The effect of climate changes on incidence of benign paroxysmal positional vertigo; a systematic review with meta-analysis of 16144 patients.

BACKGROUND: There were controversial findings in terms of the association between the incidence of Benign Paroxysmal Positional Vertigo (BPPV) and climate changes, so the current systematic review plus meta-analysis is designed to discover this possible relationship. METHODS: Web of science, PubMed, Scopus, Google Scholar, Embase, and Cochrane library were systematically searched up to August 2023. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Two authors independently reviewed the eligible articles and assessed the quality of them. RESULTS: In total, 15 studies including 16144 patients met the inclusion criteria. Ten studies reported the relation of BPPV to monthly mean temperature, 7 to monthly average humidity, 4 to monthly average rainfall, 6 to monthly sunlight time, and 2 to average solar radiation. The incidence of BPPV was associated significantly with atmospheric pressure (P: 0.003) and rainfall (P: 0.017). However, there was not any statistically significant correlation between incidence of BPPV and humidity, sunlight time, temperature, and solar radiation level (P > 0.05). CONCLUSIONS: The incidence of BPPV was higher in cold months of a year in both northern hemisphere and southern hemisphere countries. Although it can be because of negative correlation with temperature, the current meta-analysis did not find any statistically significant negative correlation with temperature. In addition, the incidence of BPPV was associated significantly with atmospheric pressure (positive correlation) and rainfall (negative correlation).

Utilization and efficacy of platelet-rich plasma and platelet-rich fibrin in otolaryngology: a systematic evidence-based review.

PURPOSE: To explore utilization and efficacy of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in different sub-specialties of otolaryngology. METHODS: A systematic search was performed using Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Medline, Clinicaltrials.gov, Scopus, and Google Scholar up to March 2024. English language randomized controlled trials with original data evaluating the use of PRP and PRF in various surgical and non-surgical procedures related to otolaryngologic sub-specialties. Dataset was limited to randomized controlled trials (RCTs) to have the best quality of evidence and possible recommendation. RESULTS: Our database search resulted in 591 manuscripts. Four hundred twenty-six studies were primarily excluded after reviewing the title and abstract. The remaining 165 articles were studied completely, and 51 articles met the inclusion criteria. All the studies were RCTs and dated from 2001 to 2024. They included 19 studies related to otology, 10 studies related to rhinology, 7 studies related to facial plastic surgery, 6 studies related to head and neck surgery, 3 studies related to general otolaryngology, 3 studies related to pediatrics, 2 studies related to laryngology, and 1 study related to sleep medicine. CONCLUSION: PRP and PRF are safe, easy to use, and potentially effective treatment options for multiple otolaryngology pathologies. As an autologous material, there is no risk of immune reaction, and thus has been selected as a viable treatment option by many otolaryngologists. Larger studies would be helpful to confirm efficacy and allow for optimized patient selection for this treatment option.

Anthropogenic vs. climatic drivers: Dissecting Lake desiccation on the Iranian plateau.

Lakes are indispensable to ecological balance, supporting biodiversity and human welfare. Despite their importance, lakes around the globe are diminishing at an alarming rate, presenting substantial environmental challenges exacerbated by climate variability and human-induced pressures, such as unsustainable land management and excessive water withdrawals. This study offers an extensive analysis of the desiccation phenomena affecting major lakes on the Iranian plateau, dissecting the complex interplay of contributing factors. We examine meteorological, hydrological, and agricultural drought conditions using indices like SPI, SDI, and SPEI to gain nuanced insights into drought dynamics. This study sheds light on the factors that contribute to the drying up of lakes and quantifies the impact of anthropogenic and climatic drivers on this phenomenon. The findings indicate that the area of all lakes has declined dramatically after the change point, ranging from 51% in the Urmia Lake to an impressive rate (i.e. 100%) in Southern Hamun. Despite the stable rate of meteorological droughts (increasing in temperature by about 1 °C since the 90s and stable precipitation patterns across most basins), the research highlights the ongoing struggle against severe hydrological and agricultural drought conditions. The study delineates the predominant role of anthropogenic activities in the diminishing lake inflows and the consequential drying of the lake, accounting for approximately 100 % in five of the seven lakes.

Uvulopalatopharyngoplasty with and without modified thyrohyoid suspension for obstructive sleep apnea treatment: a randomized clinical trial.

