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Background: The organ shortage is the main concern for kidney transplantation. Using deceased pediatric donors either as single or in an en-bloc manner is one way to solve this problem. We reviewed 21 en-bloc pediatric deceased kidney transplantations to adult recipients. Methods: From May 2010 to May 2016, 472 deceased kidney transplantations have been performed in our hospitals. Twenty-one of these were pediatric kidney transplantations to adult recipients (age < 5 years, kidney size < 8 cm, donor weight <15 kg). Follow-up (ranging from 3 to 36 months) included clinical findings and complications plus serial creatinine levels and kidney size with ultrasonography and dimercaptosuccinic acid renal scan. Results: Among 21 patients, 52.4% were female. The mean age of participants was 28.85 ± 10.29 years. The preoperative mean size of the grafts was 6.94 ± 0.58 centimeters reaching 8.52 ± 0.98 and 10.20 ± 1.2 after 3 and 12 months of postoperative follow-up, respectively (P-value < 0.001). Means of serum creatinine was 1.61 ± 0.39, 1.45 ± 0.39, 1.32 ± 0.37, and 1.17 ± 0.28 mg/dl at postoperative 1, 3, and 6 and 12 months, respectively (P-value < 0.001). In a 12-month follow-up (range, 3 to 36 months), the complication-free rate was 61.9%, one-year patient survival was 90.5%, and one-year graft survival was 100%. Conclusion: En-bloc pediatric deceased kidney transplantation is an acceptable alternative for adult recipients, with a great midterm patient and graft survival. Longer follow-up is recommended to assess their long-term outcomes. [ABSTRACT FROM AUTHOR]

An advanced and newly developed severe plastic deformation (SPD) method called accumulative fold-forging (AFF) was applied to produce layered nanostructured MgNi alloys exhibiting superior hydrogen storage capacity. Microstructural developments and storage properties were characterized in depth to correlate the structure and performance of this advanced material. The enhanced hydrogen storage performance of the magnesium-based layered composite material was investigated in comparison to the pristine state by conducting hydrogenation and dehydrogenation testing. It was also shown that the hydrogen uptake and release characteristics can be controlled by adjusting the layered structure or the Mg: Ni stoichiometry ratio. Refining the grain structure of the magnesium alloy down to the nano-scale range (∼400–900 nm) by applying high cycles AFF consolidation to promote creation of multi-million nanometric interfaces led to superior storage performance with a remarkable hydrogen absorption capacity of up to ∼1.425 wt %. X -ray diffraction (XRD) analysis of the hydrogenated products revealed the formation of MgH 2 that indicates the dominance of the magnesium matrix for controlling the hydrogen storage behavior of the layered Mg/Ni composite material. Finally, the relationship between the directional hydrogen storage behavior and the induced structural features upon AFF treatment were also established using quantitative characterization and analytical tools. [Display omitted] • AFF process was implemented for producing the layered Mg/Ni composites with UFG structure. • The hydrogen storage performance of these materials elaborated compared to the primary state of alloys. • Layered composite materials displayed superior storage behavior in the temperature range of 673–873 K. • An exceptional maximum storage capacity of up to ∼1.425 wt % was measured. • Formation of MgH 2 compound during hydrogenation determined as the leading absorption mechanism. [ABSTRACT FROM AUTHOR]

Background: The fabrication of anti-Toxoplasma drugs with less side effects and desirable efficacy is one of the important research goals facing with toxoplasmosis. This study aimed to determine the anti-Toxoplasma effects of Cinnamon zeylanicum (CZ), Moringa oleifera (MO) oil encapsulated into solid lipid nanoparticles (SLNs)., Methods: Vero cells were cultured with serial concentrations (1 mg/mL to 100 µg/mL) of CZ-SLNs and MO-SLNs in DMEM culture medium. The morphological, physical, and chemical features of nanoparticles were calculated. The cell viability assays and anti-T. gondii effects of CZ-SLNs and MO-SLNs were evaluated. The CC 50 and IC 50 indices of SLNs-enveloped extracts were calculated., Results: The particle sizes of MO-SLNs and CZ-SLNs were 411.5 and 365 nm, while PDI indices were 0.53 and 0.7, respectively. Transmission electron microscopy (TEM) showed that both MO-SLNs and CZ-SLNs were smoothed spherical nanoparticles with rounded edges. The cytotoxicity assay showed the CC 50 value of MO-SLNs at concentrations of ˃10 mg/mL. In addition, 60% of T. gondii-infected Vero cells remained alive at the concentrations ≤ 1 mg/ml, while the MO-SLNs killed at least 90% of T. gondii tachyzoites with an IC 50  > 1 µg/ml. The cytotoxicity of CZ-SLNs extract showed the CC 50 at the concentration 0.1 mg/mL. More than 50% of Vero cells, infected with T. gondii tachyzoites, survived at a concentration less than 0.1 mg/mL (IC 50 ˂ 0.1 mg/mL), while the CZ-SLNs killed at least 85% of T. gondii tachyzoites in all concentrations., Conclusion: The current results represented that the use of SLNs as a nano-carrier for M. oleifera and C. zeylanicum could kill T. gondii tachyzoites with low cytotoxicity, suggesting the effectiveness of these nano-emulsions along with the chemical agents in the treatment of Toxoplasma., (© 2024. The Author(s).)

