Brain Representation of Animal and Non-Animal Images in Patients with Mild Cognitive Impairment and Alzheimer's Disease

Background

In early Alzheimer's disease (AD), high-level visual functions and processing speed are impacted. Few functional magnetic resonance imaging (fMRI) studies have investigated high-level visual deficits in AD, yet none have explored brain activity patterns during rapid animal/non-animal categorization tasks.

Objective

To address this, we utilized the previously known Integrated Cognitive Assessment (ICA) to collect fMRI data and compare healthy controls (HC) to individuals with mild cognitive impairment (MCI) and mild AD.

Methods

The ICA encompasses a rapid visual categorization task that involves distinguishing between animals and non-animals within natural scenes. To comprehensively explore variations in brain activity levels and patterns, we conducted both univariate and multivariate analyses of fMRI data.

Results

The ICA task elicited activation across a range of brain regions, encompassing the temporal, parietal, occipital, and frontal lobes. Univariate analysis, which compared responses to animal versus non-animal stimuli, showed no significant differences in the regions of interest (ROIs) across all groups, with the exception of the left anterior supramarginal gyrus in the HC group. In contrast, multivariate analysis revealed that in both HC and MCI groups, several regions could differentiate between animals and non-animals based on distinct patterns of activity. Notably, such differentiation was absent within the mild AD group.

Conclusions

Our study highlights the ICA task's potential as a valuable cognitive assessment tool designed for MCI and AD. Additionally, our use of fMRI pattern analysis provides valuable insights into the complex changes in brain function associated with AD. This approach holds promise for enhancing our understanding of the disease's progression.

Combined action of albumin and heparin regulates lipoprotein lipase oligomerization, stability, and ligand interactions

Lipoprotein lipase (LPL), a crucial enzyme in the intravascular hydrolysis of triglyceride-rich lipoproteins, is a potential drug target for the treatment of hypertriglyceridemia. The activity and stability of LPL are influenced by a complex ligand network. Previous studies performed in dilute solutions suggest that LPL can appear in various oligomeric states. However, it was not known how the physiological environment, that is blood plasma, affects the action of LPL. In the current study, we demonstrate that albumin, the major protein component in blood plasma, has a significant impact on LPL stability, oligomerization, and ligand interactions. The effects induced by albumin could not solely be reproduced by the macromolecular crowding effect. Stabilization, isothermal titration calorimetry, and surface plasmon resonance studies revealed that albumin binds to LPL with affinity sufficient to form a complex in both the interstitial space and the capillaries. Negative stain transmission electron microscopy and raster image correlation spectroscopy showed that albumin, like heparin, induced reversible oligomerization of LPL. However, the albumin induced oligomers were structurally different from heparin-induced filament-like LPL oligomers. An intriguing observation was that no oligomers of either type were formed in the simultaneous presence of albumin and heparin. Our data also suggested that the oligomer formation protected LPL from the inactivation by its physiological regulator angiopoietin-like protein 4. The concentration of LPL and its environment could influence whether LPL follows irreversible inactivation and aggregation or reversible LPL oligomer formation, which might affect interactions with various ligands and drugs. In conclusion, the interplay between albumin and heparin could provide a mechanism for ensuring the dissociation of heparan sulfate-bound LPL oligomers into active LPL upon secretion into the interstitial space.

Designing humanitarian logistics network for managing epidemic outbreaks in disasters using Internet-of-Things. A case study: An earthquake in Salas-e-Babajani city

Along with the destructive effects of catastrophes throughout the world, the COVID-19 outbreak has intensified the severity of disasters. Although the global aid organizations and philanthropists aim to alleviate the adverse impacts, many employed actions are not impactful in dealing with the epidemic outbreak in disasters. However, there is a gap in controlling the epidemic outbreak in the aftermath of disasters. Therefore, this paper proposes a novel humanitarian location-allocation-inventory model by focusing on preventing COVID-19 outbreaks with IoT-based technology in the response phase of disasters. In this study, IoT-based systems enable aid and health-related organizations to monitor people remotely, suspect detection, surveillance, disinfection, and transportation of relief items. The presented model consists of two stages; the first is defining infected cases, transferring patients to temporary hospitals promptly, and accommodating people in evacuation centers. Next, distribution centers are located in the second stage, and relief items are transferred to temporary hospitals and evacuation centers equally regarding shortage minimization. The model is solved by the LP-metric method and applied in a real case study in Salas-e-Babajani city, Kermanshah province. Then, sensitivity analysis on significant model parameters pertaining to the virus, relief items, and capacity has been conducted. Using an IoT-based system in affected areas and evacuation centers reduces the number of infected cases and relief item's shortages. Finally, several managerial insights are obtained from sensitivity analyses provided for healthcare managers.

Improvement of DBR routing protocol in underwater wireless sensor networks using fuzzy logic and bloom filter

Routing protocols for underwater wireless sensor networks (UWSN) and underwater Internet of Things (IoT_UWSN) networks have expanded significantly. DBR routing protocol is one of the most critical routing protocols in UWSNs. In this routing protocol, the energy consumption of the nodes, the rate of loss of sent packets, and the rate of drop of routing packets due to node shutdown have created significant challenges. For this purpose, in a new scenario called FB-DBR, clustering is performed, and fuzzy logic and bloom filter are used in each cluster’s new routing protocol in underwater wireless sensor networks. Due to the fuzzy nature of the parameters used in DBR, better results are obtained and bloom filters are used in routing tables to compensate for the deceleration. as the average number of accesses to routing table entries, dead nodes, Number of Packets Sent to Base Station (BS), Number of Packets Received at BS, Packet Dropped, and Remaining Energy has improved significantly.

