Unexpectedly high mutation rate of cyp11b1 compared to cyp21a2 in randomly-selected turkish women: a large screening study.

PURPOSE: Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders resulting from enzyme deficiencies associated with steroidogenesis. The clinical presentation of non-classic CAH (NCAH) in females is often indistinguishable from other hyperandrogenic disorders like polycystic ovary syndrome (PCOS). The data on the prevalence of NCAH in unselected women in the literature is scanty. The research aimed to evaluate the prevalence of NCAH, carrier frequencies, and the correlation between clinical symptoms and genotype in Turkish women. METHODS: The study group comprised two hundred and seventy randomly-selected unrelated asymptomatic women of reproductive age (18-45). Subjects were recruited from female blood donors. All volunteers underwent clinical examination and hormone measurements. The protein-encoding exons and exon-intron boundaries of the CYP21A2, CYP11B1, HSD3ß2 and CYP21A2 promoter were sequenced by direct DNA sequencing. RESULTS: After genotyping, seven (2.2%) individuals were diagnosed with NCAH. The heterozygous carrier frequencies of CYP21A2, CYP21A2 promoter, CYP11B1, and HSD3ß2 genes with 34, 34, 41, and 1 pathologic mutation were determined at 12.6%, 12.6%, 15.2%, and 0.37% of volunteers, respectively. Gene-conversion (GC) frequencies between CYP21A2/CYP21A1P and CYP11B1/CYP11B2 were determined as 10.4% and 14.8%, respectively. CONCLUSION: Despite GC-derived higher mutation frequency determined in the CYP11B1 gene, the reason for the low frequency of NCAH due to 11OHD compared to 21OHD might be that gene-conversion arises with active CYP11B2 rather than an inactive pseudogene. HSD3ß1 exhibits high homology with HSD3ß2 located on the same chromosome; remarkably, it demonstrates low heterozygosity and no GC, most probably the outcome of a tissue-specific expression pattern.

Can we predict orthodontic extraction patterns by using machine learning?

OBJECTIVE: To investigate the utility of machine learning (ML) in accurately predicting orthodontic extraction patterns in a heterogeneous population. MATERIALS AND METHODS: The material of this retrospective study consisted of records of 366 patients treated with orthodontic extractions. The dataset was randomly split into training (70%) and test sets (30%) and was stratified according to race/ethnicity and gender. Fifty-five cephalometric and demographic input data were used to train and test multiple ML algorithms. The extraction patterns were labelled according to the previous treatment plan. Random Forest (RF), Logistic Regression (LR), and Support Vector Machine (SVM) algorithms were used to predict the patient's extraction patterns. RESULTS: The highest class accuracy percentages were obtained for the upper and lower 1st premolars (U/L4s) (RF: 81.63%, LR: 63.27%, SVM: 63.27%) and upper 1st premolars only (U4s) extraction patterns (RF: 61.11%, LR: 72.22%, SVM: 72.22%). However, all methods revealed low class accuracy rates (<50%) for the upper 1st and lower 2nd premolars (U4/L5s), upper 2nd and lower 1st premolars (U5/L4s), and upper and lower 2nd premolars (U/L5s) extraction patterns. For the overall accuracy, RF yielded the highest percentage with 54.55%, followed by SVM with 52.73% and LR with 49.09%. CONCLUSION: All tested supervised ML techniques yielded good accuracy in predicting U/L4s and U4s extraction patterns. However, they predicted poorly for the U4/L5s, U5/L4s, and U/L5s extraction patterns. Molar relationship, mandibular crowding, and overjet were found to be the most predictive indicators for determining extraction patterns.

Treatment of sialorrhea with botulinum toxin A injection in children.

AIMS: We aimed to evaluate the effectivity and safety of botulinum toxin A (BT-A) to reduce sialorrhea in children with hypersalivation due to neurological diseases. METHODS: Patients who had a complaint of severe sialorrhea were included in the study. Drooling severity of the patients was evaluated using the classification of Thomas-Stonell and Greenberg. The frequency of aspiration before and after the procedure was recorded. The 24-hour saliva amount and mean duration of two consecutive aspirations were recorded. BT-A was injected into the bilateral parotid and submandibular glands by a otorhinolaryngologist under the guidance of ultrasound guidance (USG). RESULTS: When patients' mean drooling severity scores, drooling frequency scores, mean duration of two consecutive aspirations, and amount of saliva collected before and after procedure were compared, a statistical significance was observed. One-year hospital records before after and injection were examined and it was observed that after BT-A injection, hospital visits were statistically significantly low (P = 0.017). CONCLUSION: BT-A injection into salivary glands is well tolerated, is minimally invasive, has low complication rates and should be performed into both parotid and submandibular glands under USG. Although there is still no consensus on the ideal dose and frequency of injections, it is thought that a dose of 1U/kg/gland can be used with safety in pediatric age groups and the dimensions of the salivary glands and quantitative measurements of the amount of saliva should be utilized. Larger studies involving more patients are required in order to constitute a standard injection protocol.