Background and Purpose: Renal injury is a serious disorder that can be caused by some diseases or agents. Rosmarinic acid (RA) is a natural and safe compound with powerful antioxidant and anti-inflammatory properties. In this study, the ameliorative effects of RA were assayed in folic acid (FA)-induced renal injury by involving the SIRT1/NOX1 pathway., Experimental Approach: Thirty-six male C57/BL6 mice were divided into 6 groups (n = 6) including control, vehicle, FA, RA, FA + RA 50, and FA + RA 100. After 10 days, blood urea nitrogen (BUN), creatinine, and oxidative stress were measured. The expression of SIRT1 and NOX1 proteins was evaluated by western blot. Also, histopathological alterations were assayed by H&E and PAS staining methods., Findings/results: BUN and creatinine were significantly higher in the FA group compared to the control group; however, their levels decreased after RA treatment in both doses. A significant decrease was observed in swelling, necrosis, and desquamation of tubular epithelial cells in the FA + RA 50 and FA + RA 100 groups compared to the FA group. RA in the animals receiving FA increased SIRT1 expression and the levels of GSH and SOD compared to the FA group. RA in the animals receiving FA showed a significant decrease in NOX1 expression and MDA level compared to the FA group., Conclusion and Implications: The findings declared that the administration of RA has positive effects against renal damage induced by FA. The effect might result from involvement in the SIRT1/NOX1 pathway and thereby attenuation of oxidative stress., Competing Interests: The authors declared no conflicts of interest in this study., (Copyright: © 2024 Research in Pharmaceutical Sciences.)

Purpose: Granulosa cell tumors (GCTs) of the ovary are rare but clinically significant malignancies. Despite advances in treatment, recurrence has remained a substantial challenge. This study aimed to identify clinical outcomes and potential prognostic risk factors for recurrence in patients diagnosed with GCTs., Methods: In a retrospective cohort study, the ovarian cancer database of the gynecological tertiary referral cancer center, Mashhad University of Medical Sciences, Mashhad, Iran, was searched from August 2012 to August 2023 to find GCT cases. Demographic, clinical, pathological, intervention-related factors, follow-up, and survival findings were meticulously collected. Data were analyzed using SPSS v 23., Results: Ninety-two patients with GCTs, including 86 AGCT and 6 JGCT subjects, were identified. Based on further analysis of AGCT patients, most patients were ages under 50 (58.1%), clinically presented pain (32.6%), and abnormal uterine bleeding (27.9%) as the most frequent symptoms. Stages IA (64.0%) and IC (20.9%) were common. Five-year overall and progression-free survival were 98.2% and 90.8%, respectively. With a median follow-up time of 72 (0.0-180) months, disease recurrence was observed in 19 patients (23.9%), and five patients (5.4%) died of the disease. Stage IV was a hazard factor of recurrence (HR = 7.62, 95%CI (1.89-30.63); p = 0.004)., Conclusions: The present study provides valuable insights into the outcomes and potential risk factors for recurrence in ovarian AGCTs. It duplicates the importance of stage in the prognosis of AGCT patients and highlights the safety of fertility-sparing surgery in stage I and the lack of need to administer chemotherapy in stage IC., (© 2024 The Author(s). Cancer Reports published by Wiley Periodicals LLC.)

