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Climate change and global warming pose significant threats to life on earth, leading governments worldwide to enact laws restricting carbon dioxide emissions. Traditionally, the use of Portland cement is a typical approach to increasing the bearing capacity, minimizing settlement, and improving seismic behavior of problematic soils. However, the cement industry's high energy consumption, uncontrollable emission of greenhouse gases, large carbon footprint, further depletion of natural resources, and high cost have become enormous challenges for all countries. Therefore, researchers continually seek new materials to replace ordinary Portland cement, contributing towards sustainable development. In this regard, the use of environmentally friendly, cheap, and readily available additives in modern soil methods of the construction cycle, particularly soil stabilization, is crucial. Geopolymer materials have recently emerged as serious alternatives to cement. This study aims to investigate the innovative reuse of eggshells through the geopolymerization process for engineering improvement of clayey soil. Alkali-activated binders are inorganic polymers that form repeated polymeric chains by polymerizing alumina and silica, sharing all oxygen atoms and using the alkaline cation. The combination of sodium hydroxide and sodium silicate was used as an alkaline activator in this study. The unconfined compressive strength (UCS) was the primary criterion for assessing the quality and effectiveness of the proposed solutions. This test was performed on selected combinations to assess the strength of the stabilized clay with different binder dosages and after different curing times. Moreover, the direct shear test was used to study the Mohr-Coulomb criteria parameters of the stabilized soil, namely the cohesion and angle of internal friction. Scanning Electron Microscope (SEM) microstructure observations of the natural and treated soil were conducted to investigate the strength development. The results showed that using 5, 7.5, 10, and 12.5% eggshell by dry weight activated by sodium hydroxide increases the UCS to 1.24 MPa, 1.21 MPa, 1.18 MPa, and 849 kPa, respectively, after 45 days of curing. The microstructural analysis results highlighted the reaction between the eggshell and the alkaline activator, resulting in the formation of an aluminosilicate gel.

Cardiac arrhythmias are among the leading causes of morbidity and mortality worldwide. While antiarrhythmic drugs traditionally represent the first-line management strategy, their use is often limited by profound proarrhythmic effects. Several studies, including randomized control trials (RCTs), have demonstrated the antiarrhythmic efficacy of ranolazine, which is registered as an antianginal agent, while also establishing its safety profile. This review compiles clinical evidence investigating the antiarrhythmic properties of ranolazine, focusing primarily on ventricular tachycardia (VT) and atrial fibrillation (AF), as they are common rhythm abnormalities with serious complications. Data from RCTs indicate that ranolazine reduces VT incidence, although this effect is not universal. Therefore, we attempt to better describe the patient population that gains the most benefit from ranolazine due to VT suppression. Additionally, ranolazine is known to enhance the conversion rate of AF to sinus rhythm when combined with other antiarrhythmic drugs such as amiodarone, highlighting its synergistic effect in the atrium without provoking ventricular dysrhythmias. Despite the heterogeneity in the currently available data, ranolazine appears to be an effective and safe option for the management of various arrhythmias.

Introduction. Patients with hormone receptor-positive (HR+), HER2-negative (HER2−) breast cancers have the lowest response to neoadjuvant therapy of all subtypes. The role of neoadjuvant endocrine therapy (NET) in clinically node-positive (cN+), HR+, HER2− patients is evaluated in this meta-analysis. Methods. This study was performed between January 2010 and August 2022. We evaluated the node pathologic complete response (pCR) and axillary lymph node dissection (ALND) rates after neoadjuvant endocrine therapy (NET). Results. 18,037 HR+, HER2−, cN+ stage II and stage III breast cancer patients within eleven studies received neoadjuvant treatments. 3,707 (20.6%) patients received NET and 14,330 (79.4%) received NAC. The average age of the NET patients was higher than that of the neoadjuvant chemotherapy (NAC) patients (64.1 versus 47.6 years old, p

Abstract Purpose Motifs are influenced beliefs and how individuals interact with architectural features. Additionally, decorations have been emphasized as a critical component of traditional architecture. The studying architecture in Dezful, which incorporates Xowun decorations and its historical context, motivates this study. The motifs are influenced by ideas derived from Dezful's traditional society's worldview. Therefore, in addition to documenting patterns, the study of these factors affecting the formation can be considered as research objectives. Methodology The present study is a method for studying patterns and name of Xowun decoration. In this method, the name and pattern of the designs are matched and the factors affecting them are explained. Finally, a conclusion is made based on logical inference and research findings. Results The research findings describe the hidden ideas within each of the decorative groups of Xowun decoration and represent a distinct architecture level within a valuable historical context. Furthermore, the research evidence includes a comparison of the naming and patterns associated with Xowun decoration. Conclusion The study's findings indicated that society's attitudes toward Xowun decorations influence the decoration names. Therefore, Xowun decoration can be classified into Geometric pattern, Animal-related pattern, Pattern related to plants and nature, Belief and religious model, pattern of combined geometries, Pattern influenced by construction technique. Additionally, most motifs in Xowun decorations are related to plant patterns (40.65%), while the lowest percentage is related to animal patterns (4.87%).

