Extensive Destruction Research Articles

Difficulties in rebuilding historic bridges after conflicts: the case of the Mosul stone bridge

Historic bridges are crucial city landmarks, requiring expert input to preserve them in accordance with international policies and approaches. This ensures the protection of their historical and architectural value and their preservation for as long as possible. During conflict and war, bridges often suffer significant damage, leading to extensive destruction or complete demolition. The historic stone bridge over the Al-Khosar River in Mosul, constructed during the Ottoman era in 1856, sustained direct damage during the military operations in 2017, resulting in the substantial destruction of parts of the bridge. The objective of this study is to examine the challenges and constraints encountered during the reconstruction of this significant urban landmark. To this end, the architectural and engineering aspects of the project will be analysed, while also highlighting the difficulties in adhering to the standards and requirements set forth in international conventions and legislation pertaining to the preservation of historical urban landmarks and the protection of these structures from extinction. Subsequently, a series of conclusions and recommendations will be presented, offering insights to inform future endeavours involving the restoration of similarly invaluable edifices.

Negative Pressure Wound Therapy With Instillation as an Early Intervention for Extensive Wounds From Necrotizing Fasciitis: A Case Study.

Ms. S was a 50-year-old woman hospitalized with necrotizing fasciitis from a labial abscess. After several surgical interventions wound debridements were performed consecutively for 6days. She was left with extensive full thickness tissue destruction of her abdomen, bilateral groin areas, and complete displacement of skin over her mons pubis. Wounds related to necrotizing fasciitis can be especially challenging to manage, especially when the perineal region is involved. Due to the location of such wounds, it can be difficult to maintain dressings, including negative pressure wound therapy with instillation devices (NPWTi). Ms. S. also had a history of uncontrolled diabetes mellitus, which can hinder wound healing. The Wound, Ostomy and Continence (WOC) nurse was consulted on day 6 of Ms. S's admission, for application of NPWTi. Complex NPWTi dressings were completed in the operating room (OR), 2 times weekly for 2weeks. When Ms. S was transferred from the intensive care unit to the surgical unit, NPWT dressings with instillation were used but later converted to standard NPWT, changed twice weekly by the WOC nurse. Dressings were changed at the bedside until day 29 of her admission. The management of Ms. S's extensive wounds was successful, and her wounds were closed by plastic surgery on day 29 of her admission. Ms. S was the first patient at our hospital with extensive wounds from necrotizing fasciitis to undergo surgical closure of her wounds during the same hospital admission.

Dramatic improvement of drug-resistant epilepsy following cerebral infarction: a case report

BackgroundAn estimated 30% of patients with epilepsy experience drug-resistant epilepsy, which is the failure to control seizures despite the use of two or more antiseizure medications. Although other treatment options are considered, these alternatives often prove ineffective.Case presentationA 60-year-old East Asian male patient diagnosed with drug-resistant epilepsy experienced several seizures daily despite being on eight different antiseizure medications. Seizures began at age 15. He underwent epilepsy surgery at age 34, yet the seizures persisted. An electroencephalogram revealed multifocal sharp waves in the left hemisphere. Cerebral hemorrhages at ages 47, 50, and 56 were caused by head trauma during seizures. The patient became wheelchair-bound and now resides in a nursing home. At age 58, after suffering an acute cerebral infarction due to occlusion of the left internal carotid artery, his daily seizures ceased entirely. Despite remaining wheelchair-bound, he did not experience a significant decline in his quality of life. The cessation of seizures has reduced his risk of further trauma, and he has remained seizure-free for 3 years on just one antiseizure medication.ConclusionSurgical treatments for epilepsy often fail, with insufficient resection being a leading cause of these failures. In some cases, extensive destruction from an ischemic stroke may be beneficial. Furthermore, this case suggests that infarction therapy could be a potential treatment for patients with drug-resistant epilepsy.

