Diagnostic Value of Chest Computed Tomography Scan for Identification of Foreign Body Aspiration in Children: A Systematic Review and Meta-analysis.

Introduction: Foreign body aspiration (FBA) is a common, life-threatening pediatric emergency and was shown to be associated with high risk of morbidity and mortality. This systematic review and meta-analysis aimed to investigate the diagnostic value of chest computed tomography (CT) scan for identification of FBA in children. Methods: From inception to May 2024, a systematic search was carried out across multiple databases including Medline, Scopus, and Web of Science, considering published papers in English language. Quality assessment of the included studies was performed using seven domains of Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Results: The systematic literature search yielded 7203 articles. The pooled sensitivity and specificity of chest CT scan for identification of FBA were 0.99 (95% CI: 0.98-0.99) and 0.97 (95% CI: 0.96-0.98), respectively. The pooled positive likelihood ratio was 10.12 (95% CI: 4.59-22.20), and pooled negative likelihood ratio was 0.05 (95% CI: 0.02-0.1). Furthermore, the area under the summarized receiver operating characteristic (SROC) curve was 0.98. Conclusion: Our meta-analysis revealed that despite high heterogeneity, in the diagnostic characteristics of chest CT scan among studies, it has high diagnostic value in identifying FBA in suspected pediatric cases.

Beyond biomarkers: Exploring the diverse potential of a novel phosphoprotein in lung cancer management.

In addressing the challenges of lung cancer, attention has increasingly turned to molecular diagnostics and targeted therapies, with nucleolin (NCL) assuming a pivotal role, especially in non-small cell lung cancer. The aberrant activity and cellular distribution of NCL act as crucial biomarkers for early detection and treatment monitoring, showing a strong correlation with disease progression and patient prognosis. Elevated NCL levels signal advanced disease and poorer outcomes, underscoring its significance in evaluating disease severity and therapeutic response. Strategies targeting the molecular interactions of NCL have spurred innovative approaches to inhibit tumour growth, overcome drug resistance and improve treatment efficacy. These advancements are paving the way for personalized therapies tailored to the unique molecular profiles of patients' tumours. Consequently, NCL stands at the forefront of lung cancer management, symbolizing the move towards more precise and individualized oncology care, and marking substantial progress in therapeutic development.

White matter correlates of cognition: A diffusion magnetic resonance imaging study.

BACKGROUND: Our comprehension of the interplay of cognition and the brain remains constrained. While functional imaging studies have identified cognitive brain regions, structural correlates of cognitive functions remain underexplored. Advanced methods like Diffusion Magnetic Resonance Imaging (DMRI) facilitate the exploration of brain connectivity and White Matter (WM) tract microstructure. Therefore, we conducted connectometry method on DMRI data, to reveal WM tracts associated with cognition. METHODS: 125 healthy participants from the National Institute of Mental Health Intramural Healthy Volunteer Dataset were recruited. Multiple regression analyses were conducted between DMRI-derived Quantitative Anisotropy (QA) values within WM tracts and scores of participants in Flanker Inhibitory Control and Attention Test (attention), Dimensional Change Card Sort (executive function), Picture Sequence Memory Test (episodic memory), and List Sorting Working Memory Test (working memory) tasks from National Institute of Health toolbox. The significance level was set at False Discovery Rate (FDR)<0.05. RESULTS: We identified significant positive correlations between the QA of WM tracts within the left cerebellum and bilateral fornix with attention, executive functioning, and episodic memory (FDR=0.018, 0.0002, and 0.0002, respectively), and a negative correlation between QA of WM tracts within bilateral cerebellum with attention (FDR=0.028). Working memory demonstrated positive correlations with QA of left inferior longitudinal and left inferior fronto-occipital fasciculi (FDR=0.0009), while it showed a negative correlation with QA of right cerebellar tracts (FDR=0.0005). CONCLUSION: Our results underscore the intricate link between cognitive performance and WM integrity in frontal, temporal, and cerebellar regions, offering insights into early detection and targeted interventions for cognitive disorders.

Streets and Stress: A Pilot Study on How Quality and Design of Streets Impacts on Urban Stress.

