This study aimed to calculate the rate of post‐stroke cognitive impairment (PSCI) by evaluating the cognitive domains among Lebanese stroke survivors at 3, 6, and 12 months post‐stroke, and to identify the contributing factors including pre‐ and post‐stroke related factors.A multicenter longitudinal prospective study was conducted in 10 hospitals from Beirut and Mount Lebanon for a 15‐month period. Mini‐Mental State Examination (MMSE), modified Rankin Scale (mRS), Short Form Health Survey (SF12), National Institutes of Health Stroke Scale (NIHSS), and Hospital Anxiety and Depression Scale (HADS) were used to assess cognitive function, disability degree, Quality of Life (QoL), stroke severity, and levels of anxiety and depression, respectively. Then, univariate and multivariable analyses were performed to identify the predictors of PSCI.p < .001), indicating a 37% improvement of the cognitive function over time. The most affected cognitive domain was the attention and concentration at the three time points. Independent factors that were positively associated with low MMSE scores were as follows: sedentary behavior ≥ 12 h/day , involvement of the left hemisphere , HADS ≥ 11 , and high NIHSS scores . Age was the main predictor in the three time periods . Inversely, female gender , high educational level , employment post‐stroke , high Physical Component Summary (PCS) of Quality of Life (QoL) , and the use of anti‐diabetic treatment post‐stroke  improved MMSE scores to > 23.Low MMSE scores were found among survivors during the first 3 months post‐stroke (74.8%) of whom 53.7% presented with an MMSE ≤ 17, followed by 46.7% in the 6 months, and 37.6% at 12 months post‐stroke. Follow‐up comparisons showed a significant increase of MMSE scores over time (The risk of PSCI among Lebanese stroke survivors was high especially in the acute phase, depending on various determinants. Health care providers are invited to implement an emergency rehabilitation program for an appropriate successful management of the risk factors in order to reduce stroke burden and to improve overall cognitive performance.  It was conducted over a 15‐month period of follow‐up, starting from February 2018.2.2Participants were any Lebanese subject aged ≥ 18 years old admitted to the participating hospitals between February 2018 and May 2018, being a survivor of first‐time ischemic or hemorrhagic stroke identified by the following codes of the International Classification of Diseases‐10 (ICD‐10) (I63‐I61) : cerebroThe exclusion criteria were the following: admission for a recurrent stroke or for transient ischemic accident or past medical history with neurologic disorders or cognitive sequelae .2.3Given that the estimated prevalence of stroke in Lebanon is 3.9% as reported by Jurjus et al. , the min2.4Data collection was done by trained and qualified investigators to minimize errors. Hospitals were approached to secure approval after which eligible subjects are recruited. We selected the eligible subjects from different departments through an access to the paper or web‐based hospital patients’ registries. After that, a face‐to‐face interview with the subjects and their caregivers or legal representatives was essential to get their written consent and do the subsequent follow‐up home visits scheduled at 3, 6, and 12 months post‐stroke.2.5A structured standardized validated Arabic questionnaire was used. It was divided into five major sections: socio‐demographic characteristics , lifestyle , health indicators reported in the patients’ registries , disease and its severity   = .882). Recent research has validated the use of the Arabic version of MMSE among the Lebanese population. Intra‐rater and inter‐rater test–retest score correlations were 0.89 and 0.72, respectively. A sensitivity of 80% and a specificity of 89.4% were provided  = .942). We used the validated Arabic version of NIHSS, with intra‐rater and inter‐rater agreements of 0.94 and 0.95, respectively  is a measurement tool that was created in 1989 by Brott T. and his colleagues  = .946).Modified Rankin Scale (mRS), initially described by Rankin J. in 1957 Rankin, . mRS is r) = .540). The validated Arabic translation was considered , is a questionnaire developed by Ware et al. in 1996  = .906).Hospital Anxiety and Depression Scale (HADS), designed by Zigmond and Snaith in 1983  = .854).Fatigue severity scale (FSS) is a nine‐item self‐report questionnaire scale developed by Krupp et al. in 1989  = .866).Visual analogue scale (VAS), first introduced in 1921  = .878). A validated Arabic version was used  is a 4‐item questionnaire developed by Bouhassira and colleagues in 2005  = .933).Modified Ashworth scale (MAS), described by Bohannon and Smith in 1987 . First, descriptive analyses were performed using numbers and percentages for qualitative variables and means with standard deviation (SD) for continuous variables. In addition, a one way repeated measure Analysis of Variances (ANOVA) (Bonferroni method) was important to assess the MMSE scores over time. Second, the univariate analyses were conducted. The student's t‐test and one way ANOVA were used for the comparison of means of quantitative variables with a normal distribution and equal variances, whereas the non‐parametric  test for quantitative variables with an abnormal distribution and the unequal variances were used. The Chi‐square test was used for the comparison of percentages between two qualitative variables. Then, multivariable analysis using multinomial logistic regressions adjusted for age, gender, and education was made to examine independent determinants of mild and severe cognitive impairment. The variables with univariate association at p ≤ .05 were entered into logistic regression. The goodness‐of‐fit statistic is reported to determine if the model provides a good fit for the data (p > .05). The strength of association was interpreted using the adjusted odds ratio (AOR) with 95% confidence interval (CI). A p‐value ≤ .05 was considered statistically significant.Collected data were coded, introduced, and entered into the software Statistical Package for Social Sciences (SPSS) version 25 , of whom 117 completed the whole period of follow‐up  were males and 62 41.3%) were females. The mean age was 73.7 with SD of 12 years. The majority were married (78%), lived with family members (96.1%) and 87% in less crowded houses. An important proportion of the participants were illiterate (38%). In addition, 67.3% were without any profession or retired. On the other hand, 20% of the subjects did not resume their work after having the stroke incident (Table .3% were 3.2As shown in Table The majority (70%) was not able to express themselves verbally or in writing at the time of stroke and experienced a weakness on one side of the body. The stroke severity, degree of disability, and components of QoL were estimated by NIHSS scores, mRS scores, and SF12 scores, respectively, at each time of the follow‐up. At 3 months, 16.8% of the subjects were found to have severe stroke Figure . mRS sco3.3Out of 150 enrolled subjects, 27 were deceased (18%) in the 3 months post‐stroke, followed by 3 (2.4%) in the 6 months and 2 (1.7%) in the 12 months of follow‐up. One subject was lost to follow up by the 12‐month visit. Therefore, we could not have their MMSE.n = 123) were cognitively impaired of whom 66 (53.7%) with severe impairment (MMSE ≤ 17) and 26 (21.1%) with mild impairment (18 ≤ MMSE < 24), whereas 31 survivors (25.2%) remained cognitively intact (MMSE ≥ 24). The cognitive impairment gradually decreased over time, at 6 and 12 months post‐stroke, with percentages of 46.7% (28.3% severely impaired and 18.3% mildly impaired) and 37.6% (18.8% with mild to severe cognitive impairment), respectively . The results designated a significant time effect, Wilks’ Lambda = 0.528, F  = 51.439, p < .001, n2 = 0.472. Thus, there was evidence to reject the null hypothesis. Follow‐up comparisons indicated that each pairwise difference was significant, p < .001. There was a significant increase of MMSE scores over time, indicating an improvement of the cognitive function over time.A one way repeated measures ANOVA was conducted to evaluate the null hypothesis that there was no change in the cognitive function over the time after the first‐stroke  at 3 months. They became 13.80 (± 6.92) and 26.69 (± 1.59) at 6 months versus 14.77 (± 6.72) and 28.37 (± 1.93) at 12 months, respectively (p < .001).Their mean MMSE scores were 13.08 (± 6.52) and 25.84 (± 1.49), respectively (p ≤ .010), sedentary lifestyle ≥12 h/day (55% to 77%) (p < .001), NIHSS ≥21 (30% to 60%) (p < .001), mRS ≥3 (85% to 95%) (p < .001), and low scores of PCS and MCS of the QoL (<30) (p < .05).Factors that were significantly associated with severe cognitive function decline (MMSE ≤ 17) in the three time series post‐stroke were the atrial fibrillation (AF) (27% to 46%) (p ≤ .022), HADS_D ≥ 11 (80% to 95%) (p < .001), physical disorders as FSS ≥ 4 (85% to 100%) (p ≤ .026), VAS ≥ 4 (45% to 86%) (p ≤ .015), MAS ≥ 3 (33% to 59%) (p < .001), joint contractures (50% to 60%) (p ≤ .013), falls at 3 and 6 months post‐stroke (35% to 60%) (p ≤ .006), pressure ulcers (47% to 68%) (p ≤ .001), and pneumonia at 3 months post‐stroke (28% to 42%) (p ≤ .046).In addition to the above, we also found some associations with various complications post‐stroke as follows: HADS_A ≥ 11 (35% to 60%)  (81.8% of subjects were aged ≥ 65 years old) and the presence of a caregiver (47%) (p = .002). In addition, a mean duration of hospital stay of > 9 days was associated with mild to severe cognitive impairment (p < .001). Adversely, employment post‐stroke (45.2%) (p = .001) showed better cognitive function (MMSE >24).At 3 months, a significant association was found between severe cognitive impairment (MMSE ≤ 17) and old age (p = .003), epileptic seizures (17.6%) (p = .001), DVT at 3 months post‐stroke (23.5%) (p = .012), pneumonia that occurred at 6 months (24.2%) (p = .001), and recurrent stroke at 3 and 6 months post‐stroke (9% to 15%) (p ≤ .047), all affected the cognitive function of the recruited subjects resulting in severe damage (MMSE ≤ 17). Shoulder subluxation at 3 months (15.2%) (p = .012) was associated with MMSE ≤ 17, but its occurrence at 6 months (9.1%) was associated with 18 ≤ MMSE ≤ 23 (p = .033). However, high level of education (secondary or university education) (48.4%) (p = .049) presented a protective factor for the cognitive function (MMSE > 24) at 6 months.At 6 months, falls (35.3%) (p = .028), having a left hemisphere stroke (45.5%) (p = .006), an ICU stay at stroke occurrence (59.1%) (p = 0.011), evidence of recurrent stroke at 12 months (18.2%) (p = 0.002), falls at 6 months post‐stroke (41%) (p = .006), shoulder pain at 12 months post‐stroke (36.4%) (p = .013), pneumonia at 6 months post‐stroke (33.3%) (p < .001), and DVT at 3 months post‐stroke (22.7%) (p = .048) showed a significant association with MMSE ≤ 17. Moreover, subjects suffering from neuropathic pain (DN4 ≥ 4) at 3 and 12 months presented with mild‐to‐severe cognitive impairment (20% to 40%) (p ≤ .012), whereas high educational level (45.2%) (p = .005) and use of antidiabetic treatment post‐stroke (55%) (p = .007) were associated with normal cognitive function (MMSE > 24).At 12‐month follow‐up, age ≥ 65 years old (90.9%) . Whereas, old age, sedentary lifestyle (≥ 12 h/day), and depression 3‐month post‐stroke increased two to three times the risk of severe cognitive impairment (MMSE ≤ 17) . In contrast, subjects who resumed work post‐stroke and had higher PCS scores of QoL were less likely to develop PSCI .At 3 months post‐stroke, anxiety was positively associated with 18 ≤ MMSE ≤ 23  and severe stroke (NIHSS ≥ 21)  affected severely the cognitive function (MMSE ≤ 17), whereas high educational level presented as a protective factor for the cognitive function .At 6 months, old age . Moreover, we noted that the left hemisphere stroke increased approximately threefold the risk of late cognitive decline .At the 12‐month follow‐up, old age, HADS_D ≥ 11, high NIHSS scores, continued to exhibit a significant contribution to induce an impairment of the cognitive function , and the subjects who were on anti‐diabetic treatment post‐stroke had 82% lower risk of 12‐month mild to severe cognitive impairment . Similarly, high educational level and higher PCS scores of QoL stayed having a significant association with higher scores of MMSE at 12 months post‐stroke .On the other hand, females were 91% less likely to develop MCI at 12 months post‐stroke  that were associated with poorer functional outcome and QoL. Age, low educational level, high NIHSS scores, low PCS of QoL, sedentary lifestyle, and high HADS_A and HADS_D scores were the main independent predictors of the deficit in MMSE scores among Lebanese stroke survivors. A significant substantial 37% improvement of the cognitive function was seen at 1 year post‐stroke.Compared to different eastern and western countries, PSCI rate at acute phase in Lebanon is one of the highest rates, similar to the rates in Shanghai, China (88.1%)  with mild cognition decline (18 ≤ MMSE ≤ 23). This was found inconsistent with the results of most of the previous studies  in the cause of PSCI . The funder was not involved in the study design,collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.https://publons.com/publon/10.1002/brb3.2837The peer review history for this article is available at: Supplementary InformationClick here for additional data file.Figure 1S. The severity of the stroke measured by the National Institutes of Health Stroke Scale (NIHSS). It is divided into 5 levels: 0: no stroke, 1–4: minor stroke, 5–15: moderate stroke, 15–20: moderate to severe stroke, 21–42: severe stroke.Click here for additional data file.Figure 2S. The degree of disability measured by the modified Rankin Scale (mRS). It is divided into 7 levels as follows: 0: no symptoms; 1: no significant disability despite symptoms; able to perform all the duties and usual activities; 2: low incapacity; unable to accomplish many previous things, but capable of taking care of its own affairs without assistance; 3: inability to moderate; needing help, but able to walk without assistance; 4: moderately serious disability; unable to walk without assistance and unable to meet physical needs without assistance; 5: serious disability; bedridden, incontinent and demanding necessary attention and constant nursing care; 6: death.Click here for additional data file.Figure 3S. The rates of cognitive impairment occurring after 3, 6, and 12‐month post‐stroke.Click here for additional data file.Figure 4S. The percentage of subjects with/without cognitive domain impairment according to MMSE across the 3 periods of follow‐up.Click here for additional data file.