PURPOSE: This study aims to compare the efficacy of Uvulopalatopharyngoplasty + Tongue Base Radiofrequency (TB-RF) and Uvulopalatopharyngoplasty + modified thyrohyoid suspension techniques + TB-RF which aimed to suspend base of tongue muscles anteriorly toward thyroid cartilage. METHODS: This randomized controlled trial study was conducted on 48 cases of confirmed OSA between Jan, 2019 and Aug, 2022. We divided patients into two groups. One group underwent Uvulopalatopharyngoplasty + modified thyrohyoid suspension + TB-RF technique, and another one underwent Uvulopalatopharyngoplasty + TB-RF. Then, Apnea-Hypopnea Index (AHI), mean and lowest O2 saturation, Drug-Induced Sleep Endoscopy (DISE), Epworth Sleepiness Scale (ESS), Digit Symbol Substitution Test (DSST), Stanford Subjective Snoring Scale (SSSS), and T90 indexes were evaluated before and after each surgery. RESULTS: The mean ± SD age was 39.4 ± 11.17 years. Of the 48 patients, 79.1% (n = 33) were male and 20.9% (n = 15) were female. AHI and SSSS in the Uvulopalatopharyngoplasty + modified thyrohyoid suspension group were significantly better than Uvulopalatopharyngoplasty group (P-value; 0.010). Though, there was no significant difference in terms of mean saturation, lowest desaturation, ESS, DSST, and T90 scores. The success rate in the Uvulopalatopharyngoplasty + modified thyrohyoid suspension and Uvulopalatopharyngoplasty groups, according to the Sher criteria: a minimum of 50% reduction with a final AHI less than 20, were 75% (18/24) and 41.7% (10/24), respectively. It was significantly higher in the Uvulopalatopharyngoplasty + modified thyrohyoid suspension group (P-value: 0.021). CONCLUSION: The addition of modified thyrohyoid suspension technique to Uvulopalatopharyngoplasty have better surgical outcomes and more success rate than Uvulopalatopharyngoplasty in OSA patients. TRIAL REGISTRATION: IRCT: IRCT20190602043791N2. https://en.irct.ir/trial/53365 .

Simultaneous improvements in antibacterial and flame retardant properties of PET by use of bio-nanotechnology for fabrication of high performance PET bionanocomposites.

Recently, attentions to the applications of biotechnology and nanotechnology in the polymer industries have been greater than before. Hybrid nanocomposites containing multi-type of nano structures are widely established, but application of biotechnology for in-situ embedment of nanoparticles in polymer matrix is rarely reported. In this study, poly (ethylene terephthalate) (PET) based ternary bionanocomposites containing modified chitosan (phosphorylated chitosan) and nanosilver particles were prepared by simple eco-friendly method. Chitosan was selected as a biopolymer with respect to the biological activity and compatibility with PET. Phosphorylation of chitosan was achieved in order to introduce the phosphorus moieties as a flame retardant agent in PET matrix by using chemical approach. Also a cost-effective and environmentally friendly method was used for the in-situ fabrication and decoration of silver nanoparticles on to phosphorylated chitosan in PET matrix. Effects of the hybrid system (phosphorylated chitosan and silver nanoparticles) on the morphology, thermal behavior and antibacterial properties of the PET samples were investigated by different methods. The microstructure and homogeneity of the samples were analyzed by studying of dispersion of nanoparticles in PET via scanning electron microscopy. The antibacterial properties of PET nanocomposites can be improved by insertion of silver nanoparticles into the bulk of polymer matrix. Obtained results indicated that the PET/phosphorylated chitosan/silver nanocomposites showed a significantly higher growth inhibition rate compared with the PET and PET/phosphorylated chitosan blend. Also the flame retardant properties of PET nanocomposites were drastically enhanced.

Flow assessment as a function of pump timing of tubular pulsatile pump for use as a ventricular assist device in a left heart simulator.