Primary Cutaneous Acral-type CD8-positive T-cell Lymphoproliferations: Widely Divergent Clinical Outcomes Despite Nearly Identical Histomorphology

Abstract Introduction/Objective Non-epidermotropic and acral CD8(+) T-cell proliferations have recently been reclassified as lymphoproliferative disorders (LPDs) due to their indolent course clinical. Here, we describe two cases with similar histomorphology but disparate clinical outcomes, highlighting the diagnostic challenges. Methods/Case Report Case 1: An 89-year-old male developed a 2 cm erythematous papule on the forehead. Biopsy showed a non-epidermotropic pan-dermal lymphocytic infiltrate, a distinct grenz zone, and areas of necrosis. Case 2: A 53-year-old male presented with a rapidly growing, ulcerating 8.9 cm scalp lesion. Biopsy showed a deep dermal lymphoid infiltrate with complete epidermal sparing. In both cases neoplastic cells were positive by immunohistochemistry for CD2, CD3, CD5, CD7 (partial), CD8, granzyme B, TIA-1, and CD68 (perinuclear dot-like pattern). The Ki-67 proliferation index varied modestly between cases (50% in case 1 and 70% in case 2, respectively). Despite treatment, within the span of a few months, case 2 developed adjacent, widely distributed scalp nodules with extensive local tissue destruction. Pathology was consistent with recurrent disease (flow cytometry demonstrating T-cells, co-expressing CD8, CD2, CD3, CD5, CD7 and monotypic TRBC1). Results (if a Case Study enter NA) NA Conclusion CD8+ T-cell lymphoproliferative disorders, specifically primary cutaneous acral CD8+ T-cell lymphoproliferative disorder, is a rare cutaneous T-cell disorder that was re-classified, owing to its indolent clinical course, low risk of systemic dissemination, and favorable prognosis. We report two cases of nearly identical isolated cutaneous lesions that demonstrated a CD8(+)-cytotoxic phenotype with CD68-dot-like positivity. Although all morphologic findings were supportive of the diagnosis, the aggressive clinical progression in case 2 highlights the potential for the disease to defy the classically described indolent behavior. Given that few cases with aggressive clinical courses have been published, we present these cases to underscore their complexity and propose that the classification incorporate clinicopathological correlation to guide management.

In-vitro comparison of fracture resistance of CAD/CAM porcelain restorations for endodontically treated molars

BackgroundThis study evaluates the fracture strength and patterns of feldspathic porcelain restorations made using CAD/CAM technology for lower first molars with extensive crown destruction. The restorations include post-core and full-contour crown, composite resin core and full-contour crown, and endocrown. This research provides insights into effective restorative options to address tooth fracture risk, supporting minimally invasive procedures and CAD/CAM integration in dental practices.MethodsThis study utilized 80 permanent mandibular first molars, which were divided into four groups: Group I (Post-Core-Full-contour crown), Group II (Core- Full-contour crown), Group III (Endocrown), and Group IV (Control). Root canal treatment was performed on all samples except for the control group. Following access cavity preparation, restorations for each tooth were fabricated using the CAD/CAM system and cemented with resin cement. The specimens were embedded in acrylic blocks. After undergoing thermomechanical aging, the samples were subjected to fracture resistance testing using a universal testing machine, which applied force until fracture occurred. The fracture patterns were subsequently analyzed, and the data were statistically evaluated using the Kruskal-Wallis and Chi-Square tests (p < 0.05).ResultsA significant difference in fracture values under axial forces was observed (p < 0.05). The control group had the highest fracture strength (1830 ± 277 N), while the Core- full-contour crown group showed the lowest (1532 ± 371 N). Failure types varied significantly among the groups (χ2 = 26.886, df = 9, p = 0.001). The most common failure type was Type-2 (33.75%), characterized by restorable fractures, while Type-3 fractures, unrestorable, were the least common (12.5%).ConclusionsThe findings underscore the significance of technological advancements in CAD/CAM for effectively restoring endodontically treated teeth with extensive crown damage. This study contributes valuable insights, emphasizing the clinical relevance of selecting appropriate restorative options to mitigate the risk of tooth fracture associated with coronal restoration failures.

Cocaine-induced destruction of the palate: a diagnostic and management challenge

Cocaine usage is increasing at a rate faster than population growth worldwide. The habitual and chronic insufflation of pulverised cocaine is associated with the progressive destruction of the osseocartilaginous structures of the midface, termed cocaine-induced midline destructive lesions (CIMDLs). These entities present a challenging diagnostic picture, mimicking other infectious, malignant and inflammatory conditions associated with midface destruction. CIMDLs can present along a wide spectrum of disease, with minimal palatal perforation to extensive sinonasal destruction. With the increasing usage of cocaine, there is likely to be a concurrent increase in patients presenting to emergency departments with these destructive entities. Therefore, there is a need to create awareness of this uncommon entity and to document a systematic approach that must be adopted to reach a definitive diagnosis which will subsequently inform management. We report four clinical cases of CIMDLs at varying stages of the disease process which presented to the Dublin Dental University Hospital between January 2023 and June 2024 and document their multidisciplinary management from initial presentation to eventual treatment.