Aquabacterium, Pseudomonas, Woeseia, MND1, Ignavibacterium and Truepera, accounting for 7.89% ± 8.24%, 2.32% ± 1.05%, 2.14% ± 0.94%, 2% ± 1.22%, 0.94% ± 0.14% and 0.80% ± 0.14% of the total reads, respectively. Statistical analyses showed the similarity of the sediment bacterial communities at our field sites was considerably low, far below 35%, and total organic carbon (TOC) was the dominant environmental factor affecting the spatial changes of BCC in the sediment. Thus, this study greatly improving our understanding of the microbial ecology of alpine lake in the arid and semi-arid ecosystems today so seriously threatened.Sediment bacterial communities play a critical role in biogeochemical cycling in alpine lake ecosystems. However, little is known about the sediment microbial communities in these lakes. In this study, the bacterial community composition (BCC) and their relationships with environmental factors of the sediment in Sayram Lake, the largest alpine and cold-water inland lake, China was analyzed using Illumina MiSeq sequencing. In total, we obtained 618,271 high quality sequences. The results showed that the bacterial communities with 30 phyla and 546 genera, were spread out among the 5 furface sediment samples, respectively. The communities were dominated by Proteobacteria, Acidobacteria, Planctomycetes, Gemmatimonadetes, Chloroflexi, Actinobacteria, Verrucomicrobia and Bacteroidetes, accounting for 48.15 ± 8.10%, 11.23 ± 3.10%, 8.42 ± 2.15%, 8.37 ± 2.26%, 7.40 ± 3.05%, 5.62 ± 1.25%, 4.18 ± 2.12% and 2.24 ± 1.10% of the total reads, respectively. At the genus level, the communities were dominated by The online version contains supplementary material available at 10.1186/s12866-023-02793-1. Sediment bacterial communities are a major constituent of lake ecosystems, where they play a critical role in in decomposition of organic matter and mineralization of nutrients . RecentlDetermining the bacterial diversity and community composition in different ecotype lakes is one of the necessary steps in understanding aquatic microbial ecology. The 16S ribosomal ribonucleic acid (rRNA) gene-based high-throughput sequencing now provide us with unprecedented access to the diversity and composition of lake bacterial community, and have enabled us to identify the numerically dominant species in these ecosystems and learn much about their distributions in time and space –7. Most Arid and semi-arid regions compose around 33% of the world’s land area, and in China the percentage is considerably higher, 52.5%. Lakes in these regions provide sparse, but valuable, water resources for human beings . The TiaThe present study is the first to use Illumina MiSeq sequencing of 16Sr RNA for the sediment microbial communities in Sayram Lake. Our aims were to: (i) characterize the BCC of the surface sediment in this alpine lake, (ii) determine which major environmental factor control the spatial changes of the sediment BCC.2, water mean temperature is 1.1 °C and highest temperature is about 19 °C. Only a few small rivers flows into Sayram Lake and water input mainly originate from groundwater recharge [Sayram Lake, is the largest alpine lake and the highest (2073 m above mean sea level) cold water inland lake in Xinjiang Uygur autonomous region, China Fig. . The surrecharge . Within Three surface sediment (0–2 cm), was collected with peterson sediment sampler, from each sampling sites on 16 August 2018. The pH was measured in situ with specific electrodes . The salinity was measured on location by soil electrical conductivity meter . The sediment samples were immediately transferred into sterile plastic containers, and dried with a freeze dryer  in the labortaory. Total nitrogen (TN) was determined by the micro-Kjeldahl method and total phosphorus (TP) was measured by Mo-Sb colorimetric method. TOC content and C/N ratios were analyzed using an elemental analyzer .Sediment DNA was extracted from 0.5 g sample (dry weight) using the MoBio PowerSoil™ DNA isolation kit  following the instructions of the manufacturer. The V3-V4 hypervariable regions of the bacterial 16S rRNA genes were polymerase chain reaction (PCR) amplified using the primer set 338F (5′-ACTCCTACGGGAGGCAGCAG-3′) and 806R (5′-GGACTACHVGGGTWTCTAAT-3′) . EquimolThe bioinformatic analysis was performed using the Microbial Genomics Module on CLC Genomics Workbench 20.0 . After importing raw reads, a standard quality control process was implemented, comprising merger paired reads (minimum overlap of 200 bp), trim off adapters and the primer sequences. Microbial phylotypes were assigned to operational taxonomic units . The low abundance OTUs (< 10 reads) was filtered out for minimizing the random sequencing error. Taxonomic classification of the sequences was conducted using the SILVA small subunit rRNA (SSU) database v132 [The statistical analyses and the visualization were performed by Microsoft Excel. To evaluate the β-diversity (variation of community structures) among the 5 surface sediment samples, we performed cluster analysis and non-metric multidimensional scaling (NMDS) by using Bray–Curtis similarity based on distance matrix of bacterial community , 22. To .The longitude and latitude of sampling sites, and the value for physicochemical parameters of the surface sediment in Sayram Lake is summarized in Table SWe generated 618,271 high-quality reads with a mean of 123,654 reads per sample. Across the 5 different surface sediment samples, the reads were classified into 2,486 OTUs. The rarefaction curves of Shannon index approached an asymptote after 1,500 reads  were Proteobacteria, Acidobacteria, Planctomycetes, Gemmatimonadetes, Chloroflexi, Actinobacteria, Verrucomicrobia and Bacteroidetes, accounting for 48.15 ± 8.10%, 11.23 ± 3.10%, 8.42 ± 2.15%, 8.37 ± 2.26%, 7.40 ± 3.05%, 5.62 ± 1.25%, 4.18 ± 2.12% and 2.24 ± 1.10% of the total reads, respectively  for Sayram Lake Fig. . The ploIn this study, we have shown that the dominant bacterial phylum in the Sayram Lake sediment habitats were Proteobacteria, Acidobacteria, Planctomycetes, Gemmatimonadetes, Chloroflexi, Actinobacteria, Verrucomicrobia, Bacteroidetes, and these phyla are found in the waters and sediments of other various lakes. It is known that Proteobacteria is the largest phylum of bacteria, and they might be involved in the functioning and processes of lake ecosystems , 24. ProAquabacterium, Pseudomonas, Woeseia, MND1, Ignavibacterium, and Truepera, and these genera also existed in other various environments. Previous study have showed that Aquabacterium dominated in the high arsenic groundwater, and Pseudomonas dominated in the high arsenic sediments of Hetao Plain of Inner Mongolia, China [Pseudomonas was also found in sediments of saline Qinghai Lake [Woeseia has previously been reported to existed in offshore sediments from Shenzhen, China [Woeseia and Ignavibacterium were also greatly enriched in saline–sodic soils, Northeast China [Ignavibacterium was the putative keystone species, could be responsible for the deterioration of nitrogen removal under high salinity condition in wastewater treatment system. Furthermore, Shen et al. [MND1 was existed in petroleum-contaminated soils. In addition, Truepera has been found in environments as diverse as stone ruins at historic sites in Tamil Nadu, India [The dominant genus of Sayram Lake sediment were a, China . Pseudomhai Lake , and Lakhai Lake . Woeseian, China . Woeseiast China . Ya et ast China  have indn et al.  have repu, India , an ironu, India  and compu, India .Our CCA results suggested that TOC significantly influenced the bacterial community structure of the sediment in Sayram Lake, which is in agreement with previous studies of various environments. In Lake Chaohu, China, TOC has a significant effect on the BCC of two estuaries of this lake . In LakeAdditional file 1: Table S1. The longitude and latitude of sampling sites, and the value for physicochemical parameters of 5 surface sediments in Sayram Lake. Table S2. The OTU-based species diversity represented by 4 α-diversity indices and Goods coverage of 5 sediment samples in Sayram Lake. Fig. S1. Rarefaction curves for the different sediment samples analyzed using the Shannon diversity. Fig. S2. Sediment bacterial communities clustering generated from the 16S ribosomal ribonucleic acid (rRNA) gene-based Illumina MiSeq sequencing of 16S rDNA OTUs data (97% similarity).


