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Summary: Introduction: Weight regain and insufficient weight loss are major challenges after metabolic bariatric surgery (MBS), affecting patients' comorbidities and quality of life. The current systematic review and meta‐analysis aim to assess the efficacy and safety of GLP‐1 receptor agonists (GLP‐1 RA) in patients with weight regain or insufficient weight loss after MBS. Methods: A systematic search was conducted across PubMed, Embase, Scopus, and Web of Science databases to find the relevant studies. Results: A total of 19 articles were included. The highest doses of liraglutide and semaglutide were 3 mg per day and 1 mg once weekly, respectively, in the included studies. The mean differences in weight and body mass index after treatment were −7.02 kg or 3.07 kg/m2, −8.65 or −5.22 kg/m2, and −6.99 kg or −3.09 kg/m2 for treatment durations of ≤ 6 months, 6–12 months, and >12 months with liraglutide, respectively. Additionally, weekly semaglutide showed significantly greater weight loss compared to daily liraglutide, with a mean difference of 4.15 kg. Common complications included nausea (19.1%), constipation (8.6%), abdominal pain (3.7%), and vomiting (2.4%). Conclusion: Using GLP‐1 RA is a safe and effective treatment for weight regain and insufficient weight loss after MBS. [ABSTRACT FROM AUTHOR]

Introduction: Chest wall tumors, though rare, represent a significant subset of thoracic neoplasms, accounting for approximately 5% of thoracic and 2% of overall body neoplasms. Their management has historically posed challenges for surgeons, often leading to misdiagnosis, incomplete resection, and high complication rates. An individualized surgical approach, tailored to the specific characteristics of the disease, is crucial for optimizing outcomes. Aim: To evaluate the outcomes of chest wall masses and report on individual cases. Material and methods: This retrospective cohort study included 131 patients diagnosed with chest wall masses at Ghaem University Hospital between 2011 and 2021. Data on demographics (age, gender), pre- and post-operative pathology, specific surgical procedures performed, duration of hospitalization, need for post-surgical reconstruction (e.g., flap reconstruction), and history of pre-operative chemotherapy/radiotherapy were collected from medical records. Data were analyzed using descriptive statistics and appropriate inferential tests depending on the variable type. Potential limitations such as missing data or selection bias were acknowledged. Results: A total of 131 patient records were examined, with an average age of 17.35 ±38.51 years. Of these, 50 (38.2%) were female and 81 (61.8%) were male. It was found that 54.2% of patients had benign tumors, while 45.8% had malignant tumors. Sarcoma (26%) and fibromatosis (21.4%) were the most common tumor types. No significant associations were observed between gender or history of chemotherapy and radiotherapy and the type of surgery performed (p > 0.05). However, a significant association was found between tumor histology and the type of surgery performed (p < 0.05). Conclusions: The majority of procedures performed were for fibromatous and benign tumors, while the most common malignant tumors were sarcomas, with chondrosarcoma being the predominant subtype. Tumor type significantly influenced the extent of resection and need for chest wall reconstruction. [ABSTRACT FROM AUTHOR]

An attempt is made to settle the controversy on a theory of the concentric distribution of dialectal variants for snails. This theory was presented in 1927 by Kunio Yanagita (1875-1962), outstanding Japanese folklorist. Over more than 95 years, however, its verification remains pending. On the basis of the recent achievement in the linguistic atlas project, time series analysis is made for fitting to the long-tailed rank-frequency relations of cumulative syllabics that are included in the entire dialect sequence of snails. The time reversal asymmetry (TRA) is revealed through comparison between the forward and backward analysis. The validity of the methodology is confirmed through comparison with results for several examples. Computed results show substantial TRAs between the periphery-to-center and center-to-periphery analysis for fitting to the long-tailed distribution in the cumulative frequency versus rank. This feature for the categorial data sequence is consistent with those observed for typical numerical data such as music and heartbeat signals that obey nonGaussian statistics. Application to the most parsimonious principle yields results being compatible with the above ones, which reproduces the validity of our conclusion. Finally, perturbation analysis is made for several artificially disturbed arrangements of the dialectal strata. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Vaginal cuff dehiscence post‐hysterectomy is rare yet significant. Early recognition and prompt surgical intervention are crucial to prevent complications like bowel infarction. Consider second‐look laparotomy in cases of uncertain bowel viability. Vaginal cuff dehiscence (VCD) is a rare but potentially life‐threatening complication following a hysterectomy characterized by the separation of the vaginal vault. This condition, which may result in vaginal evisceration (VE), presents a significant risk of pelvic contents, particularly the small bowel, protruding into the vagina. Early diagnosis and prompt surgical intervention are paramount to prevent severe complications, including bowel infarction, obstruction, and peritonitis. Although VCD and VE are rare, they require urgent surgical management to avoid adverse outcomes. We reported a case of small bowel evisceration in a woman with a history of total abdominal hysterectomy 6 months ago. VCD and VE are very rare but life‐threatening complications of hysterectomy. Discussing the symptoms with patients who have multiple risk factors is crucial to avoid severe sequels following hysterectomy. Based on our experience, performing a second‐look laparotomy is a reliable approach to ensure the viability of the intestinal loop. However, it will likely increase the risk of infection. [ABSTRACT FROM AUTHOR]

