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Key Clinical Message Patients with a history of persistent mesenteric ischemia should not undergo laparoscopy. Mesenteric ischemia must be kept in mind for patients who develop nonspecific abdominal symptoms following laparoscopic surgeries. Abstract During laparoscopic cholecystectomy (LC), the rise in Intra‐Abdominal Pressure due to carbon dioxide insufflation can reduce blood flow through splanchnic vessels, potentially leading to intestinal ischemia. A 72‐year‐old woman with a history of diabetes, hypertension, ischemic heart disease, and hyperlipidemia underwent LC. She was discharged but readmitted 4 days later due to peritonitis. Ischemic jejunum loops were found during surgery.

ABSTRACT Breast cancer is a common form of cancer among women characterized by the growth of malignant cells in the breast tissue. The most common treatments for this condition include chemotherapy, surgical intervention, radiation therapy, hormone therapy, and biological therapy. The primary issues associated with chemotherapy and radiation therapy are their adverse events and significant financial burden among patients in underdeveloped countries. This highlights the need to explore and develop superior therapeutic options that are less detrimental and more economically efficient. Plants provide an abundant supply of innovative compounds and present a promising new avenue for investigating cancer. Plants and their derivations are undergoing a revolution due to their reduced toxicity, expediency, cost‐effectiveness, safety, and simplicity in comparison to conventional treatment methods. Natural products are considered promising candidates for the development of anticancer drugs, due perhaps to the diverse pleiotropic effects on target events. The effects of plant‐derived products are limited to cancer cells while leaving healthy cells unaffected. Identification of compounds with strong anticancer properties and development of plant‐based medications for cancer treatment might be crucial steps in breast cancer therapy. Although bioactive compounds have potent anticancer properties, they also have drawbacks that need to be resolved before their application in clinical trials and improved for the approved drugs. This study aims to give comprehensive information on known anticancer compounds, including their sources and molecular mechanisms of actions, along with opportunities and challenges in plant‐based anticancer therapies.

Abstract Background Mastitis poses significant challenges to the dairy industry, resulting in economic losses and increased veterinary expenses. Staphylococcus aureus is a common cause of bovine mastitis, relying on efficient adhesion and biofilm formation for infection. Objectives This study aimed to employ meta‐analysis to investigate the occurrence of adhesion and biofilm genes in S. aureus associated with bovine mastitis, as documented in previous studies. Methods This meta‐analysis was done according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses, examined 22 eligible articles and revealed varying prevalence rates of adhesion and biofilm genes in S. aureus isolates from bovine mastitis. Results Among the genes, clfB showed the highest prevalence (p‐estimate = 0.905), followed by fnbA (p‐estimate = 0.689) and fnbB (p‐estimate = 0.502). The icaA and icaD genes also showed a relatively high prevalence (p‐estimate = 0.694 and 0.814, respectively). Conversely, the biofilm‐associated proteins gene had the lowest prevalence (p‐estimate = 0.043). Subgroup analyses based on mastitis types and publication years revealed no significant differences in gene prevalence. Insufficient data hindered the analysis of fib, sasG , eno and bbp genes. Conclusion This study provides valuable insights for managing S. aureus‐induced bovine mastitis. Additionally, larger‐scale research, particularly on less‐studied genes, is necessary to comprehend the molecular roles of adhesion and biofilm genes in S. aureus‐induced bovine mastitis.

Introduction A case describing bilateral limb shaking episodes in a patient with severe bilateral carotid disease ‐ a rare manifestation of limb‐shaking TIA. Methods '‐ Results CASE A 71‐year‐old male patient with a past medical history significant for type 2 diabetes mellitus and bilateral carpal tunnel syndrome is being followed for symptomatic management of known axonal sensorimotor diabetic polyneuropathy in the neuromuscular clinic. He reported on one of his follow‐up visits that he had been experiencing an eight‐month history of presyncopal to syncopal events occurring solely in the standing position, not followed by postictal state but amnesia to the syncope itself, and resulting in falls with mild injuries. He was experiencing new‐onset dry eyes and mouth but denied anhidrosis or early satiety, and cardiac event monitoring during one of these events was unremarkable for rhythmic causes. Examination was unchanged from previously and was significant for findings consistent with length‐dependent sensory loss with hyporeflexia/areflexia. The constellation of symptoms was suggestive of autonomic dysfunction, and while this may be seen with diabetic polyneuropathy, workup for alternative autonomic neuropathies (including SSA/SSB antibodies, paraneoplastic antibody panel, serum protein electrophoresis with immunofixation, serum free light chains, transthyretin amyloid) was obtained with plan for follow‐up. A few months later, he presented to the ED with intermittent upper extremity shaking (more pronounced on the right than on the left) preceding the syncopal events, which only occurred in the standing position or during physical activity and resolved with rest. There were no (transient) focal neurological deficits, including monocular vision loss or hemispheric syndrome. CTA of the head/neck was obtained and was notable for severe to critical stenoses of the bilateral internal carotid arteries (see figure 1). Duplex US revealed 80‐99% stenosis of both right and left proximal internal carotid arteries. The constellation of findings was most suggestive of bilateral limb‐shaking TIA secondary to bilateral carotid stenosis. He was started on secondary stroke prevention and referred to vascular surgery for evaluation of revascularization. The patient underwent left carotid endarterectomy briefly afterward and experienced resolution of the events – he later also underwent carotid endarterectomy of the right side and remains asymptomatic. DISCUSSION: Limb‐shaking TIA is a well‐described yet underrecognized manifestation of severe carotid disease reported by C.M. Fisher in 1962. The “limb shaking” episodes are typically unilateral, affecting the arm or leg, and are often mistaken for seizures [1]. Pathogenesis involves hemodynamic impairment related to extracranial/intracranial carotid stenosis or occlusion resulting in stereotypical recurrent contralateral limb shaking episodes precipitated by physical activity [2], [3]. The constellation of “limb shaking” spells precipitated upon standing or physical activity with resolution after activity cessation should raise suspicion for limb‐shaking TIA and warrant vascular imaging. Treatment includes medical secondary stroke prevention and revascularization procedures [4], which can alleviate or even resolve the transient symptoms [2]. Conclusion Limb‐shaking TIA is an important yet underrecognized manifestation of relative cerebral hypoperfusion related to severe cerebrovascular disease. This case describes bilateral limb shaking episodes in a patient with severe bilateral carotid disease ‐ a rare manifestation of limb‐shaking TIA.