INTRODUCTION: Although mechanical circulatory support saved many lives during the last decade, clinical observations have shown that the continuous flow pumps are associated with a much higher incidence of gastrointestinal bleeding and kidney problems, among others, compared with the earlier generation pulsatile pumps. However, the presence of several moving mechanical components made pulsatile pumps less durable, bulky, and prone to malfunction, ultimately leading to bias in favor of continuous flow designs. OBJECTIVE: The aim of the current work is to create a prototype tubular pulsatile pump and to test the timing of the pump in a left heart simulator. METHODS: A left heart simulator to mimic pumping from a failing heart was created. This was used to experimentally test the output of a prototype ventricular assist device relative to a failing heart in the form of flow and pressure. The effect of pulsation timing was quantified. RESULTS: A failing heart was simulated with an average flow rate of 1.1 L/min and a systolic pressure of 47 mm Hg. With the pump, the flow rate increases to 4.8 L/min and a systolic pressure of 110 mm Hg, in a copulsation mode, while activating for 300-400 ms. If the activation time is reduced, or increased, the pump becomes less effective. Load on the heart is reduced when the pump operates in a counterpulsation mode. CONCLUSION: A pulsatile pump, like the one proposed, provides adequate output for mechanical circulatory support, while minimizing the number of moving parts that could otherwise lead to tribological wear.

Battling Water Limits to Growth: Lessons from Water Trends in the Central Plateau of Iran.

The Zayandeh-Rud River Basin in the central plateau of Iran continues to grapple with water shortages due to a water-intensive development path made possible by a primarily supply-oriented water management approach to battle the water limits to growth. Despite inter-basin water transfers and increasing groundwater supply, recurring water shortages and associated tensions among stakeholders underscore key weaknesses in the current water management paradigm. There was an alarming trend of groundwater depletion in the basin's four main aquifers in the 1993-2016 period as indicated by the results of the Mann-Kendall3 (MK3) test and Innovative Trend Analysis (ITA) of groundwater volume. The basin's water resources declined by more than 6 BCM in 2016 compared to 2005 based on the equivalent water height (EWH) derived from monthly data (2002-2016) from the GRACE. The extensive groundwater depletion is an unequivocal evidence of reduced water availability in the face of growing basin-wide demand, necessitating water saving in all water use sectors. Implementing an integrated water resources management plan that accounts for evolving water supply priorities, growing demand and scarcity, and institutional changes is an urgent step to alleviate the growing tensions and preempt future water insecurity problems that are bound to occur if demand management approaches are delayed.

Yield prediction with machine learning algorithms and satellite images.

BACKGROUND: Barley is one of the strategic agricultural products available in the world, and yield prediction is important for ensuring food security. One way of estimating a product is to use remote sensing data in conjunction with field data and meteorological data. One of the main issues surrounding this comprises the use of machine learning techniques to create a multi-resource data-based estimation model. Many studies have been conducted on barley yield prediction from planting to harvest. Still, the effect of different time intervals on yield prediction has not been investigated. Furthermore, the effect of different periods on yield prediction has not been investigated. RESULTS: In the present study, the whole growth period was divided into three parts. Using one of the major barley production areas in Iran, the performance of the proposed model was evaluated. In the first step, a model for integrating field data, remote sensing data and meteorological data was prepared. The results obtained show that, among the four machine learning methods implemented, the gaussian process regression algorithm performed best and estimated yield with r2 = 0.84, root mean square error = 737 kg ha-1 and mean absolute = 650 kg ha-1 , 1 month before harvest. CONCLUSION: It was found that the estimation results change depending on different agricultural zones and temporal training settings. The findings of the present study provide a powerful potential tool for the yield prediction of barley using multi-source data and machine learning. © 2020 Society of Chemical Industry.

Turbulent Flow Promotes Cleavage of VWF (von Willebrand Factor) by ADAMTS13 (A Disintegrin and Metalloproteinase With a Thrombospondin Type-1 Motif, Member 13).

Objective- Acquired von Willebrand syndrome is defined by excessive cleavage of the VWF (von Willebrand Factor) and is associated with impaired primary hemostasis and severe bleeding. It often develops when blood is exposed to nonphysiological flow such as in aortic stenosis or mechanical circulatory support. We evaluated the role of laminar, transitional, and turbulent flow on VWF cleavage and the effects on VWF function. Approach and Results- We used a vane rheometer to generate laminar, transitional, and turbulent flow and evaluate the effect of each on VWF cleavage in the presence of ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type-1 motif, member 13). We performed functional assays to evaluate the effect of these flows on VWF structure and function. Computational fluid dynamics was used to estimate the flow fields and forces within the vane rheometer under each flow condition. Turbulent flow is required for excessive cleavage of VWF in an ADAMTS13-dependent manner. The assay was repeated with whole blood, and the turbulent flow had the same effect. Our computational fluid dynamics results show that under turbulent conditions, the Kolmogorov scale approaches the size of VWF. Finally, cleavage of VWF in this study has functional consequences under flow as the resulting VWF has decreased ability to bind platelets and collagen. Conclusions- Turbulent flow mediates VWF cleavage in the presence of ADAMTS13, decreasing the ability of VWF to sustain platelet adhesion. These findings impact the design of mechanical circulatory support devices and are relevant to pathological environments where turbulence is added to circulation.

