Rapid determination of hippuric acid as an exposure biomarker of toluene using a colorimetric assay and comparison with high-performance liquid chromatography

Occupational exposure to toluene is associated with health risks that require reliable monitoring methods. Hippuric acid (HA), a urinary metabolite of toluene, serves as a valuable biomarker for such exposure. Colorimetric methods for the quantitative determination of HA have gained prominence due to their simplicity, cost-effectiveness, and suitability for field application. In the present study, a simple colorimetric technique was optimized for the determination of HA in the urine sample, and compared with a usual HPLC technique. The central composite design (CCD) was applied to examine the effective parameters on the colorimetric determination of HA. The calibration curve for HA was established within the concentration range of 6 to 100 mg L-1 with R2 = 0.97. The detection limit (LOD) and quantification limit (LOQ) were determined to be 1.8 mg L-1 and 6 mg L-1 respectively. The relative standard deviation (RSD%) was less than 5%, and the recovery% (R%) was 90.5-100.1. The overall results showed good agreement between the colorimetric and HPLC results. There was a significant relationship between the results obtained from HPLC and colorimetric methods especially for higher concentration levels of HA (≥ 500 mg/g creatinine). In conclusion, our optimized colorimetric method is a simple, cost-effective, and rapid method for determination of HA in occupational exposure, which is comparable with the HPLC technique.

The mediating role of hope in the relation between uncertainty and social support with self-management among patients with ESKD undergoing hemodialysis

BACKGROUND

Self-management behaviours are critical for patients requiring regular hemodialysis (HD) therapy. This study aimed to test the relationship between social support, uncertainty and self-management among HD patients and to explore whether hope plays a mediating role.

METHODS

In a cross-sectional study, a convenience sample of 212 HD patients from two hospitals completed the Perceived Social Support Scale (PSSS), Herth Hope Index (HHI), Short form Mishel Uncertainty in Illness Scale (SF-MUIS), and hemodialysis Self-Management Instrument (HD-SMI). Data were analysed using structural equation modelling.

RESULTS

The main finding indicated that social support positively affected self-management (β = 0.50, t = 4.97, p < 0.001), and uncertainty negatively affected self-management (β =-0.37, t=-4.12, p = < 0.001). In mediational model analysis, the effect of social support on self-management was fully mediated [(β = 0.12; 95% BC CI (0.047, 0.228)] by hope. Also, the effect of uncertainty on self-management was fully mediated [(β=- 0.014; 95% BC CI (-0.114, -0.003)] by hope.

CONCLUSIONS

"Considering factors influencing self-management in HD patients is crucial for improving quality of life. Receiving support and informational resources can not only foster hope but also reduce their uncertainty, thus aiding in enhancing clinical outcomes, quality of life, and reducing complications. "Health care providers, especially nurses were advised to accept the existence of uncertainty, help patients make optimal use of support resources, and give more importance to disambiguation to reassure them. Therefore, well-designed interventions that enhance social support and hope and reduce uncertainty may help improve self-management behaviour in HD patients.

Clinical perspective: Antibody-drug conjugates for the treatment of HER2-positive breast cancer

Antibody-drug conjugates (ADCs) are a promising class of cancer biopharmaceuticals that exploit the specificity of a monoclonal antibody (mAb) to selectively deliver highly cytotoxic small molecules to targeted cancer cells, leading to an enhanced therapeutic index through increased antitumor activity and decreased off-target toxicity. ADCs hold great promise for the treatment of patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer after the approval and tremendous success of trastuzumab emtansine and trastuzumab deruxtecan, representing a turning point in both HER2-positive breast cancer treatment and ADC technology. Additionally and importantly, a total of 29 ADC candidates are now being investigated in different stages of clinical development for the treatment of HER2-positive breast cancer. The purpose of this review is to provide an insight into the ADC field in cancer treatment and present a comprehensive overview of ADCs approved or under clinical investigation for the treatment of HER2-positive breast cancer.

