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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]