A straightforward cell culture insert model to incorporate biochemical and biophysical stromal properties into transplacental transport studies

Introduction

The placental extracellular matrix (ECM) dynamically remodels over pregnancy and in disease. How these changes impact placental barrier function is poorly understood as there are limited in vitro models of the placenta with a modifiable stromal compartment to mechanistically investigate these extracellular factors. We developed a straightforward method to incorporate uniform hydrogels into standard cell culture inserts for transplacental transport studies.

Methods

Uniform polyacrylamide (PAA) gels were polymerized within cell culture inserts by (re)using the insert packaging to create a closed, controllable environmental chamber. PAA pre-polymer solution was added dropwise via a syringe to the cell culture insert and the atmosphere was purged with an inert gas. Transport and cell culture studies were conducted to validate the model.

Results

We successfully incorporated and ECM functionalized uniform PAA gels to cell culture inserts enable cell adhesion and monolayer formation. Imaging and analyte transport studies validated gel formation and expected mass transport results and successful cell studies confirmed cell viability, monolayer formation, and that the model could be used transplacental transport studies. Detailed methods and validation protocols are included.

Discussion

It is well appreciated that ECM biophysical and biochemical properties impact cell phenotype and cell signaling in many tissues including the placenta. The incorporation of a PAA gel within a cell culture insert enables independent study of placental ECM biophysical and biochemical properties in the context of transplacental transport. These straightforward and low-cost methods to build three dimensional cellular models are readily adoptable by the wider scientific community.

Regioselective sulfated chitosan produces a biocompatible and antibacterial wound dressing with low inflammatory response

The aim of current study is to tailor chitosan derivate which is water-soluble while presents original biological features of chitosan. For this purpose, the 6-O chitosan sulfate (CS) with naked amine groups was synthesized via regioselective modification of chitosan (C) during which both crosslinking capacity and antibacterial properties of the C were remained intact. This was achieved by sulfation the C under controlled acidic conditions using chlorosulfonic acid/sulfuric acid mixture. Subsequently, a chemically crosslinked hydrogel of the CS was used as a wound dressing substrate. The modified sulfate groups retained the biocompatibility of C and showed antibacterial effects against gram-positive and gram-negative bacteria. In addition, the presence of sulfate groups in the CS chemical structure improved its anticoagulant activity compared to the unmodified C. Both in vitro and in vivo enzyme-linked immunosorbent assay (ELISA) measurements showed that CS had a higher potential to bind and scavenger anti-inflammatory cytokines, including IL-6 and transforming growth factor-β (TGF-β), both of which play critical roles in the early stage of the wound healing process. After treatment of full-thickness wounds with CS hydrogels, the macrophage cells (c.a. 6 × 10⁴ cells) expressed significantly more M2 phenotype markers compared to the C group (4.2 × 10⁴ cells). Furthermore, the CS hydrogel induced better re-epithelialization and vascularization of full-thickness wounds in mice compared to the C hydrogel during 30 days.

[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.

Are Accessible Software Accountable?: A Commentary

Accessible software is increasingly important as the incidence of disability continues to increase and the population ages globally, ensuring people are not left behind in the digital revolution. Likewise, there is increased interest in ensuring software is accountable such that it is clear about the information it uses and the actions that it takes. While there has been some agreed upon definitions for accessible, interpretable, and transparent software, accountable software is lacking a universal definition and methodology. We argue that for a software to be accountable, it must also be accessible, interpretable, and transparent, and provide a methodology for developing accountable software.

Immunoengineering Biomaterials in Cell-Based Therapy for Type 1 Diabetes

Type 1 diabetes (T1D) is caused by low insulin production and chronic hyperglycemia due to the destruction of pancreatic β-cells. Cell transplantation is an attractive alternative approach compared to insulin injection. However, cell therapy has been limited by major challenges including life-long requirements for immunosuppressive drugs in order to prevent host immune responses. Encapsulation of the transplanted cells can solve the problem of immune rejection, by providing a physical barrier between the transplanted cells and the recipient's immune cells. Despite current disputes in cell encapsulation approaches, thanks to recent advances in the fields of biomaterials and transplantation immunology, extensive effort has been dedicated to immunoengineering strategies in combination with encapsulation technologies to overcome the problem of the host's immune responses. The current review summarizes the most commonly used encapsulation and immunoengineering strategies combined with cell therapy which has been applied as a novel approach to improve cell replacement therapies for the management of T1D. Recent advances in the fields of biomaterial design, nanotechnology, as well as deeper knowledge about immune modulation had significantly improved cell encapsulation strategies. However, further progress requires the combined application of novel immunoengineering approaches and islet/ß-cell transplantation.