Remotely sensed vegetation indices for crop nutrition mapping.

BACKGROUND: Spectral reflectance measurements and vegetation indices have been used widely to monitor plant nutritional status. Remote sensing methods are very fast, convenient, and non-destructive techniques for estimating crop nutrition indices. With the rapid development of remote sensing satellites, unmanned aerial vehicles, and the Internet of Things, remote sensing will increasingly be used in crop nutrition diagnosis. This can lead to lower operating costs for fertilization and can minimize loss of productivity. RESULTS: In this study, satellite images were used for 2 years to evaluate the use of vegetation indices for crop nutrition mapping, in two regions, located in the cities of Ray and Karaj. For each farm, eight reference points in each year were selected to determine the crop nutrition status for model development and accuracy assessment. Then, ten spectral vegetation indices were used to calculate the crop nutrition content at mid-season and at the end of the season. The results indicated that transformed chlorophyll absorption in reflectance index (TCARI) and modified chlorophyll absorption in reflectance index (MCARI) had the highest R2 and the lowest RMSE values, respectively (R2 TCARI = 0.83, RMSETCARI = 12.47 kg ha-1 and R2 MCARI = 0.75 and RMSEMCARI = 14.47 kg ha-1 ). CONCLUSION: The performance of TCARI and MCARI was strong across the two farms and allowed the creation of highly accurate crop nutrition maps. In conclusion, the use of the near infra-red and red-edge bands in mid-season led to better results than vegetation indices calculated at the end of the season or that do not included the red-edge band. © 2020 Society of Chemical Industry.

Comorbidity of gastrointestinal disorders, migraine, and tension-type headache: a cross-sectional study in Iran.

Migraine can be accompanied by some gastrointestinal (GI) disorders. In this study, we aimed to investigate the relationship between migraine and tension-type headache (TTH) and different lower and upper GI disorders as well as non-alcoholic fatty liver (NAFLD) and cholelithiasis. This cross-sectional study included 1574 overweight and obese participants who were referred to the Obesity Research Center of Sina Hospital, Tehran, Iran. The diagnosis of migraine and TTH was made by an expert neurologist based on the international classification of headache disorders-III ß (ICHD III ß). GI disorders, including irritable bowel syndrome (IBS), constipation, heartburn, dyspepsia, non-alcoholic fatty liver (NAFLD), and cholelithiasis, were diagnosed by a gastroenterology specialist. The overall mean age of participants was 37.44 ± 12.62. A total of 181 (11.5%) migraine sufferers (with and without aura) and 78 (5%) TTH subjects were diagnosed. After adjusting for potential confounders by multivariable regression models, migraine had significant association with IBS (OR = 5.16, 95% CI = 2.07-12.85, P = 0.000), constipation (OR = 3.96, 95% CI = 2.25-6.99, P = 0.000), dyspepsia (OR = 4.12, 95% CI = 2.63-6.45, P = 0.000), and heartburn (OR = 5.03, 95% CI 2.45-10.33, P = 0.000), while the association between migraine and NAFLD was marginally significant (OR = 2.03, 95% CI = 0.98-4.21, P = 0.055). Furthermore, the prevalence of NAFLD (OR = 2.93, 95% CI 1.29-6.65, P = 0.010) and dyspepsia (OR = 4.06, 95% CI = 2.24-7.34, P = 0.000) was significantly higher in TTH patients than the headache-free group. These findings show an association between GI disorders and primary headaches especially migraine and are, therefore, of value to the management of migraine and TTH. Further studies should investigate the etiology of the relationship between all subtypes of primary headaches and GI disorders.

Daily runoff prediction using the linear and non-linear models.