The potential of HEART score to detect the severity of coronary artery disease according to SYNTAX score

Clinical scoring systems such as the HEART score can predict major adverse cardiovascular events, but they cannot be used to demonstrate the degree and severity of coronary artery disease. We investigated the potential of HEART Score in detecting the existence and severity of coronary artery disease based on SYNTAX score. This multi-centric cross-sectional study investigated patients referred to the cardiac emergency departments of three hospitals between January 2018 and January 2020. Data including age, gender, risk factors, comorbidities, 12-lead ECG, blood pressure and echocardiogram were recorded for all the participants. Serum troponin I level was measured on admission and 6 h later. Coronary angiography was done via the femoral or radial route. HEART and SYNTAX scores were calculated for all patients and their association was assessed. 300 patients (65% female) with mean age of 58.42 ± 12.42 years were included. mean HEART Score was 5.76 ± 1.56 (min = 3, max = 9), and mean SYNTAX score was 14.82 ± 11.42 (min = 0, max = 44.5). Pearson correlation coefficient was 0.493 between HEART Score and SYNTAX score which was statistically significant (P < 0.001). We found that HEART Score of more than 6 is 52% sensitive and 74.7% specific to detect extensive coronary artery involvement (SNTAX score ≥ 23). The present study showed that the HEART score has a moderate and positive correlation with the SYNTAX score and HEART score with a cut-off value of 6 is a predictor for SYNTAX score of ≥ 23.

Metabolomics for exposure assessment and toxicity effects of occupational pollutants: current status and future perspectives

INTRODUCTION

Work-related exposures to harmful agents or factors are associated with an increase in incidence of occupational diseases. These exposures often represent a complex mixture of different stressors, challenging the ability to delineate the mechanisms and risk factors underlying exposure-disease relationships. The use of omics measurement approaches that enable characterization of biological marker patterns provide internal indicators of molecular alterations, which could be used to identify bioeffects following exposure to a toxicant. Metabolomics is the comprehensive analysis of small molecule present in biological samples, and allows identification of potential modes of action and altered pathways by systematic measurement of metabolites.

OBJECTIVES

The aim of this study is to review the application of metabolomics studies for use in occupational health, with a focus on applying metabolomics for exposure monitoring and its relationship to occupational diseases.

METHODS

PubMed, Web of Science, Embase and Scopus electronic databases were systematically searched for relevant studies published up to 2021.

RESULTS

Most of reviewed studies included worker populations exposed to heavy metals such as As, Cd, Pb, Cr, Ni, Mn and organic compounds such as tetrachlorodibenzo-p-dioxin, trichloroethylene, polyfluoroalkyl, acrylamide, polyvinyl chloride. Occupational exposures were associated with changes in metabolites and pathways, and provided novel insight into the relationship between exposure and disease outcomes. The reviewed studies demonstrate that metabolomics provides a powerful ability to identify metabolic phenotypes and bioeffect of occupational exposures.

CONCLUSION

Continued application to worker populations has the potential to enable characterization of thousands of chemical signals in biological samples, which could lead to discovery of new biomarkers of exposure for chemicals, identify possible toxicological mechanisms, and improved understanding of biological effects increasing disease risk associated with occupational exposure.

Comparison of the fracture resistance of the teeth prepared with ProTaper Universal, ProTaper Next, and ProTaper Gold rotary files

OBJECTIVES

Root canal preparation can lead to cracks on the roots by creating stresses on the root canal walls, which decreases the fracture resistance of the tooth. The present study compared the fracture resistance of the teeth prepared by the ProTaper Universal (PTU), ProTaper Next (PTN), and ProTaper Gold (PTG) rotary file systems.

MATERIALS AND METHODS

Fifty-six single-canal premolar teeth were sectioned 14 mm from the root apex. The roots were standardized based on the buccolingual and mesiodistal diameter and randomly assigned to three experimental (n = 14) and one control group (n = 14). The teeth in three experimental groups were instrumented with PTU, PTN, and PTG rotary files. The roots in the control group were not instrumented. A vertical force was applied to each root in a universal testing machine until the root fractured. The data were statistically analyzed by one-way analysis of variance.

RESULTS

There was no significant difference in the fracture resistance of the teeth between the control, PTU, PTN, and PTG groups (p = .115).

CONCLUSIONS

Root canal preparation with ProTaper files manufactured with conventional NiTi (PTU) and heat-treated alloys (PTN and PTG) did not affect the fracture resistance of teeth.

