Drop In Levels Research Articles

Useful of proximal gastrectomy with double-tract reconstruction in preventing glucose spikes

BackgroundVolatile glucose levels after gastrectomy induce dumping syndrome, which adversely affects patient quality of life. This study aimed to evaluate the glycemic variability of proximal gastrectomy with double-tract reconstruction (PGDTR) as a function-preserving procedure. MethodsThis study used a continuous glucose monitoring (CGM) system to record glycemic profiles of patients who underwent PGDTR or total gastrectomy (TG) and compared them. Moreover, this study evaluated postgastrectomy syndrome, including dumping symptoms, between the PGDTR and TG groups using the 37-item Postgastrectomy Syndrome Assessment Scale (PGSAS-37) questionnaire. ResultsOf note, 44 patients underwent PGDTR, and 42 patients underwent TG, which included more advanced cases. CGM results showed that the SD, relative SD, and maximum drop in glucose level between 30 min and 2 h after a meal were smaller in the PGDTR group than in the TG group (14.81 vs 22.40 mg/dL [P < .001], 0.14 vs 0.20 mg/dL [P < .001], and 42.06 vs 117.67 mg/dL [P < .001], respectively). For nocturnal glucose levels, SD and percentage time below the range were smaller in the PGDTR group than in the TG group (11.76 vs 15.16 mg/dL [P = .005] and 11.25% vs 35.27% [P < .001]). The PGDTR group generally performed better than the TG group on all the PGSAS-37 questionnaire items. Patients in the PGDTR group without food inflow into the remnant stomach showed similar CGM results as those in the TG group but with stronger dumping symptoms. ConclusionFood inflow into the remnant stomach is essential for PGDTR to be a function-preserving procedure as it leads to the control of dumping symptoms and lower glucose level spikes.

A case series of forearm compartment syndrome complicating transradial cardiac catheterization

BackgroundAcute compartment syndrome following a transradial coronary approach is rare. However, as the incidence of coronary arterial disease increases due to lifestyle factors and multiple comorbidities, transradial coronary angiography has become more common for diagnostic and therapeutic purposes in cardiovascular centers. Despite its rarity, we encountered two cases of acute compartment syndrome within a 1-week interval in the cardiology unit of a tertiary hospital.Case presentationThe first case involved a 75-year-old woman diagnosed with non-ST elevation myocardial infarction (NSTEMI). A coronary angiogram was performed via an uncomplicated right radial artery puncture. Following the procedure, the patient experienced significant swelling in the right forearm. An emergency fasciotomy release of the right forearm was conducted, revealing a gushing hematoma upon entering the flexor compartment. Fortunately, the wound healed well two months postoperatively with no functional deficits. In the second case, an 80-year-old man presented with severe angina pectoris upon exertion and was diagnosed with NSTEMI. The following day, he developed compartment syndrome in the left forearm, necessitating an emergency fasciotomy. Intraoperative examination revealed muscle bulging within the forearm compartments accompanied by extensive hematoma. Postoperatively, a deranged coagulation profile caused oozing from the wound. However, since there was no arterial bleeding, a compression dressing was applied. This led to a gradual drop in hemoglobin levels and worsened his heart condition. Despite resuscitative efforts and attempts to correct the coagulopathy, the patient experienced cardiorespiratory arrest and succumbed to ischemic heart disease in failure.ConclusionClinicians must remain vigilant in identifying this potentially limb-threatening condition. Patients with pre-existing anticoagulant therapy and underlying atherosclerotic disease are at a higher risk of bleeding complications. Implementing effective hemostasis techniques and promptly managing swelling can help prevent the occurrence of compartment syndrome. Timely assessment and maintaining a high level of clinical suspicion are paramount. If necessary, early consideration of decompressive fasciotomy is essential to avert catastrophic outcomes.