OBJECTIVES: To identify how quality and design of streets impacts urban stress. BACKGROUND: Few studies have comprehensively addressed environmental factors affecting stress in urban public spaces. However, a remarkable portion of our everyday life is spent in public spaces, particularly streets. METHOD: This study seeks to evaluate the effect of three types of streets as major public spaces on stress. These include a street with the dominance of green spaces (A), a motorist-oriented street (B), and a pedestrian street (C). For this purpose, we selected a group of participants (n = 16) aged 20-30, with an equal number of men and women who were generally healthy and had normal stress levels. Participants were asked to wear an electroencephalogram (EEG) headset, walk different streets, and answer the Perceived Restorativeness Scale (PRS) and urban design qualities questionnaires. RESULTS: According to the results, participants experienced the highest stress in street type B and the lowest in type A. CONCLUSIONS: Green space and vegetation, a sense of security, privacy and coziness, climatic comfort, and safety of space had the most positive effect on stress reduction. Whereas noise pollution, vehicle traffic, and crowdedness were the most critical factors of stress. Finally, our findings suggest that the component of green space has a more significant effect on stress reduction compared with the elimination of vehicle traffic.

Application of iron-intercalated graphite for modification of nickel foam cathode in heterogeneous electro-Fenton system: Bisphenol A removal from water at neutral pH.

The presence of bisphenol A (BPA) in natural waters can be highly harmful due to its high persistence and adverse effects, raising concerns to remove this hazardous compound. Herein, an electro-Fenton system is proposed to eliminate BPA, wherein the iron source in the Fenton reaction is provided by its intercalation into the carbon layers of graphite. The produced heterogeneous catalyst was then coated onto the nickel foam serving as a cathode. The magnetic graphite intercalated compound (mGIC) and the modified cathode (before and after experiments) were characterized by FE-SEM, EDX, XPS, and XRD analyses. Some effective parameters, namely pH (3-9), current density (0-20 mA cm-2), and BPA concentration (0.5-20 mg L-1) were studied. At pH 3, the removal of BPA was 95.52%, and under neutral circumstances, the BPA and TOC removals were 85.70 and 58.12%, respectively at the initial BPA concentration of 10 mg L-1. The proposed system was also applied to several water sources spiked with BPA at the concentration of 5 mg L-1 under neutral pH, which exhibited considerable removal of 99.74%, 99.72%, and 92.70% for groundwater, municipal effluent wastewater, and tap water, respectively. The proposed system was applied for 15 consecutive cycles without showing significant changes in BPA removal, indicating its excellent stability and reusability. Furthermore, based on the analysis of intermediates, a possible decomposition pathway was proposed, indicating a reduction in overall toxicity. By using the proposed heterogeneous electro-Fenton system, iron waste is avoided, and operational costs of treatment can be reduced due to the absence of iron sludge production and catalyst loss.

Bisphenol A removal in treated wastewater matrix at neutral pH using magnetic graphite intercalation compounds as persulfate activators.

Effluents of municipal wastewater treatment plants (WWTPs) are major sources for releasing contaminants of emerging concern (CECs) into the aquatic environment, which can result in negative effects on aquatic ecosystems and, as a consequence, on humans. Herein, the graphite intercalation concept was used to synthesize heterogeneous catalysts to degrade bisphenol A (BPA) as a model CEC in municipal WWTP effluents at neutral pH. The catalyst was synthesized using the simple molten salt method and showed several benefits, such as iron leaching prevention and stability in environmental matrices. Different methods were applied to describe the catalyst's structural characteristics. The proposed system removed 99.3% of BPA in 75 min using 2 g/L of the synthesized catalyst and 1.19 g/L (5 mM) persulfate at neutral pH. Quenching experiments showed that catalytic activities and BPA removals were significantly aided by both radical and non-radical pathways through the generation of free radicals and singlet oxygen (1 O2 ). Furthermore, the reuse of recycled synthesized catalyst was investigated on treated urban wastewater, and the results showed that the catalyst could degrade BPA from the wastewater in consecutive cycles, demonstrating its applicability under real conditions. PRACTITIONER POINTS: BPA was effectively removed from the effluents of municipal WWTPs at neutral pH. A new catalyst (magnetic GIC) was fabricated for heterogeneous catalytic systems. The catalyst activates persulfate to generate free radicals and 1 O2 , indicating that radical and non-radical pathways contribute to BPA degradation. The catalyst showed the ability to remove BPA even in the sixth cycle of use, demonstrating its stability and reusability.

