP treatments reduced the content of H 2 O 2 and malondialdehyde, increased the activities of superoxide dismutase and ascorbate peroxidase, enhanced proline accumulation, and improved relative water content in leaves of Cd-exposed plants. The scavenging NO by 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxy l-3-oxide (cPTIO) averted the effects of MT on the content of total alkaloid and vinblastine and antioxidative responses. Still, the effects conferred by NO on attributes mentioned above were not significantly impaired by p-chlorophenylalanine (p-CPA as an inhibitor of MT biosynthesis). These findings and multivariate analyses indicate that MT motivated terpenoid indole alkaloid biosynthesis and mitigated Cd-induced oxidative stress in the leaves of periwinkle in a NO-dependent manner., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Due to depletion of fossil fuels and environmental issues, renewable energy consumption is increasingly growing. Solar energy as the most abundant renewable energy source available is becoming more popular around the world. In the current study, the optimal sites for solar photovoltaic power plants in East Azerbaijan province, Northwest Iran, were investigated. A total of 17 variables were categorized into four groups: climatic, geomorphological, environmental, and access-economic. In order to integrate the variables, a model based on catastrophe theory in the context of GIS was applied. The relative importance and weight of the criteria are computed based on the internal mechanism of the catastrophic system, thus greatly reducing subjectivism and uncertainties of the decision-making process. Five optimal sites located in the western part of the province within the counties of Malekan, Bonab, Ajabshir, Shabestar, and Tabriz were identified as suitable sites for the construction of solar photovoltaic power plants, where there are ideal conditions in terms of many environmental-human variables such as high potential of solar energy, high sunshine hours, low relative humidity, suitable slope, poor vegetation, distance to protected areas, proximity to the population centers, excellent access to the roads and to the main power lines., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Imatinib, a potent inhibitor of targeted protein tyrosine kinases, treats chronic myeloid leukaemia (CML). Data on imatinib-associated changes in hepatic and thyroid functions are limited and conflicting., Aim: To report the prevalence of hepatic and thyroid toxicity associated with the use of imatinib in CML patients., Method: Articles for the systematic review were selected from electronic databases (PubMed, CINALH, Web of Science). Readily accessible peer-reviewed full articles in English published 1st January 2000 to 18th July 2023 were included. The search terms included combinations of: imatinib, CML, liver toxicity, hepatic toxicity, thyroid toxicity. Screening of titles, abstracts, full text articles was conducted independently by two reviewers. Inclusions and exclusions were recorded following PRISMA guidelines. Detailed reasons for exclusion were recorded. Included articles were critically appraised., Results: Ten thousand one hundred and twenty-three CML patients were reported in the 82 included studies corresponding to 21 case reports, 2 case series, 39 clinical trials and 20 observational studies were selected. Excluding case studies/reports, 1268 (12.6%; n = 1268/10046) hepatotoxicity adverse events were reported, of which 64.7% were rated as mild grade I & II adverse events, 363 (28.6%) as severe, grade III and IV adverse events; some led to treatment discontinuation, liver transplantation and fatal consequences. Twenty (35.1%) studies reported discontinuation of imatinib treatment due to the severity of hepatic toxicity. Fourteen (8.4%, n = 14/167) thyroid dysfunction adverse events were reported., Conclusion: High frequency of mild and severe hepatotoxicity, associated with imatinib in CML patients, was reported in the published literature. Low numbers of mild and manageable thyroid toxicity events were reported., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Semaglutide, liraglutide and tirzepatide are glucagon-like peptide-1 (GLP-1) receptor agonists that are effective for weight reduction. Recent reports of patients experiencing suicidal thoughts and other psychiatric adverse events while using GLP-1 agonists have raised concerns about the potential risk of self-harm and led the European Medicines Agency to investigate these medications., Aim: To identify and analyse the psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide., Method: All individual case safety reports for semaglutide, liraglutide, and tirzepatide reported to the EudraVigilance database from 01/01/2021 to 30/05/2023 were analysed. Descriptive statistics were used to explore study population characteristics., Results: During the study period, 31,444 adverse event reports were identified: semaglutide (n = 13,956; 44.4%), liraglutide (n = 16,748; 53.2%), and tirzepatide (n = 740; 2.3%). There were 372 reports with psychiatric adverse event reports (n = 372; 1.18%) with a total of 481 adverse events. Women accounted for 65% (n = 242) of these reports. Depression was the most commonly reported adverse event (n = 187; 50.3%), followed by anxiety (n = 144; 38.7%) and suicidal ideation (n = 73; 19.6%). Nine deaths (8 with liraglutide and 1 with semaglutide) and 11 life-threatening outcomes (4 associated with liraglutide and 7 with semaglutide) were reported. The fatal outcomes occurred primarily among men (8 out of 9) resulting from completed suicidal attempts and depression., Conclusion: Psychiatric adverse events comprised only 1.2% of the total reports for semaglutide, liraglutide, and tirzepatide. However, the severity and fatal outcomes of some of these reports warrant further investigation., (© 2024. The Author(s).)