Introduction and Objective: Previous studies showed that extra blood supply can decrease testicular atrophy following laparoscopic orchiopexy. We evaluated the impact of preserving the gubernacular attachment (which contains blood supply from cremasteric artery and its anastomoses) on atrophy rates following open conventional orchiopexy., Study Design: This double-blinded randomized trial was implemented from March 2022 to September 2023. Included boys with non-palpable testis, even with examination under anesthesia, underwent diagnostic laparoscopy to evaluate the testis's location and size. Nubbin testes and those with > 2-cm distance from the internal inguinal ring. Participants were assigned into two groups (gubernaculum sparing (GS) and excision (GE)) by permuted block randomization. Overall success was defined as achieving both morphologic success (atrophy <20% of the intraoperative size) and anatomical success (scrotal or high-scrotal locations). Boys were followed at three- and six-month post-surgery via ultrasound. Independent t-test, repeated ANOVA, and Friedman's tests were used where appropriate., Results: Of 92 boys (105 UDTs overall), 75 testes (36 in GS, 39 in GE groups) were used in the analysis. The mean age of participants was 25 ± 17 months (range 6-84). The mean testis size of cases intraoperatively was 460 ± 226, 396 ± 166, and 520 ± 258 mm 3 among all participants, GS, and GE cases, respectively. Both groups showed a significant decrease in testicular volume on both follow-up checkpoints, but this decrement was significantly higher in the GE group (p < 0.001). The anatomical success rate was significantly higher among GS boys (97.2% versus 82.1%; p = 0.038). The overall success rate was significantly higher for the GS group (61.1% versus 25.6%; p = 0.002)., Conclusion: Although mean testicular volume decreased in both groups, we found superior morphologic and overall success rates among the GS group. The greatest size reduction was noted at the three-month post-surgery compared to the six-month checkpoint., Trial Registration: https://irct.ir/trial/58842., Competing Interests: Conflict of interests None to declare., (Copyright © 2024 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Purpose: To compare the efficacy of a novel fusion template "reduced six-core systemic template and multiparametric magnetic resonance imaging/transrectal ultrasound (mpMRI/TRUS) fusion targeted biopsy" (TBx+6c), with mpMRI/TRUS fusion-targeted biopsy and 12-core systematic biopsy template (TBx+12c) in the diagnosis of prostate cancer (PCa)., Materials and Methods: This is an institutional review board approved single-center observational study involving adult men undergoing fusion-targeted biopsies for the diagnosis of PCa. Patients were sorted into cohorts of TBx+6c or TBx+12c based on the systematic biopsy template used. The study's main objective was to determine the cancer detection rate (CDR) for overall PCa and clinically significant PCa (csPCa) and the secondary objectives were to compare complication rates and functional outcome differences between the cohort., Results: A total of 204 patients met study's inclusion criteria. TBx+6c group had 120 patients, while TBx+12c cohort had 84 patients. The groups had similar baseline characteristics and overall CDR in the TBx+6c cohort was 71.7% versus 79.8%, compared to the TBx+12c (p = 0.18) whereas, the csPCa detection rate in the TBx+6c group was 50.8% versus 54.8% in the TBx+12c group (p = 0.5). TBx+6c cohort had lower overall complication rate of 3% versus 13%, (p = 0.01) and ≥ grade 2 complication rates (1 (1%) vs. 3(4%), p = 0.03) compared to the TBx+12c cohort. There were no differences in IIEF-5 (p = 0.5) or IPSS (p = 0.1) scores at baseline and 2-weeks and 6-weeks post-biopsy., Conclusion: TBx+6c cohort, when compared to the TBx+12c cohort, demonstrated comparable diagnostic performance along with similar functional outcomes and lower complication rates. These results suggest the importance of further exploring the clinical implications of adopting a TBx+6c schema for PCa diagnosis in comparison to the widely used TBx+12c schema through a multicenter randomized controlled trial., (© 2024 Wiley Periodicals LLC.)

