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Objective: Localized exercises are employed to activate, train, or restore the function of particular muscles and they are usually considered as part of treating individuals suffering low back pain. So, this systematic review and meta-analysis aimed to assess the efficacy of specific exercises in general population with non-specific low back pain (LBP)., Methods: We conducted electronic searches in MEDLINE/PubMed, Scopus, Web of Science (WoS), and Google scholar from January 1990 to June 2021. Initially, 47,740 records were identified. Following the removal of duplicates, 32,138 records were left. After reviewing titles and abstracts, 262 papers were chosen for thorough assessment. Among these, 208 studies were excluded, resulting in 54 trials meeting the inclusion criteria for this study. Additionally, 46 of these trials were randomized controlled trials and were further evaluated for the meta-analysis. We included trials investigating the effectiveness of exercise therapy, including isometric activation of deep trunk muscles, strengthening exercises, stabilization exercises, stretching exercises, and proprioceptive neuromuscular facilitation exercises (PNF) in LBP patients. The primary outcome was pain intensity, measured using tools such as the visual analogue scale (VAS) and numeric pain rating scale (NPRS). The secondary outcome was disability, assessed through instruments such as the Roland Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI). The quality of the eligible studies was assessed using the Verhagen tool, and the level of evidence was evaluated using the GRADE approach., Results: Based on the Verhagen tool, 46 trials (85.2%) were categorized as having low methodological quality, while 8 studies (14.8%) were considered to have medium methodological quality. The meta-analysis indicated a small efficacy in favor of isometric activation of deep trunk muscles (-0.37, 95% CI: -0.88 to 0.13), a moderate efficacy in favor of stabilization exercises (-0.53, 95% CI: -1.13 to 0.08), and a large efficacy in favor of PNF exercises (-0.91, 95% CI: -1.62 to -0.2) for reducing pain intensity as assessed by VAS or NPRS tools. Moreover, the meta-analysis revealed a moderate efficacy for isometric activation of deep trunk muscles (-0.61, CI: -1.02 to -0.19), and a large efficacy for PNF exercises (-1.26, 95% CI: -1.81 to -0.72) in improving disability, assessed using RMDQ or ODI questionnaires. The level of certainty in the evidence, as determined by the GRADE approach, was very low to low., Conclusion: These findings emphasize the importance of incorporating localized therapeutic exercises as a fundamental aspect of managing non-specific LBP. Clinicians should consider utilizing localized therapeutic exercise tailored to individual patient needs. Furthermore, further research investigating optimal exercise therapy, optimal dose of the exercises, durations, and long-term adherence is warranted to enhance the precision and efficacy of exercise-based interventions for non-specific LBP., Competing Interests: Declaration of Competing interest The authors declare that they have no conflicts of interest related to this systematic review and meta-analysis. They have not received any funding or other financial support from any organization or individual that could potentially influence the outcome of this study., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Increasing of tobacco consumption around the world has led to the production of a large volume of waterpipe wastewater that enter the environment (e.g., coastal areas)and threaten aquatic creatures. However, until now, no research has been carried out on the amounts of monocyclic and polycyclic aromatic hydrocarbons (PAHs) in hookah wastewater. In the current study, the levels of PAHs and BTEX compounds in waterpipe wastewater resulting from the use of different tobacco brands were determined and their eco-toxicological effects were also evaluated. The mean levels of ƩPAHs in waterpipe wastewater of Al Tawareg, Al-Fakher, Nakhla, Tangiers and traditional tobacco brands samples were 3.48 ± 1.65, 3.33 ± 1.52, 3.08 ± 1.25, 2.41 ± 0.87 and 0.70 ± 0.13 μg/L, respectively. The mean levels of ƩBTEX in waterpipe wastewater of Al Tawareg, Al-Fakher, Nakhla, Tangiers and traditional tobacco brands samples were also 2.53 ± 0.61, 2.65 ± 0.78, 2.51 ± 0.72, 2.35 ± 0.56, and 0.78 ± 0.12 μg/L, respectively. The maximum level of PAHs and BTEX compounds in all brands/flavors samples were for naphthalene (Naph) and toluene, respectively. The concentrations of some PAHs (fluoranthene (Flrt), anthracene (Ant), benzo(b)fluoranthene (BbF), benzo(b)fluoranthene (BkF), benzo (g,h,i)perylene (BghiP) and dibenzo (a, h) anthracene (DahA)) and BTEX compounds (benzene) in the waterpipe wastewater samples were more than recommended guidelines and standards by the international reputable organizations such as World Health Organization (WHO) for water quality. Waterpipe wastewater can be introduced as an important origin for the release of these dangerous contaminants into the environmental matrixes. Therefore, more stringent regulations should be considered for the safe disposal of such hazardous wastes including waterpipe wastewater., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)

Background: Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes mellitus (DM). DPN is the primary risk factor for diabetic foot ulcers that can cause amputation. Although several observational studies have investigated the morphological and biomechanical characteristics of peripheral nerves in DPN, interventional studies regarding the effectiveness of neurodynamic techniques (NDT) in DPN patients are confined to a handful. The effects of NDT on neuropathy severity, nerve conduction parameters, quality of life (QoL), and mechanosensitivity have not been explored yet in this population., Materials and Methods: Forty type 2 DPN (T2DPN) patients, diagnosed based on an electrodiagnosis study, will be recruited into two groups. The experimental group will receive the tibial nerve's real proximal and distal slider techniques in addition to DPN standard treatment as a basic treatment, and the control group will receive the tibial nerve's sham proximal and distal slider techniques along with the basic treatment for eight sessions twice a week. Baseline and post-intervention assessments will be based on the Michigan diabetic neuropathy score (MDNS) (primary outcome), tibial nerve conduction parameters, neuropathy-specific quality of life (Neuro QoL) questionnaire, and straight leg raising range of motion (SLR ROM) (secondary outcomes)., Results: This study is expected to last approximately seven months, depending on recruitment. The results of the study will be published in a peer-reviewed journal., Conclusions: The present study will evaluate the efficacy of NDT on the primary and secondary outcome measurements in DPN patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Advanced Biomedical Research.)

Transport of ballast water is considered a significant vector for dispersion of different pollutants, including microplastics (MPs), throughout the world's oceans. However, there is limited information on MPs in ballast water. Size distribution, polymer type, and ecological risks of MPs in ballast water were investigated for the first time in this study. The mean levels of MPs in ballast water and seawater samples were 12.53 and 11.80 items/L, respectively. MPs with a size category of 50-300 μm was the most abundant. Fiber, black, and polycarbonate (PC) were the predominant shape, color, and polymer type of identified MPs in ballast water and seawater, respectively. The pollution load index (PLI), hazard index (HI), and risk quotient (RQ) indicated high levels of MP pollution, potentially indicating an ecological risk. These findings increase our understanding of the major sources (such as ballast water), transportation routes, and related ecological risks of MPs to marine ecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)