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Purpose: Brain metastases (BM) often leave residual tumors despite having visible margins, which increases the risk of local tumor recurrence and can impact overall patient survival rates. Fluorescence-guided surgery (FGS) utilizing sodium fluorescein (FL) has been reported as an effective technique in recent studies. This study aimed to evaluate the efficacy of FL FGS in improving the extent of resection of brain metastases and its impact on overall survival. Methods: We conducted a systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Our primary focus was on gross total resection (GTR). Additionally, we extracted survival data and evaluated the risk of bias using a modified version of the Joanna Briggs Institute critical appraisal tool. Results: The study comprised 970 patients with brain metastases through eight different studies. The study found that patients who underwent FL-guided resection had a significantly higher rate of GTR (OR: 2.02, 95% CI: 1.14–3.56, p = 0.0156, I2 = 41.5%). Additionally, the study concluded that FL-guided resection is associated with better overall survival rates (HR: 0.61, 95%CI: 0.47 0.80, p = 0.0003, I2 = 41.5%). Conclusion: Our research suggests that the use of FL is associated with a higher rate of GTR and improved overall patient survival. None of the studies we reviewed reported significant complications associated with the use of FL in patients. [ABSTRACT FROM AUTHOR]

The morphology of the major and minor glands in the Persian squirrel (Sciurus anomalus) is crucial for understanding this mammal's biological and ecological relationships. This study aimed to compare the macro- and microanatomies of the major and minor salivary glands in Persian squirrels. Five euthanized adult Persian squirrels were used for this investigation. The macroscopic and microscopic evaluations were carried out after dissection, and tissue samples were fixed and slides prepared. Afterward, specific staining methods were used for the histochemical study. The results of this investigation indicated that Persian squirrels, as pets and wild rodents, have several minor salivary glands, including caudal buccal, lingual, palatine, and palatoglossal salivary glands. The rostral buccal region and labial region of the Persian squirrel were sectioned serially, but there were no salivary secretory units in these regions. The parotid gland was completely acinar serous, the submandibular salivary gland was branched tubuloacinar seromucous, and the sublingual gland was tubuloacinar seromucous. In addition, in this research, the two parts of the sublingual gland, monostomatice, and polystomatic parts, were completely determined. The striated, intercalated, interlobar, and excretory ducts composed the ductal system of the major salivary glands in Persian squirrels. The interlobar septa between the lobules contained blood vessels and interlobar ducts. The myoepithelial cells were seen around the secretory units of all major salivary glands. In conclusion, it can be noticed that the major and minor salivary glands of the Persian squirrel had been scattered in the oral cavity, such as the palatine, tongue, and buccal regions, and the secretory units of these glands were different from other rodents due to the difference in nutrition of the Persian squirrel. [ABSTRACT FROM AUTHOR]

Introduction: Type 2 diabetes mellitus (T2DM) is a significant risk factor for the development of critical limb ischemia (CLI), the most advanced stage of peripheral arterial disease. The concurrent existence of T2DM and CLI often leads to adverse outcomes, namely limb amputation. Objective: To identify biomarkers for improving the screening of CLI in high-risk people with T2DM. Methods: We investigated metabolome profiles in serum samples of 113 T2DM people with CLI (n = 23, G2) and without CLI (n = 45, G0: no lower limb stenosis (LLS) and n = 45, G1: LLS < 50%), using hydrogen nuclear magnetic resonance (1H NMR) approach. Principle component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) were used to analyze 1H NMR data. Results: Twenty potential metabolites that could discriminate people with T2DM and CLI (G2) from non-CLI patients without LLS (G0) were determined in serum samples. The correct percent of classification for the PLS-DA model for the test set samples was 85% (n = 20) and 100% (n = 5) for G0 and G2 groups, respectively. Non-CLI patients with LLS < 50% (G1) were projected on the PCA abstract space built using 20 discriminatory metabolites. Eleven people with T2DM and LLS < 50% were prospectively followed, and their ankle-brachial index (ABI) was measured after 4 years. A promising agreement existed between the PCA model's predictions and those obtained by ABI values. Conclusion: The findings suggest that confirmation of blood potential metabolic biomarkers as a complement to ABI for screening of CLI in a large group of high-risk people with T2DM is needed. [ABSTRACT FROM AUTHOR]