Periodontitis is a severe oral health condition that affects the soft tissue and bone supporting the teeth. The Mediterranean diet has been proposed as a potential contributor to reducing the risk of periodontitis. This systematic review and meta-analysis aims to explore the association between adherence to the Mediterranean diet and periodontitis. A comprehensive literature search from 1992 to January 2024 was conducted across multiple databases, including PubMed, Scopus, Web of Science, and Google Scholar. The included studies were clinical trials, randomized controlled trials, and observational studies that evaluated the impact of the Mediterranean diet on periodontitis. Data extraction and quality assessment of the included studies were performed using standardized protocols. A meta-analysis was conducted to combine effect sizes from multiple studies. This review included seven studies, comprising one cohort study, five cross-sectional studies, and one randomized controlled trial. While some studies reported a potential link between Mediterranean diet adherence and periodontitis, the overall analysis did not demonstrate a significant association. The meta-analysis revealed an Odds Ratio (95 % Confidence Interval) of 0.77 (0.58, 1.03) for the association between adherence to the Mediterranean diet and periodontitis (p  =  0.08) . This systematic review and meta-analysis found no statistically significant association between periodontitis and Mediterranean diet adherence. Future research should prioritize the implementation of rigorous clinical studies with longer follow-up periods to better understand the causal association between the Mediterranean diet and periodontitis. Observational studies with larger sample sizes are needed to establish more conclusive evidence regarding the impact of dietary patterns on periodontal health., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Dental pulp stem cells (DPSCs) originate from the neural crest and the present mesenchymal phenotype showed self-renewal capabilities and can differentiate into at least three lineages. DPSCs are easily isolated with minimal harm, no notable ethical constraints, and without general anesthesia to the donor individuals. Furthermore, cryopreservation of DPSCs provides this opportunity for autologous transplantation in future studies without fundamental changes in stemness, viability, proliferation, and differentiating features. Current approaches for pulp tissue regeneration include pulp revascularization, cell-homing-based regenerative endodontic treatment (RET), cell-transplantation-based regenerative endodontic treatment, and allogeneic transplantation. In recent years, a novel technology, organoid, provides a mimic physiological condition and tissue construct that can be applied for tissue engineering, genetic manipulation, disease modeling, single-cell high throughput analysis, living biobank, cryopreserving and maintaining cells, and therapeutic approaches based on personalized medicine. The organoids can be a reliable preclinical prediction model for evaluating cell behavior, monitoring drug response or resistance, and comparing healthy and pathological conditions for therapeutic and prognostic approaches. In the current review, we focused on the promising application of 3D organoid technology based on DPSCs in oral and maxillofacial tissue regeneration. We discussed encountering challenges and limitations, and found promising solutions to overcome obstacles., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Prostate cancer (PCa) diagnosis relies on biopsies, with transrectal ultrasound (TRUS) biopsies being common. Fusion biopsy (FB) offers improved diagnostic accuracy, but the pain and anxiety experienced by patients during biopsies is often overlooked. This study aims to compare pain and anxiety levels between standard TRUS-guided biopsy (STB) and systematic plus MRI/US fusion biopsy (STB + FB)., Materials and Methods: The study involved adult men undergoing biopsies, receiving identical peri-procedural care, including 2% lidocaine jelly in the rectum and subsequent 1% lidocaine injections (10cc per side) into the prostate-seminal vesicle junction and prostatic apical areas bilaterally. The biopsy technique was chosen based on clinical and imaging findings. Pre- and post-biopsy anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI) questionnaire, categorized as mild (20-37), moderate (38-44), or severe (45-80). Post-biopsy pain was evaluated on a numerical rating scale, ranging from 0 to 10., Results: Of the 165 patients, 99 underwent STB, and 66 underwent STB + FB. No significant differences were observed in age, race, prostate-specific antigen, prostate volume, or prior biopsies between the groups. The STB + FB group had more biopsy cores taken (16.2 vs. 12, p = 0.001) and a longer procedure time (23 vs. 10 min, p = 0.001). STB biopsy patients experienced lower post-procedural anxiety compared to STB + FB, with a mean difference of -7 (p = 0.001, d = 0.92). In the STB + FB group, 89% experienced severe post-procedural anxiety compared to 59% in STB (p = 0.002). There was no significant difference in post-procedural pain (p = 0.7). Patients with prior biopsies had significantly higher STAI(S) anxiety scores (p = 0.005), and the number of prior biopsies correlated with anxiety severity (p = 0.04) in STB + FB group., Conclusion: In summary, STB + FB group demonstrated higher post-procedural anxiety levels than the STB group, with no difference in pain levels. Additionally, patients with a history of repeat biopsies were more likely to exhibit higher STAI(S) anxiety scores., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Certain widely used pathological outcome prediction models that were developed in tertiary centers tend to overpredict outcomes in the community setting; thus, the Michigan Urological-Surgery Improvement Collaborative (MUSIC) model was developed in general urology practice to address this issue. Additionally, the development of these models involved a relatively small proportion of Black men, potentially compromising the accuracy of predictions in this patient group. We tested the validity of the MUSIC and three widely used nomograms to compare their overall and race-stratified predictive performance., Methods: We extracted data from 4139 (1138 Black) men from the Shared Equal Access Regional Cancer Hospital (SEARCH) database of the Veterans Affairs health system. The predictive performance of the MUSIC model was compared to the Memorial-Sloan Kettering (MSK), Briganti-2012, and Partin-2017 models for predicting lymph-node invasion (LNI), extra-prostatic extension (EPE), and seminal vesicle invasion (SVI)., Results: The median PSA of Black men was higher than White men (7.8 vs. 6.8 ng/ml), although they were younger by a median of three years and presented at a lower-stage disease. MUSIC model showed comparable discriminatory capacity (AUC:77.0%) compared to MSK (79.2%), Partin-2017 (74.6%), and Briganti-2012 (76.3%), with better calibration for LNI. AUCs for EPE and SVI were 72.7% and 76.9%, respectively, all comparable to the MSK and Partin models. LNI AUCs for Black and White men were 69.6% and 79.6%, respectively, while EPE and SVI AUCs were comparable between races. EPE and LNI had worse calibration in Black men. Decision curve analysis showed MUSIC superiority over the MSK model in predicting LNI, especially among Black men., Conclusion: Although the discriminatory performance of all models was comparable for each outcome, the MUSIC model exhibited superior net benefit to the MSK model in predicting LNI outcomes among Black men in the SEARCH population., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Parasites cause illnesses with broad spectrum of symptoms from mild to severe, and are responsible for a significant number of outbreaks in the world. Current anti-parasitic drugs are toxic and have significant side effects. Nano-carriers are believed to obviate the limitations of conventional drugs via decreasing side effects and increasing target delivery and drug permeability with a controlled prolonged release of a drug. Solid lipid nanoparticles (SLNs) are lipid nanoparticles (LNPs), which have frequently been practiced. Suitable release rate, stability, and target delivery make SLNs a good alternative for colloidal carriers. SLNs are supposed to have great potential to deliver natural products with anti-parasitic properties. Nanoparticles have employed to improve stability and capacity loading of SLNs, during recent years. This review describes development of SLNs, the methods of preparation, characterization, and loaded drugs into SLNs in parasitic diseases. In addition, we summarize recent development in anti-parasitic SLNs-loaded drugs., (© 2024. The Author(s).)