H plane of the feed producing a wider beam in the azimuth plane. This type of pattern is useful in applications such as projectile tracking and airport surveillance. The design parameters for optimum performances are chosen at all stages of the design. The design and analysis have been carried out using the commercial simulation tool CST Studio Suite 2022. The directivity of the sum, elevation difference and azimuth difference channels of the reflector antenna are 32.1, 28.1, and 26.4 dB at 14 GHz; 30.9, 29, and 27.3 dB at 15 GHz; 31.7, 29.6, and 27.6 dB at 16 GHz; 31.6, 29.9, and 27.8 dB at 17 GHz.This paper presents a design for a monopulse reflector antenna with asymmetric beamwidths for radar applications at the Ku band. The proposed design features a rectangular waveguide monopulse feed and a truncated parabolic reflector. An array of four open-ended rectangular waveguides were employed to realize a compact monopulse feed. The reflector is cut in the  The monopulse technique can be used to determine the target’s position from a single pulse by comparing the received signals obtained concurrently from one or more antenna beams . This maIt is worth mentioning that researchers have developed different kinds of monopulse antennas for radar applications ,2,3,4,5.In some applications, a monopulse antenna with a narrow beam in one plane and a wider beam in the other plane was required. However, investigations that achieved a concurrent sharp pencil beam at the elevation plane, an outspread beam at the azimuth plane, and a robust sum channel beam with minimum side lobes have not been sufficiently explored. Study  designedMonopulse feed design used to be very complicated because one needs to carefully combine four or five apertures to arrive at the symmetric and balanced sum and difference patterns. In this paper, we propose a very simple monopulse feed suitable for illuminating a truncated parabolic reflector. The proposed feed utilizes four rectangular waveguide apertures that are excited by a coaxial probe. It is easier to implement a monopulse comparator in a coaxial medium than in waveguide form. We employed four rectangular waveguide open-ends, which are compact and simple to realize.Few results have been published regarding monopulse reflector antennas with asymmetric beamwidths suitable for the tracking of flying objects. In this paper, we propose a design for an optimally illuminated truncated parabolic reflector antenna with well-balanced sum and difference patterns.First, a design is carried out for a monopulse consisting of four open-ended waveguide radiators, and the sum and difference gain patterns of the feed are analyzed to find an optimum reflector geometry. Part of a parabolic reflector surface is removed so that the feed optimally illuminates the reflector. Essentially, the purpose of our paper is to present an idea, not to show the result of development efforts. In this regard, we have used CST Studio Suite 2022, a well-proven simulation tool whose accuracy has been confirmed in many published papers so that the simulation alone is enough to prove the proposed concept. a and b are chosen so that the feed will give suitable sum and difference patterns at 14–17 GHz. The gap between the rectangular apertures is chosen so that the grating lobe is suppressed in the visible region of the radiation angle while the coupling between the waveguide apertures is low enough . A circular flange is employed to reduce backward radiation from the feed.L), the probe diameter (E), and the probe’s position away from the waveguide end wall (C). The length L of the probe is less than a quarter waveguide wavelength (<λg/4), and that makes it behave similar to a capacitor, thereby introducing capacitive susceptance to match the source to the load. All the parameters are optimized for frequencies of 14–17 GHz. The cutoff frequency of the fundamental TE10 mode in the rectangular waveguide is 9.375 GHz, which is determined by the waveguide’s broadwall dimensions a. The dimensions in millimeters of the designed feed are shown in Once the feed dimensions are determined, the waveguide is fed by a coaxial probe whose diameter and position are found by iterative parametric analysis. Critical to obtaining a good impedance matching of the probe-excited rectangular monopulse feed is the probe length . An elevation difference pattern is obtained by deducting the two upper apertures from the two lower quadrants (A1 + A2 − A3 − A4). Apertures A1 and A2 are excited with a phase of 0° while apertures A3 and A4 are fed with a phase of 180°. This elevation difference pattern is used to compute the target’s location in the elevation plane. The azimuthal difference pattern is realized by subtracting the right vertical apertures from the left vertical ones (A2 + A3 − A1 − A4). Aperture A2 and A3 have a phase of 0°, while apertures A1 and A4 are in a 180° phase. The azimuthal difference pattern is used to obtain the target’s location in the azimuth plane.10 mode (wave port in CST Studio Suite), while they are excited with a coaxial probe in S11) of E-plane coupling is still less than 15 dB at 14–17 GHz, as can be seen in the S41 graph; the H-plane coupling (S21) and diagonal-plane coupling (S31) are less than 31 dB at 14–17 GHz in both cases.E- and H-plane directivity patterns of the sum channel. The maximum directivity of the sum channel is 13.4, 13.7, 14.3, and 14.8 dB at 14, 15, 16, and 17 GHz, respectively. The sidelobe level is less than −10.3 dB at 14–17 GHz in both E and H planes. The E- and H-plane 3-dB beamwidths are 52.2°, 29.2 ° at 14 GHz; 48.2°, 27.3° at 15 GHz; 41.6°, 25.1° at 16 GHz; and 36.3°, and 23.3° at 17 GHz. The E- and H-plane 10-dB beamwidths are 86.24°, 48.27 ° at 14 GHz; 78.65°, 45.39° at 15 GHz; 73.6°, 42.13° at 16 GHz; and 70.33°, and 39.26° at 17 GHz. E- and H-plane phase patterns of the sum channel are shown in The initial phase center of the feed is obtained using the phase center functionality of the CST Studio Suite for the sum pattern. With the coordinate origin for patterns calculation at the initial phase center, the phase patterns of the sum and two different channels are calculated. An optimum phase center is obtained by adjusting the coordinate origin so that the phase variations in the 10-dB beamwidth of the sum pattern are minimum for the sum and difference channels. The optimum phase center was found to be 1.0 mm into the aperture. The E- and H-planes are denoted by θ1 and θ2 in D, focal length F, and E-plane illumination angle θ1 is given by Equation (1):Based on the foregoing design of the monopulse feed, a prime-focus parabolic reflector was designed. The reflector diameter was chosen for a sum gain of about 30 dB with good difference pattern characteristics. H-plane beamwidth θ2 is smaller than θ1, the reflector is truncated, as shown in θ1 and θ2 are adjusted for optimum performance in both the sum and difference patterns. When these angles are chosen for the best performance in the sum channel, the difference in the channel patterns is not good, so a compromise is required. The θ1 and θ2 parameters are obtained through an iterative calculation for the directivity pattern of the reflector. An optimum choice of θ1 and θ2 is made so that the gain requirement is met for the sum channel and a good monopulse slope performance can be obtained for the difference channels. The optimum values of θ1 and θ2 were found to be 51° and 23°, respectively. Since the 10 mode using a wave port in the CST Studio Suite. As before, the sum and difference patterns are obtained by the proper combinations of four apertures of the feed. The reflector and the feed are simulated together so that the effect of the feed scattering is included in the far-field directivity patterns. The feed’s phase center, at 1.0 mm inside the aperture, is placed at the focal point of the reflector. The waveguide is excited with the TE10-mode-feed illuminating the reflector. The reflection coefficient is less than −10 dB at 14–17 GHz, albeit with a slight increase in the periodic interference effects due to the presence of the reflector. The transmission coefficient or the coupling between apertures has also been increased again with period interferences. The E-plane coupling is still less than −15 dB at 14–17 GHz, as seen in the S41 graph. The H-plane coupling (S21) and diagonal-plane coupling (S31) are less than −18 dB at 14–17 GHz. 10-mode excited feed and is still less than −10 dB at 14–17 GHz. The coupling between the apertures is similar to that of the TE10-mode feed.E plane and H plane. The directivity patterns of the sum and difference channels are calculated by full-wave analysis using CST Studio Suite, including the feed. The sum-channel directivity patterns at smaller angles are shown in The maximum directivity of the sum channel is 32.1, 30.9, 31.7, and 31.6 dB at 14–17 GHz, respectively. The elevation difference channel directivity is 28.1, 29, 29.6, and 29.9 dB at 14–17 GHz, while the azimuth difference channel directivity is 26.4, 27.3, 27.6, and 27.8 at 14–17 GHz, respectively. The 3-dB beamwidth of the elevation sum channel and the elevation difference channels at 14–17 GHz are obtained as follows: 2.6°, 1.8° at 14 GHz; 3.2°, 1.6° at 15 GHz; 3.0°, 1.5° at 16 GHz; and 2.8°, 1.4° at 17 GHz, respectively. The 3-dB beamwidth of the azimuthal sum channel and the azimuth difference channels at 14–17 GHz are obtained as follows: 5.2°, 3.8° at 14 GHz; 5.3°, 3.6° at 15 GHz; 5.0°, 3.4° at 16 GHz; and 4.6°, 3.3° at 17 GHz, respectively.E-plane sum channel are −13, −20, −14.6, and −12.6 dB at 14, 15, 16, and 17 GHz, respectively. The sidelobe levels of the H-plane sum channel are −20, −18.8, −19.6, and −19.9 dB at the same frequencies. The sidelobe levels of the elevation difference channels are −12.6, −12, −10.4, and −9.3 dB at the same frequencies. The sidelobe levels of the azimuth difference channels are −13.3, −14, −13.7, and −13.2 dB at the same frequencies. The sidelobe levels of the E plane and in H plane. The sum- and difference-channel directivity patterns at wider angles are shown in φ = 45°). E- and H-planes are shown in the range of 14–17 GHz. The maximum directivity of the cross-polarized radiation in the E- and H-planes is 0.189, −1.50, 0.90, and 1.16 dB at 14, 15, 16, and 17 GHz, respectively. The design of a monopulse antenna consisting of a simple coax-fed monopulse feed and a truncated parabolic reflector has been presented for Ku band radar applications at 14–17 GHz requiring asymmetric beamwidths in the elevation and azimuth planes. The feed is an array of four open-ended rectangular waveguides fed by a coaxial probe. The first stage of the work presents the arrangement of the radiators and the design of the coaxial probe. E- and H-plane angles of the feed illuminating the reflector have been optimized for balanced directivities of the sum and difference channels. The designed reflector antenna has the following characteristics. The co-polarization directivity of the sum channel, elevation, and azimuth difference channels are 30.9–32.1 dB, 28.1–29.9 dB, and 26.4–27.8 dB at 14–17 GHz, respectively. The cross-polarization directivity of the sum channel, elevation, and azimuth difference channels are −1.50–1.16, 1.84–4.82, and 6.42–6.97 dB at 14–17 GHz, respectively. The E- and H-plane beamwidths of the sum channel are 2.6–3.2 and 4.6–5.3 degrees at 14–17 GHz, respectively. The E- and H-plane sidelobe levels of the sum channel are −20.0 to −12.6 dB and −20.0 to −18.8 dB at 14–17 GHz. The proposed design of a monopulse reflector antenna may find applications where asymmetric beamwidths are required, such as projectile tracking radars, airport surveillance radars, and vehicle tracking radars.The second stage detailed a final design that combines the monopulse feed with a truncated parabolic reflector. The


