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Chronic otitis media, inflammation of the middle ear, is a sequel to acute otitis media in ∼8% of children. Chronic otitis media with effusion is the most common cause of childhood deafness and is characterised by effusion of white blood cells into the auditory bulla cavity. Skull flat bones have trans-cortical vessels which are responsible for the majority of blood flow in and out of the bone. In experimental models of stroke and aseptic meningitis there is preferential recruitment of myeloid cells (neutrophils and monocytes) from the marrow in skull flat bones. We report trans-cortical vessels in the mouse temporal bone connect to the bulla mucosal vasculature and potentially represent a means to recruit myeloid cells directly into the inflamed bulla. The mutant mouse strains Junbo (MecomJbo/+) and Jeff (Fbxo11Jf/+) develop chronic otitis spontaneously; MecomJbo/+ mice have highly cellular neutrophil (90%) rich bulla exudates whereas Fbxo11Jf/+ mice have low cellularity serous effusions (5% neutrophils) indicating differing demand for neutrophil recruitment. However we found peripheral leukograms of MecomJbo/+ and Fbxo11Jf/+ mice are similar to their respective wild-type littermate controls with healthy bullae and infer preferential mobilization of myeloid cells from temporal bulla bone marrow may mitigate the need for a systemic inflammatory reaction. The cytokines, chemokines and haematopoietic factors found in the inflamed bulla represent candidate signalling molecules for myeloid cell mobilization from temporal bone marrow. The density of white blood cells in the bulla cavity is positively correlated with extent of mucosal thickening in MecomJbo/+, Fbxo11Jf/+, and EdaTa mice and is accompanied by changes in epithelial populations and bone remodelling. In MecomJbo/+ mice there was a positive correlation between bulla cavity WBC numbers and total bacterial load. The degree of inflammation varies between contralateral bullae and between mutant mice of different ages suggesting inflammation may wax and wane and may be re-initiated by a new wave of bacterial infection. Clearance of white blood cells and inflammatory stimuli from the bulla cavity is impaired and this may create a pro-inflammatory feedback loop which further exacerbates otitis media and delays its resolution.

Introduction The concept of a livable city means to be suitable for living or habitable, which has been very strong today by expanding and intensifying the problems human societies and the loose of quality of life. The phrase "livable cities" was used for the first time in 1970 by the national Arts organization to achieve their urban ideas and looking for it by other centers and research organizations such as the environmental protection organizations that has done extensive studies regarding the most of American cities was gone. Following the influence of this word in the literature related to this field can be searched in 1975 and the writings of William Marlins on the fields of livable in Saturday Review and Christian Science Monitor. In recent years, research and development in the area of ​​sustainable cities has attracted much attention. The continued growth of urbanization with social, economic, physical, and environmental problems is creating a crisis leading to metropolitan instability, which in turn reduces the viability of metropolises. According to the standards, Tabriz's livelihoods were at a low level, and lack of proper planning would make it a city in the not too distant future where it would be difficult to live. Therefore, the necessity and importance of biodiversity debate in the Tabriz metropolis is increasing. In addition, given that Iranian cities are currently suffering from a lack of attention to existing urban contexts. In this regard, the present study aimed to evaluate the viability of Tabriz urban texture. This article is based on scientific study and tries to answer the following questions. In terms of the subjective dimension of living (objectively satisfied residents) what is the status of Tabriz urban context? Data and Method This research is applied in nature and is descriptive-analytical in terms of method. The measurement tool in this study was a questionnaire developed based on the subjective-psychological dimension of living (objective satisfaction of residents). The statistical population of the study is based on the empirical view of urban environment quality assessment, the inhabitants of old and new urban texture based on Morgan table number of 1558693 people according to the size of community and according to Morgan table is 384 people, Classified by sampling and assigned appropriately to each of the low-lying, semi-rich and rich neighborhoods respectively, 39, 70 and 42 (old tissue samples) and 100, 71 and 62 (new tissue samples), respectively given. Multivariate analysis of variance (MANOVA) was used to analyze the data. Multivariate analysis of variance is the extension of variance analysis to situations in which there is more than one dependent variable. Results and Discussion What exactly is more socially viable, according to Winnewon? It's not completely clear, and people are happier and more satisfied in communities where their needs are better met. In this regard, due to the lack of attention to urban texture biodiversity and the increasing expansion of urbanization, upgrading the viability of Tabriz metropolitan area requires an examination of the status of urban tissues; And provide the basis for new urban development, insights, and cognition on the nature of Tabriz metropolitan urban biodiversity that identifies priorities for action to make these tissues viable in the decision environment. The results of the present study show that the overall life expectancy in Tabriz textures was below average, while the analysis of the current status of Tabriz's biodiversity in different dimensions shows that the average is generally achieved. In all aspects (urban services and infrastructure, urban environment, urban economy, urban management, urban history, and urban community), the findings were lower than average, and this is consistent with the findings of Rashidi et al (1395) who have estimated the biodiversity of Tabriz metropolitan area in comparison with Osco, Azarshahr, Bostanabad, Tabriz, Shabestar and Harris. This finding indicates that this metropolis will in the future be governed by the same current practice and managers and citizens will be not reinforce the deficiencies in the status queue, in the future the city will never move towards sustainability and sustainable development. According to the assessment made between the old and new textures of Tabriz metropolis, there is a significant difference in the viability. The results showed that the old tissue viability was higher than the new tissue based on the results due to the higher average ratings of services and urban infrastructure, urban community, urban history, urban economy, and urban management in the old tissue neighborhoods; This finding is in line with the findings of Dalir et al (1388) based on indicators of access to educational, health, daily shopping centers, weekly shopping malls, green spaces, recreational and sports centers, downtown and public transport to measure people's satisfaction with the new context Low level of evaluation, alignment. Conclusion The findings also indicate that in order to sustain the new texture, urban community, and urban management indices that have a significant difference with the old texture should be given more attention by city officials and managers. And in order to make old tissue more viable then the urban environment, which is less ranked than new tissue, must be taken into consideration by urban managers, so that proper planning for resource allocation and viability in these tissues should be emphasized. At the core of the indicators are the lower levels, so that by utilizing the available forces and potentials to achieve a comprehensive development that will bring prosperity and prosperity to all citizens.