Background: Osteoporosis is a skeletal and bone disorder characterized by bone fractures and decreased bone mineral density (BMD). Bisphosphonates have a great tendency to bind to minerals, and their long-term use can increase the risk of bone fragility in patients. Stopping bisphosphonates after a period of time is called a drug holiday (DH). Recent evidence has shown that patients' BMD may decrease again during DH. However, few studies have been done in this regard. In the present study, we compared the BMD of postmenopausal women during bisphosphonates treatment and 1 year after DH., Material and Methods: A total of 202 patients were selected with osteopenia (n = 95) and osteoporosis (n = 107); they had been treated with alendronate for 5 years (a rheumatologist confirmed the diagnosis of osteopenia and osteoporosis) and had undergone DH for 1 year. At the arrival of all patients, BMD was checked with the DXA (dual-energy X-ray absorptiometry) method using the 2007 American Explorer model Hologic device based on the Caucasian race. One year later, patients were reassessed for BMD by the same device., Result: The analysis of femoral neck (FN) and lumbar spine (LS) T-score indices in the osteopenia and the osteoporosis groups showed reduction after DH, and the difference was statistically significant in both groups (p = 0.001). After 1 year of stopping bisphosphonate treatment, the average of FN and LS BMD decreased in both groups (p = 0.001)., Conclusion: In general, it can be said that DH can reduce FN and LS T-scores. The results indicated a significant reduction in BMD after the DH period for both the osteoporosis and osteopenia groups in the early months. Also, the effect of DH in osteoporosis patients was more compared to the osteopenia individuals, which could have implications for their treatment approach, and also its effect on bone health. Key Points • The DH can reduce FN and LS T-scores • The BMD reduced after the DH period for both the osteoporosis and osteopenia groups • After 1 year of stopping bisphosphonate treatment, the average of FN and LS BMD decreased in both groups., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Background: Gastric cancer (GC) is one of the most common worldwide cancers and causes of death. Various studies have investigated the effect of metformin on overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and recurrence rate in diabetic patients after gastrectomy, and their results have been contradictory. This meta-analysis aimed to evaluate the effect of metformin use compared to sulfonylurea compounds with OS, CSS, RFS, and recurrence rate after gastrectomy in diabetic patients., Methods: We reviewed the Scopus, Google Scholar, PubMed, Web of Science, and Embassy databases until September 2022 based on appropriate MESH terms. All observational studies that evaluated the effect of metformin on survival in diabetic patients who underwent surgery for GC were included. The hazard ratio (HR) with a 95% confidence interval was used to estimate the effect size. The Egger test was used to evaluate publication bias., Results: Overall, nine studies, including 245,387 GC patients who underwent surgery, were included. The use of metformin significantly increased the OS rate (HR: 0.81, 95% CI: 0.78, 0.86, P: 0.001, I 2 : 4.5%), CSS rate (HR: 0.72, 95% CI: 0.63, 0.81, P: 0.011, I 2  = 0%), and RFS rate (HR: 719, 95% CI: 0.524, 0.986, P: 0.001) and decreased the recurrence rate after gastrectomy (HR: 0.83, 95% CI: 0.77, 0.87, P: 0.001, I 2 : 0%). The use of metformin was significantly associated with a greater increase in OS and CSS rate and a greater decrease in recurrence rate in the Asian population than in the Western population., Conclusion: The use of metformin in diabetic patients with GC can be associated with improved OS, CSS, RFS, and reduced recurrence rate after gastrectomy, especially in the Asian population., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: The extraction of information from images provided by medical imaging systems may be employed to obtain the specific objectives in the various fields. The quantity of signal to noise ratio (SNR) plays a crucial role in displaying the image details. The higher the SNR value, the more the information is available., Methods: In this study, a new function has been formulated using the appropriate suggestions on convolutional combination of the longitudinal and transverse magnetization components related to the relaxation times of T1 and T2 in MRI, where by introducing the distinct index on the maximum value of this function, the new maps are constructed toward the best SNR. Proposed functions were analytically simulated using Matlab software and evaluated with respect to various relaxation times. This proposed method can be applied to any medical images. For instance, the T 1 - and T 2 -weighted images of the breast indicated in the reference [35] were selected for modelling and construction of the