[Inhibition of Autophagy by 3-MA Increases Oncolysis Effect of VSV in a Murine Model of Cancer]

Vesicular stomatitis virus has been known as a potent antitumor agent because of its selective replication and lysis of tumor cells and immune-stimulating properties. In response to cellular stress and enhanced metabolism, tumor cells activate autophagy, to provide energy for the cells and preventing tumor destruction. Inhibition of autophagy can increase the therapeutic potential of many antitumor methods. This study aimed to check the efficacy of combined VSV and three-methyl adenine (3-MA) in treating a tumor model in mice. TC-1, a line of C57BL/6 mouse lung cells transformed by HPV-16 E7 and E6 oncoproteins, as well as human Ras, were used for experiments. The viability after treatment with the optimized concentration of 3-MA with or without combination with VSV was assessed by MTT. C57BL/6 male mice were injected with TC-1, and after tumor formation, 3-MA and VSV alone or in combination in two different protocols were injected into tumor mice. Tumor size, tumor-specific CTL response, and apoptosis rate were evaluated. The results showed that 3-MA combined with VSV causes more lethality in tumor cells in vitro. In vivo studies also showed that combined VSV and 3-MA treatment inhibits the progression of TC-1 cancer cells with higher efficiency, especially in daily 3-MA treatment along with four doses of VSV injection with four days' intervals. In addition, the rate of apoptosis and cytotoxic T cells activity in the groups injected with 3-MA and the virus were higher than groups receiving each agent alone. In conclusion, the association of VSV with 3-MA increases its oncolysis activity and subsequently more stimulates the immune system against the tumor. This finding suggests a combinational approach for tumor therapy with therapy. Combining oncolytic VSV with 3-MA as an autophagy inhibitor agent can improve the efficacy of tumor treatment. This combination therapy approach enhances apoptosis in tumors as well as T cell cytotoxicity against tumor cells.

Temporal dynamics of animacy categorization in the brain of patients with mild cognitive impairment

Electroencephalography (EEG) has been commonly used to measure brain alterations in Alzheimer’s Disease (AD). However, reported changes are limited to those obtained from using univariate measures, including activation level and frequency bands. To look beyond the activation level, we used multivariate pattern analysis (MVPA) to extract patterns of information from EEG responses to images in an animacy categorization task. Comparing healthy controls (HC) with patients with mild cognitive impairment (MCI), we found that the neural speed of animacy information processing is decreased in MCI patients. Moreover, we found critical time-points during which the representational pattern of animacy for MCI patients was significantly discriminable from that of HC, while the activation level remained unchanged. Together, these results suggest that the speed and pattern of animacy information processing provide clinically useful information as a potential biomarker for detecting early changes in MCI and AD patients.

Testing CPT symmetry in ortho-positronium decays with positronium annihilation tomography

Charged lepton system symmetry under combined charge, parity, and time-reversal transformation (CPT) remains scarcely tested. Despite stringent quantum-electrodynamic limits, discrepancies in predictions for the electron–positron bound state (positronium atom) motivate further investigation, including fundamental symmetry tests. While CPT noninvariance effects could be manifested in non-vanishing angular correlations between final-state photons and spin of annihilating positronium, measurements were previously limited by knowledge of the latter. Here, we demonstrate tomographic reconstruction techniques applied to three-photon annihilations of ortho-positronium atoms to estimate their spin polarisation without magnetic field or polarised positronium source. We use a plastic-scintillator-based positron-emission-tomography scanner to record ortho-positronium (o-Ps) annihilations with single-event estimation of o-Ps spin and determine the complete spectrum of an angular correlation operator sensitive to CPT-violating effects. We find no violation at the precision level of 10⁻⁴, with an over threefold improvement on the previous measurement.

CPT violation could manifest itself in annihilating positronium events, but searching for this effect would require to know the spin of the annihilating system. Here, the authors do this using a positron-emission tomography scanner, finding no violation with a statistical precision of 10⁻⁴.

Validity and Cultural Generalisability of a 5-Minute AI-Based, Computerised Cognitive Assessment in Mild Cognitive Impairment and Alzheimer's Dementia

Introduction: Early detection and monitoring of mild cognitive impairment (MCI) and Alzheimer's Disease (AD) patients are key to tackling dementia and providing benefits to patients, caregivers, healthcare providers and society. We developed the Integrated Cognitive Assessment (ICA); a 5-min, language independent computerised cognitive test that employs an Artificial Intelligence (AI) model to improve its accuracy in detecting cognitive impairment. In this study, we aimed to evaluate the generalisability of the ICA in detecting cognitive impairment in MCI and mild AD patients. Methods: We studied the ICA in 230 participants. 95 healthy volunteers, 80 MCI, and 55 mild AD participants completed the ICA, Montreal Cognitive Assessment (MoCA) and Addenbrooke's Cognitive Examination (ACE) cognitive tests. Results: The ICA demonstrated convergent validity with MoCA (Pearson r=0.58, p<0.0001) and ACE (r=0.62, p<0.0001). The ICA AI model was able to detect cognitive impairment with an AUC of 81% for MCI patients, and 88% for mild AD patients. The AI model demonstrated improved performance with increased training data and showed generalisability in performance from one population to another. The ICA correlation of 0.17 (p = 0.01) with education years is considerably smaller than that of MoCA (r = 0.34, p < 0.0001) and ACE (r = 0.41, p < 0.0001) which displayed significant correlations. In a separate study the ICA demonstrated no significant practise effect over the duration of the study. Discussion: The ICA can support clinicians by aiding accurate diagnosis of MCI and AD and is appropriate for large-scale screening of cognitive impairment. The ICA is unbiased by differences in language, culture, and education.