Introduction One of the emerging phenomena of modern urbanization that has had a significant impact on various problems in metropolitan areas is the reverse migration from urban to villages locating in the suburbs of the cities. The continuation of reverse migration has reduced life quality and doubled the pressure on the rural environment. The rapid physical growth of Tabriz (called Urban Creep) has caused the uncontrollable development of rural settlements and has created a kind of new marginalization. Currently, the growth and development rate in the villages connecting to Tabriz is very high, so that the area of these villages has multiplied in recent years, and their population is several times more than that of Tabriz city. It should be noted that the average national growth rate is increasing. However, many of the areas built in these villages are outside the legal boundaries. Due to the lack of a local urban plan, illegal constructions and marginalization in these villages occur with an upward trend. If the trend of reverse migration in these areas continues, a turbulent and organic fabric will emerge in the next few years. Data and Method This study aims to determine the effect of various factors on migration from Tabriz to the surrounding villages and explain the rapid development of these villages. A descriptive-analytical research method has been used in the study. The documentary-library tools and field studies, including questionnaire, was used to collect the information. The statistical population of this study includes the migrants returned from Tabriz to the seven studied villages. In the new comprehensive plan of Tabriz, the villages of Anakhaton, Alvar Olia, Kojovar, Sahlan, Oghli, Khilijan, Konduro (Kondrud), which were previously outside the city limits, have entered the city limits. Subsequently, the research questionnaires were completed from the seven villages connecting to Tabriz city. The components of reverse migration are physical, socio-cultural, economic, and environmental factors, of which 114 were selected using the convenience sampling method. Cronbach's alpha coefficient was used to determine the reliability of the questionnaires, and the obtained mean reliability was 0.7. Results and Discussion The average growth of the country's rural population during the last ten years (2006-2016) was 69.0%, while it was +43.83% for the studied villages in this period. This growth indicates that rapid physical development has increased in recent years in the villages surrounding Tabriz due to the high cost of land and housing in the Tabriz. The population of the studied villages in 2006 was 25892 people, which has increased to 37249 people in 2016. Furthermore, the area of other villages in 2006 was 284.61 hectares, which has increased to 552 hectares in 2016 and have grown 93.94%. Conclusion Based on the field studies and the data analysis results, in terms of population growth and population attraction, the highest population growth was related to Anakhaton village. According to the factor analysis model, twelve factors were involved in reverse migration to the villages connecting to Tabriz. In the economic and housing factor, the high cost of living in the city with a correlation coefficient of 0.731; in the ecological factor, healthy drinking water with a correlation coefficient of 0.813; in the recreational-tourism factor, the natural tourism spaces with correlation coefficient 0.8; in the entrepreneurship and employment factor, establishment of an industrial workshop in the village with a correlation coefficient of 0.705; in uniformity of social class factor, matching the village with the social class with a correlation coefficient of 0.739; in the urban pollution factor, pollution of the cities with correlation coefficient of 0.820; in village enthusiasm factor; the existence of a happy rural life with a correlation coefficient of 0.774; in the job opportunities factor, the job potentials with correlation coefficient of 0.827; in the security and spatial affiliation, the village security with a correlation coefficient of 0.715; in the high density of the city, urban population density with a correlation coefficient of 0.704; in the cultural-behavioral factors and government support, the factor of government support from the villagers in the form of equity shares and subsidies with a correlation coefficient of 0.858 were the most important variables in reverse migration from Tabriz to the connected villages. Moreover, according to the factor analysis model, the economic and housing factor (Eigenvalue=9.61) determined more than twenty-six percent of reverse migration variance and was the most important reason for the reverse migration to the surrounding villages of Tabriz. The high cost of living in the city, low income, high land prices in the city, low purchase and rental prices in the village were among the economic factors affecting the reverse migration.

In mice, rats, dogs and humans, the growth and function of sebaceous glands and eyelid Meibomian glands depend on the ectodysplasin signalling pathway. Mutation of genes encoding the ligand EDA, its transmembrane receptor EDAR and the intracellular signal transducer EDARADD leads to hypohidrotic ectodermal dysplasia, characterised by impaired development of teeth and hair, as well as cutaneous glands. The rodent ear canal has a large auditory sebaceous gland, the Zymbal’s gland, the function of which in the health of the ear canal has not been determined. We report that EDA-deficient mice, EDAR-deficient mice and EDARADD-deficient rats have Zymbal’s gland hypoplasia. EdaTa mice have 25% prevalence of otitis externa at postnatal day 21 and treatment with agonist anti-EDAR antibodies rescues Zymbal’s glands. The aetiopathogenesis of otitis externa involves infection with Gram-positive cocci, and dosing pregnant and lactating EdaTa females and pups with enrofloxacin reduces the prevalence of otitis externa. We infer that the deficit of sebum is the principal factor in predisposition to bacterial infection, and the EdaTa mouse is a potentially useful microbial challenge model for human acute otitis externa.

Abstract Background Middle ear effusion is common in brachycephalic dogs with similarities to otitis media with effusion in children. Association with the cranial and eustachian tube morphology and bacterial infection is suspected in both species. Hypothesis/objectives To determine cytological and bacteriological features of middle ear effusions in dogs, provide information on histological features, and further assess the dog as a model of the human disease. Animals Sixteen live dogs, 3 postmortem cases of middle ear effusion, and 2 postmortem controls. Methods Prospective; clinical investigation using computed tomography, magnetic resonance imaging, video‐otoscopy, myringotomy; cytological assessment of 30 and bacteriology of 28 effusions; histology and immunohistochemistry (CD3 for T‐lymphocytes, Pax5 for B lymphocytes and MAC387 for macrophages) of 10 middle ear sections. Results Effusions were associated with neurological deficits in 6/16 (38%) and concurrent atopic dermatitis and otitis externa in 9/16 (56%) of live cases. Neutrophils and macrophages predominated on cytology (median 60 [range 2%‐95.5%] and 27 [2%‐96.5%]) whether culture of effusions was positive or not. In histology sections, the mucosa was thickened in affected dogs but submucosal gland dilatation occurred in affected and unaffected dogs. There was no bacterial growth from 22/28 (79%) of effusions. Bacteria isolated from the other 6 (21%) were predominantly Staphylococcus pseudintermedius (4/6, 67%). Conclusions and Clinical Importance Clinical, morphological, and cytological findings in middle ear effusions of dogs and people suggest similar pathogeneses. Middle ear effusion of dogs could be a useful model of human otitis media with effusion. Such comparisons can improve understanding and management across species.