DESTRUCTION OF VITAMIN B12 DURING INTERACTION WITH ACTIVE OXYGEN SPECIES

One of the most attractive molecular systems in the world of chemistry and medicine is vitamin B12, which was originally discovered as a factor against deficiency (pernicious) anemia. Deficiency of this essential vitamin leads to a decrease in the number of red blood cells in the blood and a drop in hemoglobin levels. The article provides a brief overview of the processes leading to the destruction of vitamin B12 caused by hypoxia, the action hypochlorous acid, superoxide anion radical, hydrogen peroxide, hydroxyl radical, peroxynitrite. Under conditions of hypoxia, oxygen transport in the electron transport chain may be disrupted, resulting in the reduction of oxygen on ubiquinone to a superoxide radical under the action of electrons that have not reached cytochrome oxidase. Oxidative stress develops, during which oxygen-containing radicals are formed, which can cause irreversible changes in the vitamin and lead to loss of biological activity. Hydrogen peroxide formed as a result of step-by-step protonation of the formed superoxide-anion radicals can act as such oxidants. Hydrogen peroxide, in turn, is capable of reacting with metals of variable oxidation state to form a reactive hydroxyl radical, producing the Fenton reaction. In addition, hypochlorous acid formed by the enzyme myeloperoxidase in the presence of hydrogen peroxide and chloride anion, as well as peroxynitrite, an active oxidant obtained by reacting the superoxide–anion radical with nitrogen (II) oxide, can act as oxidants. The latter is produced in large quantities under hypoxia conditions due to an increase in the activity of endothelial nitric oxide synthetase. The publications devoted to the influence of various oxidants on the stability of vitamin B12 are considered. For citation: Erina A.A., Borodulin V.B., Dereven’kov I.A., Makarov S.V., Ischenko A.A. Destruction of vitamin B12 during interaction with active oxygen species. ChemChemTech [Izv. Vyssh. Uchebn. Zaved. Khim. Khim. Tekhnol.]. 2024. V. 67. N 7. P. 6-18. DOI: 10.6060/ivkkt.20246707.7043.

Late quaternary lake level variations of Mabu Co-Gala Co, southern Tibetan plateau, modulated by glacial meltwater, spillover processes and the Indian summer monsoon

Lakes on the Tibetan Plateau (TP) play a major role in the regional hydrological cycle and underpin vital ecosystem services. However, the long-term lake evolution and underlying mechanisms, especially on the exorheic southern TP, remain unclear. Here, we reconstructed the lake level variations of Mabu Co and Gala Co on the southern TP through detailed paleo-shoreline dating using post-infrared infrared stimulated luminescence (pIRIR) signals of K-feldspar single grains, and explored the driving forcings based on a comparison of paleoclimate records and geomorphological analysis. The results show that a unified paleolake at Mabu Co and Gala Co at a level ∼20 m above the modern level (a.m.l.) of Mabu Co developed during the late MIS 3 (35.9 ± 1.9–29.1 ± 1.4 ka) in response to increased glacial meltwater and Indian summer monsoon (ISM) rainfall. Under intensive glacier melting, the paleolake reached its maximum level (∼29 m a.m.l.) and area (190 km2, ∼22 times larger than the modern areas of Mabu Co and Gala Co) during the last deglacial (16.8 ± 1.0–13.6 ± 0.7 ka) and began to outflow, which triggered incision and lowering of the spill-point. The lake level showed an overall decreasing trend since the last deglacial largely influenced by the lowering of the spill-point. During the last deglacial-early Holocene (12.7 ± 0.6–9.8 ± 0.6 ka), a high-stand lower than that in the previous stage (∼24 m a.m.l.) was maintained by the strengthened ISM and glacial meltwater. In the mid-Holocene (8.7 ± 0.9–4.1 ± 0.3 ka), the paleolake experienced two rapid lake level drops in response to the weakening events of the ISM. The exposed shoreline terrace between the two lakes following the lake level drop after ∼6 ka provided an ideal living surface for the inhabitants at the Mabu Co site during 4.5–4.0 ka. We found that glacial meltwater and lake spillover processes, apart from the ISM, have exerted great impacts on the hydrological history of Mabu Co and Gala Co. The paleolakes have provided critical resources for humans at the Mabu Co site living in the alpine anoxic environment. Additionally, we suggest that lakes with low spill-points adjacent to exorheic basins on the southern TP should be given more attention regarding flooding hazard risks against increasing precipitation and glacial meltwater in the future.