Pyrrolizidine alkaloids (PA) induced hepatic sinusoidal obstruction syndrome (HSOS) occurred worldwide and the mortality rate remained high because there were no specific therapies. Defibrotide was effective for HSOS following hematopoietic stem cell transplantation. But the pathogenesis of the two types of HSOS were not equivalent. The purpose of this study was to see if defibrotide was also effective in PA induced rat HSOS.First we improved rat HSOS model by using higher dose (230 mg/kg) of monocrotaline (a kind of PA) as the dose of median lethal dose. So drug effectiveness could be assessed by survival time. Next, male SD rats were divided into 5 groups. They were control group, model group, low dose low molecular weight heparin (LMWH) treatment group, high dose LMWH treatment group and defibrotide treatment group. Rats’ survival time, liver function, white blood cell count and cytokines were compared among the groups. The DeLeve score was used to assess the severity of liver pathology.The model group exhibited typical liver pathology of HSOS, such as hepatic sinus dilation, congestion, endothelial injury of central lobular vein, coagulative necrosis of hepatocytes and fibrin deposition in the subendothelial. The pathologic characteristics indicated that the model was built up successfully. The survival rate was significantly higher in defibrotide group (81.8%) than model group (43.7%), while the survival rates were similar in the two LMWH groups (62.5% and 75%) and model group. The survival time only be prolonged by defibrotide (P=0.028) but not LMWH (P>0.05). DeLeve score was improved most in the defibrotide group than the two LMWH groups (both P<0.01). Changes in DeLeve score, liver function, plasma level of tumor necrosis factor α and plasminogen activator inhibitor-1 exhibited the same trends.Defibrotide could improve the outcome of monocrotaline-induced rat HSOS indicating that defibrotide might be a better choice than LMWH in clinical practice. Hepatic sinusoidal obstruction syndrome , was first discovered in patients who underwent hematopoietic stem cell transplantation (HSCT). The typical manifestations were hepatomegaly, ascites, right upper quadrant pain, jaundice, and abnormal liver transaminases . The maiBesides HSCT, HSOS could be caused by a variety of other factors, such as chemotherapy drugs, immunosuppressants, monoclonal antibodies, and herbal medicine . There wDefibrotide had antithrombotic, fibrinolytic, and angiogenic properties. It was the only drug which was approved to prevent and treat HSOS following HSCT , 5. Low Male SD rats were supplied by Beijing Charles River Experimental Animal Technology Co., Ltd. They were kept in a 12-hour dark/light cycle at a temperature of 18–25 °C and a humidity of 55%. The study was approved by the Animal Experimental Ethics Committee of Capital Medical University.50) in this study. First, 20 male rats were randomized into 4 groups using random number table. MCT (Medchemexpress LLC.) were garaged at a single dose of 500, 450, 400, and 350 mg/kg after starvation for 12 h. The Dm of MCT was found to be 400 mg/kg. Second, another 20 male rats were randomly divided into 4 groups and being garaged by MCT at the doses of 220 mg/kg, 180 mg/kg, 140 mg/kg, and 100 mg/kg, respectively. The Dn dose was discovered to be 140 mg/kg. Finally, six dosages were used to determine LD50.They were 400 mg/kg, 320 mg/kg, 256 mg/kg, 204 mg/kg, 163 mg/kg and 131 mg/kg. Each group had 10 rats. Within 7 days, there were 10, 8, 7, 4, 1, 1 rats died in the six groups respectively. LD 50 was calculated to be 229.31 mg/kg [95%CI ]. In the following study, the HSOS model was established using MCT garaged at a single dose of 230 mg/kg.There were several acute or chronic HSOS models previously. The toxic agents were mainly MCT  or retroIf the dose of the drug is W mg/kg for patients, the dose for rats should be W mg/kg ×70 kg×0.018/200 g. According to the formula, the dose of defibrotide should be 50 mg/kg. We dissolved defibrotide in saline at a concentration of 20 mg/ml. The high and low doses of LMWH were 400IU/kg/d and 200IU/kg/d, respectively.A total of 72 male SD rats weighing 200-250 g were randomly assigned to one of five groups. Group A (control group) had eight rats which were garaged once with 1 ml PBS at the baseline. Sixteen rats in group B (HSOS model group) were garaged once with 230 mg/kg MCT at the baseline. The other 16 rats in group C (low dose LMWH treatment group) were treated with LMWH at a dose of 200IU/kg/d in addition to MCT garage. The treatment of rats in group D (high dose LMWH treatment group) was similar to group C but the dose of LMWH was 400IU/kg/d. Sixteen rats in group E (defibrotide treatment group) were injected with defibrotide through tail venous daily at the dose of 50 mg/kg/d in addition to MCT garage. At the end of day 7, there were 8, 7, 10, 12 and 13 rats survived in group A to E and the survival rates were 100%, 43.8%, 62.5%,75.0% and 81.3%, respectively , plasma tumor necrosis factor-α (TNF-α), and plasminogen activator inhibitor-1 (PAI-1) . Rat liver was taken out and the left lateral lobe of the liver was fixed immediately in 4% paraformaldehyde. After hematoxylin and eosin (H&E) staining and Masson staining, a single pathologist evaluated the histology of HSOS. The severity of HSOS was quantified using the DeLeve score system [Rats were starved for 12 h and had access to water freely. On the day 0, 1 ml saline or MCT, was garaged at 9 AM. The survived rats were sacrificed on the 72 test was also used if indicated. The Statistical Package for Social Science for Windows, version 19.0  was used for data analyses. All comparison tests between two groups were 1-tailed with a 95% confidence interval. The survival differences were analyzed using the Kaplan-Meier method, with the Kaplan-Meier estimates being compared using a log-rank test. The statistical significance was set at the p-value of < 0.05.Descriptive values were expressed as mean ± standard deviation (SD). Student t-test or Mann-Whitney-Wilcoxon test was used to assess continuous variables according to value distributions. Categorical variables were summarized using frequencies and percentages, and data were compared using Pearson’s Chi-square or Fisher’s exact tests as needed. The χThe liver histology of group A (control group) was normal under light microscopy, as shown in Fig. According to the DeLeve score system, the liver pathology of each survived rat was assessed and classified Table . Liver iIn brief, the severity of the liver injury was group B>C>D>E>A . The results indicated that defibrotide was more effective than low dose and high dose LMWH for MCT-induced HSOS.In the study, 22/72 rats died within 7 days. The 7-day survival rate in A-E groups was 100%, 43.7%, 62.5%, 75% and 81.8%, respectively. Kaplan-Meier analysis showed that defibrotide (group E) significantly prolonged the survival time than group B (P=0.028), while there were no differences between group B and group C or D  during hemotherapy or radiotherapy. The mechanisms included glutathione depletion, nitric oxide depletion, increased intrahepatic expression of matrix metalloproteinases and vascular endothelial growth factor and activation of clotting factors . In suchThe pathology and clinical manifestation of PA-induced HSOS was similar to the HSOS following HSCT, but the pathogenesis of SEC injury was different . The actIn the past, several drugs have been attempted to treat or prevent HSOS following HSCT. Tissue plasminogen activator (t-PA) had anticoagulant and solubilizing properties, but could not increase day 100 + survival rate , 12. GluDefibrotide was a sodium salt of complex single-stranded oligodeoxyribo-nucleotides derived from porcine mucosal DNA. Defibrotide has been proved to stabilize and protect endothelial cells against activation, with properties of profibrinolytic, antithrombotic, anti-ischemic, anti-inflammatory and antiadhesive activities, without obvious systemic anticoagulant side effects . The mecThere were few studies on the treatment of PA induced HSOS. Sorafenib  and regoSurvival was ‘hard’ end-point when evaluating the effect of a drug. So we needed a rat HSOS model whose survival time could be measured. There had been several HSOS models before –20, but Defibrotide has been studied as an anti-coagulation and endothelial protection agent in different rat models. In those studies, defibrotide was given by different routes of administration and at different dosages in different animals –24. For SESs injury induced release of TNF-α and IL-1β followed by PAI-1 expression elevation. PAI-1 was a biomarker of endothelial injury, which increased significantly in HSOS , 26. OurOur research first demonstrated the effectiveness of defibrotide on MCT-induced HSOS which indicating it’s candidate role for clinical use in the future.There were also some limitations of the study. First, the results should be further confirmed in different animal models, such as seneciphylline, another kind of PA. Second, we didn’t study the mechanism thoroughly of defibrotide on the model. Third, defibrotide should be administered intravenously every 6 h according to the introduction. But we gave defibrotide once daily in the research. The administration method should be adjusted to find the best method in future studies. Nevertheless, our research provided a new choice for HSOS treatment after poisoning by PA.