The effectiveness of virtual interactive video in comparison with online classroom in the stroke topic of theoretical neurology in COVID-19 pandemic.

BACKGROUND: Sufficient interaction between the trainers and the trainees in medical education is always one of the biggest challenges for an educational system. This study was designed to evaluate the effect of virtual interactions within the educational content of stroke on the effectiveness of teaching for general medicine students during COVID-19 crisis. MATERIALS AND METHODS: Eight medical students applying for stroke education were divided into two groups by simple random sampling (Rafsanjan Medical School, 2020). The first group participated in an online classroom via the Adobe Connect platform without virtual interaction. The second group used a video presentation containing interaction scenarios. The effectiveness evaluation of each type of educational content was done by comparison of the final exam scores and the results of an electronic satisfaction questionnaire in each group. Finally, using SPSS software version 18, the data were analyzed with independent samples t-test. RESULTS: This study showed that the mean of the examination scores of the interactive virtual content group (6.14 ± 1.46) was significantly higher than the online class group (4.50 ± 1.50) (P < 0.001), and also the results of satisfaction assessment showed that this group was more satisfied with their educational content (P = 0.005). CONCLUSION: Evaluation of the virtual stroke training effectiveness for general medical students shows that the educational approach of video with virtual interactions is an effective learning method in medical topics and can be considered as an efficacious educational model in online teaching.

The Associations Between Urban Form and Major Non-communicable Diseases: a Systematic Review.

In the current century, non-communicable diseases (NCDs), particularly cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases, are the most important cause of mortality all over the world. Given the effect of the built environment on people's health, the present study seeks to conduct a systematic review in order to investigate the relationship between urban form and these four major NCDs as well as their main risk factors. Two independent reviewers in November 2020 after an extensive search through PubMed and Scopus identified 77 studies. Studies published in English were included if they addressed one or more attributes of urban form in relation to any major NCDs and their main risk factors. Publication date, country, geographical scale, study design, methods of built environment measurement, and findings of the relationships among variables were extracted from eligible studies. The findings suggest that the elements of urban form (density, transportation and accessibility, characteristics of building and streetscape, land use, spatial layouts and configuration) could increase or inhibit these diseases through their effect on physical activity, diet, air pollution, blood pressure, and obesity. However, there are study shortages, contradictions, and ambiguities in these relationships which are mainly due to methodological and conceptual challenges. As a result, more in-depth research is needed to achieve solid and consistent results that could be made into clear guidelines for planning and designing healthier cities.

EZH2 as a new therapeutic target in brain tumors: Molecular landscape, therapeutic targeting and future prospects.

Brain tumors are responsible for high mortality and morbidity worldwide. The brain tumor treatment depends on identification of molecular pathways involved in progression and malignancy. Enhancer of zeste homolog 2 (EZH2) has obtained much attention in recent years in field of cancer therapy due to its aberrant expression and capacity in modulating expression of genes by binding to their promoter and affecting methylation status. The present review focuses on EZH2 signaling in brain tumors including glioma, glioblastoma, astrocytoma, ependymomas, medulloblastoma and brain rhabdoid tumors. EZH2 signaling mainly participates in increasing proliferation and invasion of cancer cells. However, in medulloblastoma, EZH2 demonstrates tumor-suppressor activity. Furthermore, EZH2 can regulate response of brain tumors to chemotherapy and radiotherapy. Various molecular pathways can function as upstream mediators of EZH2 in brain tumors including lncRNAs and miRNAs. Owing to its enzymatic activity, EZH2 can bind to promoter of target genes to induce methylation and affects their expression. EZH2 can be considered as an independent prognostic factor in brain tumors that its upregulation provides undesirable prognosis. Both anti-tumor agents and gene therapies such as siRNA have been developed for targeting EZH2 in cancer therapy.

Targeted regulation of autophagy using nanoparticles: New insight into cancer therapy.