Genistein mitigates nitroglycerine-induced migraine: modulation of nitric oxide-mediated vasodilation and oxidative stress.

Migraine is a widespread brain condition described by frequent, recurrent episodes of incapacitating, moderate-to-severe headaches with throbbing pain that are usually one-sided. It is the 2nd most debilitating state lived with disability in terms of years, with a prevalence rate of 15-20%. Significant drops in estrogen levels have been associated with triggering acute migraine attacks in certain cases. Phytoestrogens are plant-derived compounds that resemble estrogen in structure, enabling them to imitate estrogen's functions in the body by attaching to estrogen receptors. Thus, the study was aimed to explore the protective effect of genistein against migraine. Moreover, the role of nitric oxide was also studied in the observed effect of genistein. Nitric oxide (NO) is implicated in migraine pathophysiology due to its role in promoting cerebral vasodilation and modulation of pain perception. Exploring L-NAME, a nitric oxide synthase inhibitor in migraine research helps scientists better understand the role of NO in migraine. Nitroglycerine treatment significantly increased the facial-unilateral head pain and spontaneous pain, as evidenced by the increased number of head scratching and groomings. Nitroglycerine treatment also induced anxiogenic behavior in mice. A significant reduction in the number of entries in the light phase and open arm, respectively. Biochemical analysis indicated a significant increase in inflammatory and oxidative stress in the nitroglycerin group. A significant increase and decrease in brain TBARS and GSH were observed with nitroglycerine treatment, respectively. Moreover, nitroglycerine treatment has uplifted the serum TNF-α level. Genistein (20mg/kg) significantly mitigated the facial-unilateral head pain, spontaneous pain, photophobia, and anxiety-like behavior induced by nitroglycerine. Biochemical analysis showed that genistein (20mg/kg) significantly abrogated the nitroglycerine-induced lipid peroxidation and increased serum TNF-α level. Genistein treatment also upregulated the brain GSH level and downregulated the serum TNF-α level. The L-NAME-mediated alleviation of the protective effect of genistein might be attributed to the vasodilatory effect of L-NAME. Conclusively, it can be suggested that genistein might provide relief from migraine pain by inhibiting nitric oxide-mediated vasodilation and oxidative stress.

Optimizing Recovery in Elderly Patients: Anabolic Benefits of Glucose Supplementation during the Rehydration Period.

Since many acutely admitted older adults display signs of dehydration, treatment using balanced crystalloids is an important part of medical care. Additionally, many of these patients suffer from chronic malnutrition. We speculated that the early addition of glucose might ameliorate the hospital-related drop of caloric intake and modify their catabolic status. We included patients 78 years and older, admitted acutely for non-traumatic illnesses. The patients were randomized into either receiving balanced crystalloid (PlasmaLyte; group P) or balanced crystalloid enriched with 100 g of glucose per liter (group G). The information about fluid balance and levels of minerals were collected longitudinally. In the G group, a significantly higher proportion of patients developed signs of refeeding syndrome, i.e., drops in phosphates, potassium and/or magnesium when compared to group P (83.3 vs. 16.7%, p < 0.01). The drop in phosphate levels was the most pronounced. The urinalysis showed no differences in the levels of these minerals in the urine, suggesting their uptake into the cells. There were no differences in the in-hospital mortality or in the 1-year mortality. The short-term administration of balanced crystalloids with glucose induced an anabolic shift of electrolytes in acutely admitted older adults.