Runoff prediction, as a nonlinear and complex process, is essential for designing canals, water management and planning, flood control and predicting soil erosion. There are a number of techniques for runoff prediction based on the hydro-meteorological and geomorphological variables. In recent years, several soft computing techniques have been developed to predict runoff. There are some challenging issues in runoff modeling including the selection of appropriate inputs and determination of the optimum length of training and testing data sets. In this study, the gamma test (GT), forward selection and factor analysis were used to determine the best input combination. In addition, GT was applied to determine the optimum length of training and testing data sets. Results showed the input combination based on the GT method with five variables has better performance than other combinations. For modeling, among four techniques: artificial neural networks, local linear regression, an adaptive neural-based fuzzy inference system and support vector machine (SVM), results indicated the performance of the SVM model is better than other techniques for runoff prediction in the Amameh watershed.

Expression Levels of MMP9 and PIWIL2 in Prostate Cancer: a Case-Control Study.

BACKGROUND: Prostate cancer is the second most prevalent cancer in humans. Also, this is the most common malignancy and the sixth most important cause of death in men worldwide. The most routine diagnostic test for prostate cancer is PSA test which is associated with some limitations like too many false positive results. This study intends to investigate the role of MMP9 and PIWIL2 expression levels as different biomarkers in prostate cancer biopsy specimens. This study is one of the most brilliant studies in the field of prostate cancer research for the first time focusing on the investigation of the role of two different genes in prostate cancer in biopsy specimens and on formalin-fixed paraffin-embedded tissue types in order to detect the progression and prognosis of prostate cancer patients in early stages. METHODS: Seventy formalin-fixed paraffin embedded samples (35 normal and 35 cancerous cases) were selected. Expression levels of PIWIL2 and MMP9 genes were evaluated, using real-time PCR. RESULTS: MMP9 and PIWIL2 expression levels in cancerous tissues were significantly higher than the adjacent normal tissues (p < 0.05). The survival analysis showed a significant correlation between expression level of PIWIL2 and survival rate (p < 0.05), but such correlation was not observed in case of MMP9 (p > 0.05). Higher levels of MMP9 and PIWIL2 expression were strongly related to the Gleason score and age, using Pearson's correlation co- efficient test; however, this kind of association was not evident between prostate specific antigen (PSA) and expression levels of the genes of interest. The expression level of PIWIL2 had a significant correlation with metastasis rate, but this relationship was not seen in the case of MMP9. CONCLUSIONS: The results confirmed the validity of PIWIL2 expression as a valuable prognostic biomarker for early diagnosis of prostate cancer.

Numerical simulation of the tumor interstitial fluid transport: Consideration of drug delivery mechanism.

The interstitial fluid transport plays an important role in terms of its effect on the delivery of therapeutic agents to the cancerous organs. In this study, a comprehensive numerical simulation of the interstitial fluid transport establishing 3D models of tumor and normal tissue is accomplished. Different shapes of solid tumors and their surrounding normal tissues are selected, by employing the porous media model and incorporating Darcy's model and Starling's law. Besides, effects of the tumor radius, normal tissue size, tissue hydraulic conductivity and necrotic core are investigated on the interstitial fluid pressure (IFP) and interstitial fluid velocity (IFV). Generally, results suggest that the configurations of the tumor and surrounding normal tissue affect IFP and IFV distributions inside the interstitium, which are much more pronounced for various configuration of the tumor. Furthermore, findings demonstrate that larger tumors are more prone for producing elevated IFP comparing with the smaller ones and impress both IFP and IFV dramatically. Nevertheless, normal tissue size has less impact on IFP and IFV, until its volume ratio to the tumor remains greater than unity; conversely, for the values lower than unity the variations become more significant. Finally, existence of necrotic core and its location in the tumor interstitium alters IFP and IFV patterns and increases IFV, considerably.

The Safety and Outcomes of Simultaneous Open Rhinoplasty, Alar Reduction, and Upper Lip-Lift through One Surgery.

Background: The safety and outcomes of performing a simultaneous Alar reduction, Lip lift, and Open rhinoplasty Surgery (ALOS) through independent incisions have not been reported in any study, therefore, we aimed to evaluate the safety and outcomes of this combination procedure. Methods: This retrospective review study was conducted on all cases of simultaneous ALOS, lip-lift, and alar reduction performed from 2018-2022, at Facial Plastic Surgery Clinic, New York, USA. Alar reduction involved complete through-and-through resection of alar wedge, and the type of lip lift technique was bullhorn design with excision of skin and Superficial Musculo-Aponeurotic System. Primary open rhinoplasty with inverted V-columellar incision was performed. The follow up period ranged between 4 months to 2 years, but all of patients were followed up at 6 days, one, and two months post-operatively. Results: Fifty one cases were enrolled. We reviewed criteria of complications including infection, vascular events (such as necrosis, or partial ischemia), and poor scarring, fortunately, we did not have any infection or vascular issues. In 2 cases, columellar scar was "less than optimal", but in all other cases, this scar was "not perceivable" based on the patient survey. In 4 cases, the lip lift procedure scar was considered "less than optimal" showed slight indentation of white scar of lip lift in 9/44 cases. Additionally, all columellar and alar incisions had nearly invisible scarring. Conclusion: In primary rhinoplasty cases, without any other surgeries or previous trauma in the oronasal region, performing concomitant lip lift, open rhinoplasty, and alar wedge resection is safe and does not negatively affect vascularity or scarring.