full width at x maximum (FWxM) map at the different values of x-parameter from 0.01 to 0.955 at 0.035 and 0.015 intervals. The range of x-parameter is between zero and one. To determine the maximum value of the derived SNR, these intervals have been first chosen arbitrarily. However, the smaller this interval, the more precise the value of the x-parameter at which the signal to noise is maximum., Results: The results showed that at an index value of x = 0.325, the new map of FWxM (0.325) will be constructed with a maximum derived SNR of 22.7 compared to the SNR values of T 1 - and T 2 -maps by 14.53 and 17.47, respectively., Conclusion: By convolving two orthogonal magnetization vectors, the qualified images with higher new SNR were created, which included the image with the best SNR. In other words, to optimize the adoption of MRI technique and enable the possibility of wider use, an optimal and cost-effective examination has been suggested. Our proposal aims to shorten the MRI examination to further reduce interpretation times while maintaining primary sensitivity., Significance: Our findings may help to quantitatively identify the primary sources of each type of solid and sequential cancer., (© 2023. International Federation for Medical and Biological Engineering.)

In the effort to identify sustainable sludge management options, pilot-scale sludge treatment reed beds (STRBs) were tested and assessed in the Sultanate of Oman in the first integrated experimental study of this nature-based solution in the Middle East region. A total of 18 pilot STRB units were established and monitored for almost 2 years; half were planted with native Phragmites australis reed species, and half served as unplanted control units. Employing a randomized complete block design, the study examined varying sludge loading rates (SLR) of 75, 100, and 125 kg/m 2 /year. Results underscored the effectiveness of STRBs in reducing the sludge volume, with observed reductions reaching 98.0% of the applied sludge volume, particularly prominent in the SLR75 units. During the final resting phase, the STRBs showed slightly higher concentrations of total Kjeldahl nitrogen (TKN) and total phosphorus (TP) compared to the unplanted beds, while maintaining concentrations lower than those of the applied activated sludge. Furthermore, heavy metal concentrations were consistently diminished in the STRBs compared to the unplanted beds, aligning with the established national and international standards for sludge reuse in agricultural contexts. The results of this study provide the first valuable insight into the potential of STRBs as an effective, sustainable, and climatically suitable approach for sludge dewatering. Specifically, an SLR of 100 kg/m 2 /year is proposed as an optimum loading rate for the hot and arid Middle East climate. This study advances our understanding of STRBs as a pivotal component in the realm of arid-region sludge treatment, shedding light on their capacity to facilitate enhanced dewatering, mineralization, and nutrient removal, thereby contributing to the broader discourse on sustainable waste management practices., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Extraction and processing of disseminated metalliferous ores, porphyry copper in particular, results in significant tonnages of waste and can cause severe disturbances and contamination in natural ecosystems. This is particularly important in semi-arid climates where natural soils are often deprived of organic matter and nutrients. This study was conducted on seven sites around Sungun Copper Mine, northwest Iran. Soil texture, EC, pH, and concentrations of nutrients, organic matter, along with 16 metal and metalloids were measured in 94 soil samples. Results showed a gradient of contamination from low contamination in natural hillsides to high contamination in mine waste depositories, Waste Dump and Oxide Dump, alongside Pakhir and Sungun Rivers. Nutrient deficiency occurred in disturbed sites. The main contaminant point sources were Waste Dump, mine pit drainage, and Oxide Dump. The results of Non-metric multidimensional scaling ordination showed elevated Cd, Zn, Fe, Cu, Pb, As, Mo, Mn, Co, S concentrations, high EC, and higher sand percentage in the sites affected by mine waste and acid mine drainage. Geo-Accumulation and Potential Ecological Risk Indices indicated that Pakhir riverside, Sungun riverside, and Oxide Dump have severe to moderate levels of environmental risks. Positive correlations between certain metal elements suggest common sources and similar reaction pathways, which may contribute to their similar geochemical behaviour in transport, deposition, and interdependence. Overall, the deficiency of organic matter and nutrients along with the soil sandy texture in contaminated sites of Sungun Copper Mine are the main limiting factors in managing metal mobility and soil remediation., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The aim of