Recurrent prostate cancer after primary treatment with radiation therapy is a common problem. Patients with localized recurrence may benefit from salvage therapy, but careful patient selection is crucial because not all patients will benefit from local salvage therapy, and salvage therapy has increased morbidity compared to primary treatments for prostate cancer. This review aims to provide an overview of the evaluation of patients with recurrent disease after radiation therapy and how it is continuing to evolve with increasing data on outcomes, as well as improving technologies and techniques. Our enhanced understanding of treatment outcomes and risk stratification has influenced the identification of patients who may benefit from local salvage treatment. Advances in imaging and biopsy techniques have enhanced the accuracy of locating the recurrence, which affects treatment decisions. Additionally, the growing interest in image-targeted ablative therapies that have less morbidity and complications than whole-gland therapies for suitable patients influences the evaluation process for those considering focal salvage therapy. Although significant changes have been made in the diagnostic evaluation of patients with recurrent disease after radiation therapy, it remains unclear whether these changes will ultimately improve patient outcomes.

Objective: Whether ileal conduit diversion (ICD) or orthotopic neobladder (ONB) urinary diversion provides better quality of life (QoL) is still under debate. The Bladder Cancer Index (BCI) is a specific tool for bladder cancer (BCa) patients, providing reliable results in previous studies. A validated Farsi version of the BCI concerning cultural aspects could help Farsi-speaking clinicians gain more reliable feedback on QoL following urinary diversion., Materials and Methods: Based on WHO suggestions, we translated the BCI questionnaire into the Persian language. Then, we performed a cross-sectional study on BCa patients who underwent ICD or ONB urinary diversion. We compared their QoL via BCI and WHO questionnaires. Chi-square and independent t-tests were used where appropriate., Results: The content validity ratio and the content validity indexes were 1 and 0.8-1.0, respectively. Of 57 participants, six patients (10.5%) were women. The ICD was performed for 38 (66.7%) and ONB diversion for 19 (33.3) participants. The mean age of ICD and ONB was 68.71 ± 7.40 and 64.28 ± 8.34 years, respectively (p-value: 0.055). In all sub-domains of BCI, except bowel habits, the mean scores were higher in the ICD group. A significant difference between ICD and ONB groups was found regarding urinary function (p-value<0.001). There was no significant difference between ICD and ONB groups in none of the domains of the WHO questionnaire., Conclusion: The QoL of ICD and ONB patients did not differ significantly. Even ICD may be superior in ritual purification, while the psychological status of ONB patients was better., Competing Interests: Conflict of Interests Authors declare no conflict of interests., (Copyright © 2023 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Proprietary bottle rolling systems automate some laboratory applications, however, their high costs limit accessibility. This study provides designs of an open source bottle roller that is compatible with distributed digital manufacturing using 3-D printed parts and readily-available commercial components. The experimental results show that the open source bottle roller can be fabricated for CAD$210 (about USD$150) in materials, which is 86% less expensive than the most affordable proprietary bottle roller on the market. The design, however, is more robust with enhanced capabilities. The design can be adapted to the user's needs, but is already compatible with incubators with a low profile (dimensions 50 cm x46 cm x8.8 cm) and capable of being operated at elevated temperatures. The systems can be adjusted to revolves from 1 to 200 RPM, exceeding the rotational speed of most commercial systems. The open source bottle roller as tested has a capacity greater than 1.2 kg and can roll twelve 100 mL bottles simultaneously. Validation testing showed that it can operate for days at 80 RPM without human intervention or monitoring for days at both room temperature and elevated temperatures (50 °C). Future work includes adapting the designs for different sizes and for different fabrication techniques to further reduce costs and increase flexibility., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Background: Following thyroidectomy, radioiodine therapy is the standard management of differentiated thyroid cancer. The effects of such treatment on testicular function remained a concern for cases and clinicians., Objective: We aimed to observe changes in fertility indicators in men treated with ablation., Materials and Methods: In this prospective cohort study, 18 men with differentiated thyroid cancer from June to December 2020 underwent thyroidectomy plus radioiodine therapy. Participants were grouped based on iodine dose (8 men