Abstract Concerning the overwhelming advantages of solar energy, controlling and exploiting solar energy by using solar panels is one of the main fields of research in the domain of renewable energy. The choice of solar panel technology is highly significant to exploit as much energy as possible. In this paper, the main goal is to select the best technology for solar panels by investigating nine technologies from the first, second, and third generations of solar panels. Moreover, five sustainable criteria of electrical, mechanical, economic, technical, and climate, and 20 subcriteria are given for making decision analysis. Then, the best–worst method is employed according to the experts' opinions for weighting the criteria and for comparing the ranking of the solar energy technologies a framework based on the MULTIMOOSRAL multiple criteria decision‐making method is proposed. Finally, sensitivity analysis will be conducted on the ranking of the technologies. By exploiting the proposed methodology, CIS/CIGS and Perovskite Solar cell are ranked 1 and 2 as the best solar panel technologies for the selected locations.

Abstract Background Obesity and arteriosclerosis are both independently associated with cardiovascular disease risk. Obesity also may increase arterial stiffness. Aims This study aimed to investigate the association between anthropometric indices and non‐invasive arterial stiffness parameters, using data from a large population‐based cohort of seemingly healthy women and men. Methods A total of 5023 eligible participants were included in the study. The pulse wave velocity (PWV), central blood pressures, and bio‐impedance measures were obtained at the time of enrollment. Multiple regression analysis was performed to assess the relationship between anthropometric indices with arterial stiffness parameters. Results The mean age of participants was 45.3 ± 8.8 years, 2368 (47.1%) were males and 2655 (52.8%) were females. The prevalence of participant with underweight, normal weight, overweight, and obesity were 0.73%, 33.2%, 48.7%, and 17.2% respectively. Systolic and diastolic blood pressure, fatty liver, and hypertension were significantly higher in overweight/obesity participants. The overweight/obesity participants had significantly higher PWV than the normal‐weight group (471.5 ± 42.6/496.7 ± 47.5 cm/s vs. 448.1 ± 41.4 cm/s, p

Abstract Background and Aims Considering the increasing prevalence of dental services in the community and the impossibility of identifying each infected patient, hand sanitation is the most critical factor in controlling infection in these centers. Therefore, this study aimed to determine the effect of educational intervention on the hand health behavior of the staff of Tehran dentistry clinics based on the health belief model (HBM). Methods In this quasi‐experimental study in 2017, 128 employees of the health centers were selected through a multistage sampling method and they were placed in two groups of intervention and control (each 64 people). The data was collected using a questionnaire devised by the researcher. The validity and reliability of the questionnaire were determined. The questionnaire consisted of demographics, knowledge, structures of the HBM, and behavior variables. Then, the intervention was administered based on HBM‐based education. Data were analyzed by SPSS16 and independent t test, χ2, and repeated measurement analysis of variance. Results Before the intervention, the two intervention and control groups did not differ significantly in terms of demographic variables, mean scores of knowledge, constructs of HBM, and hand hygiene behavior (p > 0.05), while the intervention group was scored higher significantly compared to the control one after the intervention (p

Abstract The consequences of climate change, primarily due to natural and human factors, have caused many problems in the last decade that have affected different sections of society. One of the most important consequences is the occurrence of natural atmospheric—climatic disasters (drought). One of these regions is Iran in the Middle East, which has been suffering from this drought in the last decade. This investigation aims to evaluate and monitor drought and its impacts on environment changes in Iran. To conduct this research, the TERRA satellite data and the MODIS sensor were used over a 21‐year period, and the Normalised Differential Vegetation Index and Palmer Drought Severity Index Indicators were used to monitor drought and to estimate the soil moisture by the Soil Moisture Calculation satellite. Finally, to estimate the amount of precipitation and evapotranspiration, cumulative precipitation and real evapotranspiration, actual evaporation and transpiration were used. Findings showed that in the investigation region, the severity and frequency of drought have increased in recent years. Soil moisture has also decreased, indicating the inverse relationship between drought intensity and soil surface moisture, meaning that as the intensity of drought increases, the amount of soil surface moisture decreases. However, in the investigation region during the study course, the accumulation of rain showed a direct relationship with evaporation and transpiration. The highest monthly drought intensity of Palmer was 5.65% in May 2000. Also, the highest amount of wet year in November 2018 is 3.6%. The highest amount of rainfall was 61.25 mm in October 2018. Based on the results obtained in this research, drought has occurred in the investigation region in recent years, the intensity of which in the south, eastern and centre half of the country, especially the provinces of south Khorasan, Semnan, Hormozgan, Sistan and Baluchestan, Khuzestan and Ilam more it has been more than other provinces. To manage and control drought in the investigation region, in the various sectors affected by drought (agriculture, environment, surface water resources, forests, pastures and watershed management and natural ecosystems) strategies and plans in the short term, medium‐term and long‐term in line with natural and human factors and climate change to be adopted.