Effects of Metformin on Experimental Varicocele in Rats

The current study aimed to determine the effect of metformin (MET) on histopathologic evaluation and antioxidant enzyme activity in experimental varicocele-induced rats. A total of 60 rats were randomly divided into six experimental groups. Group 1 (control) received no medication and underwent no surgery. In group 2 (sham), the rats received no medication and the abdominal cavity was opened; however, there was no varicocele induction. In group 3 (varicocele), the abdominal cavity was opened and the rats underwent varicocele induction and received no medication. In group 4, the abdominal cavity was opened and the animals received 25 mg/kg of MET for 42 days and were varicocele-induced. Groups 5 and 6 were similar to group 4 except that the animals received 50 and 100 mg/kg of MET, respectively. At the end of the 21st and 42nd days, the rats were euthanized and the left testis was removed for histological analysis and measurement of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GPx), and total antioxidant status levels. According to the results, a dose-dependent difference was observed in testis damage grade in the MET treated groups, compared to that reported for the varicocele group (p &amp;lt;0.05). No difference was observed between 25 and 50 mg/kg of MET (P&amp;gt;0.05). Tissue MDA levels significantly increased in varicocele rats (p &amp;lt;0.05); however, MET (25, 50, and 100 mg/kg) in a dose-dependent manner decreased varicocele-induced MDA (p &amp;lt;0.05). Experimental varicocele significantly decreased SOD activity, compared to that reported for the control group (p &amp;lt;0.05). The administration of MET (25, 50, and 100 mg/kg) significantly increased tissue SOD activity in varicocele rats (p &amp;lt;0.05). The MET (25, 50, and 100 mg/kg) in a dose-dependent manner increased GPx activity in varicocele rats (p &amp;lt;0.05). There was no difference in MDA, SOD, and GPx levels between 25 and 50 mg/kg MET groups (P&amp;gt;0.05). The aforementioned findings suggested that MET treatment had beneficial effects on varicocele.

Risk Assessment of Phthalate Compounds in Bottled Water Consumed in Isfahan, Iran

Background: Phthalates are main ingredients of polyethylene terephthalate (PET) bottles used for storage of water. These compounds can cause adverse effects on human health. The purpose of this study was the quantification of the amounts of phthalates migrated in bottled water as well as the risk assessment of those compounds. Methods: This cross sectional study was performed on 15 PET bottled water samples of popular brands distributed in Isfahan city, Iran. The samples were immediately sent to laboratory for analysis. Amounts of Phthalic Anhydride (PA), di-2 ethylhexyl phthalate (DEHP), di-buthyl phthalate (DBP), di-ethyl phthalate (DEP), and terphthalic acid (TPA) in bottled water samples were measured using Gas Chromatography-Mass Spectrometry (GC-MS) analysis. Risk assessment of migrated compounds were calculated and com- pared with Hazard Quito (HQ) standards. Results: The ranges of PA, DEHP, DBP, and TPA were 2.3-26, 171-845, 30-2251, and 24-657 ppb, respectively. DEP was not found in none of the analyzed samples. HQ levels of DEHP, TPA, and DBP were more than 1 in bottled water. Conclusion: In the current study, the concentration of DEHP, TPA, and DBP in some bottled water of Isfahan, Iran were higher than the permitted limits. Also, HQ levels of these three migrated compounds were more than 1 in bottled water that is alarming for public health in this region of Iran.

Drift Diffusion Model of Animacy Categorization Task Can Detect Patients with Mild Cognitive Impairment and Mild Alzheimer's Disease

Purpose: The process of neurodegeneration in Alzheimer's Disease (AD) is irreversible using current therapeutics. An earlier diagnosis of the disease can lead to earlier interventions, which will help patients sustain their cognitive abilities for longer. Individuals within the early stages of AD, shown to have trouble making confident and sounds decisions. Here we proposed a computational approach to quantify the decision-making ability in patients with mild cognitive impairment and mild AD. Materials and Methods: To study the quantified decision-making abilities at the early stages of the disease, we took advantage of a 2-Alternative Forced-Choice (2AFC) task. We applied the Drift Diffusion Model to determine whether the information accumulation process in a categorization task is altered in patients with mild cognitive impairment and mild AD. We implemented a classification model to detect cognitive impairment based on the Drift Diffusion Model's estimated parameters. Results: The results show a significant correlation of the classification score with the standard pen-and-paper tests, suggesting that the quantified decision-making parameters are undergoing significant change in patients with cognitive impairment. Conclusion: We confirmed that the decision-making ability deteriorates at the early stages of AD. We introduced a computational approach for measuring the decline in decision-making and used that measurement to distinguish patients from healthy individuals.

Comparison of error tree analysis and TRIPOD BETA in accident analysis of a power plant industry using hierarchical analysis

Introduction: Due to the importance and necessity of accident analysis, it is necessary to use the proper technique for precise accident analysis and provide corrective and preventive measures to prevent an accident's recurrence. Materials and Methods: In this descriptive-analytical paper, the most important criteria for investigating and selecting accident investigation and analysis techniques and selecting the best accident analysis method were identified in critical industrial accidents in the construction phase, were identified and analyzed. In this study, the most important criteria for selecting an accident analysis method were identified using previous research and gathering expert opinions. Then, two critical power plant accidents were analyzed using TRIPOD BETA and FTA accident analysis methods. Then the pairwise comparisons matrix was formed based on the strengths and weaknesses of the models. Finally, the prioritization of these two methods was done using the hierarchical analysis decision-making method.  Results: In this paper, seven key factors, model realism, model descriptive, systematic modeling, run time, required training courses, ability to quantify, and visibility of events, were identified as the most important criteria for selecting an incident analysis method. Conclusion: The TRIPOD BETA method has been introduced as an optimal method for investigating specific events due to its capabilities.