this study is to estimate the joint moments of the ankle, knee, and hip joints during walking. A sit-to-stand (STS) movement analysis was first performed on 20 participants with different anthropometric characteristics. Then, analysis of the dynamics of the STS motion was used to develop a biomechanical model. Decision tree (DT), linear regression (LR), support vector machine (SVM), random forest (RF), and three deep learning (DL) algorithms and deep neural network (DNN), long-short-term memory (LSTM), and convolutional neural network (CNN) are examined in this work to estimate three joint moments: ankle, knee, and hip. The results of the seven algorithms were evaluated using four statistical benchmarks: MSR, RMSE, correlation coefficient (R), and MAE to find the most accurate one. The results show that the most successful algorithms were LSTM in estimating knee, hip, and ankle joint moments using 19 and 7 inputs. The R value was 0.9990 using 19 inputs and 0.9972 using 7 inputs. The other algorithms have a correlation coefficient (R) success of 0.9902, 0.9770, 0.9884, 0.9577, 0.9786, and 0.9022 for RF, CNN, DT, DNN, SVM, and LR, respectively. The prediction of joint moments plays a crucial role in the design of the biomechanical system with the desired mechanical properties. Especially, the need has arisen to predict joint moments in a shorter time to utilize in real-time active prosthesis/orthosis controllers., (© 2023. International Federation for Medical and Biological Engineering.)

This study addresses the significant concern of pharmaceutical contaminants, including antipyretic and antibiotic drugs, in municipal and industrial wastewater, impacting both the environment and human health. We investigate incorporating zinc-based metal-organic framework (Zn-MOF) nanofillers into polyamide layers, developing thin-film composite (PA-TFC) nanofiltration membranes via interfacial polymerization to remove paracetamol, ibuprofen, and amoxicillin from simulated wastewater. Characterization confirms Zn-MOF's presence in the PA-TFC membrane, affecting structural topology, pore size, contact angles, and zeta potential. Zn-MOF nanofillers strongly adhere to the polyamide layer, influencing membrane surface chemistry and morphology. The newly developed MOF/PA-TFC nanofiltration membranes demonstrate a remarkable water flux of up to 35 LMH, showcasing superior removal efficiency for the three pharmaceutical contaminants when compared to PA-TFC membranes. Specifically, the rejection rates for paracetamol, ibuprofen, and amoxicillin are notably high at 93%, 98%, and 99%, respectively. Consequently, this study establishes MOF/PA-TFC nanofiltration membranes as a highly efficient solution for removing emerging pharmaceutical contaminants from environmental water, promoting sustainability and safeguarding water resources., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Various organisms, such as bacteria, viruses, and fungi, can cause corneal ulcers. One of the leading causes of vision loss and disability worldwide is corneal ulceration. Practical, accessible, and affordable treatment for this disease seems essential., Materials and Methods: Fifteen New Zealand rabbits infected with Staphylococcus aureus (ATCC 25923) corneal ulcers were randomly divided into three groups of five for the present study. (I, II, and III). Group I was used as the control group (without treatment). The second group received an iodine solution (1.25%) without a nanoparticle structure (betadine). The third group received an iodine solution with a nanoparticle structure used as eye drops. Drops in the corneal ulcer group were used five times daily for 14 days. Microbial counts and disease severity scores were measured on the first, second, fifth, and fourteenth days and compared between groups separately for each disease., Results: The results showed that the changes in microbial load were significant in the group that received betadine and nanoparticles. The microbial load was further reduced when using iodine nanoparticles than betadine. The betadine and nano-iodine groups significantly reduced the severity of the disease in rabbits with corneal ulcers (p < 0.05). The average changes in disease severity score were 4.8 ± 1.3, -2.6 ± 0.89, and -2.22 ± 1.22 in the untreated, nano iodine, and betadine groups, respectively. However, a significant increase in disease severity was observed in the untreated group (p = 0.001). It shows a significant difference (p < 0.001) between the nano iodine, betadine, and untreated groups. However, the difference in disease severity changes between nano iodine and non-nano iodine groups was insignificant., Conclusion: Nanoparticle iodine is more effective than non-nanoparticle iodine in reducing bacterial load. In reducing the severity of the disease, both types of iodine were superior to no treatment. But there was no apparent difference between the two groups treated with iodine., (© 2023. The Author(s).)