with 30 mCi vs. 10 men with ≥ 150 mCi). Baseline values (V B ) of the follicular stimulating hormone, luteinizing hormone, testosterone, and sperm analyses were measured 3 wk before iodine ablation and repeated 3 (V 3 ) and 12 (V 12 ) months later. They were analyzed once as a whole and once based on their groups via ANOVA and Friedman's tests where appropriate., Results: The mean age of participants was 35.61 ± 9.74 yr. Follicular stimulating hormone levels showed a significant trend among all participants (V B : 12.51 ± 1.72, V 3 : 13.54 ± 1.41, and V 12 : 13.10 ± 1.67 IU/mL; p < 0.001). Luteinizing hormone showed a similar pattern (V B : 4.98 ± 1.27, V 3 : 5.65 ± 1.29, and V 12 : 5.21 ± 0.95 IU/mL; p < 0.001). Testosterone levels did not differ significantly from baseline. Sperm count decreased at the first checkpoint and returned to normal after 12 months (V B : 38.22 ± 19.40, V 3 : 32.05 ± 17.96, and V 12 : 36.66 ± 18.81 million/mL; p < 0.001). Sperm motility and morphology did not change significantly., Conclusion: Our research showed that even less than 5 GBq irradiation could induce a transient testicular dysfunction in the first 3 months of therapy, but it was mostly reversible after 12 months., Competing Interests: The authors declare that there is no conflict of interest., (Copyright © 2023 Soltani et al.)

Ball milling is used for comminution by rotating a drum to grind materials using balls with specific diameters. Ball milling advantages include the potential for high capacity, predicted fineness in a specific amount of time, reliability, safety, and simplicity, but has disadvantages of high weight, energy consumption and costs, which limit accessibility. To overcome these limitations this study applies the free and open source hardware approach coupled to distributed digital manufacturing to fabricate a ball mill with a simple, customizable design that can be used in a wide range of scientific applications and circumstances including those without access to reliable grid electricity. The highly-customizable design reduces the cost to

Objective. To assess validity of the Farsi-translated version of the Jefferson Scale of Empathy-Health Profession Student version (JSE-HPS) and measure empathy scores of Iranian pharmacy students. Methods. The JSE-HPS questionnaire was administered to 504 Iranian pharmacy students in 2019. Confirmatory factor analysis and exploratory factor analysis were used to explore the underlying components and construct validity. Group comparisons of the empathy scores and the underlying components were conducted using statistical tests. Results. Based on 496 useable survey questionnaires, three domains of empathy among Iranian pharmacy students were confirmed by confirmatory factor analysis: compassionate care, perspective taking, and standing in a patient's shoes. Two items in the JSE-HPS were removed, as their factor loadings were under the permissible limits in exploratory factor analysis. Empathy scores were significantly higher among female pharmacy students. Conclusion. These findings support the validity and reliability of the Farsi version of the JSE-HPS among Iranian pharmacy students., (© 2023 American Association of Colleges of Pharmacy.)

Background: Surgical reconstruction is the gold standard of treatment for Peyronie's disease (PD). Grafting procedures provide satisfactory outcomes in patients with complex curvature, short penile length, and without previous erectile dysfunction (ED). We aimed to compare two different grafting methods of reconstruction in patients with PD., Method: Fifty-two PD patients at Imam-Reza hospital of Mashhad from October 2011 to January 2019 with stable plaque, penile angulation of >60˚, complex curvature, and without ED who consented to cooperate, included in our study and divided into two groups. The first group consists of 26 patients, undergone grafting through a double-Y incision and a single saphenous graft placed within the incision. For the second group, two smaller saphenous vein grafts were placed in the two parallel incisions. ED assessed pre- and post-operational via the International index of erectile function. Penile angulation less than 20 degrees was considered a favorable outcome. Patients followed for 18 months, and sacculation, penile shortening, post-operation infection, and penile hypoesthesia were assessed as complications. We used a paired t-test to compare these two groups., Results: ED was 25% and 12% in the first and the second group, respectively. Statistics showed no difference between the two groups regarding pre and post-operational ED ( P =0.1). Regarding complications during follow-up, sacculation occurred in four patients of the first group and none of the second group patients but no significant difference ( P =0.23)., Conclusion: We found no superiority to declare between these two procedures, although regarding the small sample size of our study, further evaluations are needed to establish more reliable results., Competing Interests: The authors declare that there is no conflict of interests.