Rod separation by sawtooth channel

By applying entropic barriers, we present a rod separation mechanism that induces the movement of rods of different sizes in the opposite directions. This mechanism is based on the combination of the saw-tooth channel, a static force, and an oscillating driving force. The asymmetric shape of the channel and the elongated shape of the rod causesa complicated interaction effect between the rods and the channel walls which reduces the accessible configuration space for the rods and leads to entropic free-energy effects.

Performance assessment of the 2 γpositronium imaging with the total-body PET scanners

Purpose

In living organisms, the positron-electron annihilation (occurring during the PET imaging) proceeds in about 30% via creation of a metastable ortho-positronium atom. In the tissue, due to the pick-off and conversion processes, over 98% of ortho-positronia annihilate into two 511 keV photons. In this article, we assess the feasibility for reconstruction of the mean ortho-positronium lifetime image based on annihilations into two photons. The main objectives of this work include the (i) estimation of the sensitivity of the total-body PET scanners for the ortho-positronium mean lifetime imaging using 2γ annihilations and (ii) estimation of the spatial and time resolution of the ortho-positronium image as a function of the coincidence resolving time (CRT) of the scanner.

Methods

Simulations are conducted assuming that radiopharmaceutical is labeled with ⁴⁴Sc isotope emitting one positron and one prompt gamma. The image is reconstructed on the basis of triple coincidence events. The ortho-positronium lifetime spectrum is determined for each voxel of the image. Calculations were performed for cases of total-body detectors build of (i) LYSO scintillators as used in the EXPLORER PET and (ii) plastic scintillators as anticipated for the cost-effective total-body J-PET scanner. To assess the spatial and time resolution, the four cases were considered assuming that CRT is equal to 500 ps, 140 ps, 50 ps, and 10 ps.

Results

The estimated total-body PET sensitivity for the registration and selection of image forming triple coincidences (2γ+γ_prompt) is larger by a factor of 13.5 (for LYSO PET) and by factor of 5.2 (for plastic PET) with respect to the sensitivity for the standard 2γ imaging by LYSO PET scanners with AFOV = 20 cm. The spatial resolution of the ortho-positronium image is comparable with the resolution achievable when using TOF-FBP algorithms already for CRT = 50 ps. For the 20-min scan, the resolution better than 20 ps is expected for the mean ortho-positronium lifetime image determination.

Conclusions

Ortho-positronium mean lifetime imaging based on the annihilations into two photons and prompt gamma is shown to be feasible with the advent of the high sensitivity total-body PET systems and time resolution of the order of tens of picoseconds.

Reducing pain at split thickness donor sites with silicone dressing compared to petrolatum gauze dressing

Many modalities have been introduced to reduce devastating pain at the donor area. This is a prospective, randomized study to assess the effect of silicone dressing in reducing pain at split-thickness skin donor sites, and compare it with traditional petrolatum gauze. The patients were allocated to receive standard dressing (petrolatum gauze) or silicone dressing over skin donor sites. Pattern and severity of pain at the sites were assessed in both groups using the Visual Analog Scale for pain. Pattern of pain at the donor site during the postoperative period was consistently lower with silicone dressing (p<0.005). Regarding severity of pain, there were differences between the two groups (p.<005), but there were no significant differences between the two sexes regarding pattern and severity of pain (p>0.5). This study showed silicone dressing to be superior to petrolatum gauze in reducing severity and pattern of pain. It may increase patient satisfaction.

Effectiveness of incorporating occupational therapy in rehabilitation of hand burn patients

One of the main goals in the rehabilitation process of patients with burn to their hands is their return to society and their professional occupation, which has a direct positive influence on these patients' quality of life. The goal of this research project was to investigate the effect of early intervention with occupational therapy in patients with burns to their hands. The study included 30 patients with second or third degree hand burns. Patients were added to the study 12 days after their burn wounds and grafted areas had healed. They had 3 sessions of occupational therapy per week for 8 weeks. These sessions included active and passive range of motion exercises, active resistive exercises, stretching exercises and practicing activities of daily living. Functionality of the hand was assessed before and after the 8 weeks of occupational therapy using the DASH questionnaire. The average initial DASH score before intervention with occupational therapy was 60.9, and after 8 weeks of occupational therapy it was 33.9 (average difference between the pre-intervention and post-intervention DASH scores is 27 points, p < 0.001). After 8 weeks of occupational therapy, patients performed activities of daily living with a lot less difficulty, and an increase in functionality of the hands was observed. This study suggests that early intervention with rehabilitative therapies is advantageous and may result in improved hand function.

Does fibroblast growth factor 23 correlates with volume status in hemodialysis patients?

Introduction: Volume overload is a known risk factor for cardiovascular disease and stroke in hemodialysis patients. The use of fibroblast growth factor 23 (FGF23) as a volume overload marker has been validated in multiple studies. Objectives: This is a prospective cross-sectional study considering the association between FGF23 and bioimpedance-measured volume overload in hemodialysis patients. Patients and Methods: Bioimpedance analysis was performed on 43 hemodialysis patients at the end of hemodialysis to evaluate the remaining volume overload and serum FGF23 was measured before hemodialysis. Results: The results indicated no significant correlation between mean serum FGF23 levels and volume overload in hemodialysis patients (P=0.824). Conclusion: Although this study did not show any association between volume overload and FGF23, further studies are needed to define the role of FGF23 as a volume overload marker.