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.

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 <0.05). No difference was observed between 25 and 50 mg/kg of MET (P>0.05). Tissue MDA levels significantly increased in varicocele rats (p <0.05); however, MET (25, 50, and 100 mg/kg) in a dose-dependent manner decreased varicocele-induced MDA (p <0.05). Experimental varicocele significantly decreased SOD activity, compared to that reported for the control group (p <0.05). The administration of MET (25, 50, and 100 mg/kg) significantly increased tissue SOD activity in varicocele rats (p <0.05). The MET (25, 50, and 100 mg/kg) in a dose-dependent manner increased GPx activity in varicocele rats (p <0.05). There was no difference in MDA, SOD, and GPx levels between 25 and 50 mg/kg MET groups (P>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.

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.

Simulating Public Buses as a Mobile Platform for Deployment of Publicly Accessible Automated External Defibrillators

Introduction: Public access defibrillation (PAD) programs seek to optimize locations of automated external defibrillators (AEDs) to minimize the time from out-of-hospital cardiac arrest (OHCA) recognition to defibrillation. Most PAD programs have focused on static AED (S-AED) locations in high traffic areas; pervasive electronic data infrastructure incorporating real-time geospatial data opens the possibility for AED deployment on mobile infrastructure for retrieval by nearby non-passengers. Performance characteristics of such systems are not known. Hypothesis: We hypothesized that publicly accessible AEDs located on buses would increase publicly accessible AED coverage and reduce AED retrieval time relative to statically located AEDs. Methods: S-AED sites in Pittsburgh, PA were identified and consolidated to 1 AED per building for analysis (n = 582). Public bus routes and schedules were obtained from the Port Authority of Allegheny County. OHCA locations and times were obtained from the Pittsburgh site of the Resuscitation Outcomes Consortium. Two simulations were conducted to assess the characteristics and impact of AEDs located on buses. In Simulation #1, geographic coverage area of AEDs located on buses (B-AEDs) was estimated using a 1/8th mile (201 m) retrieval radius during weekday, Saturday and Sunday periods. Cumulative geographic coverage across each period of the week was compared to S-AED coverage and the added coverage provided by B-AEDs was calculated. In Simulation #2, spatiotemporal event coverage was estimated for historical OHCA events, assuming constraints designed to reflect real world AED retrieval scenarios. Event coverage and AED retrieval time were compared between B-AEDs and S-AEDs across periods of the week and residential/nonresidential spatial areas. Results: Cumulative geographic coverage by S-AEDs was 23% across all periods, assuming uniform access hours. B-AEDs alone versus B-AEDs + S-AEDs covered 20% vs. 34% (weekday), 14% + 30% (Saturday), and 10% + 28% (Sunday). There was no statistically significant difference in 3-minute historical AED accessibility between only B-AEDs and only S-AEDs in standalone deployments (12% vs. 14%). However, when allowing for retrieval of either type of AED in the same scenario, event coverage was improved to 22% (p < 0.001). Conclusion: Deployment of B-AEDs may improve AED coverage but not as a standalone deployment strategy.

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.

Using phone sensors and an artificial neural network to detect gait changes during drinking episodes in the natural environment

BACKGROUND

Phone sensors could be useful in assessing changes in gait that occur with alcohol consumption. This study determined (1) feasibility of collecting gait-related data during drinking occasions in the natural environment, and (2) how gait-related features measured by phone sensors relate to estimated blood alcohol concentration (eBAC).

METHODS

Ten young adult heavy drinkers were prompted to complete a 5-step gait task every hour from 8pm to 12am over four consecutive weekends. We collected 3-axis accelerometer, gyroscope, and magnetometer data from phone sensors, and computed 24 gait-related features using a sliding window technique. eBAC levels were calculated at each time point based on Ecological Momentary Assessment (EMA) of alcohol use. We used an artificial neural network model to analyze associations between sensor features and eBACs in training (70% of the data) and validation and test (30% of the data) datasets.