Background: Accurate staging is crucial to determine the type of treatment for patients with bladder cancer (BCa), especially in high-risk cases. We aimed to assess the role of bone scan in the initial staging of muscle-invasive bladder carcinoma (MIBC)., Material and Methods: Forty-five patients with MIBC were referred to our tertiary clinic to perform a technetium 99m-methyl diphosphonate (Tc99m-MDP) bone scan from January 2019 to March 2020. The patients underwent bone scintigraphy with pelvic SPECT/CT before radical cystectomy. Whole-body scanning was performed 4 hours after Tc99m-MDP injection in both anterior and posterior views. Since the most common bone involvement site in these patients is the pelvic bones and the spine, pelvic SPECT/CT was performed in all patients., Results: Frequency of skeletal metastasis was 26.7%. Only 19% of the metastases were detected by previous pelvic CT/MRI images performed for routine staging. All the reported skeletal metastases by previous anatomical imaging methods were detected in the bone scan. There was no statistically significant correlation between bone metastasis and the patient's age, lymph nodes metastasis (LNM), hydronephrosis, and muscle-invasive type. The mean serum calcium level was 8.7 ± 0.57 in patients with bone metastasis and 8.87 ± 0.99 in patients without bone metastasis, which was not statistically significant., Conclusion: Bone scan has higher diagnostic performance than conventional imaging methods for detecting bone metastases. It changed the management plan in 8.8% of our patients, so we conclude that performing a whole-body bone scan in the initial staging of MIBC would be helpful., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Delayed cancer diagnosis and inefficient cancer prognosis determination are problems faced in cancer diagnosis and treatment. MicroRNAs (miRs), especially miR-212, have shown a promise in cancer diagnosis and prognosis. Herein, we performed a systematic review and meta-analysis to assess the prognostic and diagnostic value of miR-212 level in cancer and evaluated its association with patient characteristics., Methods: A fully electronic literature search using related keywords was performed in PubMed, Scopus, Web of Science, Embase, and ScienceDirect databases by June 6, 2021, with no time or language restriction. Meta-analysis was performed to pool survival prognosis data using hazard ratio (HR), association using odds ratio (OR), and diagnostic data using sensitivity, specificity, and diagnostic odds ratio (DOR). Sub-group analysis and meta-regression were performed as appropriate., Results: Results of 28 studies on 1880 patients showed a poor cancer prognosis with high levels of miR-212 in pancreatic ductal adenocarcinoma (PDAC, HR = 2.451 [1.447-4.149]), and a poor cancer prognosis with low levels of miR-212 in other cancers (HR = 2.514 [2.162-2.923]). Higher alpha-fetoprotein (AFP) level and Edmondson-Steiner grade were factors associated with miR-212 low level incidence. Diagnostic odds ratio 10.688 (3.644-31.348) and SROC AUC of 0.84 confirmed high diagnostic performance of miR-212., Conclusion: Our systematic review and meta-analysis results confirm miR-212 high value in cancer prognosis and diagnosis. High level of miR-212 showed poor prognosis in PDAC and low level of miR-212 showed poor prognosis in other cancers. in conclusion, miR-212 could be a novel potential biomarker in cancer diagnosis and prognosis., (© 2022. The Author(s).)

A 53-year-old woman with a plantar malignant melanoma lesion was referred to our tertiary clinic for sentinel lymph node mapping. Lymphoscintigraphy with 99m Tc-Phytate detected ipsilateral inguinal and popliteal sentinel nodes. After total resection of nodes, the pathology report confirmed that all specimens were involved by the tumor. As part of an institutional study evaluating somatostatin receptor avidity of melanoma by 99m Tc-HYNIC-TOC scan, she also underwent a whole-body octreotide scan, which surprisingly showed intense tracer uptake in the right cervical region, confining in SPECT/CT images to a mass at the C2 spinal level, adjacent to the right carotid bifurcation. Neck surgery with gamma probe after injection of another dose of 99m Tc-HYNIC-TOC was performed successfully, and the pathology report was consistent with a carotid body tumor. To best our knowledge, our case is the first one in the literature, which reports an incidental paraganglioma with 99m Tc-HYNIC-TOC scan which resected via radio-guided surgery, again with 99m Tc-HYNIC-TOC tracer., (© 2022 mums.ac.ir All rights reserved.)