Patients with mutations in the ectodysplasin receptor signalling pathway genes – the X-linked ligand ectodysplasin-A (EDA), the receptor EDAR or the receptor adapter EDARADD – have hypohidrotic ectodermal dysplasia (HED). In addition to having impaired development of teeth, hair, eccrine sweat glands, and salivary and mammary glands, HED patients have ear, nose and throat disease. The mouse strains Tabby (EdaTa) and downless (Edardl-J/dl-J) have rhinitis and otitis media due to loss of submucosal glands in the upper airway. We report that prenatal correction of EDAR signalling in EdaTa mice with the agonist anti-EDAR antibody rescues the auditory-tube submucosal glands and prevents otitis media, rhinitis and nasopharyngitis. The sparse- and wavy-haired (swh) rat strain carries a mutation in the Edaradd gene and has similar cutaneous HED phenotypes to mouse models. We report that auditory-tube submucosal glands are smaller in the homozygous mutant Edaraddswh/swh than those in unaffected heterozygous Edaraddswh/+ rats, and that this predisposes them to otitis media. Furthermore, the pathogenesis of otitis media in the rat HED model differs from that in mice, as otitis media is the primary pathology, and rhinitis is a later-onset phenotype. These findings in rodent HED models imply that hypomorphic as well as null mutations in EDAR signalling pathway genes may predispose to otitis media in humans. In addition, this work suggests that the recent successful prenatal treatment of X-linked HED (XLHED) in humans may also prevent ear, nose and throat disease, and provides diagnostic criteria that distinguish HED-associated otitis media from chronic otitis media with effusion, which is common in children.

Auditory bulla cavitation defects are a cause of otitis media, but the normal cellular pattern of bulla mesenchyme regression and its failure are not well understood. In mice, neural-crest-derived mesenchyme occupies the bulla from embryonic day 17.5 (E17.5) to postnatal day 11 (P11) and then regresses to form the adult air-filled bulla cavity. We report that bulla mesenchyme is bordered by a single layer of non-ciliated epithelium characterized by interdigitating cells with desmosome cell junctions and a basal lamina, and by Bpifa1 gene expression and laminin staining of the basal lamina. At P11-P12, the mesenchyme shrinks: mesenchyme-associated epithelium shortens, and mesenchymal cells and extracellular matrix collagen fibrils condense, culminating in the formation of cochlea promontory mucosa bordered by compact non-ciliated epithelial cells. FBXO11 is a candidate disease gene in human chronic otitis media with effusion and we report that a bulla cavitation defect initiates the pathogenesis of otitis media in the established mouse model Jeff (Fbxo11Jf/+). Persistent mesenchyme in Fbxo11Jf/+ bullae has limited mesenchymal cell condensation, fibrosis and hyperplasia of the mesenchyme-associated epithelium. Subsequent modification forms fibrous adhesions that link the mucosa and the tympanic membrane, and this is accompanied by dystrophic mineralization and accumulation of serous effusion in the bulla cavity. Mouse models of bulla cavitation defects are important because their study in humans is limited to post-mortem samples. This work indicates new diagnostic criteria for this otitis media aetiology in humans, and the prospects of studying the molecular mechanisms of murine bulla cavitation in organ culture.

Acute otitis media, inflammation of the middle ear, is the most common bacterial infection in children and, as a consequence, is the most common reason for antimicrobial prescription to this age group. There is currently no effective vaccine for the principal pathogen involved, non-typeable Haemophilus influenzae (NTHi). The most frequently used and widely accepted experimental animal model of middle ear infection is in chinchillas, but mice and gerbils have also been used. We have established a robust model of middle ear infection by NTHi in the Junbo mouse, a mutant mouse line that spontaneously develops chronic middle ear inflammation in specific pathogen-free conditions. The heterozygote Junbo mouse (Jbo/+) bears a mutation in a gene (Evi1, also known as Mecom) that plays a role in host innate immune regulation; pre-existing middle ear inflammation promotes NTHi middle ear infection. A single intranasal inoculation with NTHi produces high rates (up to 90%) of middle ear infection and bacterial titres (104-105 colony-forming units/µl) in bulla fluids. Bacteria are cleared from the majority of middle ears between day 21 and 35 post-inoculation but remain in approximately 20% of middle ears at least up to day 56 post-infection. The expression of Toll-like receptor-dependent response cytokine genes is elevated in the middle ear of the Jbo/+ mouse following NTHi infection. The translational potential of the Junbo model for studying antimicrobial intervention regimens was shown using a 3 day course of azithromycin to clear NTHi infection, and its potential use in vaccine development studies was shown by demonstrating protection in mice immunized with killed homologous, but not heterologous, NTHi bacteria.

Abstract Marfan syndrome (MFS) is a connective tissue disorder that can lead to cardiovascular and musculoskeletal abnormalities. Aortic aneurysms and dissections are frequently seen in patients with MFS whereas peripheral vascular aneurysms in subclavian and axillary arteries territory considered very unusual. We reported a case of 54-year-old female with known history of MFS who had undergone a mechanical valve Bentall procedure due to severe aortic regurgitation and ascending aorta aneurysm in addition to thoracoabdominal aortic repair and who presented with a pulsatile painful mass in her right axillary region that turn to be significant true aneurysms of right subclavian and axillary arteries. To relive symptoms and to avoid further complications patient underwent successful surgical repair. Our case demonstrated rare locations of true peripheral aneurysms as a possible manifestation of MFS appeared several years post Bentall procedure and thoracoabdominal aortic repair and highlights also the importance of long-term monitoring to detect earlier such manifestation and avoid complications by surgical repair.

Introduction: The most important pollutant in surface water sources is turbidity. The aim of the study is to determine the most effective thyme plant extract as a natural coagulant to remove water turbidity and compare it with alum as a chemical coagulant.. Materials and Methods: In this study, plant extracts obtained from Thymus vulgaris (Tv), Thymus kotschyanus (Tk), and Thymus eriocalyx (Te) were used as natural coagulants for elimination of water turbidity. Then, the best of plant extract was confirmed by ninhydrin and FTIR analyses and the effect of simultaneous use of plant extract with chemical coagulant of aluminum sulfate (alum) was investigated in the hybrid ratio of 1:1, 2:1, and 1:2. Then, the effect of parameters include of pH, coagulant dose, turbidity removal efficiency, and the most suitable solvent for coagulant extraction were studied. Results: The results of this study showed that among the natural coagulants, Tv had a higher efficiency in elimination of water turbidity, and the highest amounts of turbidity elimination for Tv, alum, and Tv/alum hybrid coagulants was 94, 90, and 96, respectively. According to the results of this study, the most effective solvent for preparing plant extracts was 1M KCl solvent. Conclusion: The natural coagulant removes more turbidity from water than the chemical coagulant, and the simultaneous use of natural and chemical coagulants with a 1:1 ratio was more effective.