Normal cells depend on autophagy to maintain cellular homeostasis by recycling damaged organelles and misfolded proteins and degrading toxic agents. Similar to apoptosis, targeting autophagy has been under attention in cancer therapy. However, autophagy has both pro-survival and pro-death functions in tumors, and its targeting requires further elucidation. The current review focuses on using nanoparticles for targeting autophagy in cancer treatment. Nanocarriers can deliver autophagy regulators along with chemotherapeutic agents leading to intracellular accumulation in cancer cells and synergistic cancer therapy. Furthermore, genetic tools such as siRNA and shRNA can be used for targeting molecular components that regulate autophagy, such as the ATG12-ATG5-ATG16L1 complex. A number of nanostructures, such as gold and zinc oxide nanoparticles, can be used to enhance oxidative stress-mediated apoptosis and autophagy, reducing cancer progression. Further, using nanoparticles to modulate autophagy potentiates the anti-tumor effects of cisplatin and gefitinib during chemotherapy. Polymeric nanoparticles, lipid-based nanostructures and carbon-based nanomaterials are among other nanoparticles capable of regulating autophagy in cancer cells. Of note, various regulatory components of autophagy such as ATGs, Beclin-1 and LC3-II can be affected by nanomaterials. Based on the role of nanomaterial-induced autophagy as pro-survival or pro-death, further targeting can potentiate the fight against cancer cells.

Second Transurethral Resection of Bladder Tumor: Is it Necessary in All T1 and/or High-Grade Tumors?

PURPOSE: To evaluate the role of second transurethral resection of bladder tumor (TURBT) in patients with T1 and/or high-grade bladder tumor regarding tumor size, multiplicity, and presence or absence of muscle in specimens of initial resection. MATERIALS AND METHODS: A total of 107 patients with either primary T1 or high-grade urothelial bladder cancer underwent second TURBT within 6 weeks after initial surgery and prior to starting intravesical immunotherapy. We assessed the incidence of residual disease and upstaging in second TURBT. RESULTS: Upstaging was noted in 11 (10.3%) patients and residual tumor was evident in 29 (27%) patients. Disease upstaging had a statistically significant association with tumor size, multifocality, and absence of muscle at initial resection in univariate analysis. Presence of residual tumor in second resection also showed significant association with tumor size and absence of muscle at initial resection but not multifocality. Multivariate logistic regression analysis revealed that absence of muscle at initial resection independently predicts disease upstaging during second TURBT (OR = 8.123, 95% CI: 1.478-44.632). Furthermore, both tumor size (OR = 13.573, 95% CI: 3.104-59.359) and absence of muscle (OR = 21.214, 95% CI: 6.062-74.244) were independent predictors of residual disease in second TURBT. CONCLUSION: We showed that second TURBT in a subset of patients with single, small T1 and/or high-grade tumor who underwent complete initial resection might be of limited value.

Antimicrobial activity of tetraacetylethylenediamine-sodium perborate versus sodium hypochlorite against Enterococcus faecalis.

Background. This study evaluated the antimicrobial activity of Tetraacetylethylenediamine-sodium perborate (TAED-SP) in comparison to 2.5% and 5% sodium hypochlorite (NaOCl) against Enterococcus faecalis. Methods. A standard suspension of E. faecalis was inoculated on 60 plates containing Mueller-Hinton agar culture medium. Four sterile disks of Beckman filtration paper were placed on each plate. TAED-SP, 5% and 2.5% NaOCl were placed on three disks. Sterile physiologic saline was placed on the fourth disk as negative control. After 24-hour incubation, the diameter of the inhibition zone around the disks was measured using a transparent ruler. One-way Analysis of Variance (ANOVA) was used to compare the mean zone of microbial growth in the groups. P-values less than 0.05 were considered statistically significant. Results. There was a significant difference in the diameter of the inhibition zones between groups (P < 0.05). The Tukey post hoc test showed a higher diameter of the inhibitory zone with TAED-SP than that of 2.5% NaOCl. However, there were no significant differences between the inhibitory zones of TAED-SP and 5% NaOCl. Conclusion. TAED-SP and 5% NaOCl have similar antibacterial activity against E. faecalis; however, TAED-SP has a greater antibacterial effect compared to 2.5% NaOCl.