Diabetes and foot burns

The incidence of diabetes and diabetic foot burns is increasing worldwide. In the present study, we surveyed frequency, morbidity and mortality of diabetic foot burn patients in our centre. The study was a cross-sectional survey with one-year follow up of our adult diabetic patients with lower extremity burns. Data on demographics, cause of burn, time from injury to hospital, TBSA, presence of neuropathy and diabetic foot, treatment plan for controlling blood sugar, smoking, infection, morbidity, co-morbid diseases, amputation and mortality were gathered from patient files. Statistical analysis was done with SPSS 21 software. A p value less than 0.05 was considered significant. Of the 34,300 burn patients seen in a year, 2096 were admitted according to ABA criteria. 47 patients had diabetic foot burn. Half of them had diabetic neuropathy. 48.9% had type I diabetes and 51.1% had type II. 70.2% were male, 29.8% were female. Mean +/- SD age was 58 +/- 14 years; 14 patients were smokers and 40 had co-morbid diseases. Hypertension frequency was 44%, ischemic heart disease 25%, CVA 8.5% and renal failure 6.4%. Half of the patients had uncontrolled blood sugar. Mean +/- SD delay in admission was 2.5±1.5 (days). Mean +/- SD TBSA was 2.4 +/- 1.4%. Mean +/- SD length of stay was 11.4±6.1 (days). 8.5% underwent amputation and there were no deaths. Diabetic foot burn patients delay seeking medical attention, have a longer length of stay, more complications and more amputations than other burn patients (compared with our previous study on burn patients). Prevention and training programs are highly needed to prevent foot burns.

Effective optimization using sample persistence: A case study on quantum annealers and various Monte Carlo optimization methods

We present and apply a general-purpose, multistart algorithm for improving the performance of low-energy samplers used for solving optimization problems. The algorithm iteratively fixes the value of a large portion of the variables to values that have a high probability of being optimal. The resulting problems are smaller and less connected, and samplers tend to give better low-energy samples for these problems. The algorithm is trivially parallelizable since each start in the multistart algorithm is independent, and could be applied to any heuristic solver that can be run multiple times to give a sample. We present results for several classes of hard problems solved using simulated annealing, path-integral quantum Monte Carlo, parallel tempering with isoenergetic cluster moves, and a quantum annealer, and show that the success metrics and the scaling are improved substantially. When combined with this algorithm, the quantum annealer's scaling was substantially improved for native Chimera graph problems. In addition, with this algorithm the scaling of the time to solution of the quantum annealer is comparable to the Hamze-de Freitas-Selby algorithm on the weak-strong cluster problems introduced by Boixo et al. Parallel tempering with isoenergetic cluster moves was able to consistently solve three-dimensional spin glass problems with 8000 variables when combined with our method, whereas without our method it could not solve any.

Correlation of occurrence of infection in burn patients

The study of burn flora is helpful in determining current antibiotic susceptibilities and locating development of multidrug resistant bacterial strains among the unit's usual flora. In this study, we aimed to determine the bacteriological pattern of blood, urine and sputum infections and their correlation with burn wound infections. We used data from our burn registry program. All data on demographics, burn wounds and burn wound infection, bacteria isolated, sensitivity to different antibiotics, burn wound culture, sputum culture, urine culture and catheter tip culture were recorded. We had 1721 hospitalized burn patients. Mean age was 26.3+/-20.25 years old. Mean hospital stay was 14.41 days (range 0-64 days). Mean (SD) TBSA was 16.48 (20.67) years. Mortality rate was 5.9%. Burn wound infection was present in 38.54%. The most frequent species was Staphylococcus spp. (55.1%), followed by Pseudomonas (14.29%), Enterococcus (12.24%), E. coli (4%), Klebsiella and Proteus (both 2%). Urine culture was positive in 27.9%, sputum culture was positive in 1.14%, catheter tip culture was positive in 12.3% and blood culture was positive in 7.6% of the cases. There were correlations between positive wound culture and blood and urine culture, most of them with one bacteria species. The most frequent disseminated bacteria was Pseudomonas aeruginosa and the most sensitive antibiotic was Amikacin. More than 39.2% of our positive culture patients had 3 or more positive cultures, and 36.5% had similar culture results for one bacteria, which was a sign of disseminated infection.

LA50 in burn injuries

Burn injuries put a huge financial burden on patients and healthcare systems. They are the 8th leading cause of mortality and the 13th most common cause of morbidity in our country. We used data from our Burn Registry Program to evaluate risk factors for mortality and lethal area fifty percent (LA50) in all burn patients admitted over two years. We used multiple logistic regressions to identify risk factors for mortality. LA50 is a reliable aggregate index for hospital care quality and a good measure for comparing results, also with those of other countries. 28,690 burn patients sought medical attention in the Emergency Department, and 1721 of them were admitted. Male to female ratio was 1,75:1. 514 patients were under 15 years old. Median age was 25 (range: 3 months - 93 years). Overall, probability of death was 8.4%. LA50 was 62.31% (CI 95%: 56.57-70.02) for patients aged 15 and over and 72.52% (CI 95%: 61.01-100) for those under 15. In the final model, we found that Adjusted OR was significant for age, female sex, TBSA and inhalation injury (P < 0.05). LA50 values showed that children tolerate more extensive burns. Female sex, burn size, age and inhalation injury were the main risk factors for death. Authorities should pay special attention to these variables, especially in prevention programs, to reduce mortality and improve patient outcome. Children have better outcome than adults given equal burn size. Suicide rates are higher for women than men in our country.