Abstract Mild Cognitive Impairment (MCI) is a neurological condition characterized by a noticeable decline in cognitive abilities that falls between normal aging and dementia. Along with some biomarkers like GAP-43, Aβ, tau, and P-tau, brain activity and connectivity are ascribed to MCI; however, the link between brain connectivity changes and such biomarkers in MCI is still being investigated. This study explores the relationship between biomarkers like GAP-43, Aβ, tau, and P-tau, and brain connectivity. We enrolled 25 Participants with normal cognitive function and 23 patients with MCI. Levels of GAP-43, Aβ1–42, t-tau, and p-tau181p in the CSF were measured, and functional connectivity measures including ROI-to-voxel (RV) correlations and the DMN RV-ratio were extracted from the resting-state fMRI data. P-values below 0.05 were considered significant. The results showed that in CN individuals, higher connectivity within the both anterior default mode network (aDMN) and posterior DMN (pDMN) was associated with higher levels of the biomarker GAP-43. In contrast, MCI individuals showed significant negative correlations between DMN connectivity and levels of tau and P-tau. Notably, no significant correlations were found between Aβ levels and connectivity measures in either group. These findings suggest that elevated levels of GAP-43 indicate increased functional connectivity in aDMN and pDMN. Conversely, elevated levels of tau and p-tau can disrupt connectivity through various mechanisms. Thus, the accumulation of tau and p-tau can lead to impaired neuronal connectivity, contributing to cognitive decline.

Abstract Alzheimer’s disease (AD) is a degenerative neurological condition that gradually impairs cognitive abilities, disrupts memory retention, and impedes daily functioning by impacting the cells of the brain. A key characteristic of AD is the accumulation of amyloid-beta (Aβ) plaques, which play pivotal roles in disease progression. These plaques initiate a cascade of events including neuroinflammation, synaptic dysfunction, tau pathology, oxidative stress, impaired protein clearance, mitochondrial dysfunction, and disrupted calcium homeostasis. Aβ accumulation is also closely associated with other hallmark features of AD, underscoring its significance. Aβ is generated through cleavage of the amyloid precursor protein (APP) and plays a dual role depending on its processing pathway. The non-amyloidogenic pathway reduces Aβ production and has neuroprotective and anti-inflammatory effects, whereas the amyloidogenic pathway leads to the production of Aβ peptides, including Aβ40 and Aβ42, which contribute to neurodegeneration and toxic effects in AD. Understanding the multifaceted role of Aβ, particularly in AD, is crucial for developing effective therapeutic strategies that target Aβ metabolism, aggregation, and clearance with the aim of mitigating the detrimental consequences of the disease. This review aims to explore the mechanisms and functions of Aβ under normal and abnormal conditions, particularly in AD, by examining both its beneficial and detrimental effects.

Abstract Context Resveratrol (RV), a natural compound found in grapes, berries, and peanuts, has been extensively studied for its potential in treating Alzheimer’s disease (AD). RV has shown promise in inhibiting the formation of beta-amyloid plaques (Aβ) and neurofibrillary tangles (NFTs), protecting against neuronal damage and oxidative stress, reducing inflammation, promoting neuroprotection, and improving the function of the blood–brain barrier (BBB). However, conflicting results have been reported, necessitating a comprehensive umbrella review of systematic reviews to provide an unbiased conclusion on the therapeutic effectiveness of RV in AD. Objective The objective of this study was to systematically synthesize and evaluate systematic and meta-analysis reviews investigating the role of RV in AD using data from both human and animal studies. Data sources and extraction Of the 34 systematic and meta-analysis reviews examining the association between RV and AD that were collected, six were included in this study based on specific selection criteria. To identify pertinent studies, a comprehensive search was conducted in English-language peer-reviewed journals without any restrictions on the publication date until October 15, 2023. The search was carried out across multiple databases, including Embase, MEDLINE (PubMed), Cochrane Library, Web of Science, and Google Scholar, utilizing appropriate terms relevant to the specific research field. The AMSTAR-2 and ROBIS tools were also used to evaluate the quality and risk of bias of the included systematic reviews, respectively. Two researchers independently extracted and analyzed the data, resolving any discrepancies through consensus. Of note, the study adhered to the PRIOR checklist. Data analysis This umbrella review presented robust evidence supporting the positive impacts of RV in AD, irrespective of the specific mechanisms involved. It indeed indicated that all six systematic and meta-analysis reviews unanimously concluded that the consumption of RV can be effective in the treatment of AD. Conclusion RV exhibits promising potential for benefiting individuals with AD through various mechanisms. It has been observed to enhance cognitive function, reduce Aβ accumulation, provide neuroprotection, protect the BBB, support mitochondrial function, facilitate synaptic plasticity, stabilize tau proteins, mitigate oxidative stress, and reduce neuroinflammation commonly associated with AD. Graphical abstract

Hereditary colorectal cancer syndromes, such as Lynch syndrome and familial adenomatous polyposis (FAP), present significant clinical challenges due to the heightened cancer risks associated with these genetic conditions. This review explores genetic profiling impact on surgical decisions for hereditary colorectal cancer (HCRC), assessing options, timing, and outcomes. Genotypes of different HCRCs are discussed, revealing a connection between genetic profiles, disease severity, and outcomes. For Lynch syndrome, mutations in the MLH1, MSH2, MSH6, and PMS2 genes guide the choice of surgery. Subtotal colectomy is recommended for patients with mutations in MLH1 and MSH2, while segmental colectomy is preferred for those with MSH6 and PMS2 mutations. In cases of metachronous colon cancer after segmental colectomy, subtotal colectomy with ileorectal anastomosis is advised for all mutations. Surgical strategies for primary rectal cancer include anterior resection or abdominoperineal resection (APR), irrespective of the specific mutation. For rectal cancer occurring after a previous segmental colectomy, proctocolectomy with ileal pouch-anal anastomosis (IPAA) or APR with a permanent ileostomy is recommended. In FAP, surgical decisions are based on genotype-phenotype correlations. The risk of desmoid tumors post-surgery supports a single-stage approach, particularly for certain APC gene variants. Juvenile Polyposis Syndrome (JPS) surgical decisions involve genetic testing, polyp characteristics with attention to vascular lesions in SMAD4 mutation carriers. However, genetic profiling does not directly dictate the specific surgical approach for JPS. In conclusion this review highlights the critical role of personalized surgical plans based on genetic profiles to optimize patient outcomes and reduce cancer risk. Further research is needed to refine these strategies and enhance clinical guidelines.