Improved flap perfusion and hemostasis after postoperative embolization in free flap surgery: a case report

This study aims to present a novel use of coil embolization in managing postoperative bleeding after free flap surgery, a technique typically reserved for other medical complications. We report the case of a 77-year-old female patient who underwent muscle-sparing latissimus dorsi free flap surgery for recurrent myxofibrosarcoma on her left thigh. Although hemostasis was achieved hemostasis during surgery, the patient experienced postoperative bleeding, which was initially managed with compression and blood transfusions. Upon a critical drop in the hemoglobin level, coil embolization was performed at the proximal segment of the descending branch of the lateral circumflex femoral artery. Coil embolization successfully controlled bleeding, while preserving blood flow to the flap. The patient’s hemoglobin levels stabilized, and the flap’s perfusion improved post-procedure. This approach proved effective in managing bleeding in areas other than the anastomosis site, with the patient showing a satisfactory recovery and no significant complications in the 30-day postoperative period. Coil embolization, a method commonly used for gastrointestinal bleeding and other vascular issues, can be a viable and effective option for controlling postoperative bleeding after free flap surgery. This case demonstrates its potential as a lifesaving intervention while preserving flap viability. However, further research with more cases is needed to evaluate the generalizability and long-term outcomes of this technique in similar surgical contexts.

Mangrove vegetation response to alteration in coastal geomorphology after an earthquake in Andaman Islands, India

The 2004 Sumatra-Andaman earthquake caused a devastating tsunami and shifts in land elevations, which had an instantaneous as well as the long-term impact on the Andaman Islands. Especially, the coastal uplift and subsidence has altered the tidal regime, leading to mass mortality and degradation of mangroves (∼150 sq. km). The tectonic shift in the Andaman archipelago has created three broader geographical units: North Andaman with coastal uplift (∼1.3 m) – sea level drop (SLD) scenario; Middle Andaman with minor to no change in coastal geomorphology – no change scenario; and South Andaman with coastal subsidence (∼1.1 m) – sea level rise (SLR) scenario. How these changes in the tidal regime have influenced mangrove vegetation remains less understood. Therefore, we assessed mangrove vegetation characteristics across the Andaman Islands to examine mangrove response to coastal uplift and subsidence after 18 years since the disturbance. The uplifted sites mimicking the SLD scenario appeared more destructive to mangroves (tree density - 771/ha) in comparison to subsided sites mimicking the SLR scenario (tree density - 937/ha), while no change sites with the highest tree density (1288/ha) showed lowest impacts to mangrove. The species diversity (H’=Shannon-Wiener index) within recruitment cohorts (seedlings: <1 cm DBH and saplings: ≥1 cm and <5 cm DBH) sapling (H’=1.57), and seedling (H’=1.48) was significantly higher than the trees (H’=1.20). Rhizophora apiculata and Ceriops tagal were the dominant species (cumulative IVI 60%) found in survived mangrove forests demonstrating their high resilience for sudden changes in tidal regime. Our study provided a comprehensive account of mangrove vegetation response after a major disruptive event in 2004. Long-term monitoring of these novel sites would enhance our understanding of mangrove response to sea level change, which can also provide significant insights for the restoration and management of mangroves.

Risk assessment of land subsidence based on GIS in the Yongqiao area, Suzhou City, China.

This study focuses on the Yongqiao District in Suzhou City, Anhui Province, China, aiming to analyze the current situation of ground settlement and its influencing factors in the area. The selected risk indices include settlement rate, cumulative settlement amount, groundwater level drop funnel, thickness of loose sediment layer, thickness of soft soil layer, and the number of groundwater extraction layers. Additionally, vulnerability indices such as population density, building density, road traffic, and functional zoning are considered. An evaluation index system for assessing land Subsidence risk was established. The risk evaluation of land Subsidence was conducted using the Hierarchical analysis-composite index method and ArcGIS spatial analysis, The evaluation results show that the area of higher risk area is about 2.82 km2, accounting for 0.96% of the total area, mainly distributed in the area of Jiuli village, Sanba Street. The middle risk area is distributed around the higher area, with an area of about 9.18 km2, accounting for 3.13% of the total area. The lower risk areas were distributed in most of the study area, covering an area of 222.24 km2, accounting for 75.82% of the total area. The low risk assessment area is mainly distributed in Bianhe Street and part of Zhuxianzhuang Town, with an area of about 58.88 km2, accounting for 20.09% of the total area. The findings of this study are not only crucial for informing local policies and practices related to land use planning, infrastructure development, and emergency response but also enhance our understanding of the complexities of land Subsidence processes and their interactions with human activities, informing future research and practice in environmental risk assessment and management.