Comprehensive Analysis of Garcin Syndrome: A Systematic Review of the Etiology, Diagnosis, and Treatment.

Garcin syndrome is a rare neurological condition characterized by progressive unilateral involvement of multiple cranial nerves, without typical intracranial hypertension. It is often linked with aggressive malignancies and invasive infections; hence, it presents significant diagnostic and therapeutic challenges. Despite the advances in medical technology, the prognosis still remains poor, and there is limited literature on comprehensive reviews regarding its etiology, diagnosis, and management. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-based systematic review was performed in order to compile updated evidence related to Garcin syndrome. The PubMed and Scopus databases were comprehensively searched using the search terms "Garcin syndrome" AND ("etiology" OR "diagnosis" OR "treatment" OR "management"). Information was obtained from case reports and focused on common etiologies, clinical presentations, diagnostic methodologies, treatment protocols, and outcomes. The review discussed very diverse etiologies of Garcin syndrome. The most common among these were skull base tumors, metastatic lesions, and invasive infections like mucormycosis. Most of these were multiple cranial nerve (CN) involvements in which CN V (trigeminal nerve), CN VII (facial nerve), or CN XII (hypoglossal nerve) involvement was common. Advanced imaging, especially MRI, played a very crucial role in diagnosis, showing the presence of extensive bony destruction with the involvement of cranial nerves. Treatment was varied according to the etiology, ranging from chemotherapy and radiotherapy in neoplastic cases to active surgical intervention supported by antifungal therapy in infected cases. Garcin syndrome is a clinical challenge due to its diverse etiologies and complex management profile. While early diagnosis and intervention are emphasized, the prognosis remains grave, especially in cases presenting with metastatic disease or immunocompromised states. Future research should focus on better, more sensitive diagnostic modalities and the investigation of newer therapeutic approaches for Garcin syndrome patients.

Probabilistic Seismic Hazard Assessment of Lisbon (Portugal)

The 1755 Lisbon earthquake holds significant historical importance in Portuguese history. The subsequent tsunami resulted in extensive destruction and damage, affecting not only Lisbon but also other regions of Portugal, Spain, and North Africa. This significant and hazardous event led to an increase in awareness about earthquake and tsunami risks, not only within Portugal but throughout Europe. This heightened awareness facilitated advancements in scientific developments, including design codes, standards, and earthquake engineering. However, recent studies focusing on hazard assessment for Lisbon are limited. For this reason, this paper aims to present a comprehensive probabilistic seismic hazard analysis (PSHA) for the Lisbon metropolitan area. The first stage of PSHA involves defining applicable and active seismic source models (area and line sources) within the study area. Subsequently, historical and instrumental earthquake records are collected to build a homogenized earthquake catalog, utilizing both global and local earthquake databases. Following this, the completeness level of the earthquake catalog is tested. By incorporating suitable ground motion models to the region and local soil characteristics, seismic hazard maps for various return periods and hazard curves in terms of peak ground acceleration (PGA) are developed. The findings based on the area source model agree with existing literature, indicating PGA values ranging from 0.3 g to 0.9 g, 0.2 g to 0.7 g, 0.2 g to 0.5 g, and 0.1 g to 0.3 g for return periods of 2475, 975, 475, and 50 years, respectively.

EP568 - A rare case of necrotizing fasciitis caused by Streptococcus Anginosus and Staphylococcus Lugdunensis