Introduction: The atypical anatomy of the C2 vertebra has led to terminological discrepancies within reports and studies in the literature regarding the location of its pedicle, pars interarticularis, and isthmus. These discrepancies not only limit the power of morphometric analyses, but they also confuse technical reports regarding operations involving C2, and thus confuse our ability to properly communicate this anatomy. Herein, we examine the variations in nomenclature regarding the pedicle, pars interarticularis, and isthmus of C2, and via an anatomical study, propose new terminology., Methods: The articular surface and underlying superior and inferior articular processes and adjacent transverse processes were removed from 15 C2 vertebrae (30 sides). Specifically, the areas regarded as the pedicle, pars interarticularis, and isthmus were evaluated. Morphometrics were performed., Results: Our results indicate that, anatomically, C2 has no "isthmus" and that a pars interarticularis for C2, when present, is very short. Deconstruction of the attached parts allowed for visualization of a bony arch extending from the anterior most aspect of the lamina to the body of C2. The arch is composed almost entirely of trabecular bone and without its attached parts, e.g., transverse process, really has no cortical bone laterally., Conclusions: We propose a more accurate terminology, the pedicle, for pars/pedicle screw placement of C2. Such a term more accurately describes this unique structure of the C2 vertebra and would alleviate terminological confusion in the future literature on this topic., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Purpose: The Eastern Mediterranean Region (EMR) countries suffer from exposure to high levels of ambient air pollutants due to dust storms and have unique climatic as well as topographic and socio-economic conditions which lead to adverse health effects on humans. The purpose of the review was to evaluate the quantity and quality of published articles on air pollution and health-based studies in 22 EMR countries to determine if they can be applied to adopting air quality standards., Methods: We designed a review based on a broad search of the literature in the Scopus, PubMed, and web of science (WOS) databases published from January 1, 2000, to January 2, 2022, using combinations of the following relevant terms: air pollution, health, and EMR countries. The generic eligibility criteria for this review were based on the population, exposure, comparator, outcome, and study design (PECOS) statement., Results: The search results showed that following the PRISMA approach, of 2947 identified articles, 353 studies were included in this review. The analysis of the types of studies showed that about 70% of the studies conducted in EMR countries were Health Burden Estimation studies (31%), Ecological and time trend ecological studies (23%), and cross-sectional studies (16%). Also, researchers from Iran participated in the most published relevant studies in the region 255 (~ 63%) and just 10 published documents met all the PECOS criteria., Conclusion: The lack of sufficient studies which can meet the PECOS appraising criteria and the lack of professionals in this field are some of the issues that make it impossible to use as potential documents in the WHO future studies and adopt air quality standards., Supplementary Information: The online version contains supplementary material available at 10.1007/s40201-023-00862-1., Competing Interests: Conflict of interestThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

The acid-mediated (oxalic acid [OXA], cinnamic acid [CA], and itaconic acid [IA]) SnO 2 nanorods were synthesized by the hydrothermal method. The synthesized SnO 2 nanorods, in turn, were analyzed with various physico-chemical techniques such as the X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), scanning electron microscope (SEM), and Raman spectroscopy. Furthermore, the photocatalytic activity of the different SnO 2 nanorods was investigated with the malachite green (MG) dye under visible light illumination. The OXA-SnO 2 nanorods displayed an excellent degradation performance with observed value at 91% and it was compared to CA and IA-SnO 2 nanomaterials. This tetragonal phase was identified and confirmed by XRD studies. In this regards, obtained band gap energy is low then optimally performed to the photocatalytic evolution. The OXA-SnO 2 materials were tested for antibacterial and antifungal studies; this was as shown in good biological activities with admire to the different bacterial strains. The Candida albicans (antifungal) and Enterococcus faecalis (Gram-positive) bacteria were not affected in the microbial studies., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Incense sticks ash is one of the most unexplored by-products generated at religious places and houses obtained after the combustion