The role of androgen receptor CAG repeat polymorphism in androgen excess disorder and idiopathic hirsutism.

PURPOSE: The study aimed to investigate whether repeat number in the androgen receptor (AR) gene has any contribution to phenotypes of the disease of androgen excess (polycystic ovary syndrome (PCOS), idiopathic hyperandrogenemia (IHA) and idiopathic hirsutism (IH) in a cohort of Turkish women. METHODS: Three hundred and fifty-four voluntary premenopausal women (172 healthy controls and 182 patients with androgen excess disorders and idiopathic hirsutism) 18-45 years of age seen at an outpatient endocrine clinic at Erciyes University Hospital between January 2013 and December 2014 were included. All volunteers have undergone physical examination and biochemical evaluation. The polymorphic (CAG)n repeat of the human AR was determined by fragment analyses. RESULTS: Detailed clinical analyses of the patients ended up with 137 PCOS, 24 IHA, and 21 IH. Pairwise comparisons revealed the CAG repeat number differences between the PCOS and controls (p = 0.005) and IH and controls (p = 0.020). Women with CAG repeat length ≤ 17 had a significantly increased twofold risk for PCOS than those women with > 17 CAG repeats OR: 2.0 (95% CI 1.2-3.3, p = 0.005). Women with CAG repeat length ≤ 17 had a significantly increased threefold risk for IH than those women with > 17 CAG repeats OR: 2.9 (95% CI 1.2-7.3, p = 0.020). When correlation analysis was performed, a weak negative correlation was detected between the short allele and FGS score (r = - 0.131, p = 0.013) and a positive relationship between total testosterone and longer allele in the IHA group (r = 0.425, p = 0.039). Median repeat length of the shorter allele between oligomenorrhea and woman with normal menstrual cycle was found to be statistically significant (p = 0.017). CONCLUSION: This study indicated that the risk of PCOS and IH is associated with the inheritance of ARs with shorter CAG repeats.

The Effects of O6-methyl Guanine DNA-methyl Transferase Promotor Methylation and CpG1, CpG2, CpG3 and CpG4 Methylation on Treatment Response and their Prognostic Significance in Patients with Glioblastoma.

This retrospective study examined the prognostic significance and treatment effect of promoter methylation of O6- methyl guanine methyl transferase (MGMT) and meth-ylation of CpG 1, CpG2, CpG3 and CpG4 in glioblastoma (GB) patients received postoperative radiotherapy (PORT), with or without adjuvant temozolomide (TMZ). One hundred patients with GB who received PORT with concomitant TMZ plus adjuvant TMZ or PORT alone, were included. The MGMT promoter methylation of CpG1, CpG2, CpG3 and CpG4 islands were examined. Overall, MGMT-methylation emerged as a significant prognostic factor for better overall survival (OS) and progression-free survival (PFS) [odds ratio (OR): 0.609, 95% confidence interval (95% CI): 0.395-0.939, p = 0.02; OR: 0.662,95% CI: 0.430-1019, p = 0.5, respectively]. The methylation of each CpG1, CpG2, CpG3 and CpG4 islands was found to have no significant effects on OS and the methylation of each CpGl, CpG2 and CpG4 islands had no significant effect on PFS (p <0.05 for all). On the other hand, the methylation of CpG3 had a positive prognostic effect on PFS (OR: 2.1, 95% CI: 0.99-4.67, p = 0.04). In the group that only received radiotherapy (RT), CpG1 and CpC3 methylations were found to have a positive prognostic significance in terms of PFS (OR: 266, 95% CI: 1.05-6.75, p -0.03 for CpG1; OR: 2.4, 95% CI: 1.01-5.92, p = 0.04 for CpG3). The MGMT promoter methylation represents an important biomarker for predicting response to therapy. Individual islands, particularly CpG3, deserves further investigation as a prognostic marker. Further studies need to be done with larger sample sizes to clarify the results.