This study aimed to evaluate the long-term effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) injections in the treatment of choroidal neovascularization (CNV) associated with angioid streaks.  Multicenter retrospective cohort study, including eyes with CNV secondary to angioid streaks treated with anti-VEGF injections, were performed. Best-corrected visual acuity (BCVA) in ETDRS letters; qualitative and quantitative  OCT parameters; anti-VEGF type; and number of injections were collected at baseline and at 3, 6, 12, 24, 36, 48, 60, and 72 months. P=0.003). Then, BCVA remained stable. The mean foveal thickness decreased from 343.3 ± 120.2 μm at baseline to 268.3 ± 65.4 at 48 months (P=0.021). The mean number of injections was 4.6 ± 2.1 at 12 months, decreasing to 1.7 ± 2.4 injections between 36 and 48 months (P=0.093).  Thirty-nine eyes from 29 patients, 17 (58.6%) females, were included. The mean follow-up time was 69.4 ± 34.5 months. BCVA was 59.3 ± 23.3 letters at baseline and 63.7 ± 21.9 letters at 48 months. At 3 months, BCVA improved 6.9 ± 11.7 letters ( This real-world study suggests that the functional and morphologic response to anti-VEGF therapy for CNV related to angioid streaks is generally satisfactory and maintained in the long term. Angioid streaks were first described as irregular red/brown lines that surround concentrically or radiate out of the optic nerve head , 2. CurrAround the fourth to fifth decades of life, the visual acuity of untreated patients is less than 20/200 due to disciform scar formation and concomitant atrophy –11. ReceTherefore, the primary endpoint of this study was to evaluate the effectiveness of intravitreal anti-VEGF injections at 48 months in the treatment of CNV associated with angioid streaks in a real-world study. The secondary endpoints were to evaluate the functional and structural changes after 60 and at 72 months of anti-VEGF treatment for those patients with longer follow-up.This is a multicenter retrospective cohort study, which included eyes with CNV secondary to angioid streaks treated with intravitreal anti-VEGF injections . This study adhered to the tenets of the Declaration of Helsinki and was approved by the local Ethics Committee of five Portuguese hospitals.All patients underwent an ophthalmologic examination, including measurement of best-corrected visual acuity (BCVA) using Early Treatment Diabetic Retinopathy Study (ETDRS) charts, slit-lamp biomicroscopy, fundus color photography, fluorescein angiography (FA), and spectral-domain optical coherence tomography (SD-OCT). The anti-VEGF treatments assessed in this study were ranibizumab (0.5 mg/0.05 mL), bevacizumab (1.25 mg/0.05 mL), and aflibercept (2 mg/0.05 mL). As patients were treated by the attending retina specialist in different institutions, different treatment agents and protocols were applied .The presence of fibrosis or atrophy was assessed using SD-OCT.We analyzed sociodemographic characteristics , systemic associated disease conditions, previous treatments , and CNV location . BCVA (ETDRS letters); qualitative (atrophy and fibrosis) and quantitative  SD-OCT parameters; and number of intravitreal injections were also collected at baseline  and at 3, 6, 12, 24, 36, 48, 60, and 72 months after initiating treatment.Patients older than 18 years, treated with anti-VEGF agents for CNV secondary with angioid streaks at the retina departments from the previously referred Portuguese hospitals, were included. Patients had to have at least 36 months of follow-up data since the beginning of the anti-VEGF treatment. Eyes with prior intraocular surgery were also included. Eligible patients were identified by review of medical records. Both eyes of a patient were included for analysis, if eligible.Patients were excluded if presented with any other ocular disease that could compromise vision in the study eye. Patients with systemic or ocular diseases that interfered with the acquisition of OCT were also excluded.The primary outcome was the variation of BCVA at 48 months of follow-up after initial anti-VEGF treatment.The secondary outcomes were the variation of BCVA after 60 and at 72 months of anti-VEGF treatment (for those patients with longer follow-up), characterization of CNV location, variation of central macular thickness (CMT), development of complications (fibrosis/atrophy), and the number of anti-VEGF injections administered during follow-up.® statistical software .Statistical analysis was performed using the SPSSn) and relative (%) frequencies.Quantitative variables were described through mean ± standard deviation and categorical variables through absolute  was performed to analyze the changes in BCVA and CMT. Bonferroni's correction for multiple comparisons was applied. The association between two quantitative variables was assessed through Pearson's correlation coefficient (r) or Spearman's correlation coefficient (rs) in case the normality assumption was not verified.The Kolmogorov–Smirnov test and normal probability plots were used to confirm the normal distribution of continuous variables. Categorical variables were compared using a chi-squared test or, for low count variables, Fisher's exact test. Continuous independent variables following a normal distribution were compared using an independent-samples P value less than 0.05.Statistical significance for all the analyses was set at a As previously stated, both eyes from the same patient were included, which we considered an acceptable trade-off for a larger sample size of this rare condition.Thirty-nine eyes from 29 patients were included in the study. Demographic and baseline characteristics are described in Overall, the mean study follow-up was 69.4 ± 34.5 months (range 36–135).P=0.85) (P=0.003).The mean BCVA was 59.3 ± 23.3 letters at baseline and 63.7 ± 21.9 letters after 48 months (P=0.85) . At 3 moAt baseline, 10 (25.6%) eyes had a BCVA inferior to 35 letters. After 48 months, 3 of 28 (10.7%) eyes had a BCVA inferior to 35 letters, 6 of 28 (21.4%) eyes showed a BCVA gain of ≥15 letters, and 12 of 28 (42.9%) had a stable BCVA .rs = −0.635; P=0.001). Furthermore, baseline BCVA was negatively correlated with baseline CMT .Baseline BCVA was significantly and negatively correlated with the difference between BCVA at 48 months and at baseline (μm to 318.8 ± 127.5 μm at 3 months (P=0.091) and to 298.7 ± 83.8 μm at 12 months (P=0.055). Although in the first 36 months, changes in CMT were not significant, at 48 months, CMT decreased significantly to 268.3 ± 65.4 μm (P=0.021) compared with baseline (The mean baseline CMT decreased from 343.3 ± 120.0 baseline . At 48 mP=0.007 vs. 12 months); 2.3 ± 3.2 injections  at 36 months (P=0.003 vs. 24 months); and 1.7 ± 2.4 injections  at 48 months (P=0.002 vs. 36 months) (P=0.746).The mean number of anti-VEGF injections was 4.6 ± 2.1 injections in the first 12 months , decreasing significantly across the study time points: 2.6 ± 2.9 injections  at 24 months ( months) . The totn = 10), subgroup B—between 6 and 10 cumulative injections (n = 6), and subgroup C—equal or more than 11 cumulative injections (n = 10). No statistically significant associations were observed between any of the subgroups for cumulative number of injections and BCVA at 48 months. Moreover, in a univariate regression analysis, no statistically significant association was found between the number of injections performed and BCVA (P=0.093).In a subgroup analysis, the affected eyes were divided according to the cumulative number of injections performed between baseline and 48 months: subgroup A—equal or less than 5 cumulative injections (No systemic or ocular side effects were registered during the entire follow-up.P=0.047); however, foveal fibrosis was not associated with BCVA (P=0.647).Initially, 7 of 34 (20.6%) eyes had retinal atrophy and 6 of 35 (17.1%) eyes had fibrosis. At 48 months, 17 of 28 (60.7%) eyes had atrophy and 17 of 28 (60.7%) had fibrosis. At 48 months, foveal atrophy was statistically associated with inferior BCVA (P=0.412) or fibrosis development (P=0.509). Moreover, we did not observe a significant association between CMT and CNV location (P=0.628).At 36 months, no statistically significant association was found between the CNV location and atrophy (P=0.974). The mean CMT was 361.5 ± 37.0 μm at baseline and 243.5 ± 54.6 μm at 60 months (P=0.018).Twenty (51.3%) eyes completed 60 months of follow-up. The mean BCVA was 59.0 ± 5.1 letters at baseline and 58.8 ± 5.6 letters at 60 months (P=0.060). The mean CMT was 347.7 ± 146.0 μm at baseline and 231.0 ± 47.7 μm after 72 months (P=0.200).Fourteen (35.9%) eyes completed 72 months of follow-up. The mean BCVA was 52.8 ± 24.1 letters at baseline and 62.5 ± 21.9 letters at 72 months (P=0.003). After this time point, BCVA remained stable in 21 of 28 (75%) eyes at 48 months . Macular thickness stabilized or decreased in 16 of 35 eyes (45.7%) . In TillThe PIXEL study included 98 eyes of 72 patients with PXE and CNV secondary to angioid streaks treated with ranibizumab . The meaIn the first 12 months, in our study, a mean number of 4.6 ± 2.1 injections were performed, being similar to the PIXEL study (4.1 ± 2.3 injections) . The totRegarding the CMT variation, we observed a progressive reduction during the follow-up, as observed in other studies , 19, 20.In 2006, the first favorable results for the treatment of CNV secondary to angioid streaks were achieved with bevacizumab . AfterwaThis study had important limitations. First, the observational design and the retrospective nature of the study were limitations as data from all patients were not available at each and every time point because some patients were not observed on the analyzed time points. Another drawback was related to the treatment with different anti-VEGF agents and the different treatment protocols. As this study included patients from different Portuguese institutions, the treatment regimen varied according to the clinical practice at each institution and according to the retinal specialist who assisted the patient. In addition, the anti-VEGF used, as well as the criteria for drug switch, varied between institutions and some patients were treated with different anti-VEGF agents over time. Thus, as previously referred, this study was not able to analyze the functional and structural outcomes caused by individual anti-VEGF agent or according to the treatment protocol. As CNV secondary to angioid streaks is a rare disorder, we included patients treated previously with PDT, which may bias the results.Therefore, despite the limitations explained before, our study described the expected results in the real-world setting, contrary to many clinical trials that show promising results, but do not reflect the conditions of our daily clinical practice such as patients' difficulties to attend medical appointments and to comply with therapeutic regimens. Moreover, it presents favorable results that support the current clinical practice in Portugal and other European centers with anti-VEGF therapy for CNV related to angioid streaks.Our study's strengths lie in its long-term follow-up, the significant number of patients included, and the fact that it describes the results of a real-life multicenter setting. To our knowledge, this is one of the studies with the longest follow-up time of patients with CNV secondary to angioid streaks performed so far.In conclusion, this study demonstrated that the functional and morphologic response to anti-VEGF therapy for CNV related to angioid streaks is generally satisfactory and may be maintained on the long term. Of notice, the comparison across retrospective and real-world studies should be done with caution as the study populations vary with respect to the study settings, dosing regimens, previous treatment profiles, and underlying comorbidities. Further long-term prospective studies with a larger sample size are needed to evaluate the long-term effectiveness and the best protocol regimen of anti-VEGF treatment in CNV secondary to angioid streaks.