Financial burden of burn injuries in iran: a report from the burn registry program

Understanding the cost of burn treatment is very important for patients, their families, governmental authorities and insurance companies. It alleviates patient and familial stress, provides a framework for better use of resources, and facilitates better performance between burn centers. Hospital burn costs can provide a basis for authorities to budget for acute burn treatment, for further management of chronic complications, and for planning prevention and public educational programs in Iran. To identify costs we used data from our burn registry program. Over the two-year assessment period, we treated roughly 28,700 burn patients, 1,721 of whom were admitted, with a mortality rate of 5.9%. The male to female ratio was 1.7:1 (63% male; 37% female). Flame burns were most frequent (49.8%) followed by scalds (35.7%). Mean hospital stay was 14.41 days (range 0-64 days). Mean TBSA was 17.39%. Skin grafts were carried out in 65.4% of the patients, with a mean of 5.2 surgeries per patient. The total cost of all patient admissions over the two years was US$ 4,835,000. The maximum treatment cost for one patient was US$ 91,000. The mean cost per patient was US$ 2,810 (29,500,000 Rials). The mean cost for each percent of burn was US$ 162. The mean cost for a one-day stay in hospital was US$ 195. The mean cost of each operation was US$ 540. Patients who contracted infections endured longer hospital stays, meaning increased costs of US$ 195 per day. With comparable outcome and results, the cost of burn treatment in Iran is cheaper than in the US and Europe.

Epidemiology of outpatient burns in Iran: an update

Burn injury remains a serious and devastating issue faced by developing countries. It is also true, however, that the developed world still tackles many of the challenges caused by burns. In order to reduce this problem through preventive programs, the characteristics of this type of injury must be studied and well documented in each setting. Our study aims to show the epidemiology, demographic distribution and clinical outcomes of burns patients referred to Motahari Burn Hospital, the burn care center that receives the most referrals in Iran. This cross-sectional study, from March 2009 to March 2010, included 6,910 patients with burn injuries who were managed as outpatients. The patient demographics along with the characteristics of the burn injuries and their outcomes were recorded for each case and then evaluated. A total of 6,910 burn patients with a mean ± SD age of 30.20 ± 19.11 years presented to our Emergency Department and were treated as outpatients. Of these, 2,900 were female (41.97%) and 4,010 were male (58.03%). Most of the patients were in the 25-35 year age group, with a prevalence of 1,148 (28.6% of total) males and 716 females (24.7% of total), followed by those aged <15-years-old. Most patients had been burned accidentally. An increase in the instance of self-immolation was identified with an increase in the TBSA burned. Mean follow-up was 30+/-5 months. The results revealed that burns were most likely to occur during housekeeping. Other high risk groups identified were males, those aged from 25 to 35 years-old, and those with lower socio-economic status.

The burn registry program in Iran - First report

Burn injury is still a major problem in Iran, resulting in many reports which are usually dispersed, uncoordinated and probably unreliable. We created a burn registry comprised of a data entry program with 222 variables for each admitted burn patient. This program was established in August 2010 at the Iran University of Medical Sciences, Motahari Burn Hospital. We had 14,277 burn patients from August 2010 to August 2011, 877 of whom were admitted to the hospital. Of the patients, 65.9% were male and 34.1% were female. The age was 28.85 years (SD = 19.77). The most prevalent cause of burn was flame 78.5% (pipe propane gas 57.2; kerosene 19.9%). The mean total body surface area (TBSA) involvement was 23%. A total of 77.8% of patients were discharged with partial recovery, while mortality was 8.9%. The mean hospital stay was 14.63 days (SD =11.07). The program is designed to help understand the scope of burn injury in Iran, providing information on patients, etiology, and course of treatment. It also highlights differences between various parts of the country in terms of the causes and frequency of burn injuries. Moreover, the burn registry provides a basis for further research and surveys for treatment and preventive programs. Our results showed that, although Emergency Medical Services (EMS) staff are highly capable and well-trained, their coverage seems to be less than 50% and needs to be increased. Marriage status was shown to have no influence on the occurrence of burns, and among our patients, 57.0 % were poorly educated.

Burn wound healing with injection of adipose-derived stem cells: a mouse model study

Stem cells have shown promise with regard to the healing process of burn wounds. However, donor sites for these cells are still under investigation. The aim of this study is to review the efficacy of adipose tissue-derived stem cells (ADSCs) in accelerating wound healing of third degree burns in a mouse model. To this end, forty healthy male inbred Balb/c mice were selected and set up as an experimental model for third degree burn wounds. They were randomly divided into 3 equally sized groups: the ADSCs group, the mechanically prepared adipose tissue group, and the control group. The wounds were examined daily until the mice were sacrificed for tissue sampling in the 3(rd) week. Our results showed that wound surface area and eschar thickness were smaller in the ADSCs group throughout the study period, although there was no significant difference between the groups for decreasing values of wound area characteristics. In terms of wound healing parameters, lymphocyte and macrophage cell counts were larger in the ADSCs group compared to the other groups. Fibroplasia, collagen synthesis and remodeling were more aberrant in this group. However, there was no statistically significant difference in either of these observed differences (p>0.05). Although enzymatically prepared ADSCs seem a potential treatment in wound healing, our study of a mouse model burn wound revealed no significant improvement in using this option.