Polyoxometalates (POMS) are a class of mineral clusters of transition metals or rare-earth elements linked together by Oxo ligands. POMs have been identified as antibacterial, antiviral, and anticancer agents after decades of research since the onset of the 20th century. Furthermore, in recent years POMs have been studied for their applications in diagnosis, photodynamic therapy, photothermal therapy, and theragnostic. However, these last-mentioned POM applications have rarely been reviewed. Considering the potential characteristic features of POMs, comprising their easy, inexpensive, and scalable synthesis, and with special attention to the challenges of their application, POMs would be great alternatives to many conventional medical tools in the field of cancer treatment and diagnosis. In this review, we report recent updated research around utilizing POMs in cancer diagnosis and theragnostic. Publications are on basic topics including POMs in magnetic resonance imaging (MRI), POMs in computed tomography (CT), POMs in cancer photoluminescence (PL) imaging, POMs in multimodality, POMs in radiation therapy applications, POMs as radiosensitizer and promotor of drug release, and POMs in theragnostic applications. It is hoped that this review paper will be useful for those researchers who are interested in expanding the applications of polyoxometalates in the field of cancer treatment and diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Given the limited use of the 6-minute walking distance (6MWD) test as a replacement for standard tests in thoracic surgery, insufficient research exists on the prognostic value of this test, and further studies are necessary. This study aimed to investigate the correlation between pulmonary function tests (PFT) and the 6MWD test in lung resection patients. Methods: This cross-sectional study, conducted in 2021-2022, involved lung resection candidates referred to the thoracic surgery clinic. Demographic data, including age, sex, and body mass index (BMI), were collected, and pulmonary function tests and 6MWD tests were conducted for all patients. The sample size of the study was 31, and all patients received routine treatment during hospitalization. Results: Of the 31 subjects included in the study, 16 were male (51.6%) and 15 (48.4%) were female. The mean age of the patients was 33.45 ± 13.78 years. The median forced expiratory volume in one second (FEV1) and the mean ratio of FEV1/forced vital capacity (FVC) were 2.16 (1.49-2.85) liters and 81.80 ± 7.34%, respectively. No significant correlation was found between the results of 6MWD and PFT, including FVC, FEV1, and FEV1/FVC ratio (P> 0.05). Conclusion: The 6MWD test is a more economical and easily accessible test than PFT. However, this study found no correlation between the 6MWD test and spirometry parameters. Therefore, we suggest that surgeons should not rely on the 6MWD test as a predictive value for assessing respiratory function in lung resection candidates. The study's findings have important implications for clinical practice. [ABSTRACT FROM AUTHOR]

Objective: This study was performed with the aim to evaluate the results of the treatment of vaginal fistulas caused by pelvic malignancy and to present a new surgical technique. In this retrospective study, patients with vaginal fistula who have been treated in Ghaem and Omid Hospitals of Mashhad University of Medical Sciences from 2004 to 2020 were studied. The inclusion criteria were the patients whose fistulas were caused by malignant neoplasia with pelvic organ origin. The patients with fistulas caused by other causes were excluded from the study. Patients' information was collected from the electronic records and the hospital archives and also the information recorded by the surgeon. Results: Out of 26 patients with vaginal fistula caused by pelvic malignancies, 18 cases had enterovaginal fistula. Cancer of cervix (11 cases) was the most prevalent cancer. Time interval between the incidence of fistula and the onset of the disease was 43.5 months. About 16 patients had a history of radiotherapy before the onset of the fistula, and 23 cases had undergone surgery before the onset of fistula. About 11 patients were treated with resection, 8 patients with ostomy, and 5 with fistulized loop bypass. Discussion and conclusion: In cases of extensive pelvic involvement with a tumor, it is recommended to use intestinal bypass in fistula site with the technique provided in this article, since it controls the symptoms of the patient and has limited complications. [ABSTRACT FROM AUTHOR]