of incense sticks. Every year, tonnes of incense sticks ash is produced at religious places in India which are disposed of into the rivers and water bodies. The presence of heavy metals and high content of alkali metals challenges a potential threat to the living organism after the disposal in the river. The leaching of heavy metals and alkali metals may lead to water pollution. Besides this, incense sticks also have a high amount of calcium, silica, alumina, and ferrous along with traces of rutile and other oxides either in crystalline or amorphous phases. The incense sticks ash, heavy metals, and alkali metals can be extracted by water, mineral acids, and alkali. Ferrous can be extracted by magnetic separation, while calcium by HCl, alumina by sulfuric acid treatment, and silica by strong hydroxides like NaOH. The recovery of such elements by using acids and bases will eliminate their toxic heavy metals at the same time recovering major value-added minerals from it. Here, in the present research work, the effect on the elemental composition, morphology, crystallinity, and size of incense sticks ash particles was observed by extracting ferrous, followed by extraction of calcium by HCl and alumina by H 2 SO 4 at 90-95 °C for 90 min. The final residue was treated with 4 M NaOH, in order to extract leachable silica at 90 °C for 90 min along with continuous stirring. The transformation of various minerals phases and microstructures of incense sticks ash (ISA) and other residues during ferrous, extraction, calcium, and alumina and silica extraction was studied using Fourier transform infrared (FTIR), dynamic light scattering (DLS), X-ray fluorescence (XRF), X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), and inductively coupled plasma-optical emission spectroscopy (ICP-OES). DLS was used for analyzing the size during the experiments while FTIR helped in the confirmation of the formation of new products during the treatments. From the various instrumental analyses, it was found that the toxic metals present in the initial incense sticks ash got eliminated. Besides this, the major alkali metals, i.e., Ca and Mg, got reduced during these successive treatments. Initially, there were mainly irregular shaped, micron-sized particles that were dominant in the incense sticks ash particles. Besides this, there were plenty of carbon particles left unburned during combustion. In the final residue, nanosized flowers shaped along with cuboidal micron-sized particles were dominant. present in If, such sequential techniques will be applied by the industries based on recycling of incense sticks ash, then not only the solid waste pollution will be reduced but also numerous value-added minerals like ferrous, silica, alumina calcium oxides and carbonates can be recovered from such waste. The value-added minerals could act as an economical and sustainable source of adsorbent for wastewater treatment in future., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The production and release of nanoparticles and their impacts on living organisms are among the most important concerns in the world. Spirulina platensis was chosen because of its ability to absorb more elements than other algae. Therefore, an experiment was conducted to improve the product quality of spirulina exposed to new type of nanoparticles. In this experiment, vanadium oxide nanoparticles (VNPs) and tungsten oxide nanoparticles (WNPs) were used at concentrations of 0, 0.001, 0.017, and 0.05 g/l. The measured indices such as protein percentage and concentrations of phycobiliproteins and carbohydrates were the most important parameters of spirulina. Results showed that the concentration of 0.001 g/l of VNPs significantly affected the amounts of protein and phycocyanin. It has also been observed that 0.001 g/l of WNPs significantly influenced the amounts of protein (5.3%) and phycocyanin (90%); however, WNPs at all concentrations increased the concentrations of protein and phycocyanin. A concentration of 0.05 g/l of WNPs increased phycocyanin content by 83% over the control. The examination of nanoparticles by spirulina showed that VNPs were more adsorbed by spirulina than WNPs. In general, VNPs were toxic to algae at concentrations of 0.017 and 0.05 g/l, but WNPs did not show any fatal toxicity., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Abnormal angiogenesis contributes to the pathogenesis of various diseases. The medicinal usage of Agrostemma githago L. seed (A. githago herein) has been stated in traditional medicine. This study aims to investigate the anti-angiogenic potential of aqueous extract of A. githago. In order to test the effect of A. githago extract, its impact on HUVECs, T98G, and HGF2PI2 cells was assessed by looking at cellular viability, changes in the distribution of cells in different phases of the cell cycle, induction of oxidative stress, and apoptosis. In addition, the