Silver and zinc oxide nanostructures loaded on activated carbon as new adsorbents for removal of methylene green

In this study, the removal of methylene green (MG) from aqueous solution based on two new adsorbents including silver nanoparticles and zinc oxide nanorods loaded on activated carbon (Ag-NP-AC and ZnO-NR-AC, respectively) has been carried out. The dependency of removal process to variables such as contact time, pH, amount of adsorbents, and initial MG concentration were examined and optimized. It was found that the maximum MG removal percentage was achieved at pH = 7.0 following stirring at 400 r min−1 for 7 and 6 min for Ag-NP-AC and ZnO-NR-AC, respectively. Equilibrium data were well fitted with the Langmuir model having maximum adsorption capacity of 166.7 and 200 mg g−1 for Ag-NP-AC and ZnO-NR-AC, respectively. Thermodynamic parameters of MG adsorption on Ag-NP-AC such as enthalpy and entropy changes, activation energy, sticking probability, and Gibbs free energy changes show the spontaneous and endothermic nature of the removal process. Among different conventional kinetic models, the pseudo second-order kinetics in addition to particle diffusion mechanism is the best and efficient model for the prediction and explanation of experimental data of MG adsorption onto both adsorbents.

Augmenting the expression of NKp44 molecule and the natural killer activity in peripheral blood mononuclear cells from patients with malignant colorectal carcinoma

OBJECTIVE

NKp44 and NKG2D are of the main NK activating receptors involved in recognition and killing of tumors. Here we studied the stimulatory effects of PHA and/or K562 cell line on induction of NKp44 and NKG2D expression and the NK activity of PBMCs from patients with colorectal carcinoma (CRC).

MATERIALS AND METHODS

Peripheral blood samples were collected from 10 patients with CRC. The peripheral blood mononuclear cells (PBMCs) from each patient received a single stimulation with PHA or double stimulation with PHA and irradiated K562 cell line (iK562). The expression of CD56, NKG2D and NKp44 were detected by flowcytometry. The NK activity of PBMCs against a colorectal carcinoma cell line named as SW742 was determined with 51Cr-release assay.

RESULTS

Double stimulation of PBMCs with PHA+iK562 significantly augmented the number CD56(+) cells compared to PHA alone and non-stimulated PBMCs (P<0.000, P<0.0000; respectively). A single stimulation of PBMCs with PHA resulted in an enhancement in NKG2D and NKp44 expression from 16.6±3.3% (for non-stimulated PBMCs) to 42±5.6% and 48.1±3.8% respectively (p<0.05). Double stimulation of PBMCs augmented the NKp44 expression significantly in comparison with single stimulation with PHA (73.6±12%, p<0.05). Double stimulation of PBMCs significantly enhanced the NK activity against SW742 target cells compared to single stimulation with PHA (p<0.05).

DISCUSSION AND CONCLUSION

Our results demonstrated that the mitogen and iK562 exposure to PBMCs can significantly improve NK activity which is co-related to the higher expression of NKp44 and NKG2D. These data may help to improve cancer immunotherapy protocols.

Structure of vomeronasal organ (Jacobson organ) in male Camelus Domesticus Var. dromedaris persica

The vomeronasal organ (VNO) is a tubular structure in the roof of nasal cavity. The important role of this organ is olfaction of sexual odour. In this study, position, anatomical structure and histology of VNO in Iranian camels (camelus domesticus var. dromedaris persica) were determined. Fourteen healthy male camel heads were collected from an industrial slaughterhouse in Tehran, Iran, for anatomical and histological studies (seven each). The length of VNO and width of dental pad and the number and width of palatine crests were measured. For anatomical studies, the mandible was removed, and maxilla and nasal cavity was cut longitudinally and transversely. For histological studies, the mandible was removed, and first 0.5 cm of initial part of VNO was cut. Then, nasal cavity was cut in some segments with 2 cm thickness. The width of VNO was 3.85 ± 0.31 cm and 1.57 ± 0.18 cm in front and distal parts, respectively. The length of VNO was 15.61 ± 0.59 cm. In histological examinations, VNO was surrounded by J-shape hyaline cartilage. The lining epithelium of lateral wall of VNO was originated from respiratory epithelium, while it had an olfactory epithelium origin in the medial wall. Lamina propria and tunica submucosa were a cavernous connective tissue with seromucous gland with abundant of serous secretory units. The lumen of VNO opens into nasal cavity. The presence of olfactory epithelium found in our study indicates an important role for VNO in pheromone perception and beginning of sexual behaviour.

Epidemiology of paediatric burns in Iran

We surveyed the epidemiology of the patients in a tertiary burn care centre (the Motahari Burn Hospital) in Tehran in the 4-yr period 2005-2009. Scalding was the major cause of burn injury for patients under the age of 6, while there were many more flame and electrical burns in late childhood. Males were mainly affected (male to female ratio, 1.7:1). Most burns occurred in the summer, probably due to older children's increased outdoor activities during school vacations. Most of the injuries took place in the kitchen. Age was directly related to the higher total body surface area and mortality rate. Explosion of propane gas at home had a high incidence. Length of hospital stay increased in relation to the burn surface area. Infants were found to be at greatest risk for burn injuries, while older children were at higher risk for severe burns. Before arriving at the hospital, 22 patients had received traditional therapy in the home which was not effective and caused some problems. Pre-hospital care by emergency medicine service personnel was complete and effective. 374 patients had positive results for wound culture (42.9%). The most frequent bacteria found in burn wound cultures was coagulase-negative Staphylococcus (66.8%). Blood culture was positive in 12% of the patients with positive burn wound culture and the most frequent bacteria in blood culture was Pseudomonas aeruginosa. The overall mortality rate was 10.6%. Treatment and prevention programmes should target high risk groups. Important criteria include older age, flame burn, presence of inhalation injury, total body surface area burned above 40%, and sepsis.