Background: Nipple-sparing mastectomy (NSM) is considered to be one of the most commonly used method of surgery in breast cancer. Oncologic and surgical complications are the major concerns associated with the NSM as a treatment or prophylactic approach for patients. The effective local control is the main goal in breast cancer treatment although aesthetic outcome and nipple-areola complex sensation are also important. Method: This retrospective, descriptive, and cross-sectional study was performed on 35 hospitalized patients who underwent the NSM with axillary incision at the Department of Breast and Reconstructive Surgery at Sine Hospital, Tehran, Iran from April 2015 to April 2016. The patients were followed up in the first and second weeks and the first and third months following the surgery. Results: 20 women who underwent the NSM were studied. The mean results in the flap sensation and in the nipple-areola complex sensation were 5.2 ± 2.4 and 5 ± 2.29, respectively. Major necrosis was reported in one patient in each follow-up session. Conclusion: Although acceptable necrosis rate and significant sensation recovery after this method of mastectomy makes it more accentuated, certain complications and necessary revision surgeries after the NSM may diminish the favorable results, including sensation.

Some of the most impressive displays of delicate plaster work can be found when we look up in a space in Islamic Iranian architecture. Plaster is an ideal medium for decorative work, because it can take fine detail. It is also versatile: plaster can be formed into ornate, multi-layered ceiling medallions, intricate friezes replete with scrolls and swags, or long runs of coved cornice work. Plaster can be cast, shaped, carved, sculpted, sanded, or cut. When Islam opened a new view to art philosophy, it affected the ornament style in Iranian architecture. If one had to choose the defining material of Muslim culture, it would, without a doubt, be stucco. In contemporary history, plaster has been considered a relatively poor material, probably due to its lack of application in heavy duty building work, its easy handling and the simple process it takes to transform it from rock mineral. But, human dexterity, particularly that of Muslim artisans, helped to produce designs in stucco, and numerous buildings decorated with that technique have survived for us to admire. Architectural decoration has been one of the most resilient of the Islamic arts. The partial and more often overall decoration of buildings has been a characteristic feature of Islamic architecture from the eighth century onwards. Religious monuments as well as secular complexes have been decorated with an array of styles and techniques that reflected the multiplicity of Muslim societies and their cultural expressions. The importance given to decorating one's built environment has also been applied to temporary settlements such as tented encampments. Islamic plasterwork covers almost every single surface of walls, arches, vaults and ceilings, gaining an almost textile-like quality through their intricate ornament and vibrant palette of colours. Its almost overwhelming appearance is the result of the interconnection and superimposition of different ornamental elements: calligraphic inscriptions, geometric lazo. The interior decorations are centered on the mihrab. In fact, one can find almost all elements and methods of decoration on and around this symbolic place. There is a harmonious and creative co-existence between plaster, marble and brass. In addition, the mihrab typifies the beautiful marriage of all methods of decoration, especially geometry, floriation, calligraphy. The main roll of mihrab and its decoration became a mainstream in aesthetic orientation in Iranian art and architecture that spread to numerous architectural types such as schools to houses. One of the types of secular architecture is the house. Therefore, in order to evaluate this hypothesis and find the answer to the question: In what period are Chohar-soffeh decorations of Dosiran village rooted? the authors attempted to gather the information about Dosiran’s Chohar-soffeh houses and their decorations, and then examined the characteristics of these decorations and index samples similar to them in the history of the country and finally made a comparative comparison of the physical content of these samples. The research method includes survey, analytical-descriptive and interpretive-historical methods. Research data were obtained through field surveys, personal observations, and library documents. The research tool is logical inference and comparative comparison based on Carry-Walk-Method. Finally, it was concluded that two types of these inscriptions have a body similar to the plaster altars of the Ilkhanid period and in terms of content have the salient features of the plasterwork of this period; nevertheless, works of art combining the late Sassanid and early Islamic periods can also be seen in the drawings of all these inscriptions. The ornaments of Dosiran’s Chohar-soffehs, due to their appearance, organization and special content, as well as the way they are placed on the walls of the plates and the level of rib vaults, have given double value to the mansions of Gholam Hossein Naderi and Koohyar Dashti. These inscriptions include five different shapes and three general patterns. From the studies and comparisons, it was concluded that the Dosiran’s Chohar-soffehs strongly show the artistic course of the country from the late Sassanid period to the Ilkhanid period due to having well-known and important designs in the art history of Iran such as arabesques and Khataee motifs, flowers, knots (Gereh) and significant objects, which are mainly rooted in the Islamic period, as well as representing distinctive features such as great similarity to the valuable and sacred pattern of the altar in Islamic art and architecture, indicative features of Ilkhanid altars, using similar motifs to widely used motifs of the Sassanid era, the application of the natural form of plants and important techniques such as Muqarnas and honeysuckle (Laneh Zanbouri) ornament. The appearance and origins of the drawings of these inscriptions and the adapted examples are evidence of this claim; because despite the existence of continuity and artistic connection in the history of the country, some artistic features are specific to a particular period of history and are less considered in later periods. However, in Dosiran’s Chohar-soffehs, the characteristics of the bedrock of several periods are shown together.