Double connection of partial anomalous pulmonary venous return is a very rare congenital anomaly where at least one pulmonary vein, but not all, drains into the left atrium and systemic venous circulation with subsequent left to right shunt.

Abstract Sleep-disordered breathing (SDB) is a prevalent disorder characterized by recurrent episodic upper airway obstruction. Using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we apply principal component analysis (PCA) to seven SDB-related measures. We estimate the associations of the top two SDB PCs with serum levels of 617 metabolites, in both single-metabolite analysis, and a joint penalized regression analysis. The discovery analysis includes 3299 individuals, with validation in a separate dataset of 1522 individuals. Five metabolite associations with SDB PCs are discovered and replicated. SDB PC1, characterized by frequent respiratory events common in older and male adults, is associated with pregnanolone and progesterone-related sulfated metabolites. SDB PC2, characterized by short respiratory event length and self-reported restless sleep, enriched in young adults, is associated with sphingomyelins. Metabolite risk scores (MRSs), representing metabolite signatures associated with the two SDB PCs, are associated with 6-year incident hypertension and diabetes. These MRSs have the potential to serve as biomarkers for SDB, guiding risk stratification and treatment decisions.

Background Tribulus terrestris (TT) extract has shown good antibacterial activity against some bacteria. However, there are limited data on its cariogenic properties. This in vitro study aimed to evaluate the antibacterial and antibiofilm activities of TT extract against Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sorbinus), and Lactobacillus acidophilus (L. acidophilus) as the important cariogenic bacteria. Materials and Methods This study was designed in an experimental model (in vitro). Phytochemical tests were carried out to detect herbal compounds in the TT extract. Agar well diffusion was performed to compare the extract (500–62.5 mg/mL) with different concentrations of chlorhexidine (2–0.25 mg/mL). The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the TT extract and chlorhexidine were also determined. The lowest concentration showing ≥50% inhibition of biofilm formation (MBIC50) was determined using crystal violet assay. Further, the time-kill assay (Log of CFU/mL) was performed, and acid production (pH) was measured at 1 × MIC concentration in 2, 4, 8, 12, and 24 h. Data analysis conducted using SPSS software (v26, IBM) involved One-way analysis of variance, Tukey post hoc tests, and t-test to compare concentrations and groups. Significance level is set at 0.05. Results The TT extract mostly consisted of flavonoids. Its inhibition zones in the well diffusion test were statistically comparable with chlorhexidine in some concentrations (P > 0.05). The MIC of the TT extract was 15.625 mg/mL for all tested bacteria, whereas the MBC ranged from 31.25 to 62.5 mg/mL. Further, the MBIC50 ranged from 7.8125 to 15.625 mg/mL for the extract. Time-kill assay showed that the bactericidal activity of the TT extract lasted for 8, 12, and 2 h for S. mutans, S. sobrinus, and L. acidophilus, respectively. The acid production decreased obviously after 8 h. Conclusion The TT extract showed good time-dependent antibacterial and antibiofilm activity, as well as acid production inhibition, against cariogenic bacteria in laboratory experiments.

Sodium lauryl sulfate (SLS) is an anionic surfactant, which has a wide range of usage in the health sector and in dental pharmaceutical products, especially in toothpastes. The objective of this review was to investigate the effects of SLS containing dentifrices on oral and periodontal health, possible side effects, and its benefits. A thorough literature search was done using databases of PubMed and Google Scholar and finally, 40 articles were included in the study. This narrative review revealed the sources of discrepancy and conflicting results regarding the impact of SLS on oral cavity as well as a lack of sufficient evidence in most topics. Hence, the evidence suggests improved drug bioavailability when used as a solubilizer, improved plaque control, and reduction in bad breath. On the other hand, SLS can serve as a risk indicator of prolonged oral wound healing time, recurrent aphthous stomatitis.

Surgical interventions, like barbed reposition pharyngoplasty (BRP), are a valuable alternative for patients with obstructive sleep apnea (OSA) who are unable to tolerate continuous positive airway pressure (CPAP). However, predicting surgical success remains challenging, partly due to the contribution of non-anatomical factors. Therefore, combined medical treatment with acetazolamide, known to stabilize respiratory drive, may lead to superior surgical results. This double-blind, parallel-group randomized controlled trial evaluates the efficacy of acetazolamide as an add-on therapy to BRP in OSA. A total of 26 patients with moderate to severe OSA undergoing BRP were randomized to receive either acetazolamide or placebo post-surgery for 16 weeks. The group who was treated with BRP in combination with acetazolamide showed a reduction in AHI of 69.4%, significantly surpassing the 32.7% reduction of the BRP + placebo group (p < 0.01). The sleep apnea-specific hypoxic burden also decreased significantly in the group who was treated with BRP + acetazolamide (p < 0.01), but not in the group receiving BRP + placebo (p = 0.28). Based on these results, acetazolamide as an add-on therapy following BRP surgery shows promise in improving outcomes for OSA patients, addressing both anatomical and non-anatomical factors.

Patients with chronic rhinosinusitis (CRS) report improved sleep quality after dupilumab, an anti IL4/13 therapy. Concurrent CRS and obstructive sleep apnea (OSA) cases are not rare, and CRS seemingly raises nasal resistance. Thus, we hypothesized that improved sleep quality by dupilumab therapy in CRS patients might be due to lowered nasal resistance and subsequent improvement of unrecognized comorbid OSA. Patients with concurrent CRS and OSA were recruited. Nasal resistance was measured invasively with transnasal pressure and flow data collected during normal respiration in the supine position. Results from the first five participants did not support our hypothesis. Subjective and objective measures for CRS and nasal resistance values were improved with dupilumab therapy in CRS patients with nasal polyps. However, apnea severity and sleep-related subjective parameters did not change. In the patients with CRS without nasal polyps, no significant changes in either CRS or OSA-related measures were observed.