Background: To evaluate the performance, quality and effectiveness of “IEO-TIRADS” in assigning a TI-RADS score to thyroid nodules (TN) when compared with “EU-TIRADS” and the US risk score calculated with the S-Detect software (“S-Detect”). The primary objective is the evaluation of diagnostic accuracy (DA) by “IEO-TIRADS”, “S-Detect” and “EU-TIRADS”, and the secondary objective is to evaluate the diagnostic performances of the scores, using the histological report as the gold standard. Methods: A radiologist collected all three scores of the TNs detected and determined the risk of malignancy. The results of all the scores were compared with the histological specimens. The sensitivity (SE), specificity (SP), and diagnostic accuracy (DA), with their 95% confidence interval (95% CI), were calculated for each method. Results: 140 TNs were observed in 93 patients and classified according to all three scores. “IEO-TIRADS” has an SE of 73.6%, an SP of 59.2% and a DA of 68.6%. “EU-TIRADS” has an SE of 90.1%, an SP of 32.7% and a DA of 70.0%. “S-Detect” has an SE of 67.0%, an SP of 69.4% and a DA of 67.9%. Conclusion: “IEO-TIRADS” has a similar diagnostic performance to “S-Detect” and “EU-TIRADS”. Providing a comparable DA with other reporting systems, IEO-TIRADS holds the potential of being applied in clinical practice. Thyroid nodules (TN) represent a common finding in clinical practice, with an incidence of 19–68% in the general population ,3. No siOnly 5–7% of TNs in the adult population are detected by physical examination; the majority of them are asymptomatic, and are detected incidentally with a prevalence of 65% by conventional ultrasound (US), 15% by computed tomography (CT) or magnetic resonance imaging (MRI), and 1.2% by fluorodeoxyglucose positron emission tomography (PET) ; 29 of 49 nodules were correctly classified as benign, leading to an SP of 59.2% [95% CI: 45.4–73.0%]. The DA was 68.6% [95% CI: 60.9–76.3%].According to “EU-TIRADS”, 82 of 91 nodules were correctly classified as malignant, reaching an SE of 90.1% [95% CI: 84.0–96.2%]; 16 of 49 nodules were correctly classified as benign, resulting in an SP of 32.7% [95% CI: 19.5–45.8%]. The DA was 70.0% [95% CI: 62.4–77.6%].According to “S-Detect”, 61 of 91 nodules were correctly classified as malignant, with an SE of 67.0% [95% CI: 57.4–76.7%]; 34 of 49 nodules were correctly classified as benign, resulting in an SP of 69.4% [95% CI: 56.5–82.3%]. The DA was 67.9% [95% CI: 60.1–75.6%].p-values of “IEO-TIRADS” vs. “S-Detect” and “IEO-TIRADS” vs. “EU-TIRADS” are reported in The difference between the DA among the “IEO-TIRADS” and “S-Detect” methods, and among “IEO-TIRADS” and “EU-TIRADS” was, respectively, 0.7% [95% CI: −8.3–9.8%] and −1.4% [95% CI: -9.7–6.9%]. The estimated differences [95% CI] and Since 2009, when Horvath and Park initially proposed TI-RADS, the scoring system has been modified over the years, and it is ongoing evaluation and being amended to improve the accuracy of the diagnosis of malignant TNs with US . NowadayUS has a pivotal role in the diagnosis of TNs. However, US alone has several limitations regarding the overlapping boundaries, morphology, vascularization and echostructure. Moreover, the accuracy of diagnosis is affected by subjective factors related to the radiologist, because US is an operator-dependent exam.The diagnosis of TNs directly affects the therapeutic decisions and patient prognosis; therefore, it has important clinical significance.Thyroid nodule management has been modified significantly in recent years, with the inclusion of observation protocols for low-risk thyroid cancer and minimally invasive treatments such as thermal ablation for both benign and malignant thyroid nodules ,27,28.The improvement of a simpler reporting system would help to achieve larger diffusion of standardized reporting, with a consequential relevant impact on the complex clinical management of patients with thyroid nodules. In this scenario, the so-called IEO-TIRADS has been developed in accordance with radiologists and surgeons at our institution, to provide a simple and reliable reporting system.This study’s aim is to compare the diagnostic performance of “IEO-TIRADS”, “S-Detect” and “EU-TIRADS” for predicting the risk of TN malignancy. To the best of our knowledge, this study is the only study that compares the diagnostic performance of “S-Detect” software, “EU-TIRADS” and “IEO-TIRADS” classification in predicting TN malignancy.S-Detect software is an advanced innovative device, with the aim of improving the non-invasive classification of TNs ,25,29,30In our study, EU-TIRADS showed higher SE but lower SP, while S-Detect had higher SP but lower SE. IEO-TIRADS, on the contrary, achieved good results in both SE and SP. The data of our study are quite consistent with other recent studies. Dobruch-Sobczak et al., have reported 98.7% SE and 39.8% SP . DiffereThe primary aim of this study was to determine whether the accuracy of defining the malignant or benign nature of the nodules of “IEO-TIRADS” was similar to that of both “S-Detect” and “EU-TIRADS”, using the histological report as the gold standard.The DAs of “IEO-TIRADS”, “S-Detect” and “EU-TIRADS” were, respectively, 68.6% [95% CI: 60.9–76.3%], 67.9% [95% CI: 60.1–75.6%] and 70.0% [95% CI: 62.4–77.6%].The difference between the DA among “IEO-TIRADS” and “S-Detect” methods, and among “IEO-TIRADS” and “EU-TIRADS” was, respectively, 0.7% [95% CI: −8.3–9.8%] and −1.4% [95% CI: −9.7–6.9%], suggesting that the diagnostic accuracy of the “IEO-TIRADS” method was similar to that of both “S-Detect” and “EU-TIRADS”.Our study has some limitations. The first is the oncological population of our study, because the performance of different classification systems depends on the population being examined. Second is the small cohort of TNs. The third is that this study was conducted in a single center, and all US examinations were performed by a radiologist with extensive experience, so intra and interobserver agreement were not evaluated in this study.We can conclude that the “IEO-TIRADS” classification system for the evaluation of TNs has a similar diagnostic performance to both “S-Detect” and “EU-TIRADS”.We believe that this new model makes the report easier to read and understand by surgeons and patients. The graphical representation maps of TNs and cervical LNs identified during the US examination facilitate the TN and LN location according to anatomical planes. This increases the diagnostic confidence in the evaluation of the benign or malignant nature of a lesion in a rapid, easy and effective way.This new system is simple to be applied and is also appreciated by surgeons and endocrinologists. Providing comparable DA with other reporting systems, IEO-TIRADS holds the potential of being largely applied in clinical practice.


Thirty minutes following AlP poisoning, the electrocardiographic (ECG), blood pressure (BP), and heart rate (HR) parameters were examined for 180 min. The EDA was injected 60 min following the AlP poisoning intraperitoneally. Also, 24 h after poisoning, echocardiography was carried out to evaluate the ejection fraction (EF), stroke volume (SV), and cardiac output (CO). The biochemical and molecular parameters, such as the activities of the mitochondrial complexes, reactive oxygen species (ROS), apoptosis and necrosis, and troponin I and lactate levels, were also examined after 12 and 24 h in the heart tissue. According to the results, AlP-induced ECG abnormalities, decrease in blood pressure, heart rate, SV, EF%, and CO were significantly improved with EDA at doses of 30 and 45 mg/kg. Likewise, EDA significantly improved complex I and IV activity, apoptosis and necrosis, ROS, troponin I, and lactate levels following AlP-poisoning (p < 0.05). Also, the mean survival time was increased following EDA treatment, which can be attributed to the EDA’s protective effects against diverse underlying mechanisms of phosphine-induced cardiac toxicity. These findings suggest that EDA, by ameliorating heart function and modulating mitochondrial activity, might relieve AlP-induced cardiotoxicity. Nonetheless, additional investigations are required to examine any potential clinical advantages of EDA in this toxicity.Aluminum phosphide (AlP) poisoning can be highly fatal due to its severe toxicity to the heart. Based on the evidence, edaravone (EDA) has protective effects on various pathological conditions of the heart. This research aimed to examine the potential protective effects of EDA on AlP-induced cardiotoxicity in rats. The rats were divided into six groups, including almond oil (control), normal saline, AlP (LD This pesticide is extensively utilized for agricultural product protection from insects and rodents during transportation and storage . Despitearnitine , vasoprearnitine , melatonarnitine , Mg nanoarnitine , triiodoarnitine , iron suarnitine , levosimarnitine , taurinearnitine , exenatiarnitine , and minarnitine  on the c+2 overloads, ROS production, and iNOS expression in cardiovascular disease  is a known potent free radical scavenger and strong antioxidant that has been clinically used to treat acute ischemic stroke and amyotrophic lateral sclerosis since 2001 and 2017, respectively . Various disease . EDA red disease . Also, E disease . Further disease .The outcomes of investigations into the substantial protective effects on the cardiovascular system and the solid anti-apoptotic, antioxidant and antiarrhythmic effects of EDA bring about the idea that EDA could be a highly effective drug to improve phosphine-induced cardiotoxicity. Therefore, this research aimed to examine the potential protective effects of EDA on hemodynamic, electrocardiographic (ECG), echocardiographic, molecular, and biochemical properties in rats poisoned with aluminum phosphide at two specific time intervals.Edaravone was purchased from Sigma-Aldrich. The AlP tablets were supplied by Samiran Company (Iran). The Mitochondria isolation kit was obtained from BioChain Inc. (United States). The ApoFlowExVR fluorescein isothiocyanate (FITC) kit was purchased from Exbio . Kits for lactate and troponin I assay were purchased from ZellBio (Germany). The rest of the chemicals were supplied by Sigma-Aldrich (Germany).Male Wistar rats weighing 200–250 g were utilized in the experiments. The animals were kept in standard polycarbonate cages in suitable conditions, including a 12-h light-dark cycle, a 20°C–25°C temperature, and a humidity of 50%. A normal diet and water were readily available to rats. All animal processes were done following the authorized, ethical protocols and guidelines for using animals of the Ethics Committee at TUMS (CO: IR.TUMS.MEDICINE.REC.1399.756).50 was reported at 8.5–12.7 mg/kg. Usually, 100% mortality (LD100) occurs at doses above 14 mg/kg, and mortality is not observed in amounts less than 8 mg/kg. Therefore, to determine the precise LD50 of AlP for this study, doses of 8, 10, 12, and 14 mg/kg were examined in four groups (n = 4). For this purpose, the powdered AlP tablet was dissolved in almond oil and orally gavaged to the rats. After monitoring for 24 h, the mortality was recorded in each group. Finally, according to Karber’s method , , , AlP+20 50), , AlP+30 50),  AlP+45 mTo record the parameters, including PR interval, QRS complex duration, ST height, QTc, blood pressure (BP), and heart rate (HR), the PowerLab device  was utilized. At first, AlP was orally gavaged to all rats, excluding the control group. After 30 min, the rats, based on ketamine/xylazine (50/5 mg/kg), were anesthetized and connected to the PowerLab device utilizing the electrodes. EDA was injected 30 min after the connection, and the rats were monitored for 180 min. To maintain complete anesthesia, a maintenance dose of ketamine (25–30 mg/kg) was injected every 45 min. Also, the systolic blood pressure was measured utilizing a noninvasive BP tail cuff.After 24 h, the alive rats were anesthetized, using simultaneous ketamine 50 mg/kg and xylazine 5 mg/kg, and their chest hair was shaved. To examine the echocardiography parameters, including stroke volume (SV) and ejection fraction (EF), the M-mode short-axis echocardiography was accomplished by utilizing a cardiac ultrasound . The cardiac output (CO) was calculated by