Management of renal mass during pregnancy is challenging. There is no consensus regarding the fundamental timing issues (which trimester) of the interventions and patient positioning during the procedures. We present three pregnant women with renal mass and their management, focusing on patient positioning and timing of surgical intervention. All patients were positioned supine with a 30-degree rotation to the left lateral without signs of compromising fetal circulation. This report's three major takeaway points are the following: (1) Renal mass biopsy might be more beneficial in pregnant women than the normal population (unless CT findings suggest vascular angiomyolipomas) to achieve a definite diagnosis and avoid unnecessary interventions during pregnancy. (2) Surgical interventions, if indicated, should be performed as soon as possible and are applicable in all trimesters of pregnancy. (3) A minimum of 15-degree left lateral tilt (for both right- and left-sided renal masses) can provide enough venous return during the nephrectomy., Competing Interests: The authors have no conflict of interest to declare., (Copyright © 2022 Hamidreza Ghorbani et al.)

Background: The diagnosis of pulmonary embolism (PE) because of nonspecific clinical presentation remains as a challenge for emergency physicians. Arterial to end-tidal partial pressure of carbon dioxide (P(a-Et) CO 2 ) gradient may be useful in the evaluation of PE. This aimed to define the diagnostic role of P(a-Et)CO 2 gradient by sidestream capnography, as a noninvasive method, and D-dimer in patients with PE., Materials and Methods: Two hundred and three patients with chest pain or dyspnea who attend the hospital emergency ward were enrolled over a study period at a single academic center. PE was confirmed by multidetector computed tomography (MDCT) scans. PaCO 2 , EtCO 2 , and D-dimer were measured within 24 h of MDCT by capnograph., Results: The combination of P(a-Et)CO 2 gradient (cutoff >9.2 ng/ml) and D-dimer (cutoff >3011 ng/ml) with sensitivity and specificity of 30.2% and 87.2% showed a significant diagnostic value in detecting PE (area under the curve = 0.577, P = 0.045) but not alone ( P > 0.05)., Conclusion: As the results show, the combination of P(a-Et)CO 2 gradient and D-dimer can show an acceptable diagnostic value in detecting PE, although it suggests further research on evaluating the diagnostic value of P(a-Et)CO 2 gradient and combining it with other diagnostic criteria to achieve a definite and generalizable result., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Advanced Biomedical Research.)

Background and Aims: Visceral adiposity index (VAI) is a novel marker of fat distribution and function which incorporates both anthropometric and laboratory measures. Recently, several studies have suggested VAI as a screening tool for metabolic syndrome (MetS). Here, we aimed to consolidate the results of these studies by performing a systematic review and meta-analysis., Methods and Results: We searched PubMed and EMBASE online databases for eligible studies that investigated the association of VAI and MetS. After reviewing 294 records, we included 33 eligible papers with a sum of 20516 MetS and 53242 healthy participants. The risk of bias in the included studies was assessed, and the relevant data was extracted. All included studies reported a significant association between VAI and MetS screening, but were highly heterogeneous in their reported effects. We pooled the diagnostic test accuracy metrics of VAI for MetS screening and showed that it has a moderate-to-high accuracy with an area under the summary receiver operating characteristics curve of 0.847, a pooled sensitivity of 78%, and a pooled specificity of 79%. Besides, we pooled the difference in means of VAI between patients with MetS and healthy controls, revealing that VAI was 2.15 units higher in MetS patients., Conclusions: VAI is an accurate, low-cost, and widely available screening marker for MetS. However, further studies are needed to evaluate its applicability in clinical practice, determine an optimal cut-off, and identify populations that would benefit the most from it., Competing Interests: The authors report no conflicts of interest regarding the publication of this paper., (Copyright © 2021 Moniba Bijari et al.)

Urothelial carcinoma (UC) of the bladder is exceedingly rare in the pediatric population. It commonly presents as isolated hematuria. Considering the age group, the physician's low index of suspicion causes a delay in diagnosis. We present a seven-year-old girl complaining of dysuria and painless, intermittent hematuria. She was misdiagnosed with urinary tract infection several times. Although the initial ultrasound showed no abnormality, the second ultrasound after one year detected the tumor. The confirmation and resection are simultaneously achieved by cystoscopy. We concluded that chemotherapy is unnecessary due to the tumor's low-grade nature and the absence of detrusor involvement. One-year follow-up showed no relapse., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Reza Abbasion et al.)