release of VEGF, ANG2, and MMP2/9 factors, along with the expressions of the critical Notch signaling pathway players and VEGF receptors (VEGFR), was measured. Furthermore, a γ-secretase inhibitor (LY411575) was applied to determine whether Notch inhibition restores A. githago effects. As a further characterization, total phenolic and flavonoid contents of A. githago were estimated, and five triterpene saponin compounds were identified using LC-ESI-MS. In response to A. githago extract, a reduction in total cell viability, along with the induction of ROS and apoptosis, was detected. Exposure to the A. githago extract could modulate the release of VEGF and ANG2 from T98G and HUVECs, respectively. In addition, A. githago reduced the release of MMP2/9. Furthermore, Notch1, DLL4, and HEY2 transcripts and protein expressions were up-regulated, while VEGFR2 was down-regulated in treated HUVEC cells. Treatment with the A. githago extract resulted in a dose-dependent inhibition of AKT phosphorylation. Inhibition of Notch signaling retrieved the viability loss, reduced intracellular ROS, and alleviated the impaired tube formation in A. githago-treated HUVECs. Overall, these data underscore the anti-angiogenic potential of A. githago via inducing apoptosis, modifying the expression levels of VEGF/VEGFR2, and impacting the release of MMP2/9 and ANG2, effects that are most probably modulated through the Notch/VEGF signaling axis., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Stroke is the leading cause of epilepsy in the elderly, ahead of degenerative diseases, tumors and head injuries. It constitutes a significant complication and a considerable comorbidity. The aim of our study was to describe the main factors implicated in the occurrence of post-stroke seizures and to identify the predictors of seizure recurrence. We conducted a descriptive, retrospective, monocentric study from January 2010 to December 2019, including patients who presented seizures following an ischemic stroke. We classified these seizures according to the International League Against Epilepsy (ILAE) into acute symptomatic seizures (ASS) if they occur within seven days of stroke, and unprovoked seizures (US) if they occur after more than one week. Clinical, para-clinical, therapeutic and follow-up data were statistically analyzed and compared. A total of 52 patients were included (39 men, 13 women; median age 55.1 years). 21 cases (40%) had ASS and the remaining 31 cases (60%) presented US. Young age below 65 years (71%), middle cerebral artery infarcts (83%), and cortical localization (87%) were the main factors depicted in our series. Parietal lobe infarction was more associated with US than ASS (p = 0.035). 24 patients (46%) have presented a recurrence of seizures (8/21 of ASS and 16/31 of US). The use of sodium valproate in monotherapy was identified as a recurrence risk factor (p = 0.013). In patients with post-stroke seizures, parietal lobe infarcts are more associated with US. We identified a higher risk of seizure recurrence in patients treated with sodium valproate monotherapy., (© 2021. Belgian Neurological Society.)

Improved understanding of the key mechanisms underlying cerebral ischemic injury is essential for the discovery of efficacious novel therapeutics for stroke. Through detailed analysis of plasma samples obtained from a large number of healthy volunteers (n = 90) and ischemic stroke patients (n = 81), the current study found significant elevations in the levels of TNF-α at baseline (within the first 48 h of stroke) and on days 7, 30, 90 after ischaemic stroke. It then assessed the impact of this inflammatory cytokine on an in vitro model of human blood-brain barrier (BBB) and revealed dramatic impairments in both barrier integrity and function, the main cause of early death after an ischemic stroke. Co-treatment of BBB models in similar experiments with outgrowth endothelial cell-derived conditioned media (OEC-CM) negated the deleterious effects of TNF-α on BBB. Effective suppression of anti-angiogenic factor endostatin, stress fiber formation, oxidative stress, and apoptosis along with concomitant improvements in extracellular matrix adhesive and tubulogenic properties of brain microvascular endothelial cells and OECs played an important role in OEC-CM-mediated benefits. Significant increases in pro-angiogenic endothelin-1 and monocyte chemoattractant protein-1 in OEC-CM compared to the secretomes of OEC and HBMEC, detected by proteome profiling assay, accentuate the beneficial effects of OEC-CM. In conclusion, this reverse translational study identifies TNF-α as an important mediator of post-ischemic cerebral barrier damage and proposes OEC-CM as a potential vasculoprotective therapeutic strategy by demonstrating its ability to regulate a wide range of mechanisms associated with BBB function. Clinical trial registration NCT02980354., (© 2022. The Author(s).)