RESULTS

We analyzed 128 data points where both eBAC and gait-related sensor data were captured, either when not drinking (n=60), while eBAC was ascending (n=55) or eBAC was descending (n=13). 21 data points were captured at times when the eBAC was greater than the legal limit (0.08mg/dl). Using a Bayesian regularized neural network, gait-related phone sensor features showed a high correlation with eBAC (Pearson's r>0.9), and >95% of estimated eBAC would fall between -0.012 and +0.012 of actual eBAC.

CONCLUSIONS

It is feasible to collect gait-related data from smartphone sensors during drinking occasions in the natural environment. Sensor-based features can be used to infer gait changes associated with elevated blood alcohol content.

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.

Adapting the Index of Relative Rurality (IRR) to Estimate Rurality at the ZIP Code Level: A Rural Classification System in Health Services Research

BACKGROUND

Accurate analysis of health problems facing rural residents depends on how rurality is defined. Health services research relies frequently on the rural urban commuting area (RUCA) codes to estimate rurality at the small area level. We modified the county-level Index of Relative Rurality (IRR) to the ZIP code level (IRRZIP ) to create an alternative small-area-level rural classification system. We then compared how the 2 rural classification systems differ in how rural areas and populations are defined and in methodological analysis.

METHODS

We linked data for veterans (n = 37,466) who attended the VA Pittsburgh Healthcare System to 2000 United States Census and the US Department of Agriculture's Economic Research Service data.

RESULTS

The RUCA and the IRRZIP do not consistently classify the same ZIP code areas and populations as rural. Using the IRRZIP , each 10th increment in increased rurality was associated with a 2.6 increased odds of receiving primary care at a satellite clinic.

CONCLUSIONS

The IRRZIP is a straightforward measure that is easy to use and interpret and may be a relevant alternative rural classification system that can be used in health services research.

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.

Childhood abuse affects emotional closeness with family in mid- and later life

OBJECTIVE

Knowledge about the effects of early life adversity on kin relationships in later years is sparse. The purpose of this study was to examine if childhood abuse and adversity negatively influences emotional closeness with family in mid- and later life. A second goal was to determine the role of psychosocial resources and personality traits in buffering the effects of early adversities. Gender and cohort differences were explored to see if men were differentially affected than women and whether middle-aged adults (35-49 years old) were differentially affected than older adults (50-74 years old) by the effects of childhood abuse and adversity.

METHODS

Using retrospective accounts of early family abuse and adversities of 1,266 middle aged adults and 1,219 older adults from a large population-based survey, the National Survey of Midlife Development in United States (MIDUS), separate multiple regression analyses were conducted for the two cohorts to examine the effects of childhood emotional and physical abuse and family adversities on perceived emotional closeness with family. Interaction effects between childhood abuse and adversity (e.g., being expelled from school, death of sibling, parental divorce, losing a home to a natural disaster) with psychosocial resources (perceived control and self acceptance), personality characteristics (extraversion and neuroticism), and gender were examined.

RESULTS

Results of OLS regressions suggest emotional and physical abuse predicted family closeness in middle-aged adults. Conversely, only emotional abuse predicted family closeness in older adults. Moderation models revealed that high levels of self acceptance were associated with better maintenance of emotional closeness among middle-aged adults who were emotionally and physically abused as children. Older adults with lower extraversion who experienced emotional abuse or reported greater number of adversities in childhood were found to be at higher risk for lower emotional closeness with family. Early life adversities were more detrimental for women.

CONCLUSIONS

Findings suggest that the aftermath of childhood abuse does not dissipate with time, but continues to influence family relationships in mid- and later life. Identifying the links between childhood adversities and adult relationships can help identify strategic points for intervention to reduce the long-term effects of accumulated adverse experiences over the life course.

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.

Development of a selective and sensitive flotation method for determination of trace amounts of cobalt, nickel, copper and iron in environmental samples

A simple, selective and rapid flotation method for the separation-preconcentration of trace amounts of cobalt, nickel, iron and copper ions using phenyl 2-pyridyl ketone oxime (PPKO) has been developed prior to their flame atomic absorption spectrometric determinations. The influence of pH, amount of PPKO as collector, type and amount of eluting agent, type and amount of surfactant as floating agent and ionic strength was evaluated on the recoveries of analytes. The influences of the concomitant ions on the recoveries of the analyte ions were also examined. The enrichment factor was 93. The detection limits based on 3 sigma for Cu, Ni, Co and Fe were 0.7, 0.7, 0.8, and 0.7 ng mL(-1), respectively. The method has been successfully applied for determination of trace amounts of ions in various real samples.