Comprehensive genotyping of Turkish women with hirsutism.

INTRODUCTION: Hirsutism is a medical sign rather than a disease affects 5-8% of women of reproductive age. Hirsutism is associated with hyperandrogenemia in most patients excluding those with idiopathic hirsutism (IH). The most common cause of hirsutism is polycystic ovary syndrome (PCOS) followed by IH and idiopathic hyperandrogenemia (IHA); however, the clinical presentation of non-classical congenital adrenal hyperplasia (NCAH) in females is often indistinguishable from other hyperandrogenic disorders with common clinical signs such as hirsutism. OBJECTIVE: The primary aim of the study is to examine the physical properties of the three genes and to make a detailed comparison of the mutations with the clinical data to contribute the etiology of hirsutism. SUBJECTS AND METHODS: 122 women admitted to the Endocrinology Clinic at Erciyes University Hospital with hirsutism were enrolled in the study between 2013-2014. All the participants were clinically evaluated. Protein-encoding exons, exon-intron boundaries of CYP21A2 (including proximal promoter), CYP11B1 and HSD3B2 genes were analyzed via state-of-the-art genetic studies. RESULTS: DNA sequencing analyses revealed two homozygous and three compound heterozygous 21-hydroxylase deficient (21OHD) NCAH patients. Additionally, three novel CYP21A2 mutations (A89V, M187I and G491S) and two novel CYP11B1 mutations (V188I and G87A) were determined. The frequencies of heterozygous mutations in CYP21A2 (including promoter), CYP11B1 and HSD3B2 genes were determined as 26.5% (15% coding region, 11.5% promoter), 11.5% and 0%, respectively. CONCLUSION: 21OHD-NCAH prevalence was determined to be ~4%. Unexpectedly, high heterozygous mutation rates were observed in CYP11B1 gene and CYP21A2 promoter region. CYP11B1 and HSD3B2 deficiencies were not prevalent in Turkish women with hirsutism despite the existence of higher heterozygous mutation rate in CYP11B1.

Challenges in the Search for Perchlorate and Other Hydrated Minerals With 2.1-µm Absorptions on Mars.

A previously unidentified artifact has been found in Compact Reconnaissance Imaging Spectrometer for Mars targeted I/F data. It exists in a small fraction (<0.05%) of pixels within 90% of images investigated and occurs in regions of high spectral/spatial variance. This artifact mimics real mineral absorptions in width and depth and occurs most often at 1.9 and 2.1 µm, thus interfering in the search for some mineral phases, including alunite, kieserite, serpentine, and perchlorate. A filtering step in the data processing pipeline, between radiance and I/F versions of the data, convolves narrow artifacts ("spikes") with real atmospheric absorptions in these wavelength regions to create spurious absorption-like features. The majority of previous orbital detections of alunite, kieserite, and serpentine we investigated can be confirmed using radiance and raw data, but few to none of the perchlorate detections reported in published literature remain robust over the 1.0- to 2.65-µm wavelength range. PLAIN LANGUAGE SUMMARY: Many minerals can be identified with remote sensing data by their characteristic absorptions in visible-shortwave infrared data. This type of data has allowed geological interpretation of much of Mars' surface, using satellite-based observation. We have discovered an issue with the Compact Reconnaissance Imaging Spectrometer for Mars instrument's data processing pipeline. In ~ <0.05% of pixels in almost all images, noise in the data is smoothed in such a way that it mimics real mineral absorptions, falsely making it look as though certain minerals are present on Mars' surface. The vast majority of previously identified minerals are still confirmed after accounting for the artifact, but some to all perchlorate detections and a few serpentine detections were not confirmed, suggesting that the artifact created false detections. This means concentrated regions of perchlorate may not occur on Mars and so may not be available to generate possibly habitable salty liquid water at very cold temperatures.

Genetic tests for low- and middle-income countries: a literature review.

The aim of this review is to describe a series of ten genetic diseases with Mendelian inheritance pattern in people of low- or middle-income countries, which can be easily identified with simple and affordable methods. Recent information shows that although genetic diseases account for more than 10% of infant mortality in such countries, testing, counseling, and treatment of genetic diseases is not a priority. The selection criteria for the genetic tests that are discussed in this review are: i) the frequency of the genetic disease in the general population, ii) the cost and ease of execution, and iii) the report of validated methods in the literature for the diagnosis of these diseases. The goal is to promote diagnosis of genetic diseases at low-cost and with relative ease, thereby enabling appropriate treatments, reducing mortality, and preventing genetic diseases in high-risk families.