Adenosine deaminase 2 deficiency (DADA2), a rare and potentially fatal systemic autoinflammatory disease, is characterized by low or lack of ADA2 activity due to ADA2 mutations. DADA2 symptoms are variable and include vasculitis, immunodeficiency, and cytopenia. Minimal data are available from Saudi Arabia. This retrospective study conducted at seven major tertiary medical centers examined the phenotypic and genotypic variabilities, clinical and diagnostic findings, and treatment outcomes among 20 Saudi patients with DADA2 from 14 families. The median age of the study cohort was 9.5 years (4-26 years). The clinical presentation was before the age of 5 months in 25% of patients. Homozygous c.1447-1451del mutation was the most frequent ADA2 alteration (40%), followed by c.882-2A:G (30%). All tested patients exhibited absent or near-absent ADA2 activity. Phenotypic manifestations included stroke (40%), hematological abnormalities (95%), lymphoproliferation (65%), and recurrent infection (45%). Five and three patients had extracranial vasculitis features and Hodgkin lymphoma, respectively. Atypical manifestations included growth retardation (30%) and transverse myelitis. Anti-tumor necrosis factor (anti-TNF) therapy was the main treatment. Some patients underwent blood transfusion, splenectomy, cyclosporine and colony-stimulating factor therapies, and hematopoietic stem cell transplantation due to anti-TNF therapy failure. Fulminant hepatitis and septic multiorgan failure caused mortality in three patients. Thus, this study revealed the variability in the molecular and clinical characteristics of DADA2 in the study cohort with predominant aberrant hematological and immunological characteristics. Consensus diagnostic criteria will facilitate early diagnosis and treatment. Additionally, disease registries or large prospective studies are needed for evaluating rare disease complications, such as cancer., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Accurate diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) is a significant challenge. Misdiagnosis has significant negative medical side effects. Due to the complex nature of this disorder, there is no computational expert system for diagnosis. Recently, automatic diagnosis of ADHD by machine learning analysis of brain signals has received an increased attention. This paper aimed to achieve an accurate model to discriminate between ADHD patients and healthy controls by pattern discovery. Event-Related Potentials (ERP) data were collected from ADHD patients and healthy controls. After pre-processing, ERP signals were decomposed and features were calculated for different frequency bands. The classification was carried out based on each feature using seven machine learning algorithms. Important features were then selected and combined. To find specific patterns for each model, the classification was repeated using the proposed patterns. Results indicated that the combination of complementary features can significantly improve the performance of the predictive models. The newly developed features, defined based on band power, were able to provide the best classification using the Generalized Linear Model, Logistic Regression, and Deep Learning with the average accuracy and Receiver operating characteristic curve > %99.85 and > 0.999, respectively. High and low frequencies (Beta, Delta) performed better than the mid, frequencies in the discrimination of ADHD from control. Altogether, this study developed a machine learning expert system that minimises misdiagnosis of ADHD and is beneficial for the evaluation of treatment efficacy., (© The Author(s) 2022.)

Glioma is an aggressive type of cancer that develops in the brain or spinal cord. Due to many differences in its shape and appearance, accurate segmentation of glioma for identifying all parts of the tumor and its surrounding cancerous tissues is a challenging task. In recent researches, the combination of multi-atlas segmentation and machine learning methods provides robust and accurate results by learning from annotated atlas datasets. To overcome the side effects of limited existing information on atlas-based segmentation, and the long training phase of learning methods, we proposed a semi-supervised unified framework for multi-label segmentation that formulates this problem in terms of a Markov Random Field energy optimization on a parametric graph. To evaluate the proposed framework, we apply it to publicly available BRATS datasets, including low- and high-grade glioma tumors. Experimental results indicate competitive performance compared to the state-of-the-art methods. Compared with the top ranked methods, the proposed framework obtains the best dice score for segmenting of "whole tumor" (WT), "tumor core" (TC ) and "enhancing active tumor" (ET) regions. The achieved accuracy is 94[Formula: see text] characterized by the mean dice score. The motivation of using MRF graph is to map the segmentation problem to an optimization model in a graphical environment. Therefore, by defining perfect graph structure and optimum constraints and flows in the continuous max-flow model, the segmentation is performed precisely., (© 2022. The Author(s) under exclusive licence to Society for Imaging Informatics in Medicine.)

The use of land-based ecological potential is a key management factor in achieving sustainable development and conserving soil and water resources. The purpose of this study is to use multi-time images of Sentinel-2 to determine the area of agricultural lands and evaluate their ecological potential in Bastam, Semnan Province, Iran. Therefore, in the first step, the most common agricultural lands (including apricot and grape orchards), field crops (including wheat and forage maize), and their phenological period were determined. Then, the information was classified using, namely support vector machine, maximum likelihood, and minimum distance. In the next step, soil, topography, and climate data were extracted according to expert opinions and the analysis of the basin's natural potential. The ecological evaluation models of the region were applied to homogeneous units, and after calculating the ecological potential index by the integrated ANP-WLC model, the ecological potential map was generated. The results of the land use classification showed that the support vector machine model and the minimum distance, respectively, had the best and worst performance with kappa coefficient of 0.82 and 0.61. The highest area of cultivated lands (3423 hectares) was estimated for wheat and the lowest (738 hectares) for forage maize. Moreover, the results of the ecological potential evaluation showed that 60% of apricot orchards, and 40.19% of the wheat fields, were in the class of good ecological potential. Overall, 2290 hectares were in the poor class, and 4030 hectares in the excellent class in terms of ecological potential., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)