Mashhad University of Medical Sciences

There is a bidirectional relationship between epilepsy-related stigma (ERS) and medical outcomes. ERS negatively influences treatment adherence and disease management, whereas insufficient medical improvement can, in turn, exacerbate ERS. ERS remains a significant challenge, often leading to delays in diagnosis, limiting appropriate therapies, and creating difficulties in social integration for patients with epilepsy. Even when treatment successfully achieves seizure cessation, failure to address ERS can limit patient social integration, reduce quality of life, and hamper long-term psychosocial recovery. Previous studies suggest that a holistic and personalized medicine approach that addresses both the medical and psychosocial aspects of epilepsy, with a particular focus on reducing ERS, can significantly improve diagnosis and treatment outcomes. Integrating culturally sensitive mental health support and community-specific advocacy initiatives targeting ERS reduction into the routine management of epilepsy can promote clinical and psychosocial outcomes and help patients in their reintegration into normal daily life. Key initiatives may include personalized counseling to mitigate the emotional and psychological impact of ERS, targeted cultural competency training for healthcare professionals, and public awareness campaigns. Integrating these strategies into comprehensive epilepsy care is particularly important for marginalized populations, where poverty and limited healthcare access exacerbate ERS. A personalized anti-ERS plan that integrates individualized clinical management with targeted interventions designed for the specific ERS experiences of each patient can improve treatment adherence, enhance cognitive and emotional well-being, and promote better social integration by addressing both the psychological and social dimensions of ERS.

To compare macular atrophy following neovascular age-related macular degeneration (nAMD) vs. geographic atrophy (GA) following dry AMD. We analysed 60 eyes from 44 patients: 30 eyes with de novo GA and 30 with macular atrophy secondary to nAMD. All patients had monthly follow-ups before GA onset and continued for at least two years after. GA was defined as complete retinal pigment epithelium atrophy ≥250 μm using OCT scans. OCT biomarkers at GA onset, including central macular thickness (CMT), subfoveal choroidal thickness (SFCT), epiretinal membrane (ERM), double-layer sign (DLS), subretinal hyperreflective material (SRHM), hyperreflective foci (HRF), outer retinal tubulation (ORT), and intraretinal fluid (IRF), were assessed. Chi-square test, Spearman correlation, and linear mixed models were used. The mean age was 80.06 ± 8.60 years, with 50.0% male. Eyes with nAMD progressed to macular atrophy after 31.38 ± 30.72 months and 8.86 ± 10.84 anti-vascular endothelial growth factor (VEGF) injections. Compared to de novo GA, eyes with macular atrophy following nAMD had larger baseline atrophic area (3.791 ± 2.661 mm² vs. 1.115 ± 0.951 mm²; P < 0.001) and greater atrophy growth (2.646 ± 2.014 mm² vs. 0.652 ± 0.722 mm²; P < 0.001), with more frequent ERM, DLS, HRF, SRHM, ORT, and IRF. Atrophy growth correlated with baseline SFCT (r = -0.545, P = 0.002) and GA area (r = 0.501, P = 0.005) but not with the number of anti-VEGF injections (p > 0.05). Eyes with macular atrophy secondary to nAMD exhibit larger initial atrophic areas and faster progression compared to de novo GA. OCT biomarkers may detect previous exudation, helping identify cases where recently FDA-approved GA therapies may be relatively contraindicated due to prior disease.

Colorectal cancer (CRC) is known as one of the most common types of cancer in the world, and its early detection plays a decisive role in the success of treatment and preventing the spread of tumors in the body. Early detection is usually done through the identification of biomarkers, and the use of new sensing technologies can significantly improve the detection process. In recent years, the development and application of various biosensors, including electrical, optical, mechanical, and electrochemical sensors, for CRC detection has attracted considerable attention from researchers. Among them, electrochemical biosensors are considered a very suitable option for CRC detection due to their features such as short detection time, high sensitivity, and the ability to detect very small amounts of biomarkers. In general, combining these sensors with various nanostructures can significantly increase their sensitivity and stability. Among these nanomaterials, graphene and its derivatives, including graphene oxide (GO), reduced graphene oxide (rGO), and graphene quantum dots (GQDs), have attracted significant attention due to their unique electrical properties, high specific surface area, excellent conductivity, and superior mechanical properties, making them ideal candidates for the fabrication of electrochemical biosensors. This review focuses on graphene-based electrochemical biosensors for CRC detection over the past five years, analyzing key biomarkers such as carcinoembryonic antigen (CEA), carbohydrate antigen 19–9 (CA 19–9), and microRNAs (miRNAs), which are commonly used for CRC diagnosis. In addition, indicators such as the linear performance range (LR), typically ranging from nanomolar (nM) to micromolar (μM), and the limit of detection (LOD), ranging from femtomolar (fM) to nanomolar (nM) concentrations, have been discussed. Finally, alongside outlining the challenges associated with the development of this category of biosensors, future prospects and strategies aimed at enhancing efficiency, selectivity, reproducibility, and broadening the clinical applications of graphene-based electrochemical biosensors have also been discussed. Overall, this study demonstrates that combining graphene with advanced sensing technologies could pave the way for the development of rapid, accurate, and reliable diagnostic tools, contributing to significant progress in the early detection of CRC. • Overview of current biosensor technologies applied for colorectal cancer detection. • Focus on recent advances in graphene-based electrochemical biosensors. • Graphene nanostructures enhance sensitivity, conductivity, and biomarker detection. • Comparison of graphene-derived materials for CRC-related biomarker sensing. • Identification of challenges, limitations, and future directions for clinical translation.

The Arbaeen long walk (ALW) is an annual religious pilgrimage in which over 20 million Muslims walk more than 80 km between Najaf and Karbala in Iraq. While this event may affect participants' health, its impact has not been comprehensively studied. This study aimed to explore the perceived effects of the Arbaeen walk on individuals' health across multiple dimensions. In this qualitative study, 19 university students who participated in ALW were interviewed using a semi-structured guide. Content analysis was applied to the interview data using MAXQDA 2018. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) to ensure methodological rigor. A total of 264 initial codes were identified, which were consolidated into 78 unique codes, including 52 positive and 24 negative outcomes. These groups comprised 78 unique codes, with 52 codes representing positive outcomes of the Arbaeen walk and 24 codes representing negative outcomes. Based on frequency, the most significant positive outcomes of the Arbaeen walk were "Peace of mind and heart," "Cultural exchange with other countries," and "Strengthening the relationship between God and individuals." In terms of negative outcomes, the code frequency highlighted the prevalence of "Outbreak of infectious diseases," "Physical fatigue," and "Excessive waste generation." Participation in the Arbaeen walk is associated with diverse positive effects on physical, mental, and social well-being, although some negative health outcomes were also reported. These findings highlight the broad scope of health impacts related to this pilgrimage and underscore the need for further investigation into its effects.

Prime editing has recently gained attention for its promising potential in treating genetic disorders caused by different types of mutations. This method, based on Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR), has led to the development of new strategies that offer improved editing efficiency. Additionally, the components of prime editing-namely, the prime editor (PE) and the prime editing guide RNA (PegRNA)-have been enhanced through rational design and direct evolution of structural modifications. These improvements have resulted in better performance and new capabilities, driven by novel mutations or components. In this review, we compare various studies that report enhanced versions of PE or PegRNA, which achieve more efficient results. These advancements hold the potential to accelerate and simplify the development of gene therapies for a range of genetic disorders.