Attitude control of a 3-DoF quadrotor platform using a linear quadratic integral differential game approach.

In this study, a linear quadratic integral differential game approach is applied to regulate and track the Euler angles for a quadrotor experimental platform using two players. One produces commands for each channel of the quadrotor and another generates the worst disturbance based on the mini-maximization of a quadratic criterion with integral action. For this purpose, first, the attitude dynamics of the platform are modeled and its parameters are identified based on the Nonlinear Least Squares Trust-Region Reflective method. The performance of the proposed controller is evaluated for regulation and tracking problems. The ability of the controller is also examined in the disturbance rejection. Moreover, the influence of uncertainty modeling is studied on the obtained results. Then, the performance of the proposed controller is compared with the classic Proportional Integral Derivative, Linear Quadratic Regulator, and Linear Quadratic Integral Regulator. The results demonstrate the effectiveness of the Game Theory on the Linear Quadratic Regulator approach when the input disturbance occurs.

The combined effects of anthropogenic and climate change on river flow alterations in the Southern Caspian Sea Iran.

In recent years, the effects of human activities and climate change on river flow patterns have become a major concern worldwide. This is particularly true in the southern Caspian Sea (SCS) region of Iran, where increasing water-intensive socio-economic development and climate change have significantly altered river flow regimes. To better understand these changes, this study employs two nonparametric methods, the modified Mann-Kendall method (MK3) and Innovative Trend Analysis (ITA), to examine spatial and temporal changes in hydrometeorological variables in the SCS. The study also evaluates the impact of human activities and climate change on river flow alteration using elasticity-based methods and the Budyko hypothesis in 40 rivers on the closest gauges to the Caspian Sea. The results indicate an alarming trend of increasing temperature, potential evapotranspiration, and decreasing river flows in the SCS region. In particular, human activities were found to be responsible for around 91.7 % of the change on average, resulting in a significant decline in inflow to the Caspian Sea by about 3216 MCM annually. This declining trend in inflow could potentially exacerbate the eutrophication conditions in the Sea and negatively impact its ecosystem and economics. Therefore, appropriate measures need to be taken to address these environmental and socio-economic issues in the southern Caspian Sea region.

Can river flow prevent land subsidence in urban areas?

Land subsidence, a silent death, occurs due to various factors like significant reduction in groundwater (GW) levels. It is a widespread phenomenon with irreparable consequences on buildings, infrastructures, and, in severe cases, groundwater aquifers. This study aims to assess the impact of river flow on the acceleration and control of land subsidence in an arid and semi-arid region. To achieve this goal, we analyze the interconnection between GW and SW and investigate the role of the Zayandeh-Rud River's drying up on land subsidence in the Isfahan-Borkhar aquifer in Iran's central plateau. To facilitate this assessment, we utilize the Interferometric Synthetic Aperture Radar (InSAR) technique to estimate the vertical deformation velocity of the aquifer (average land subsidence rate). The results show that the Isfahan-Borkhar aquifer has experienced a significant annual decline of more than 25 m, with an alarming rate exceeding 0.8 m/year. Our analysis of 31 piezometric wells (P-Wells) from 2000 to 2022 reveals a downward monotonic (in 16 P-Wells) and nonmonotonic (in 12 P-Wells) trend in groundwater table changes. Moreover, the GW table in the P-Wells near the river depends entirely on river flow. Furthermore, our findings indicate that river regulation exerts a dominant role in the control of land subsidence. Consequently, when water flows in the Zayandeh-Rud River, the rate of land subsidence declines significantly, particularly in urban regions. Therefore, maintaining a constant flow of water in the river can prevent or reduce ongoing land subsidence in Isfahan.