GENETIC DISORDERS OF PITUITARY DEVELOPMENT IN PATIENTS WITH SHEEHAN'S SYNDROME.

INTRODUCTION: Genetic disorders associated with the development of the pituitary gland and cranial bones may cause a genetic tendency toward Sheehan's syndrome (SS). Our aim in this study was to investigate expression disorders in the genes responsible for the development of the pituitary gland and cranial bones in patients with SS. MATERIALS AND METHODS: Forty-four patients who were previously diagnosed with SS and 43 healthy women were compared in terms of the mean expression values of genes including the prophet of PIT-1 (PROP1), HESX homeobox 1 (HESX1), POU class 1 homeobox 1 (POU1F1), LIM homeobox 3 (LHX3), LHX4, glioma-associated oncogene homolog 2 (GLI2), orthodenticle homeobox 2 (OTX2), SIX homeobox 3 (SIX3), SIX6, T-box transcription factor 19 (TBX19), transducin-like enhancer protein 1 (TLE1), TLE3, distal-less homeobox 2 (DLX2), DLX5, MSH homeobox 2 (MSX2), and paired box 3 (PAX3). RESULTS: The mean expression values of the HESX1, TLE1, TLE3, and MSX2 genes were significantly different in the SS group from the healthy control group, while the mean expression values of the remaining genes were similar. CONCLUSION: The present study concludes that abnormal expressions of HESX1, TLE1, TLE3, and MSX2 genes may cause a genetic predisposition to the development of SS.

A huge cutaneous horn of ear.

A rare case of huge cutaneous horn of the ear was presented. The lesion was totally excised over the auricular cartilage with a 5-mm margin and the defect was closed with a full-thickness skin graft taken from the preauricular area. To the best of our knowledge, there is no any report of this kind of interesting cutaneous corn of the ear.

Syndromes presenting adducted thumb with/without clubfoot and Dundar syndrome.

Congenital adducted thumb has been called variously as congenital clasped thumb, thumb in palm deformity or flexion adduction deformity of the thumb. This condition can be an isolated anomaly or associated with several genetic disorders. The syndromes that include adducted thumb as a cardinal feature such as Dundar Syndrome are few in the literature. This syndrome is an autosomal-recessive very rare disorder characterized by typical facial appearance with dysmorphic features that includes wasted build, hyperextensible, thin and translucent skin with atrophic scarring, severe congenital contractures of fingers and thumbs, club feet, severe kyphoscoliosis, joint instability, muscular hypotonia, and ocular involvement. Heart, kidney, and/or intestinal defects can also be observed. Up to date the syndrome is described in few families in the literature. Here we discuss the syndromes that include adducted thumb as a cardinal feature and also the differential diagnosis of the Dundar Syndrome according to the literature.

Identification of predictive patient characteristics for assessing the probability of COVID-19 in-hospital mortality.

As the world emerges from the COVID-19 pandemic, there is an urgent need to understand patient factors that may be used to predict the occurrence of severe cases and patient mortality. Approximately 20% of SARS-CoV-2 infections lead to acute respiratory distress syndrome caused by the harmful actions of inflammatory mediators. Patients with severe COVID-19 are often afflicted with neurologic symptoms, and individuals with pre-existing neurodegenerative disease have an increased risk of severe COVID-19. Although collectively, these observations point to a bidirectional relationship between severe COVID-19 and neurologic disorders, little is known about the underlying mechanisms. Here, we analyzed the electronic health records of 471 patients with severe COVID-19 to identify clinical characteristics most predictive of mortality. Feature discovery was conducted by training a regularized logistic regression classifier that serves as a machine-learning model with an embedded feature selection capability. SHAP analysis using the trained classifier revealed that a small ensemble of readily observable clinical features, including characteristics associated with cognitive impairment, could predict in-hospital mortality with an accuracy greater than 0.85 (expressed as the area under the ROC curve of the classifier). These findings have important implications for the prioritization of clinical measures used to identify patients with COVID-19 (and, potentially, other forms of acute respiratory distress syndrome) having an elevated risk of death.

Author Correction: Achievement of sustainable development goals through the Mediterranean diet.