Purpose: Peripheral neuropathy is a dose-limiting adverse effect of oxaliplatin. The aim of this study was to evaluate the efficacy and safety of duloxetine in the prevention of oxaliplatin-induced peripheral neuropathy (OIPN). Method: Cancer patients receiving oxaliplatin based chemotherapy were randomized into two arms. Duloxetine 60 mg capsule was given in the first 14 days of each chemotherapy cycle to one arm and placebo was similarly given to another. We compared the two arms based on the incidence of neuropathy and the results of the nerve conduction study (NCS). Grade of complained neuropathy was recorded according to Common Terminology Criteria for Adverse Events (CTCAE). Results: Thirty-two patients mostly rectal cancer (90.6%) were randomized to duloxetine and placebo arms. Highest grade of neuropathy in each cycle was not significantly different between the two groups. Six weeks after treatment incidence of neuropathy of any grade was 52.9 in duloxetine arm compared to 76.9% in placebo arm (P: 0.26). Patients in the duloxetine arm had a lower percentage of chemotherapy cycles (mean) in which they reported distal paresthesia (51% vs. 84%, P = 0.01) and throat discomfort (37% vs. 69%, P = 0.01). Results of NCS were mostly comparable between the two arms except for the velocity in two of the examined nerve which was significantly higher in duloxetine group. Duloxetine was safe and well-tolerated. Conclusion: Although a definite conclusion might be difficult to draw but administering duloxetine for 14 days in each chemotherapy cycle could not decrease the incidence of acute OIPN based on CTCAE grading system. [ABSTRACT FROM AUTHOR]

Human activities are the most effective and significant cause of environmental changes, some of which are destructive and others are beneficial. One of the most effective steps to protect the environment is to assess farmers' behavior in achieving the goals of environmental sustainability. This study aimed to analyze the environmental sustainability behavior of farmers using the norm activation theory (NAT) in a questionnaire-based survey. The statistical population comprised wheat farmers in Kermanshah province, Iran (N = 126,900). The sample size was determined to be 382 farmers by Krejcie and Morgan's table. The validity of the questionnaire was verified by experts and its reliability was confirmed by a pilot test and calculating Cronbach's alpha. Five variables of perceived behavior control, perceived self-efficacy, ascription of responsibility, denial of responsibility, and awareness of consequences had significant effects on personal norms. The variable of personal norms had a significant effect on farmers' sustainable behavior. By and large, it can be concluded that NAT can adequately account for the environmental sustainability of farmers. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the efficacy of empagliflozin compared to pioglitazone in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2DM). Methods: In this prospective randomized, double-blind, placebo-controlled trial, we assigned 106 patients with NAFLD and T2DM to receive empagliflozin 10 mg (n = 35), pioglitazone 30 mg (n = 34), or placebo (n = 37) for 24 weeks. Liver fat content and liver stiffness were measured using fibroscans. Body composition assessment was performed by dual-energy x-ray absorptiometry (DEXA) scans. The primary end point was change from baseline in liver steatosis, using the controlled attenuation parameter (CAP) score. Results: A borderline significant decrease in CAP score was observed with empagliflozin compared to placebo, mean difference: − 29.6 dB/m (− 39.5 to − 19.6) versus − 16.4 dB/m (− 25.0 to − 7.8), respectively; p = 0.05. Using multivariate analysis, we observed a significant reduction in the placebo-corrected change in liver stiffness measurement (LSM) with empagliflozin compared to pioglitazone: − 0.77 kPa (− 1.45, − 0.09), p = 0.02, versus 0.01 kPa (95% CI − 0.70, 0.71, p = 0.98), p for comparison = 0.03. Changes in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT), fasting insulin, homeostatic model assessment for insulin resistance (HOMA-IR), HOMA2-IR, fibrosis-4 index (FIB4 index), NAFLD fibrosis score, aspartate aminotransferase to platelet ratio index (APRI), android/gynecoid ratio (A/G ratio), and skeletal muscle index (SMI) were comparable between the two treatment groups, while significant reductions of the body weight and visceral fat area were observed only in the empagliflozin group (p < 0.001 and p = 0.01, respectively) and both were increased in the placebo and pioglitazone groups. There were no serious adverse events in either group. Conclusion: Treatment for 24 weeks with empagliflozin, in contrast to pioglitazone, was associated with improvement of liver steatosis and fibrosis in patients with NAFLD and T2DM. In addition, body weight and abdominal fat area were decreased in the empagliflozin group. Trial Registration: Iranian Registry of Clinical Trials (IRCT), IRCT20190122042450N3. [ABSTRACT FROM AUTHOR]