Abstract Necrotizing fasciitis (NF) is a rare soft tissue infection involving the fascial planes, causing rapid and extensive tissue destruction. We present a unique case of NF in a patient with poor glycemic control caused by atypical pathogens. A 66-year-old female with a recent biopsy for a wart-like lesion developed a wound infection, with greenish-black exudate. Initial observations were: temperature: 39.4 degrees, heart rate: 105, GCS: 15/15. Physical examination revealed a grossly filiform lesion below her abdominal apron measuring 7cm in diameter. The patient was empirically treated with IV Co-Amoxiclav. Abnormal biochemistry results are shown below. Microbiological analysis revealed Streptococcus Anginosus, anaerobes and Staphylococcus Lugdunensis. CT abdomen revealed extensive inflammatory changes with gas and fluid collection and enlarged pelvic and inguinal lymph nodes. Two urgent surgical explorations and debridements, with meticulous wound care using negative pressure wound dressings (Prevena) were done. Intravenous Gentamicin, Benzylpenicillin, Clindamycin, Metronidazole and Flucloxacillin were administered for six weeks. The patient's clinical status gradually improved. Streptococcus Anginosus, that is part of the Streptococcus Milleri group and Staphylococcus Lugdunensis, a coagulase-negative Staphylococci (CoNS) are commensal organisms of the oral and gastrointestinal tracts. These organisms possess virulence factors that facilitate tissue invasion and destruction, causing an aggressive course of NF. This case highlights the importance of considering atypical pathogens, especially in patients with predisposing factors such as diabetes and obesity. Early recognition, prompt surgical intervention and a multidisciplinary approach are essential for improving outcomes in these cases.TestResultWhite Blood Cells (WBC)22,200 [WBCs per microliter]Sodium123 [mmol/L]Chloride88 [mmol/L]C-reactive protein (CRP)318 [mg/L]Blood Glucose19.3 [mmol/L]

Coronary Artery Aneurysm or Ectasia as a Form of Coronary Artery Remodeling: Etiology, Pathogenesis, Diagnostics, Complications, and Treatment.

Coronary artery aneurysm or ectasia (CAAE) is a term that includes both coronary artery ectasia (CAE) and coronary artery aneurysm (CAA), despite distinct phenotypes and definitions. This anomaly can be found in 0.15-5.3% of coronary angiography. CAE is a diffuse dilatation of the coronary artery at least 1.5 times wider than the diameter of the normal coronary artery in a patient with a length of over 20 mm or greater than one-third of the vessel. CAE can be further subdivided into diffuse and focal dilations by the number and the length of the dilated vessels. Histologically, it presents with extensive destruction of musculoelastic elements, marked degradation of collagen and elastic fibers, and disruption of the elastic lamina. Conversely, CAA is a focal lesion manifesting as focal dilatation, which can be fusiform (if the longitudinal diameter is greater than the transverse) or saccular (if the longitudinal diameter is smaller than the transverse). Giant CAA is defined as a 4-fold enlargement of the vessel diameter and is observed in only 0.02% of patients after coronary. An aneurysmal lesion can be either single or multiple. It can be either a congenital or acquired phenomenon. The pathophysiological mechanisms responsible for the formation of CAAE are not well understood. Atherosclerosis is the most common etiology of CAAE in adults, while Kawasaki disease is the most common in children. Other etiological factors include systemic connective tissue diseases, infectious diseases, vasculitis, congenital anomalies, genetic factors, and idiopathic CAA. Invasive assessment of CAAE is based on coronary angiography. Coronary computed tomography (CT) is a noninvasive method that enables accurate evaluation of aneurysm size and location. The most common complications are coronary spasm, local thrombosis, distal embolization, coronary artery rupture, and compression of adjacent structures by giant coronary aneurysms. The approach to each patient with CAAE should depend on the severity of symptoms, anatomical structure, size, and location of the aneurysm. Treatment methods should be carefully considered to avoid possible complications of CAAE. Simultaneously, we should not unnecessarily expose the patient to the risk of intervention or surgical treatment. Patients can be offered conservative or invasive treatment. However, there are still numerous controversies and ambiguities regarding the etiology, prognosis, and treatment of patients with coronary artery aneurysms. This study summarizes the current knowledge about this disease's etiology, pathogenesis, and management.

A Comprehensive Review of Low-Dose Interleukin-2 (IL-2) Therapy for Systemic Lupus Erythematosus: Mechanisms, Efficacy, and Clinical Applications.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that causes extensive inflammation and tissue destruction across several organs. Conventional therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and immunosuppressive drugs, can have serious adverse effects and are not always successful. This study looks at the possibility of low-dose interleukin-2 (IL-2) therapy as a new treatment for SLE, focusing on its mechanics, effectiveness, and clinical applicability. Low-dose IL-2 treatment selectively increases and activates regulatory T cells (Tregs), which are essential for immunological tolerance but are often lacking in SLE patients. Unlike standard medicines, which widely inhibit the immune system, low-dose IL-2 provides a more tailored approach with fewer side effects. We examined preclinical and clinical research and discovered that low-dose IL-2 dramatically enhances Treg numbers and function, lowers disease activity, and improves clinical outcomes. The primary molecular processes include the stimulation of the Janus kinase - signal transducer of activators of transcription (JAK-STAT), phosphatidylinositol 3-kinase - protein kinase B (PI3K-Akt), and mitogen‑activated protein kinase (MAPK) pathways, which enhance Treg proliferation, survival, and activity. A thorough review of clinical studies finds that low-dose IL-2 treatment is well-tolerated and effective, with fewer side effects than biologics like belimumab and rituximab. Furthermore, IL-2 therapy provides prospects for combination therapies, which may improve therapeutic success by addressing numerous components of the immune response. Despite these encouraging findings, problems such as patient response variability and the need for long-term safety data persist. Future research should prioritize refining dose regimes, discovering biomarkers for patient selection, and investigating combination medicines. Addressing these issues might solidify low-dose IL-2 treatment as a cornerstone in SLE care, providing a more accurate and individualized approach to immune regulation while considerably improving patient outcomes.