The impact of polystyrene nanoplastics (PSNPs) on physiological and biochemical parameters of the microalgae Spirulina platensis

Nanoplastics, as emerging pollutants, have harmful effects on living organisms and the environment, the mechanisms and extent of which remain unclear. Microalgae, as one of the most important biological groups in the food chain and sensitive environmental indicators to various pollutants, are considered a suitable option for investigating the effects of nanoplastics. In this study, the effects of polystyrene nanoplastics on the growth rate, dry weight, chlorophyll a and carotenoid levels, proline, and lipid peroxidation in the Spirulina platensis were examined. Three concentrations of 0.1, 1, and 10 mg L-1 of PSNPs were used alongside a control sample with zero concentration, with four repetitions in one-liter containers for 20 days under optimal temperature and light conditions. Various analyses, including growth rate, dry weight, proline, chlorophyll a and carotenoid levels, and lipid peroxidation, were performed. The results indicated that exposure to PSNP stress led to a significant decrease in growth rate, dry weight, and chlorophyll a and carotenoid levels compared to the control sample. Furthermore, this stress increased the levels of proline and lipid peroxidation in Spirulina platensis. Morphological analysis via microscopy supported these findings, indicating considerable environmental risks associated with PSNPs.

Advancing air quality forecasting in Abu Dhabi, UAE using time series models

This research enhances air quality predictions in Abu Dhabi by employing Autoregressive Integrated Moving Average (ARIMA) models on comprehensive air quality data collected from 2015 to 2023. We collected hourly data on nitrogen dioxide (NO2), particulate matter (PM10), and fine particulate matter (PM2.5) from 19 well-placed ground monitoring stations. Our approach utilized ARIMA models to forecast future pollutant levels, with extensive data preparation and exploratory analysis conducted in R. Our results found a significant drop in NO2 levels after 2020 and the highest levels of particulate matter observed in 2022. The findings of our research confirm the effectiveness of the models, indicated by Mean Absolute Percentage Error (MAPE) values ranging from 7.71 to 8.59. Additionally, our study provides valuable spatiotemporal insights into air pollution historical evolution, identifying key times and areas of heightened pollution, which can help in devising focused air quality management strategies. This research demonstrates the potential of ARIMA models in precise air quality forecasting, aiding in proactive public health initiatives and environmental policy development, consistent with Abu Dhabi’s Vision 2030.

Wavelength-specific negatively phototactic responses of the burrowing mayfly larvae Ephoron virgo.

Mayflies are typically negatively phototactic during larval development, whereas the adults possess positive phototaxis. However, no extensive research has been done into the wavelength dependence of phototaxis in any mayfly larvae. We measured the repellency rate of Ephoron virgo larvae to light as a function of wavelength in the 368-743 nm spectral range. We established that the magnitude of repellence increased with decreasing wavelength and the maximal responses were elicited by 400 nm violet light. This wavelength dependence of phototaxis is similar to the recently reported spectral sensitivity of positive phototaxis of the twilight-swarming E. virgo adults. Negative phototaxis not only facilitates predation evasion: avoidance of the blue-violet spectral range could also promote the larvae to withdraw towards the river midline in the case of a drop in the water level, when the underwater light becomes enriched with shorter wavelengths as a result of the decreasing depth of overhead river water.