Background & Objective: Vaginal birth after Cesarean (VBAC) is often offered as an option after a single cesarean section (CS). To evaluate the success rate of vaginal birth after two cesarean sections (VBAC-2). Materials & Methods: We searched MEDLINE, EMBASE, PubMed, Scopus, using search terms (cesarean OR cesarean OR caesarean OR caesarian) AND ("Vaginal birth after cesar Keywords: Vaginal birth after Cesarean, Cesarean section, Maternal, Fetal outcomesean" OR VBAC) AND (two OR Twice OR second OR multiple). Two independent reviewers performed the study selection, and abstracted and tabulated data and pooled estimates were obtained. Meta-analyses were performed using Open-meta and Comprehensive Meta-Analysis. Results: Mean success rate of VBAC-2 was 72% (2174 out of 3020 cases) with a range of 24-90%. The mean hysterectomy rate was 0.43% ranging from 0% to 1.7%. Our meta-analysis showed no significant difference between VBAC-2 and CS-3 in the case of hysterectomy, with a pooled odds ratio (OR) of 0.699, but with a wide confidence interval (95% CI was 0.347-1.407). VBAC-2 being associated with 2-fold increased risk of perinatal mortality compared to CS-3. Conclusion: Vaginal delivery is a suitable option for women with two previous cesarean sections; the outcomes are significantly more favorable for women with a history of vaginal birth. [ABSTRACT FROM AUTHOR]

One of the chief pathways to regulate p53 levels is MDM2 protein, which negatively controls p53 by direct inhibition. Many cancers overproduce MDM2 protein to interrupt p53 functions. Therefore, impeding MDM2's binding to p53 can reactivate p53 in tumor cells may suggest an effective approach for tumor therapy. Here, some Monastrol derivatives were designed in silico as MDM2 inhibitors, and their initial cytotoxicity was evaluated in vitro on MFC‐7 and MDA‐MB‐231 cells. A small library of Monastrol derivatives was created, and virtual screening (VS) was performed on them. The first‐ranked compound, which was extracted from VS, and the other six compounds 5a‐5f were selected to carry out the single‐docking and docking with explicit waters. The compound with the best average results was then subjected to molecular dynamic (MD) simulation. Compounds 5a‐5f were chemically synthesized and evaluated in vitro for their initial cytotoxicity on MFC‐7 and MDA‐MB‐231 cells by MTT assay. The best compound was compound 5d with ΔGave = −10.35 kcal/mol. MD simulation revealed a median potency in comparison with Nutlin‐3a. The MTT assay confirmed the docking and MD experiments. 5d has an IC50 of 60.09 μM on MCF‐7 cells. We attempted to use Monastrol scaffold as a potent inhibitor of MDM2 rather than an Eg5 inhibitor using in silico modification. The results obtained from the in silico and in vitro evaluations were noteworthy and warranted much more effort in the future. [ABSTRACT FROM AUTHOR]

The effectiveness of immunotherapy for most cancer patients remains low, with approximately 10–30% of those treated surviving. Thus, much effort is being put into finding new ways to improve immune checkpoint therapy. Our review concludes that inhibition of proprotein convertase subtilisin/Kexin type 9 (PCSK9), which plays a critical role in regulating cholesterol metabolism, can cause movement of T cells toward tumors, with increased sensitivity to immune checkpoint therapies. We searched PubMed, NCBI, Scopus, and Google Scholar for the published articles without limitations on publication dates. We used the following terms: “PCSK9”, “Cancer”, “Immune Checkpoint”, and “Cancer Prognosis” in the title and/or abstract. Our search initially revealed 600 records on the subject and stored them in the used databases under EndNote X8 management software. A total of 161 articles were selected and through a careful review, 76 were included in our research. We concluded that PCSK9 reduces the number of LDL receptors (LDL-R) on the cell surface, which is linked to its ability to regulate cholesterol levels in the body. Also, we discuss how suppressing PCSK9 leads to the MHC-1 accumulation on the surface of cancer cells, which results in T lymphocyte invasion. Finally, we believe that inhibiting PCSK9 may be an effective strategy for improving cancer immunotherapy. [ABSTRACT FROM AUTHOR]