Psycho Social Challenges Experienced by Flood Victims in Charsaadda, Pakistan

Flood victims face a complicated set of emotional, social, and mental challenges that require advanced knowledge and personalized treatments. The July 2010 flood severely disrupted Pakistani society, inflicting chaos and structural damage and needing a new framework for the people of Khyber Pakhtunkhwa. This research investigates the social and psychological effects of the floods on residents of Charsadda, Pakistan. The information was gathered from people affected by floods in Charsadda, Pakistan. Purposive sampling methods were used to choose responders. N = 377 flood victims were selected from four villages in Union Council Agra. The data for this research was gathered from flood victims using a closed-ended questionnaire. The study emphasizes the enormous social and emotional hardship that flood victims experience, extensive property destruction and health issues. They lacked zeal for their well-being and exhibited excessive emotional reactions. The study suggests focusing social rehabilitation on financial aid and interest-free loans, conducting training sessions and building adequate therapy programs for future calamities. Psychological treatment can offer comfort and support to those impacted. Those who are impacted can find comfort via psychological treatment.

Combined endodontic and regenerative periodontal therapy for managing questionable mandibular anterior teeth with radicular cysts

Abstract Endodontic microsurgery (EMS) presents a great treatment option for unresolved periradicular pathologies, typically involving the removal of the apical root portion and adjacent inflamed tissues. This case report describes the management of persistent periapical lesions in the lower anterior teeth of a 32-year-old male. Root canal treatment was completed 4 years before presentation. The patient presented to the clinic with tooth mobility and mild discomfort and large radiographical periapical radiolucency. The case was diagnosed with previously treated with asymptomatic apical periodontitis. EMS was performed in conjunction with periodontal-guided tissue regeneration that includes bone graft and resorbable membrane and the teeth showed favorable resolution of the symptoms. Histopathological analysis showed the presence of a radicular cyst. After 3 years of follow-up, cone-beam computed tomography and periapical radiographs demonstrated substantial lesion regression and favorable outcome. This case report offering promising insights into the synergistic potential of combined endodontic and regenerative periodontal therapy in cases with unresolved periapical lesion with extensive bone destruction.

Black carbon and particulate matter concentrations amid central Chile's extreme wildfires

The increase in the frequency and severity of global wildfires has been largely influenced by climate change and land use changes. From February 2 to 6, 2024, central Chile experienced its most devastating wildland-urban interface wildfire in history, severely impacting the Valparaíso region. This catastrophic event, which led to extensive forest destruction, the loss of thousands of homes, and over a hundred human fatalities, directly impacted the area surrounding the campus of Federico Santa María Technical University. In that period, an air quality monitoring campaign was set up on the campus to measure black carbon (BC) and particulate matter (PM) during the wildfire season. The monitoring station was located directly within the smoke plume, allowing for the collection of unprecedented air quality data. Extremely high concentrations of BC at 880 nm were reported during the wildfires, with a daily mean (±σ) of 14.83 ± 19.52 μg m−3. Peak concentrations measured at 880 nm and 375 nm reached 812.89 μg m−3 and 1561.24 μg m−3, respectively. The maximum daily mean BC concentrations at these wavelengths were 55 and 99 times higher, respectively, compared to the pre-event period. The mean Ångström absorbing coefficient during the event was 1.66, indicating biomass burning as the primary BC source, while the maximum BC/PM2.5 ratio (at 375 nm) reached 57 %. From February 2 to 5, 2024, PM concentrations exceeded the Chilean air quality standard by 82 % and 198 % for coarse and fine particles, respectively. These levels are 4.7 and 6.0 times higher than the World Health Organization's recommendations. These elevated concentrations persisted for up to three days after the fire was extinguished.This study provides unique evidence of the rapid deterioration of regional air quality during a wildfire event using in situ measurements, serving as a stark reminder of the far-reaching consequences of a warming climate.