Sustainability analysis of single vs. multiple adaptation strategies in tackling the adverse impacts of climate change on groundwater resources using water-food-energy nexus approach

Research has shown that groundwater level has decreased in the last few decades worldwide. In future periods, due to global warming and the change in the amount and regime of precipitation, the intensity of groundwater level drop in various parts of the world will increase. This study aims to investigate both single and multiple adaptation strategies to obtain sustainable groundwater resources. At first, the system dynamics model of the Alborz province as the study area, which is located in the center of Iran and includes three aquifers, was developed considering socio-economic, hydrology, agriculture, and energy subsystems. Then, the system was calibrated during an observation period using behavior repetition and extreme conditions tests. Next, the temperature and precipitation data obtained from 16 AOGCM-AR6 models under the SSP2-4.5 scenario were downscaled in the region. The ensemble mean values of temperature and precipitation showed an increase of 1.8 °C in temperature and a 3.5% decrease in precipitation in the period of 2021–2050 compared to the 1985–2014 period. The introduction of downscaled climate scenarios to the developed system dynamics model revealed a sharp drop in the groundwater of the aquifers until 2050. Different adaptation strategies based on water demand management in the agricultural, domestic, and industrial sectors were determined for all three aquifers based on consulting with decision-makers and evaluated using the system dynamics model. Evaluating sustainability indices showed the insignificant effectiveness of each adaptation strategy individually for each aquifer. Meanwhile, the combination of adaptation strategies will not only increase the sustainability of the water systems of the region but will also cause the groundwater level of all aquifers to rise. The framework introduced in this research can be used in most surface and groundwater resource systems to determine the most efficient solutions to adapt to the effects of climate change.

Effect of sequential gemcitabine and epirubicin therapy on high-risk non-muscle invasive bladder cancer following transurethral bladder tumour resection

Purpose: To investigate the efficacy of sequential gemcitabine and epirubicin therapy on high-risk non-muscle invasive bladder cancer (NMIBC) after transurethral resection of bladder tumour (TURBT). Methods: The records of 100 high-risk NMIBC patients, who underwent TURBT at the Tongling People's Hospital, Tongling City, China between January 2020 and March 2023 were retrospectively analyzed. A total of 46 patients, treated with epirubicin after operation, were assigned to control group, while 54 patients, treated with both gemcitabine and epirubicin, were included in the study group. DKK-1 and YKL-4 levels were assayed by immunomagnetic bead‐based liquid chip technology and enzyme-linked immunosorbent assay, respectively. Furthermore, treatment efficacy was determined and compared between the two groups. Results: There were no significant differences in the pre-treatment DKK-1 and YKL-40 levels between the two groups (p &gt; 0.05). However, both groups experienced a significant drop in post-treatment levels, with significantly lower post-treatment levels in the study group (p &lt; 0.05). There were no significant differences in catheter retention time and hospitalization time between the two groups (p &gt; 0.05). The study group achieved a significantly better overall response rate than the control group. The pre-treatment SF-36 scores of the two groups were similar, while their post-treatment SF-36 scores increased significantly (p &lt; 0.05). Conclusion: Sequential therapy with gemcitabine and epirubicin is effective in the therapy of high-risk NMIBC after TURBT. It significantly lowers DKK-1 and YKL-40 levels, improves postoperative quality of life and reduces the postoperative recurrence rate without increasing adverse reactions and affecting the catheter retention and hospitalization times. A more comprehensive analysis is required to obtain improved outcomes.

Sodium arsenite and arsenic trioxide differently affect the oxidative stress of lymphoblastoid cells: An intricate crosstalk between mitochondria, autophagy and cell death.