Dyes are one of the most common contaminants in industrial effluents, whose continuous release into the environment has become an increasing global concern. In this work, nanoparticles of zero-valent iron (NZVI) were synthesized using the chemical regeneration method ،and were utilized for the first time as a catalyst in the advanced Sono-Nano-Fenton hybrid method for the decomposition of Reactive Red 198 (RR198). The properties of zero-valent iron nanoparticles were analyzed using SEM and XRD. The effect of pH, initial dye concentration, nanoparticle dosage, zero-valent iron and H2O2 concentration on the decomposition efficiency of Red Reactive 198 was investigated. Comparing the efficiency of Reactivate 198 dye degradation in Sonolysis, Sono-NZVI, Sono-H2O2 and Sono-Nano Fenton processes showed that 97 % efficiency was achieved by the Sono-Nano Fenton process in 60 min. The kinetics of the removal process showed that this process follows pseudo-first-order kinetics and the Langmuir-Hinshelwood model. The results indicate that the effectiveness of the ultrasonic process in removing resistant organic pollutants such as dyes increases tremendously with the synergy of the Fenton process.

Immune checkpoint inhibitors work by blocking the "checkpoint" mechanism that tumors use to hide from the immune system, therefore also weakening the immune system. Consequently, checkpoint inhibitors can cause autoimmune reactions, resulting in adverse effects. Prompt identification and management of adverse effects are critical for patients under checkpoint inhibitor therapy due to the potential severity and unpredictability of these immune-related adverse events.

Cancer treatment can lead to combined heart and kidney complications, which can have a significant impact on patient outcomes. Chemotherapy and radiation therapy used to treat cancer can cause damage to both the heart and kidneys, leading to a range of complications. Managing combined heart and kidney complications following cancer treatment requires a collaborative and multidisciplinary approach, with regular monitoring and personalized management plans tailored to the individual patient’s needs.

Coronary cameral fistula (CCF) is defined as an abnormal connection between the coronary artery and any cardiac chamber. It usually appears due to abnormal embryogenesis and represents less than 1% of the population. Most CCF cases are asymptomatic, however large CCFs may cause symptoms and complications. We present a case of a young female with symptomatic CCF suspected on echocardiography and confirmed by computed tomography coronary angiography. She was successfully treated surgically with total improvement of symptoms.

This study evaluated the performance of TiO2–ZnO/biochar as activator of persulfate (PS) for degradation of furfural. After the successful synthesis of the catalyst, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM) methods were used to investigate the properties of TiO2–ZnO/biochar. The findings of this research suggests that under optimal conditions (pH = 3, catalyst dosage = 1 g/L, persulfate concentration = 1.2 mM, and furfural concentration = 10 mg/L), the PS/Catalysts/UV system can remove 96 % of furfural within 15 min. Under ideal conditions, the experimental results fit well with the first-order kinetic model (R2 > 0.95), and the rate constant (Kobs) was derived as 0.195 min−1. The quenching experiments provided further insights that confirmed the participation of SO4°− and OH° radicals in the degradation process. Nevertheless, the evidence strongly supports the idea that SO4°− plays a more prominent and dominant role as the primary radical species responsible for furfural degradation. Based on the obtained results, it can be concluded that the PS/Catalysts/UV system has an appropriate ability to remove furfural from aqueous solutions, which suggests promising perspectives for its practical application in pollutant treatment scenarios.

The presence of benzene, toluene, ethylbenzene, and xylene compounds (BTEX) in the breathing air outside and inside buildings is one of the most significant problems related to human health today. This study was performed to determine the concentration of BTEX pollutants in indoor environments. PhoCheck was used to detect the concentration of BTEX compounds. In this study, the concentration (BTEX pollutant) was assessed in four indoor spaces, including restaurants, laundries, hair salons, and photocopying centers. The results showed that the average concentration of all four searched compounds was higher than the recommended limit of the Environmental Protection Agency (EPA). The results of carcinogenic risk assessment by benzene and ethylbenzene compounds show 2153 × 10−4 and 913 × 10−5 respectively. The HQ values for toluene and xylene were 1.397 and 0.505, respectively, indicating that exposure to toluene alone may have adverse effects on human health, while exposure to xylene alone has no adverse effects. The hazard index (HI) for toluene and xylene pollutants was higher than one. An HI value higher than one means that the two contaminants toluene and xylene in the air we breathe may have adverse effects on human health. As a result, the necessary control measures should be taken to prevent the unfavorable effects of these two pollutants.

Abstract The combination of noradrenergic (reboxetine) plus antimuscarinic (oxybutynin) drugs (reb-oxy) reduced obstructive sleep apnea (OSA) severity but no data are available on its effects on cardiac autonomic modulation. We sought to evaluate the impact of 1-week reb-oxy treatment on cardiovascular autonomic control in OSA patients. OSA patients were randomized to a double-blind, crossover trial comparing 4 mg reboxetine plus 5 mg oxybutynin to a placebo for OSA treatment. Heart rate (HR) variability (HRV), ambulatory blood pressure (BP) monitoring (ABPM) over 24 h baseline and after treatment were performed. Baroreflex sensitivity was tested over beat-to-beat BP recordings. 16 subjects with (median [interquartile range]) age 57 [51–61] years and body mass index 30 [26–36]kg/m2 completed the study. The median nocturnal HR was 65 [60–69] bpm at baseline and increased to 69 [64–77] bpm on reb-oxy vs 66 [59–70] bpm on placebo (p = 0.02). The mean 24 h HR from ABPM was not different among treatment groups. Reb-oxy administration was not associated with any modification in HRV or BP. Reb-oxy increased the baroreflex sensitivity and did not induce orthostatic hypotension. In conclusion, administration of reb-oxy did not induce clinically relevant sympathetic overactivity over 1-week and, together with a reduction in OSA severity, it improved the baroreflex function.

Crime prediction in video-surveillance systems is required to prevent incident and protect assets. In this sense, our article proposes first artificial intelligence approach for Robbery Behavior Potential (RBP) prediction and detection in an indoor camera. Our method is based on three detection modules including head cover, crowd and loitering detection modules for timely actions and preventing robbery. The two first modules are implemented by retraining YOLOV5 model with our gathered dataset which is annotated manually. In addition, we innovate a novel definition for loitering detection module which is based on DeepSORT algorithm. A fuzzy inference machine renders an expert knowledge as rules and then makes final decision about predicted robbery potential. This is laborious due to: different manner of robber, different angle of surveillance camera and low resolution of video images. We accomplished our experiment on real world video surveillance images and reaching the F1-score of 0.537. Hence, to make an experimental comparison with the other related works, we define threshold value for RBP to evaluate video images as a robbery detection problem. Under this assumption, the experimental results show that the proposed method performs significantly better in detecting the robbery as compared to the robbery detection methods by distinctly report with F1-score of 0.607. We strongly believe that the application of the proposed method could cause reduction of robbery detriment in a control center of surveillance cameras by predicting and preventing incident of robbery. On the other hand, situational awareness of human operator enhances and more cameras can be managed.