Harmfulness and biological characters of a leaf beetle Gastrolina depressa (Coleoptera: Chrysomelidae) to its host plant Pterocarya stenoptera (Fagales: Juglandaceae)

Gastrolina depressa (Coleoptera: Chrysomelidae) has been found to damage many walnut plants in China. It prefers to feed on the annual leaves of an important economic plant, Pterocarya stenoptera (Fagales: Juglandaceae), and causes extensive cosmetic destruction, even plant death. Nevertheless, its biological characteristics are mostly unknown. In this study, we investigate the harmful and biological characteristics of G. depressa with different developmental stages. The results showed that G. depressa had four developmental stages: egg, larva (1st -3rd instar), pupa, and adult, the life history lasted nine days, with obvious overlapping generations. The food intake of the larvae increased with the increase of the instar, and the maximum food intake of the 3rd instar larvae was 448.19 mm2. The abdomen of the females was enlarged before oviposition, and the average number of eggs laid was 47.63 ± 13.53. Bioassay showed that there was no difference in the search time for the young (2.03, 1.25, 1.15, and 0.91 min) and old leaves (1.68, 1.15, 0.90, and 1.93 min) of P. stenoptera between 1st -3rd instar larvae and adults; the feeding preference of 1st -3rd instar larvae and adults for young leaves was higher than that to old leaves (23.33%, 26.67%, 33.33%, and 21.67%, respectively). The successful selection rates of 1st -3rd instar larvae and adults to young leaves (81.67%, 80%, 85.00%, and 70.00%, respectively) was higher than to old leaves (8.35%, 11.67%, 3.34%, and 11.67%, respectively).

γ-Conglutin Immunoreactivity Is Differently Affected by Thermal Treatment and Gastrointestinal Digestion in Lupine Species.

Lupine is a legume commonly used in human diet as a functional food due to its high nutritional content and important technological properties. However, its consumption can lead to the manifestation of adverse immunological reactions, posing significant health issues in sensitized/allergic patients. This work aims to investigate the effect of food processing combined with simulated gastrointestinal (GI) digestion on the immunoreactivity of lupine γ-conglutin. Model foods of wheat pasta containing 35% of lupine flour (Lupinus albus, L. luteus, and L. angustifolius) were prepared and submitted to a boiling process. The proteins were extracted and their profiles characterized by SDS-PAGE. Simulated GI digestion was performed on thermally treated pasta using the INFOGEST harmonized digestion protocol 2.0. The IgG binding capacity of γ-conglutin was assessed by immunoblotting in non-reducing conditions and indirect ELISA with specific antibodies. Results demonstrate that the boiling treatment affected the immunoreactivity of the three lupine species differently. Simulated GI digestion led to extensive destruction of the protein structure, more significant in the intestinal phase, reducing but not abolishing the IgG affinity to γ-conglutin and its potential presentation to immunocompetent cells. This information can offer valuable insights to the food industry for developing food formulations with reduced allergenic properties.

A multicenter study of long-term outcomes of relapsing polychondritis in Iran

Relapsing polychondritis (RP) is a systemic immune mediated disease characterized by recurrent episodes of inflammation in various cartilage-rich areas. RP may cause extensive tissue destruction and is associated with significant morbidity and mortality. In this multicenter study, we considered the remission status and long-term outcomes of RP in patients who were followed-up in six referral rheumatology centers in Iran. Outcomes of disease was assessed by remission status and RP induced damage. A total of 29 patients with RP were examined for enrollment in the study, and 26 patients with a minimum follow-up period of 6 months were included in the RP outcome analysis. Median time to control of symptoms and sustained remission were 5 and 23 weeks, respectively. Prednisolone was discontinued in 8 (30.8%) patients and medication-free remission was achieved in 7 (23.1%) patients. Regarding the disease course, 34.6% of patients had a relapsing–remitting course, 42.3% had a monophasic course, and 23.1% had an always-active course. Despite extensive treatment with immunosuppressive medications, RP induced damage was developed in 21 (80.8%) patients. Ear deformity and osteoporosis were the most common RP induced damage. Long-term remission and medications-free remission in RP is accessible. However, RP related damage occur in majority of patients.