Correction to: Eur Rev Med Pharmacol Sci 2023; 27 (6 Suppl): 89-99-DOI: 10.26355/eurrev_202312_34693 After publication and following some post-publication concerns, the authors have applied the following corrections to the galley proof. -       The conflict of interest section has been amended as follows: M.C. Medori and D. Malacarne are employees at MAGI'S LAB. K. Donato is employee at MAGI EUREGIO and MAGISNAT. M. Bertelli is president of MAGI EUREGIO, MAGISNAT, and MAGI's LAB. E. Borghetti is president at AERSAFE srl. C. Zuccato is researcher at AERSAFE srl. E. Borghetti is patent inventor (IT202100021344A1, IT202100020330A1, WO2021260537A1, WO2022259165A1). M. Bertelli is patent inventor (US20220362260A1, US20230173003A1, WO2022079498A1). D. Malacarne is patent inventor (WO2022079498A1; US20230173003A1). S. Michelini is patent inventor (US20220362260A1). M. Bertelli, S. Michelini, and K. Donato are patent applicants (Application Number: 18/516,241). M. Bertelli and K. Donato are patent applicants (Application Number: 18/466.879). M. Bertelli, K. Donato, and S. Michelini are patent applicants (Application Number: 63/495,155). The remaining authors have no conflict of interest to disclose. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/34693.

A new finding in a patient with Mowat Wilson syndrome: peripupillary atrophy and gingival hypertrophy.

Mowat-Wilson syndrome is a genetic disease characterized by typical facial features, Hirschsprung disease and multiple congenital abnormalities. MWS is a single gene disorder. One of the most specific clinical signs in MWS is the distinctive face. We report a two-year-old boy with multiple congenital anomalies. He had peripupillary atrophy and gingival hypertrophy different from the literature. The patient was also diagnosed with his clinical findings. These features may be important in Mowat-Wilson syndrome and clinicians should keep these findings in mind.

Deep-Learning-Based High-Intensity Focused Ultrasound Lesion Segmentation in Multi-Wavelength Photoacoustic Imaging.

Photoacoustic (PA) imaging can be used to monitor high-intensity focused ultrasound (HIFU) therapies because ablation changes the optical absorption spectrum of the tissue, and this change can be detected with PA imaging. Multi-wavelength photoacoustic (MWPA) imaging makes this change easier to detect by repeating PA imaging at multiple optical wavelengths and sampling the optical absorption spectrum more thoroughly. Real-time pixel-wise classification in MWPA imaging can assist clinicians in monitoring HIFU lesion formation and will be a crucial milestone towards full HIFU therapy automation based on artificial intelligence. In this paper, we present a deep-learning-based approach to segment HIFU lesions in MWPA images. Ex vivo bovine tissue is ablated with HIFU and imaged via MWPA imaging. The acquired MWPA images are then used to train and test a convolutional neural network (CNN) for lesion segmentation. Traditional machine learning algorithms are also trained and tested to compare with the CNN, and the results show that the performance of the CNN significantly exceeds traditional machine learning algorithms. Feature selection is conducted to reduce the number of wavelengths to facilitate real-time implementation while retaining good segmentation performance. This study demonstrates the feasibility and high performance of the deep-learning-based lesion segmentation method in MWPA imaging to monitor HIFU lesion formation and the potential to implement this method in real time.

A machine learning model for orthodontic extraction/non-extraction decision in a racially and ethnically diverse patient population.

INTRODUCTION: The purpose of the present study was to create a machine learning (ML) algorithm with the ability to predict the extraction/non-extraction decision in a racially and ethnically diverse sample. METHODS: Data was gathered from the records of 393 patients (200 non-extraction and 193 extraction) from a racially and ethnically diverse population. Four ML models (logistic regression [LR], random forest [RF], support vector machine [SVM], and neural network [NN]) were trained on a training set (70% of samples) and then tested on the remaining samples (30%). The accuracy and precision of the ML model predictions were calculated using the area under the curve (AUC) of the receiver operating characteristics (ROC) curve. The proportion of correct extraction/non-extraction decisions was also calculated. RESULTS: The LR, SVM, and NN models performed best, with an AUC of the ROC of 91.0%, 92.5%, and 92.3%, respectively. The overall proportion of correct decisions was 82%, 76%, 83%, and 81% for the LR, RF, SVM, and NN models, respectively. The features found to be most helpful to the ML algorithms in making their decisions were maxillary crowding/spacing, L1-NB (mm), U1-NA (mm), PFH:AFH, and SN-MP(̊), although many other features contributed significantly. CONCLUSIONS: ML models can predict the extraction decision in a racially and ethnically diverse patient population with a high degree of accuracy and precision. Crowding, sagittal, and vertical characteristics all featured prominently in the hierarchy of components most influential to the ML decision-making process.