Introduction: Despite the high prevalence of non-alcoholic fatty liver disease (NAFLD) and its associated co-morbidities, no efficient treatment in a high percentage of individuals is available. Beneficial effects of sodium–glucose co-transporter 2 inhibitors on fatty liver have been investigated in people with type 2 diabetes (T2DM). The aim of this study was to explore the effect of empagliflozin on liver steatosis and fibrosis in patients with NAFLD without T2DM. Methods: In this prospective randomized, double-blind, placebo-controlled clinical trial, participants with NAFLD were randomized to empagliflozin (10 mg/day) (n = 43) or placebo (n = 47) for 24 weeks. Hepatic steatosis and fibrosis were assessed using transient elastography to measure the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). The primary outcome was the change in CAP score at 24 weeks. Results: There was significant decrease in CAP score in both groups but no significant difference was observed between the two groups (P = 0.396). LSM was significantly decreased in the empagliflozin-treated group (6.03 ± 1.40 to 5.33 ± 1.08 kPa; P = 0.001), while no change was found in the placebo group. In subgroups analysis of patients with significant steatosis at baseline (CAP ≥ 302 dB/m), steatosis significantly improved in the empagliflozin group (37.2% vs. 17%; P = 0.035). There was a significant decrease in the grade of liver fat on visual analysis of ultrasound images, AST, ALT, and fasting insulin levels in the empagliflozin group, while no changes were observed in the placebo group. Conclusions: Empagliflozin improves liver steatosis and, more importantly, measures of liver fibrosis in patients with NAFLD without T2DM. Trial registration: ClinicalTrials.gov identifier, IRCT20190122042450N1. [ABSTRACT FROM AUTHOR]

Inflow prediction of reservoirs is of considerable importance due to its application in water resources management related to downstream water release planning and flood protection. Therefore, in this research, different new input patterns for predicting inflow to Zayandehroud dam reservoir is proposed employing artificial neural network (ANN) and support vector machine (SVM) models. Nine different models with different patterns of input data such as inflow to the dam reservoir considering time duration lags, time index, and monthly rainfall of Ghaleh-Shahrokh station have been proposed to predict the inflow to the dam reservoir. Comparison of the results indicates that the ninth proposed model has the least error for inflow prediction in which the results of SVM model outperform those of ANN model. That is, the least error has been obtained using the ninth SVM (ANN) model with correlation coefficient (R) values of 0.8962 (0.89296), 0.9303 (0.92983) and 0.9622 (0.95333) and root mean squared error (RMSE) values of 47.9346 (48.5441), 42.69093 (43.748) and 23.56193 (28.5125) for training, validation and test data, respectively. [ABSTRACT FROM AUTHOR]