Abstract In the present study, the magnetic NH2-MIL-101(Al)/chitosan nanocomposite (MIL/Cs@Fe3O4 NCs) was synthesized and used in the removal of azithromycin (AZT) from an aqueous solution for the first time. The as-synthesized MIL/Cs@Fe3O4 NCs was characterized by SEM, TEM, XRD, FTIR, BET, and VSM techniques. The effect of various key factors in the AZT adsorption process was modeled and optimized using response surface methodology based on central composite design (RSM-CCD). The low value of p-value (1.3101e−06) and RSD (1.873) parameters, along with the coefficient of determination > 0.997 implied that the developed model was well fitted with experimental data. Under the optimized conditions, including pH: 7.992, adsorbent dose: 0.279 g/L, time: 64.256 min and AZT concentration: 10.107 mg/L, removal efficiency and AZT adsorption capacity were obtained as 98.362 ± 3.24% and 238.553 mg/g, respectively. The fitting of data with the Langmuir isotherm (R2: 0.998, X2: 0.011) and Pseudo-second-order kinetics (R2: 0.999, X2: 0.013) showed that the adsorption process is monolayer and chemical in nature. ΔH° > 0, ΔS° > 0, and ∆G°

Abstract Melanoma is the most aggressive form of skin cancer resulting from genetic mutations in melanocytes. Several factors have been considered to be involved in melanoma progression, including genetic alteration, processes of damaged DNA repair, and changes in mechanisms of cell growth and proliferation. Epigenetics is the other factor with a crucial role in melanoma development. Epigenetic changes have become novel targets for treating patients suffering from melanoma. These changes can alter the expression of microRNAs and their interaction with target genes, which involves cell growth, differentiation, or even death. Given these circumstances, we conducted the present review to discuss the melanoma risk factors and represent the current knowledge about the factors related to its etiopathogenesis. Moreover, various epigenetic pathways, which are involved in melanoma progression, treatment, and chemo-resistance, as well as employed epigenetic factors as a solution to the problems, will be discussed in detail.

Abstract Exosomes, known as a type of extracellular vesicles (EVs), are lipid particles comprising heterogeneous contents such as nucleic acids, proteins, and DNA. These bi-layered particles are naturally released into the extracellular periphery by a variety of cells such as neoplastic cells. Given that exosomes have unique properties, they can be used as vectors and carriers of biological and medicinal particles like drugs for delivering to the desired areas. The proteins and RNAs being encompassed by the circulating exosomes in B-cell malignancies are deemed as the promising sources for diagnostic and prognostic biomarkers, as well as therapeutic agents. Exosomes can also provide a “snapshot” view of the tumor and metastatic landscape at any particular time. Further, clinical research has shown that exosomes are produced by immune cells such as dendritic cells can stimulate the immune system, so these exosomes can be used in antitumor vaccines. Despite the great potential of exosomes in the fields of diagnostic and treatment, further studies are in need for these purposes to reach a convergence notion. This review highlights the applications of exosomes in multiple immune-related diseases, including chronic lymphocytic leukemia, multiple sclerosis, and arthritis rheumatoid, as well as explaining sundry aspects of exosome therapy and the function of exosomes in diagnosing diseases.

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is considered a rare congenital heart disease where the take-off of the left coronary artery abnormally originates from the pulmonary artery instead of left aortic sinus. It is associated with a high mortality rate in the first year of life and sudden death in adults if left untreated. We report an adult form of ALCAPA syndrome in a 20-year-old female who presented with anginal pain for the previous few months. Unfortunately, the patient was hesitant to have surgery at the time.

Abstract Background Breast cancer is defined as a biological and molecular heterogeneous disorder that originates from breast cells. Genetic predisposition is the most important factor giving rise to this malignancy. The most notable mutations in breast cancer occur in the BRCA1 and BRCA2 genes. Owing to disease heterogeneity, lack of therapeutic target, anti-cancer drug resistance, residual disease, and recurrence, researchers are faced with challenges in developing strategies to treat patients with breast cancer. Results It has recently been reported that epigenetic processes such as DNA methylation and histone modification, as well as microRNAs (miRNAs), have potently contributed to the pathophysiology, diagnosis, and treatment of breast cancer. These observations have persuaded researchers to move their therapeutic approaches beyond the genetic framework toward the epigenetic concept. Conclusion Herein we discuss the molecular and epigenetic mechanisms underlying breast cancer progression and resistance as well as various aspects of epigenetic-based therapies as monotherapy and combined with immunotherapy.

The robust adaptive leader-follower formation control of uncertain unmanned surface vehicles (USVs) subject to stochastic environmental loads is investigated in this paper. The stochastic additive noises are included in the kinematics which stands for the un-modeled dynamics and uncertainty. The disturbances induced by waves, wind and ocean currents in the kinetics are also separated into deterministic and stochastic components. A comprehensive model including kinematics and kinetics of each USV agent is then derived as stochastic differential equations including standard Wiener processes. Thus, the problem formulation is much more challenging and practical since both the exogenous disturbances and kinematics states are defined by stochastic differential equations. In order to guarantee that all the tracking errors converge to a ball centered at the origin in probability, quartic Lyapunov functions synthesis, dynamic surface control (DSC) technique, the projection algorithm, and neural networks (NNs) are employed. Finally, the simulation experiments quantify the effectiveness of proposed approach.

Hydatid disease, also known as cystic echinococcosis, is a parasitic infection caused by the larval stage of Echinococcus granulosus. It usually invades organs such as the liver and the lungs but can affect any organ. Isolated cardiac involvement is a rare manifestation. We present a case of isolated left ventricle hydatid cyst with negative serological tests, which was treated with surgical removal and confirmed by histopathological examination.