A novel statistical methodology for quantifying the spatial arrangements of axons in peripheral nerves.

A thorough understanding of the neuroanatomy of peripheral nerves is required for a better insight into their function and the development of neuromodulation tools and strategies. In biophysical modeling, it is commonly assumed that the complex spatial arrangement of myelinated and unmyelinated axons in peripheral nerves is random, however, in reality the axonal organization is inhomogeneous and anisotropic. Present quantitative neuroanatomy methods analyze peripheral nerves in terms of the number of axons and the morphometric characteristics of the axons, such as area and diameter. In this study, we employed spatial statistics and point process models to describe the spatial arrangement of axons and Sinkhorn distances to compute the similarities between these arrangements (in terms of first- and second-order statistics) in various vagus and pelvic nerve cross-sections. We utilized high-resolution transmission electron microscopy (TEM) images that have been segmented using a custom-built high-throughput deep learning system based on a highly modified U-Net architecture. Our findings show a novel and innovative approach to quantifying similarities between spatial point patterns using metrics derived from the solution to the optimal transport problem. We also present a generalizable pipeline for quantitative analysis of peripheral nerve architecture. Our data demonstrate differences between male- and female-originating samples and similarities between the pelvic and abdominal vagus nerves.

Unleashing the potential of biotechnology for sustainable development.

The UN Sustainable Development Goals (SDGs) strive to eliminate poverty, preserve the planet, and promote shared prosperity through sustainable and inclusive means by 2030. This requires the implementation of a diverse set of strategies to overcome challenges and foster synergies among different SDG targets, facilitating the achievement of these ambitious goals. The aim of this review is to highlight the world's progress toward SDGs with the utilization of biotechnological advancements, including targets, strategies, synergies, and challenges. We scrutinized published research articles in peer-reviewed journals, UN reports, and scientific books that were relevant to the current topic. We identified some major challenges faced by the countries, especially developing ones, in the way of sustainable progress. These include inadequate governance, fragile states, armed conflicts, rising inequality, limited economic progress, climate change, environmental degradation, and food insecurity. Biotechnological advancements contribute to sustainable resource management, environmental conservation, and ecosystem restoration. Collaboration among countries and organizations is crucial for sharing knowledge and providing technical and financial assistance to developing nations.

Achievement of sustainable development goals through the Mediterranean diet.

The prosperity of our planet relies on the cardinal concept of sustainable development. The dietary choices of humans play a pivotal role in creating a peaceful and contented world. In this context, the Mediterranean diet (MD) has emerged as a valuable approach to accomplishing such progress, wherein the rights of all living beings are equally honored. This review aims to analyze the significance of a plant-based diet, particularly the Mediterranean diet, in attaining sustainable development goals. A comprehensive search of the literature was conducted to gather the most reliable and published scientific evidence from books and papers. Within this research endeavor, specific Sustainable Development Goals (SDGs) are individually addressed in relation to the adoption of the Mediterranean diet as a foundational nutritional paradigm. Our research findings underscore the immense importance of the MD and advocate for its worldwide implementation to accomplish sustainable development objectives. The MD emerges as the most suitable dietary option for fostering sustainability and tranquility in our world. It is crucial to prioritize the global implementation of the MD to genuinely achieve sustainable development.

Bioetics Issues of Artificial Placenta and Artificial Womb Technology.

Abstract: The worldwide infertility crisis and the increase in mortality and morbidity among infants, due to preterm births and associated complications, have stimulated research into artificial placenta (AP) and artificial womb (AW) technology as novel solutions. These technologies mimic the natural environment provided in the mother's womb, using chambers that ensure the supply of nutrients to the fetus and disposal of waste substances through an appropriate mechanism. This review aims to highlight the background of AP and AW technologies, revisit their historical development and proposed applications, and discuss challenges and bioethical and moral issues. Further research is required to investigate any negative effects of these new technologies, and ethical concerns pertaining to the structure and operation of this newly developed technology must be addressed and resolved prior to its introduction to the public sphere.