The role of Nuclear Magnetic Resonance (NMR) spectroscopy in cattle metabolism

Nuclear Magnetic Resonance (NMR) spectroscopy is a powerful analytical tool that has significantly advanced the understanding of cattle metabolism. Nuclear Magnetic Resonance (NMR) spectroscopy plays a pivotal role in the study of cattle metabolism, offering distinct advantages over other spectrometric methods. NMR spectroscopy is a powerful analytical tool that provides detailed molecular insights by exploiting the magnetic properties of atomic nuclei. Unlike mass spectrometry and infrared spectroscopy, NMR does not require extensive sample preparation or destruction, preserving the integrity of biological samples. This non-invasive nature is particularly beneficial for longitudinal studies in cattle, where metabolic changes over time are of interest. One of the key strengths of NMR spectroscopy is its ability to simultaneously detect and quantify a broad range of metabolites in complex biological matrices, such as blood, urine, and tissue extracts. This comprehensive metabolic profiling is crucial for understanding the biochemical pathways and physiological states in cattle. NMR's high reproducibility and quantitative accuracy further enhance its suitability for metabolic studies, enabling precise monitoring of metabolic fluctuations in response to dietary changes, environmental stressors, or disease conditions. NMR spectroscopy also offers unique advantages in elucidating structural information about metabolites. Through multidimensional NMR techniques, researchers can determine the molecular structure and conformation of metabolites, providing deeper insights into metabolic functions and interactions. This structural elucidation is often challenging with other spectrometric methods, which may lack the resolution or require derivatization of samples. Moreover, NMR spectroscopy's non-destructive nature allows for the analysis of living tissues and in vivo studies, facilitating real-time monitoring of metabolic processes. This capability is instrumental in studying dynamic metabolic responses and adaptations in cattle under different physiological states. Additionally, the development of advanced NMR techniques, such as high-resolution magic angle spinning (HR-MAS) and hyperpolarization, has further expanded the scope of NMR applications in metabolic research. NMR spectroscopy stands out as a superior method for studying cattle metabolism due to its non-destructive approach, comprehensive metabolic profiling, structural elucidation capabilities, and potential for in vivo analysis. These advantages make NMR an indispensable tool in advancing our understanding of cattle metabolism and improving livestock health and productivity. Keywords: Nuclear Magnetic Resonance (NMR), Cattles, Metabolomics.

Single-cell RNA sequencing reveals that NRF2 regulates vascular smooth muscle cell phenotypic switching in abdominal aortic aneurysm.

Abdominal aortic aneurysm (AAA) is a life-threatening disease characterized by extensive membrane destruction in the vascular wall that is closely associated with vascular smooth muscle cell (VSMC) phenotypic switching. A thorough understanding of the changes in regulatory factors during VSMC phenotypic switching is essential for managing AAA therapy. In this study, we revealed the impact of NRF2 on the modulation of VSMC phenotype and the development of AAA based on single-cell RNA sequencing analysis. By utilizing a murine model of VSMC-specific knockout of nuclear factor E2-related factor 2 (NRF2), we observed that the absence of NRF2 in VSMCs exacerbated AAA formation in an angiotensin II-induced AAA model. The downregulation of NRF2 promoted VSMC phenotypic switching, leading to an enhanced inflammatory response. Through genome-wide transcriptome analysis and loss- or gain-of-function experiments, we discovered that NRF2 upregulated the expression of VSMC contractile phenotype-specific genes by facilitating microRNA-145 (miR-145) expression. Our data identified NRF2 as a novel regulator involved in maintaining the VSMC contractile phenotype while also influencing AAA formation through an miR-145-dependent regulatory mechanism.

International Legal Aspects of the Assessment of Environmental Damage Caused by Military Actions

Military actions not only cause massive human casualties and extensive destruction of homes, infrastructure, and other property, but also a significant environmental damage. It raises the issue of the importance of assessment of environmental damage as a necessary prerequisite for obtaining reparations. The paper analyses international legal documents which relate to the issue of assessment of the amount of environmental damage, as well as relevant decisions of international bodies in this sphere. A conclusion was made about the lack of a uniform approach to the assessment of amount of environmental damage, both in international documents and in international judicial practice. The necessity of the adoption of an international document that would establish the methodology which should be used during environmental damage assessment was proved. This paper should determine components of the environment deterioration of which should be compensated.