Abstract Designing and producing an effective vaccine is the best possible way to reduce the burden and spread of a disease. During the coronavirus disease 2019 (COVID-19) pandemic, many large pharmaceutical and biotechnology companies invested a great deal of time and money in trying to control and combat the disease. In this regard, due to the urgent need, many vaccines are now available earlier than scheduled. Based on their manufacturing technology, the vaccines available for COVID-19 (severe acute respiratory syndrome coronavirus 2 (SAR-CoV2)) infection can be classified into four platforms: RNA vaccines, adenovirus vector vaccines, subunit (protein-based) vaccines, and inactivated virus vaccines. Moreover, various drugs have been deemed to negatively affect the progression of the infection via various actions. However, adaptive variants of the SARS-CoV-2 genome can alter the pathogenic potential of the virus and increase the difficulty of both drug and vaccine development. In this review, along with drugs used in COVID-19 treatment, currently authorized COVID-19 vaccines as well as variants of the virus are described and evaluated, considering all platforms. Graphical abstract

Abstract Background Nowadays, conventional medical treatments such as surgery, radiotherapy, and chemotherapy cannot cure all types of cancer. A promising approach to treat solid tumors is the use of tumor-targeting peptides to deliver drugs or active agents selectively. Result Introducing beneficial therapeutic approaches, such as therapeutic peptides and their varied methods of action against tumor cells, can aid researchers in the discovery of novel peptides for cancer treatment. The biomedical applications of therapeutic peptides are highly interesting. These peptides, owing to their high selectivity, specificity, small dimensions, high biocompatibility, and easy modification, provide good opportunities for targeted drug delivery. In recent years, peptides have shown considerable promise as therapeutics or targeting ligands in cancer research and nanotechnology. Conclusion This study reviews a variety of therapeutic peptides and targeting ligands in cancer therapy. Initially, three types of tumor-homing and cell-penetrating peptides (CPPs) are described, and then their applications in breast, glioma, colorectal, and melanoma cancer research are discussed.

The proliferation of communication systems used in and around man-made structures has resulted in a growing need to determine the reflection and transmission properties of various commonly used building materials at radio frequencies typically used in businesses and residential environments. This paper describes the calculation of reflection and transmission coefficients for reinforced concrete walls as a function of wall thicknesses and rebar lattice configuration over a frequency range of 100-6000 MHz. The transmission and reflection coefficients were calculated using a finite-difference time-domain (FDTD) solution of Maxwell's equations. The rebar structures analyzed include both a two-dimensional (2-D) trellis-like structure and a one-dimensional (1-D) structure, where the reenforcing bars are all oriented in the same direction. In general, the results show that the reinforced concrete structures severely attenuate signals with wavelengths that are much larger than the rebar lattice and that the transmitted signal has a complex structure with resonances and nulls that strongly depend upon the geometry of the reinforcing structure and the concrete wall thickness. Index Terms--Finite-difference time-domain (FDTD), propagation model, reflection and transmission coefficient, reinforced concrete.

The Islamic revolution of Iran as a social revolution was a unique event. During this event, the Pahlavi dynasty collapsed after 53 years of ruling Iran. This study was conducted to investigate the reasons for the decline and collapse of this dynasty through different aspects. According to the limitations, the researchers examined this issue from the viewpoint of the concept of patronage. Thus, the question in this study was that what effect the corruption had on the collapse and decline of the Pahlavi government. In this study, the researchers mentioned that patronage is one of the most important factors that led to popular protests against the government and led the Pahlavi regime to collapse. This paper uses the causal mechanism method (process tracking). The data was collected by the library research method. The focus of this research was on time and space constraints of Iran in the 1340s and 1350s.

Introduction. The sella turcica is one of the important landmarks of lateral cephalometry, which is used in orthodontics for the diagnosis, treatment plan, and evaluation of skeletal development and maturity. The purpose of the present study is to investigate the relationship between the dimensions and morphology of sella turcica with the long-face growth pattern and people with an open bite. This study also examines the relationship between sella turcica bridging (STB) and the vertical growth pattern. Methods. As many as 153 radiographs were analyzed using the Romexis software, considering the basal, gonial, and FMA angles to determine the vertical growth pattern of the face. The basal angle was also used to check for an open bite. Of these patients, 80 had a long vertical face growth pattern, and 73 had a normal face growth pattern. The four landmarks of tuberculum sellae, dorsum sellae, sellae floor, and posterior clinoid were determined on the cephalograms to measure the length, depth, and anteroposterior diameter of the sella turcica. Results. In this study, it was found that the chance of developing a long face in people with partial and complete bridging is 8.37 and 1.92, respectively. An increase in the length of the sella turcica for one unit decreases the chance of a long face, and as the depth of the sella turcica increases, the chance of a long face increases. Conclusions. STB is frequently seen in people with long faces. However, this finding should be considered in relation to other diagnostic parameters. The shorter the length and higher the depth of sella turcica, the higher the chance of developing a long face.

Abstract Auto-immune diseases involved at least 25% of the population in wealthy countries. Several factors including genetic, epigenetic, and environmental elements are implicated in development of Rheumatoid Arthritis as an autoimmune disease. Autoantibodies cause synovial inflammation and arthritis, if left untreated or being under continual external stimulation, could result in chronic inflammation, joint injury, and disability. T- and B-cells, signaling molecules, proinflammatory mediators, and synovium-specific targets are among the new therapeutic targets. Exosomes could be employed as therapeutic vectors in the treatment of autoimmune diseases. Herein, the role of cell organelle particularly exosomes in Rheumatoid Arthritis had discussed and some therapeutic applications of exosome highlighted.

Abstract The trace elements copper (Cu) and zinc (Zn) are essential for maintaining oxidative balance, and cardiac surgery is known to provoke an increase in oxidative stress. We investigated the variations in serum Zn and Cu concentrations before and after surgery in patients undergoing on‐ and off‐pump CABG and heart valve replacement. We performed a prospective study on patients undergoing on‐ or off‐pump CABG, or heart valve replacement surgery (48, 51, and 47 patients, respectively). Venous blood samples were obtained, and serum Cu and Zn concentrations were measured preoperatively, 24 h postoperatively, and the time of discharge. In addition, echocardiography was carried out on all patients before surgery and again on the day of discharge. We found the temporal changes in Cu, Zn, and Zn/Cu ratio were significantly different in all three groups of surgery (p 0.05). In conclusion, the concentrations of Cu and Zn were markedly reduced after on‐ and off‐pump CABG and valve replacement surgery. This may suggest that supplementary Zn and Cu administration could be beneficial during open‐heart surgeries. However, more long‐term studies with more patients are needed to confirm this hypothesis.