During an organism’s evolution, functional adaptations help species to become better suited to their ecological niches. From the morphological aspect, these adaptations are reflected in the anatomical specializations of different organs. Specializations of the lingual organ is a critical adaptation of birds, such as the white-headed duck (Oxyura leucocephala), that enables their nutritional requirements to be met. For optimal use of the available food resources, the white-headed duck utilizes three methods of food collection, namely pecking, grazing and filter-feeding. Since this species is classified as endangered, we conducted the present study on two carcasses of the white-headed duck (death due to natural causes) employing routine histological methods, light microscopy and scanning electron microscopy. Our results show that the tongue of this bird shares some similarities and some differences with the tongue of other members of the family Anatidae. The results confirm that it is better adapted to the filter-feeding method rather than to other types of food intake. This adaptation is reflected by anatomical specializations of its lingual structures, including the stair-like outline shape, bi-sectional lingual body, a deep median sulcus, lateral conical papillae, mucus secreting glands, lack of serous secreting glands, cartilaginous skeleton and the triangular fibromuscular structure of the lingual body. The so-called triangular structure and cartilaginous skeleton are the major structures involved in the lingual motions during the filter-feeding method. The presence of the triangular structure and its connection with the cartilaginous skeleton and lingual mucosa have not previously been reported in any species of birds. [ABSTRACT FROM AUTHOR]

The hedgehog tongue is a tactile and taste organ which carries out various functions. Detailed functional and morphological studies are required to clearly define the relationship of the hedgehog tongue with taste, food palatability, mastication and swallowing of food, as well as the production of sounds. The aim of this study was to determine the relationship between the morphological characteristics of the European hedgehog tongue and the lifestyle of this animal, as well as to compare findings with the results of studies on other vertebrates. Gross and micro-anatomical light and scanning electron microscopy studies revealed that the hedgehog tongue could be divided in three areas, namely the apex, body and root. A keratinized stratified squamous epithelium, which was smooth on the ventral surface but bore four types of papillae on the dorsal surface, lined the tongue. Three types of these papillae were found to have gustatory functions and to express their activity in close relation with the salivary glands. These simple conical filiform papillae were situated caudally and distributed one after the other without a break. The dome-shaped fungiform papillae on the apex, with the highest distribution rate on the apex edge, were small, but those on the body and root were large. The three circular vallate papillae were arranged in a triangular shape. The foliate papillae with a few tiny projections, found in a shallow furrow, were situated between the root and the body. Most of the nerve fibers observed in different sections of the tongue tissue were of the unmyelinated type, confirming that the main task of the hedgehog tongue was its gustatory function. [ABSTRACT FROM AUTHOR]

Osteomyelitis can present as a severe complication in diabetic patients. The present study was structured to evaluate the histopathological characteristics of bone infection in the feet of diabetic patients and to associate any clinical variables seen with each type of bone infection. Eighty-four cases of osteomyelitis were evaluated microbiologically and histopathologically after samples were collected under sterile conditions in an operating room. The data generated were analysed using SPSS software. Polymorphonuclear neutrophil (PMN) infiltrates were associated with acute osteomyelitis (AO) (22 cases (26.2%)) and chronic acute osteomyelitis (CAO) (10 cases (11.9%)), whereas a strong association was observed between mononuclear infiltrates and chronic osteomyelitis (CO) (33 cases (39.3%)) and fibrosis (19 cases (22.6%)). Ulcer longevity on hospital admission varied for each condition: AO (10.9 + 22 weeks), CO (29.1 + 20.6 weeks), CAO (31.5 + 22.2 weeks) and fibrosis (30.5 + 23 weeks) ( P < 0.05) (values expressed as mean + SD). The same was true for the presence of pathogenic bacteria: AO (16/22, 72.7%), CO (27/33, 81.8%), CAO (7/10, 70%) and fibrosis (16/19, 84.2%). There was significant correlation between histopathological features and presence of bacteria and longevity of the ulcer on presentation ( P < 0.05). Osteomyelitis in the feet of diabetic patients should be classified as four specific but interlinked groups: acute, chronic, acute on chronic and fibrosis. [ABSTRACT FROM AUTHOR]

The affiliation of the third author has been incorrectly published in the original publication of the article. The correct affiliation is provided in this erratum. [ABSTRACT FROM AUTHOR]