Abstract Background Insulin edema is a rare complication which can present after initiation or intensification of insulin therapy in people with diabetes. Initiation of closed-loop hybrid insulin pump therapy can result in rapid improvement in glycemic control for people with diabetes. We present a case in which transition to a closed-loop hybrid insulin pump system, followed by significant improvement in glycemic control, led to development of insulin edema in a person with type 1 diabetes. Case presentation We present a 51-year-old woman with type 1 diabetes of 16 years duration, on insulin pump therapy for more than 10 years, who presented for follow-up 7 weeks after transitioning to a hybrid closed-loop insulin pump system with continuous glucose monitoring (CGM). She complained of weight gain and bilateral lower extremity edema which had started two weeks after the change in pump modality. Laboratory studies and echocardiogram did not reveal any etiology of the acute edema. HbA1c was 3.3% lower than the previous measurement 15 weeks earlier, and there was a significant increase in the daily total insulin dose. With exclusion of other causes of acute edema, the patient was diagnosed with insulin edema and started on hydrochlorothiazide. On follow up, her lower extremity edema significantly improved although her weight did not return to baseline. Conclusion To our knowledge, this is the first case of insulin edema reported in a person with type 1 diabetes using CGM and a hybrid closed-loop insulin pump system. The increase in total daily insulin dose, rapid improvement of glycemic control, and lack of hypoglycemic episodes were important factors to consider in evaluation of this case. Use of hybrid closed-loop systems can help achieve rapid improvement in glycemic control in people with diabetes. This case suggests that consideration should be given to adjusting initial blood glucose targets when starting these remarkable new technologies in people with baseline poor glycemic control.

The regular behavior of the pulsations of high-amplitude δ Sct (HADS) stars gives a greater chance to investigate the interiors of stars. We analyzed seven HADS stars showing peak-to-peak amplitudes of more than 0.3 mag that were newly observed by TESS. We obtained that TIC 374753270, TIC 710783, and TIC 187386415 pulsate in fundamental radial mode; also, TIC 130474019 and TIC 160120432 show double radial modes. On the other hand, TIC 148357344 and TIC 278119167 demonstrate triple-mode behavior. Our analysis shows that these seven stars are close to the red edge of the (inside) instability strip in the Hertzsprung–Russell diagram. The fundamental mode of these seven targets follows the period–luminosity (PL) relation for δ Sct stars. However, TIC 278119167 deviates slightly from the fundamental PL relation. The double-mode and triple-mode HADS stars (TIC 130474019, TIC 160120432, TIC 148357344, and TIC 278119167) are in agreement with the period ratio ranges (fundamental to first and second overtones). Using the information of 176 HADS stars (Netzel and Smolec), we find a scaling relation ( $[\mathrm{Fe}/{\rm{H}}]\propto \mathrm{log}({M}^{7.95\pm 0.15}{L}^{-1.83\pm 0.11}{\rm{P}}{0}^{0.79\pm 0.14}{T}_{\mathrm{eff}}^{0.047\pm 0.02}$ )) between the metallicity ([Fe/H]) and mass ( M ), luminosity ( L ), effective temperature ( T _eff ), and the fundamental period (P0). We estimate the metallicity of the seven newly identified HADS stars ranging from −0.62 to 0.37 dex.