Although the toxicity of arsenic depends on its chemical forms, few studies have taken into account the ambiguous phenomenon that sodium arsenite (NaAsO2) acts as a potent carcinogen while arsenic trioxide (ATO, As2O3) serves as an effective therapeutic agent in lymphoma, suggesting that NaAsO2 and As2O3 may act via paradoxical ways to either promote or inhibit cancer pathogenesis. Here, we compared the cellular response of the two arsenical compounds, NaAsO2 and As2O3, on the Burkitt lymphoma cell model, the Epstein Barr Virus (EBV)-positive P3HR1 cells. Using flow cytometry and biochemistry analyses, we showed that a NaAsO2 treatment induces P3HR1 cell death, combined with drastic drops in ΔΨm, NAD(P)H and ATP levels. In contrast, As2O3-treated cells resist to cell death, with a moderate reduction of ΔΨm, NAD(P)H and ATP. While both compounds block cells in G2/M and affect their protein carbonylation and lipid peroxidation, As2O3 induces a milder increase in superoxide anions and H2O2 than NaAsO2, associated to a milder inhibition of antioxidant defenses. By electron microscopy, RT-qPCR and image cytometry analyses, we showed that As2O3-treated cells display an overall autophagic response, combined with mitophagy and an unfolded protein response, characteristics that were not observed following a NaAsO2 treatment. As previous works showed that As2O3 reactivates EBV in P3HR1 cells, we treated the EBV- Ramos-1 cells and showed that autophagy was not induced in these EBV- cells upon As2O3 treatment suggesting that the boost of autophagy observed in As2O3-treated P3HR1 cells could be due to the presence of EBV in these cells. Overall, our results suggest that As2O3 is an autophagic inducer which action is enhanced when EBV is present in the cells, in contrast to NaAsO2, which induces cell death. That's why As2O3 is combined with other chemicals, as all-trans retinoic acid, to better target cancer cells in therapeutic treatments.

A system dynamics approach for sustainable groundwater management considering climate change, inter-organizational relationships, and domestic water saving

This article uses system dynamic modeling to examine the relationship between water allocation from the Ilam dam and groundwater fluctuation, as well as the effects of climate change, changes in inter-organizational relationships, and water demand management on water allocation and groundwater level fluctuations. The results showed that agricultural water allocation has a direct effect on groundwater level fluctuations. In the first scenario, which examined the effects of climate change, the comparison of three climate change scenarios (SSP126, SSP245, and SSP585) was carried out. The results illustrated that with temperature increasing and precipitation decreasing occurred in SSP585, the groundwater drawdown increases about 0.8 m more than SSP126. The second scenario examined the effects of changes in inter-organizational relationships. Based on the results of centrality measures in the social network analysis method, it was found that the organizational power of the stakeholder organization in the agriculture sector is greater than the ones in the environment sector. This causes the allocation to the agriculture sector to be prioritized over the environment. This scenario was analyzed by assuming a change in organizational power and giving priority to the water allocation of the environmental sector. The results showed that environmental needs (maximum 0.3 MCM) were almost entirely met in the second scenario, compared to the basic scenario. Also, the decrease in agricultural water allocation has led to an increase in groundwater usage by farmers, resulting in a 20 cm drop in groundwater levels. Therefore, regarding the sustainable management of water resources, directing attention towards alternative livelihoods for farmers can contribute to environmental water rights and the remediation of aquifers. The third scenario examined the effects of water demand management. The results showed that saving 20–25% of water in the domestic sector can reduce 40–50 cm maximum groundwater drawdown which align with sustainable groundwater management.

Different Effects of Hylocecarus Polyrhizus and Hylocecarus Undatus Extract on Reducing Total Cholesterol of Male Rattus Norvegicus Wistar Strain

A chronic ailment that is caused by excessive food consumption and a lack of physical activity, obesity is a condition that may be prevented. The tropical dragon fruit can control cholesterol levels, support the immune system, and give a natural colorant for culinary applications. In a true experimental research, sample with rats were fed red and white dragon fruit extracts to determine the amounts of cholesterol in their bodies. Spectrophotometry was used to determine the rats' blood lipid profiles, cholesterol levels, and body weight after they were fed a meal that was high in fat and contained duck egg yolk. For this study, extracts from red and white dragon fruits were administered to male Wistar rats to determine their effects on cholesterol levels. After fourteen days, both groups had a reduction in high cholesterol levels, with group 4 exhibiting the most significant drop in cholesterol levels. Additionally, the extracts decreased the levels of MDA while simultaneously increasing the levels of SOD. The most significant rise was seen in group 4, given white dragon fruit extract at 140 mg/200 gr BW daily. SPSS was utilized to analyze the effects of dragon fruit on blood cholesterol levels in experimental animals, employing the LSD technique and one-way ANOVA.