multiplying the heart rate and stroke volume.After following for 12 and 24 h, the rats were anesthetized with ketamine (50 mg/kg) and xylazine (5 mg/kg) and then sacrificed. The hearts of the rats were surgically isolated, and to wipe the blood, it was washed with cold phosphate buffer. Then, the heart tissues were frozen at −80°C for biochemical and mitochondrial assays.The Bradford spectrophotometry protein assay assessed the heart tissue protein concentration. As the standard protein concentration, bovine serum albumin was utilized. The heart tissue samples’ absorbance values were determined at 595 nm using a spectrophotometer set setup .Investigation of complex I (NADH dehydrogenase) activity was performed based on the Sherwood and Hirst method , which wThe level of heart mitochondrial ROS was examined with a fluorescence spectrophotometer utilizing 2′,7′-dichlorofluorescein diacetate (DCF-DA), which cellular peroxides changed into highly fluorescent DCF. At 37°C and in a dark environment, the supernatants were incubated with 5 µM DCF-DA for 30 min. A fluorometer was then used to record fluorescence at 525 nm of emission and 488 nm of excitation. As a result, the ROS level in each group was assessed using a standard curve and expressed as Unit/mg of tissue protein .Initially, according to the method of Schlüter, the cardiac cells were separated from fresh cardiac tissue . Then caThe lactate level of heart tissue was measured on a homogenous tissue according to the lactate assay kit protocol . The troponin I (cTnI) level was assessed on homogenated heart tissue according to the kit protocol of ZellBio GmbH, Germany. To check the absorbance of specimens, a microplate reader  was utilized.50); ; ; AlP+20 50); ; AlP+30 50); ; AlP+45 p < 0.05 was regarded as statistically significant. The results are presented as mean ± standard deviation (SD).The Kaplan-Meier method with log-rank (Mantel-Cox) was used as a survival time assessment method. A two-way ANOVA test was utilized to analyze the flow cytometry and ECG results. The one-way ANOVA test was conducted for data analysis of the other results. The Tukey test was used for the post hoc test, and There were no significant differences between the almond oil and normal saline groups. Therefore, the data of the normal saline group are not shown.p < 0.05). The QRS duration widening appeared 60–90 min after AlP treatment. EDA treatment in all three groups  significantly improved the QRS duration at 120–150 and 150–180 min (p < 0.05). Further, QTc interval prolongation caused by AlP was significantly (p < 0.05) improved by 30 and 45 mg/kg of EDA treatment from 60 min onwards. A significant increase in ST-segment was observed in the AlP group compared to the control group. The EDA treatment (30 and 45 mg/kg) significantly reduced the ST segment in comparison to the Alp group after 60 min (p < 0.05) (p < 0.05). The progressive deterioration in BP due to AlP was improved with all doses from 90 to 120 min onwards (p < 0.05)  . Also, c < 0.05) . Also, t < 0.05) .p < 0.05). The SV and LVEF significantly improved with EDA treatment at 30 and 45 mg/kg dosages (p < 0.05). Also, the cardiac output was significantly improved compared to the AlP group in all three EDA doses . In the evaluation of EF, the difference between the control group and EDA treatment at 30 and 45 mg/kg dosages was not significant (p < 0.05). In addition, in the SV evaluation, the difference between the control group and the AlP + EDA 45 mg/kg group was not significant (p < 0.05)  .p < 0.05). As shown in p < 0.05).The mitochondrial complex I activity was significantly decreased in the AlP poisoning groups at 12 and 24 h (p < 0.05) (There were no significant differences in complex II activity between the treated groups and the control group ( < 0.05) .p < 0.05). Treatment with 30 and 45 mg/kg doses of EDA significantly improved the complex IV activity compared to the relevant AIP group in 24 and 12 h times. (p < 0.05) (AlP poisoning significantly repressed the activity of complex IV at 12 and 24 h duration compared to the control groups ( < 0.05) .p < 0.05). As shown in p < 0.05).The heart mitochondrial ROS level was significantly enhanced by AlP poisoning (p < 0.05). The EDA treatment in a dose-dependent procedure significantly enhanced live cells from 64.9% up to 83.6%, 86.2%, and 89.6%, utilizing 20, 30, and 45 mg/kg of EDA, respectively (p < 0.05). In the same way, the early apoptosis, late apoptosis, and necrosis cells significantly decreased in a dose-dependent manner utilizing 20, 30, and 45 mg/kg of EDA. It should be noted that the difference between the percentage of live cells in the control group and the AlP + EDA 45 mg/kg group was not significant . Treatment with 20, 30, and 45 mg/kg doses of EDA in the 24 h duration, as well as 30 and 45 mg/kg in the 12 h duration, significantly decreased the heart tissue lactate level in comparison to the relevant AIP group (p < 0.05) (As shown in  < 0.05) .p < 0.05). As shown in p < 0.05).The heart tissue cTnI level was significantly enhanced by AlP poisoning at both times (12 and 24 h) in comparison to the control group (50), AlP + EDA 20 mg/kg, AlP + EDA 30 mg/kg, and AlP + EDA 45 mg/kg groups were 16.66%, 16.66%, 33.33%, and 50%, respectively. This indicates that the chance of survival increases with an increasing dose of EDA  was 23.5 h. The median survival times for the AlP + EDA 20 mg/kg, AlP + EDA 30 mg/kg, and AlP + EDA 45 mg/kg groups were 30.5, 39, and 47 h, respectively. Also, the survival percentage for the AlP  is the leading site of the electron transport chain, which is disrupted by phosphine and reduces the level of ATP and energy required by the cell. Phosphine appears to be a nonspecific inhibitor of cytochrome and interacts with any macromolecule and enzymes containing the heme group . SimilarAccording to several investigations, apoptosis and necrosis are induced by phosphine in cardiac cells . Possibl+2 overloads, ROS production, and iNOS expression in cardiovascular disease (Interestingly, no significant difference was observed between the 45 mg/kg EDA dose and the control group in the rate of viable cells. This impact could be due to its potent free radical scavenging capabilities, or it could be due to the prevention of mitochondrial permeability transition pore opening and cytochrome C release . In line disease .The previous study has shown that phosphine can significantly change oxidative stress biomarkers. It has been demonstrated that phosphine increases ROS and lipid peroxidase levels by disrupting the electron transfer chain. This increases free radical generation and changes in antioxidant mechanisms . VariousVentricular dysfunction deteriorates and myocardial necrosis occurs as a result of acute myocardial infarction brought on by reduced coronary artery flow . For yeaThe cTnI is a specific and highly sensitive biomarker for myocardial cell injury and myocardial infarction . StudiesPatients exposed to phosphine, intentionally or accidentally, die within a short time because there is no specific antidote for this toxicity, and there is not enough time for specialists to provide supportive care. This study showed that EDA, which has high antioxidant, anti-apoptotic, and anti-inflammatory actions on cardiac cells, can attenuate the toxic effects of AlP and increase survival time in poisoned rats.50. The strengths of this study were the use of appropriate analytical methods and the analysis of biochemical and molecular experiments conducted at 12 and 24 h following poisoning, which have not been performed in analogous studies with EDA.The main limitation of the current study was that, due to the high mortality rate of severe AlP poisoning, it was impossible to study at doses higher than LDAccording to the findings of this study, AlP-induced hemodynamic, electrocardiographic, echocardiographic, molecular, and biochemical abnormalities in the heart were improved by EDA administration. Also, the mean survival time was increased following EDA treatment, which can be attributed to the EDA’s protective effects against diverse underlying mechanisms of phosphine-induced cardiac toxicity. This study shows that EDA, with its advantageous features, can play a potential role in reducing cardiac manifestations caused by phosphine poisoning. Therefore, as an adjunct choice, EDA is a good candidate for treating AlP poisoning and other supportive treatments. Despite possible efforts to find an antidote for phosphine poisoning, no results have yet been achieved. Therefore, considering that the main mechanism of phosphine toxicity is severe oxidative stress and disturbance of the electron transport chain, a drug such as EDA, a powerful scavenger, can reduce the severe toxicity caused by phosphine. Although intraperitoneal EDA administration effectively treats AlP poisoning, EDA IV administration is faster and more efficacious. Therefore, a similar investigation with EDA IV administration is required. Also, due to the effect of drug monotherapy on this toxicity, it is recommended to evaluate the treatment with edaravone and typical managements like catecholamines and other antioxidant drugs for a synergistic effect. It is noteworthy that further research utilizing various clinical trials and animal models is needed to examine the mechanism of EDA capability for managing phosphine poisoning.


Moreover, OCPs in different types of vegetables exceeded the maximum residue limits (MRLs), and the exceeding rates in various vegetables decreased in the following order: leafy vegetables (19.12%) > root vegetables (18.75%) > fruit vegetables (3.85%). The proportions of OCPs exceeding MRL in different vegetables were found in the following descending order: Welsh onion (22.50%) > radish (18.75%) > Chinese cabbage (14.29%) > pepper (6.90%) > cucumber (3.23%) > eggplant (2.94%) > tomato (2.78%). The sources’ identification results showed that DDTs in vegetables came mainly from newly imported technical DDTs and dicofol, while HCHs originated mainly from lindane. For both adults and children, the average target hazard quotients (avg. THQ) were all less than 1, and the average hazard index (avg. HI) values were 0.043 and 0.036, respectively. There were no significant health risks associated with OCP exposure for the inhabitants of the study area.In this study, eleven organochlorine pesticides (OCPs) in fresh vegetables in the Changchun suburb were investigated, and their potential health risks were evaluated. The average concentrations of OCPs in edible parts of vegetables were found in the following descending order: Σhexachlorocyclohexanes (ΣHCHs) (6.60 µg·kg Numerouectively . Althougectively ,4.