Human Bone Marrow-derived Mesenchymal Stem Cell: A Source for Cell-Based Therapy

BACKGROUND

The ability of mesenchymal stem cells (MSCs) to differentiate into many cell types, and modulate immune responses, makes them an attractive therapeutic tool for cell transplantation and tissue engineering.

OBJECTIVE

This project was designed for isolation, culture, and characterization of human marrow-derived MSCs based on the immunophenotypic markers and the differentiation potential.

METHODS

Bone marrow of healthy donors was aspirated from the iliac crest. Mononuclear cells were layered over the Ficoll-Paque density-gradient and plated in tissue cultures dish. The adherent cells expanded rapidly and maintained with periodic passages until a relatively homogeneous population was established. The identification of adherent cells and the immune-surface markers was performed by flow cytometric analysis at the third passage. The in vitro differentiation of MSCs into osteoblast and adipocytes was also achieved.

RESULTS

The MSCs were CD11b (CR3), CD45, CD34, CD31 (PCAM-1), CD40, CD80 (B7-1), and HLA-class II negative because antigen expression was less than 5%, while they showed a high expression of CD90, and CD73. The differentiation of osteoblasts, is determined by deposition of a mineralized extracellular matrix in the culture plates that can be detected with Alizarin Red. Adipocytes were easily identified by their morphology and staining with Oil Red.

CONCLUSION

MSCs can be isolated and expanded from most healthy donors, providing for a source of cell-based therapy.

Endothelial Nitric Oxide Synthase Gene T-786C Polymorphism in Renal Transplant Recipients

BACKGROUND

Nitric oxide (NO) is a major mediator in vascular biology, regulating regional blood flow. NO and the enzymes required for its production contribute to ischemia-reperfusion injury. The T-786C functional polymorphism in the promoter region substantially reduces promoter activity of the endothelial nitric oxide synthase (eNOS) gene and compromises endothelial NO synthesis.

OBJECTIVE

To examine the association between T-786C (rs 2070744) single nucleotide polymorphism (SNP) in eNOS gene and the development of acute rejection in renal transplant patients.

METHODS

60 renal transplant recipients (30 with episodes of acute rejection (ARs) and 30 without rejection (non-ARs)), between June 2008 and March 2010, were included in this study. The polymorphism was determined by PCR-restriction fragment-length polymorphism analysis.

RESULTS

The distribution of the genotypes were TT/TC/CC 60%, 33.4%, 6.6%, and 43%, 46.7%, 13.3% in ARs and non-ARs, respectively (p=0.28). The frequency of T-allele was 76.7% and 66.3%; and for C-allele was 66.6% and 33.3% in ARs and non-ARs, respectively (p=0.09). There were no significant associations between these polymorphisms and acute and chronic kidney allograft rejection.

CONCLUSION

We could not detect any significant association between polymorphism in T-786C of eNOS gene and the development of acute rejection.

A basic neural traffic noise prediction model for Tehran's roads

We present an artificial neural network model to predict hourly A-weighted equivalent sound pressure levels (L(Aeq,1h)) for roads in Tehran at distances less than 4 m from the nearside carriageway edge. Our model uses the UK Calculation of Road Traffic Noise (CORTN) approach. Data were obtained from 50 sampling locations near five roads in Tehran at nearside carriageway edge distances of less than 4 m. The data were randomly assigned to training, testing, and holdout subsets. Model training was carried out using the training and testing subsets and comprised 60% and 20% of the data, respectively. Model validation was performed using the remaining 20% of data as a holdout subset. We examine the overall model efficiency using non-parametric tests, such as the Wilcoxon matched-pairs signed-rank test for the training step and the Kolmogorov-Smirnov test for two independent samples for the validation step. Our results indicate that a neural network approach can be applied for traffic noise prediction in Tehran in a statistically sound manner. The Wilcoxon matched-pairs signed-ranks test detects no significant difference between the absolute testing set errors of the developed neural network and a calibrated version of the CORTN model.

Effectiveness of integrative and instrumental reminiscence therapies on depression symptoms reduction in institutionalized older adults: an empirical study

OBJECTIVE

Reminiscence therapy is a psychological intervention which is specifically designed to address issues of particular relevance to older adults, such as depression. The latest approach to the research on therapeutic utility of reminiscence is gaining popularity among researchers and practitioners, and has yielded promising results. Specifying different types of reminiscence is a crucial component of the approach. The aim of this study was to examine the therapeutic effectiveness of integrative and instrumental types of reminiscence for the treatment of depression in institutionalized older adults dwelling in a nursing home.

METHOD

The study employed a three-group pre-post-test design with random allocation to instrumental or integrative reminiscence or an active social discussion control condition. Twenty-nine institutionalized older adults (12 men and 17 women) with depressive symptoms varying from mild to severe constituted the sample. The interventions were implemented in a short-form group format.

FINDINGS

Analysis of changes from pre-test to post-test revealed that integrative reminiscence therapy led to statistically significant reduction in symptoms of depression in contrast with the control group. Although instrumental reminiscence therapy also reduced depressive symptoms, this improvement was not statistically significant compared to the control group.

CONCLUSION

This study provides additional support for the effectiveness of integrative reminiscence therapy as an intervention for depressed older adults living in residential care settings. This study also provides support for the hypothesis that certain types of reminiscence produce their own specific effects.