Seaway restriction, sea level drop and erosion in the Alboran Basin from a paleotopographic reconstruction for the Messinian Salinity Crisis

The Messinian Salinity Crisis (MSC) resulted from changes in the Atlantic-Mediterranean connectivity in the Alboran Basin, a region with a complex and debated geodynamic configuration. Since the MSC, this basin's topography and its record of the Messinian Erosional Surface have been subject to vertical motions due to sediment accumulation, tectonic deformation, isostasy, and latent effects of thermal cooling after extension and magmatic arc formation. The objective of this work is to restore these contributions to post-Messinian subsidence in order to quantify the original depth of formation of the MSC features. We do this by performing a pseudo-3D planform flexural isostatic reconstruction of the Messinian Erosion Surface mapped from an extensive set of seismic reflection data. We focus on identifying the most likely position of the gateway between Atlantic and Mediterranean, the effect of a drawdown on gateway topography and connectivity, and the depth of proposed erosional features related to the Messinian lowstand. The results indicate that the depth of the Alboran Basin by the end of the Messinian was about 500 m shallower than nowadays, but over 500 m deep on average, reaching depths of >1000 m in most subbasins, even when accounting for the possible ∼300 m isostatic rebound caused by water unloading in a largely desiccated Alboran Sea during the MSC. Although these results are compatible with volcanic cones locally emerging above sea level at the East Alboran Volcanic Arc during the Messinian, several lows remaining in the reconstruction suggest that that region is unlikely to have been the sill between Atlantic and Mediterranean at that time, unless the basin saw unconstrained dynamic topography contributions of over −500 m. Full desiccation of the Alboran Basin implies an uplift of up to 100 m at the Strait of Gibraltar, and uplift rates too high to be counteracted by erosion, suggesting that full disconnection and the main corresponding evaporative drawdown took place only once. The terraces and canyons in the West Alboran are restored to depths between 250 and 550 m (shallowest terrace) and 750–1500 m (deepest terrace), and cannot be clearly linked to a single, stable water level during the MSC, pointing to climate-controlled variations in the water level during the isolation phase.

Spontaneous and Treatment-Related Changes of Serum Calcitonin in Medullary Thyroid Cancer: Long-Term Experience in a Patient With Multiple Endocrine Neoplasia Type 2B.

Medullary thyroid carcinoma (MTC) in MEN2B syndrome is associated with germline RET mutation. Patients harboring de novo mutations are usually diagnosed at more advanced disease stages. We present a young woman with Met918Th mutation diagnosed with stage IV MTC at age 10 years. The disease progressed despite total thyroidectomy and multiple surgical interventions for cervical lymph node recurrences, leading to distant metastases in the fifth year after the initial diagnosis. Subsequently, she underwent five different types of tyrosine kinase inhibitor (TKI) treatments. The 17-year disease course was divided into periods defined by four surgical interventions and sequential treatment intervals with four multikinase (sunitinib, vandetanib, cabozantinib, and lenvatinib) and one RET-selective TKI (selpercatinib). Tumor growth for different phases of spontaneous development and drug treatment intervals was characterized by changes in serial log-transformed calcitonin measurements (n = 114). Three operations (one for calcitonin-producing adrenal pheochromocytoma) were associated with drops in calcitonin levels. All of the nonselective TKIs were stopped due to adverse effects. As reflected by the negative calcitonin doubling rate, the best treatment response was observed with selpercatinib, which was associated with an initial large drop followed by a decreasing calcitonin trajectory over 514 days without any major side effects. This case of MEN2B medullary thyroid cancer with long-term survival presents how the effectiveness of different treatment modalities can be estimated using log-transformed calcitonin levels. Furthermore, our experience supports the view that serial calcitonin measurements may be more sensitive than radiological follow-up in advanced MTC. Our patient also represents a new case of rarely reported calcitonin-producing pheochromocytomas.

Short-term Outcomes of Surgical Treatment of Benign Obstructive Jaundice, Sana'a, Yemen.

Short-term Outcomes of Surgical Treatment of Benign Obstructive Jaundice, Sana'a, Yemen.