−1, whereas DDTs, heptachlor, and dieldrin was also detected [−1 [−1 and 58.8 µg·kg−1, respectively [Vegetables have become one of the major foods in people’s daily diet due to their high nutritional value and provide various vitamins, minerals, dietary fiber, and antioxidants for the human body. The physiological characteristics of vegetables make them more susceptible to pesticide pollution than crops . Vegetabdetected . The maxcted [−1 . The monectively . AlthougAs a transitional zone between agricultural production and urban living, suburban areas have become important production bases for regional vegetable products. Regarding the transportation costs and preservation requirements of vegetables, more and more suburban farmland is used to cultivate vegetables, and therefore, suburban vegetable production has become an important part of the regional agricultural economy . With thLocated in northeastern China, Changchun is an important agricultural production base. Vegetables constitute a major part of the diet of local inhabitants. Natives have some special dietary habits for vegetables, such as direct consumption of raw vegetables , and also store some non-perishable vegetables in autumn for consumption during winter–spring. Vegetables are of great significance to local residents, and it is important to understand the edible safety of vegetables in the region. In view of this, seven kinds of vegetables were collected in the suburbs of Changchun with the purposes of (1) quantifying the concentrations of OCPs in fresh vegetables; (2) identifying the potential sources of OCPs; (3) calculating the THQ and HI of OCPs to evaluate the health risks of consuming the vegetables. The results will provide evidence for policymakers to take targeted measures to reduce potential health risks from intoxicated vegetables and ensure the safe consumption of suburban vegetables.2, whereas the vegetable yield is about 9.8 × 104 tons.Changchun, the capital of Jilin Province, is located in northeast China  and is also an important crop and commodity grain base in China. Changchun belongs to the continental monsoon climate with an annual average temperature of 4.8 °C and annual average precipitation of 569.6 mm. The main soil type is typical phaeozem. The vegetable-cultivated area in the suburbs of Changchun is about 3617 hmThe suburbs of Changchun were divided into a grid of 1 × 1 km cells, and 54 typical vegetable plots were selected . A handhOCPs standard solutions were purchased from the National Sharing Platform for Reference Materials in China, including eight OCPs mixed standard solutions  and single standard solutions . Acetone and n-hexane (high-performance liquid chromatography grade), anhydrous sodium sulfate , activated alumina (40–60 mesh), and silica gel (60–100 mesh) were obtained from Aladdin Chemical Corp., China. Anhydrous sodium sulfate was dried for 3 h at 400 °C before use and after cooling, stored in a desiccator for subsequent use. The silica gel was activated for 12 h at 180 °C. The filter paper and cotton thread used to wrap the samples in Soxhlet extraction were sequentially washed with acetone, n-hexane, and distilled water in an ultrasonic cleaner and dried in a baking oven.The Soxhlet extraction and purification process of OCPs followed the previously reported modified method .v:v) was added to extract for 24 h. The extracts were concentrated using a rotary evaporator to nearly dry, and 5 mL n-hexane was added to redissolve to complete the solvent conversion.Extraction: Vegetable samples were cut into small pieces. First, 30.0 g of samples were accurately weighed, and an appropriate amount of anhydrous sodium sulfate was added to them. After grinding in the mortar, the mixtures were put into the Soxhlet extractor, and a 100 mL n-hexane-acetone mixture , and the eluate was collected. The eluent was concentrated with a rotary evaporator and dissolved in 1 mL of n-hexane to determine its concentration.Analysis: The OCPs were analyzed using gas chromatography  with the electron capture detector (ECD), equipped with an HP-5 chromatographic column . High-purity nitrogen (purity > 99.99%) was used as carrier gas. The injection and detector temperatures were set to 260 °C and 300 °C, respectively. One microliter of the extract was injected in the splitless mode. The temperature programming of GC was set as follows: the initial temperature at 100 °C for 1 min, ramping to 190 °C at 12 °C/min, and held for 8 min, followed by continuous ramping to 250 °C at 3 °C/min, and held for 10 min. The characteristic chromatogram of 11 OCPs is presented in −1. Each sample was spiked in triplicate and then analyzed using the proposed method. −1 was used to quantify the calibration curves, and the linear relationship of R2 > 0.99 was obtained. All concentrations of OCPs were based on a fresh basis.The analytical procedures used in this study were conducted under strict quality assurance and quality control. Quality assurance and control were conducted using procedural blanks, spiked blanks, and duplicate samples. A signal-to-noise ratio of 3 was used to calculate the limits of detection (LODs). Recoveries were determined by spiking the blank vegetable samples with a standard mix solution, and the spiked concentration was set to 50.00 µg·kgThe target hazard quotient (THQ) was applied to evaluate the human health risk of OCP residues in the vegetables . Due to −1·d−1) depends on both the individual OCP concentrations and the daily consumption of food [C is the concentration of OCPs in vegetables (µg·kg−1), Con is the average daily vegetable consumption of local inhabitants (242.00 g·d−1 for adults and 108.50 g·d−1 for children) [BW (kg) represents the average body weight (55.90 kg for adults and 32.70 kg for children) [The estimated daily intake  , and BW hildren) .As the evaluation standard, the THQ was based on the ratio of EDI to acceptable daily intake (ADI). The ADI was obtained based upon the standard GB 2763-2021, China   and listThe multiple health risks of various OCPs in vegetables were represented by the hazard index (HI). Moreover, based upon the daily average consumption of vegetables for a human being, HI is calculated using Equation (3).If the value of THQ or HI was less than 1, there was no obvious health risk. However, if the value of THQ or HI was greater than 1, there was a possibility of obvious toxic effects on human health. Furthermore, with the increase in the value of THQ, the probability of toxic impacts increased.The overall detection rate of 11 OCPs in the collected vegetable samples was 55.61%, with the highest detection rate of 70.59% in leafy vegetables, followed by root vegetables (62.50%) and fruit vegetables (46.92%) . The det−1) > ΣDDTs (5.82 µg·kg−1) > ΣChlordanes (2.37 µg·kg−1) > heptachlor (0.29 µg·kg−1). The average concentrations of HCHs and DDTs were 9.43–11.94 µg·kg−1 and 9.34–11.43 µg·kg−1 in leafy vegetables, 8.42 µg·kg−1 and 8.36 µg·kg−1 in root vegetables, and 1.91–6.64 µg·kg−1 and 1.34–5.64 µg·kg−1 in fruit vegetables, respectively. Compared with root and fruit vegetables, the OCPs in leafy vegetables showed higher concentrations, which was consistent with the results of Chourasiya et al. (2015) [−1) had the highest average concentration of HCHs among all vegetables, followed by Chinese cabbage (9.43 µg·kg−1) and radish (8.42 µg·kg−1). Vegetables with lower HCH residues were eggplant (3.14 µg·kg−1) and cucumber (1.91 µg·kg−1). The concentrations of DDTs in different vegetables showed the same concentration characteristic of: Welsh onion > Chinese cabbage > radish > pepper > tomato > eggplant > cucumber.The statistical characteristics of the residual concentrations of OCPs in different vegetables are presented in . 2015) . The lar. (2015) . Some st15 . The . (2015) ,21. Wels2 and a greening rate of 36.5% [In order to strengthen the control of pesticide residues in food, China implemented the national food safety standard—maximum residue limits of pesticides in food  in 2012. The standard stipulated the maximum residue limits (MRLs) of various pesticides in different kinds of foods and supplemented and amended the standard in 2014, 2019, and 2021, respectively. The proportions of 11 OCPs exceeding the corresponding MRLs in edible parts of different vegetables are listed in of 36.5% . Becauseof 36.5% ,26.−1) was significantly higher than those in Taizhou, China (0.30 µg·kg−1) [−1) [−1) [−1) [−1) [−1) was much higher than those of the city of Northwest Russia (0.07 µg·kg−1) [−1) [−1) [−1) [The residues of HCHs and DDTs in suburban vegetables of Changchun were compared with those in other regions around the world, and it was found that the average concentration of DDTs in the vegetables from Changchun suburbs (5.82 µg·kgµg·kg−1) , city of−1) [−1) , Taiwan −1) [−1)  and Camb China 0. µg·kg−1 −1) [−1) . However−1) [−1) . The aveµg·kg−1) , Cambodi China 0. µg·kg−1 −1) [−1) , whereas−1) [−1) .p, p′-DDT/Wp, p′-DDE of less than 1 indicates that DDTs are from historical inputs, while a ratio of Wp, p′-DDT/Wp, p′-DDE of greater than 1 indicates the new application of DDTs. In this study, the average value of Wp, p′-DDT/Wp, p′-DDE was 2.29 -HCH can be used to indicate whether the sources of HCHs are historical residues or new inputs. The ratio of Wβ-HCH/W(α + γ)-HCH > 0.5 indicates a source of historical pollution [α-HCH/Wγ-HCH in all vegetables were less than 1, indicating that there were lindane inputs in the vegetable growing environment. The ratios of Wβ-HCH/W(α + γ)-HCH were within the range of 0.06–1.13, whereas the ratios of leafy vegetables (Chinese cabbage 0.21 and Welsh onion 0.38) were less than 0.5, indicating that HCHs in these two vegetables were mainly derived from the new application of lindane, while the wet and dry deposition of the atmosphere might be the main input route. The ratios of eggplant, pepper, cucumber, and radish were all greater than 0.5. It can be concluded that the HCHs in these four vegetables mainly came from the historical residues of lindane in the soil.γ-HCH and β-HCH were the main components of HCHs in suburban vegetables of Changchun, with a cumulative contribution rate of 91.52%, while the contribution rates of α-HCH and δ-HCH were only 6.36% and 2.12%, respectively . Yi et aironment . The ratollution . Accordi−1·d−1) were higher than those of most other regions except for Taizhou, China (0.137 µg·kg−1·d−1). In contrast, the intakes of DDTs (0.019–0.025 µg·kg−1·d−1) of the inhabitants in Changchun were higher than those of Dalian, China (0.003 µg·kg−1·d−1), Denmark (0.0037 µg·kg−1·d−1), and Punjab Province, Pakistan (0.019 µg·kg−1·d−1), but lower than those of Jakarta, Bogor, and Yogyakarta, Indonesia (0.040 µg·kg−1·d−1) and Taizhou, China (0.076 µg·kg−1·d−1). In general, the consumption of OCPs through suburban vegetables by residents in the study area was at a high level.The calculated EDI, THQ, and HI values of different OCPs for children and adults in Changchun are presented in The max THQs of HCHs, DDTs, Chlordane, and heptachlor for adults were 0.060, 0.038, 0.32, and 0.38, respectively, and those for children were 0.046, 0.029, 0.25, and 0.29, respectively . For bot−1, whereas the long-term consumption of croaker might have certain potential health risks. A study from Pakistan showed that OCPs’ residuals in cereals were up to 15.2 µg·kg−1 (dry weight), whereas the consumption of contaminated cereal crops could pose a health risk to the population in the study area [Although daily intake of OCPs through vegetables is an important route of dietary exposure for people, many studies have reported that humans can also be exposed to OCPs through other foods such as rice, vegetable oils, fruits, aquatic products, and meats ,38,41,42−1 lipid), which was 2.5 times that of the 20-year-old. Meanwhile, the concentrations of DDTs in primiparous mothers were higher than those in prolific mothers, which resulted in increased exposure to DDTs in neonates. In addition, DDT in humans was mainly derived from the diet. Therefore, future protection policies regarding exposure to OCPs should consider vulnerable groups such as the elderly, pregnant women, and younger infants, as they have a higher sensitivity to pollutants and may be more vulnerable than adolescents and adults.In addition, when assessing the health risks of OCPs, special groups such as the elderly, pregnant women, and infants should be considered. Wang (2021)  found thIn this study, the characteristics, sources, and health risks of residual OCPs in vegetables in Changchun suburbs (China) were studied. The residues of OCPs in leafy vegetables were found to be higher than those in root and fruit vegetables. The residues of OCPs in 9.81% of the vegetable samples were higher than the MRLs, and the ratio of exceeding the MRLs was found in the descending order of leafy vegetables > root vegetables > fruit vegetables. The ratios of OCPs exceeding the MRLs in different vegetables decreased in the following order: Welsh onion > radish > Chinese cabbage > pepper > cucumber > eggplant > tomato. The source identification results showed that the DDTs in vegetables mainly came from a mixed source of technical DDTs and dicofol, of which dicofol was the predominant source. The HCHs in Chinese cabbage and Welsh onion mainly originated from new inputs of lindane, while the HCHs in eggplant, pepper, cucumber, and radish came from the historical residue of lindane in soil. The THQ values of OCPs were all less than 1, whereas the avg. HI values of adults and children were 0.043 and 0.036, respectively. The health risks of OCPs in vegetables were not obvious to the consumers. Although OCPs have been banned in China for decades, they still have high detection rates and residues in vegetables. Therefore, regular inspection of agricultural products and supervision of production, sales, and use of pesticides should be strengthened.