Evaluation of oxidative stress and biochemical biomarkers, and psychological parameters in cement plant workers

The cement industry is one of the main world industries with exposure to a wide range of hazardous chemical and physical occupational agents that may increase free radicals and lead to disease. The aim of this study was to evaluate oxidative stress, biochemical markers, and psychological parameters among cement plant workers. In this cross-sectional study, 40 workers exposed to cement and 40 office employees were selected as the exposed and non-exposed groups, respectively. Exposure to cement dust, silica, and noise were, respectively, assessed using the NIOSH 0600, NIOSH 7601, and noise dosimetry methods. Oxidative stress biomarkers including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), total antioxidant capacity (TAC), and biochemical parameters were measured in the serum of all participants. Depression, anxiety, and stress were assessed by the Depression Anxiety Stress Scales (DASS-21) questionnaire. The results demonstrated that the level of MDA as a marker of oxidative stress was significantly higher in the exposed group. The level of antioxidant enzymes including SOD and CAT were also significantly higher in the exposed group. The level of TAC was lower in the exposed group, but the difference was not statistically significant. The levels of alkaline phosphatase (ALP), aspartate transaminase (AST), and the scores of depression and stress were also significantly higher in the exposed group. According to our results, noise, cement dust, and silica exposure were associated with oxidative stress, and this may be one of the mechanisms in which they adversely affect liver function and mental health.

Compliance with Antibiotics Prophylaxis Guideline in Surgical Patients in ICUs of a Teaching Referral Hospital

Antimicrobial prophylaxis used for surgical procedures remains one of the measures for the prevention of surgical site infections (SSIs). The present study was designed to assess the compliance with clinical practice guideline for antimicrobial prophylaxis in variable surgeries conducted in the intensive care units (ICUs) of a major referral hospital. This cross-sectional investigation was carried out by prospective data collected from October 2017 to March 2018 in the intensive care unit (ICU) of Nemazi hospital in Shiraz. Demographic characteristics, surgery type as well as antibiotic treatment were gathered from medical records and entered in data collection forms. We reviewed compliance and adherence of prophylactic antibiotic administration to the Infectious Diseases Society of America (IDSA) guideline and evaluated the courses of antimicrobial drugs. If an antibiotic administrated for surgical prophylaxis was different from the guideline, the antibiotic was classified as non-guideline-based antibiotics. Most patients participated in this study were male (64.5%). Only 8.75% of the administrated antibiotics chosen for surgical prophylaxis were found to be appropriate antibiotic prescriptions; however, those patients receiving appropriate antibiotics prescribed an inappropriate dosage. In addition, the antibiotics were administrated with inappropriate durations in all cases. Our findings indicated that adherence to the IDSA international guideline seems to be far from ideal in Namazi hospital for antimicrobial prophylaxis, resulting in the unsuitable administration of a wide variety of antibiotics.

Evaluation of the effect of sofosbuvir and daclatasvir in hospitalized COVID-19 patients: a randomized double-blind clinical trial (DISCOVER)

Background

The combination of sofosbuvir and daclatasvir has shown preliminary efficacy for hospitalized patients with COVID-19 in four open-label studies with small sample sizes. This larger trial aimed to assess if the addition of sofosbuvir/daclatasvir to standard care improved clinical outcomes in hospitalized patients with COVID-19.

Methods

This was a placebo-controlled, double-blind, randomized clinical trial in adults hospitalized with COVID-19 at 19 hospitals in Iran. Patients were randomized to oral sofosbuvir/daclatasvir 400/60 mg once-daily or placebo in addition to standard of care. Patients were included if they had positive PCR or diagnostic chest CT, O₂ saturation <95% and compatible symptoms. The primary outcome was hospital discharge within 10 days of randomization. Secondary outcomes included mortality and time to clinical events. The trial is registered on the Iran Registry of Clinical Trials under IRCT20200624047908N1.

Results

Between July and October 2020, 1083 patients were randomized to either the sofosbuvir/daclatasvir arm (n = 541) or the placebo arm (n = 542). No significant difference was observed in the primary outcome of hospital discharge within 10 days, which was achieved by 415/541 (77%) in the sofosbuvir/daclatasvir arm and 411/542 (76%) in the placebo arm [risk ratio (RR) 1.01, 95% CI 0.95–1.08, P = 0.734]. In-hospital mortality was 60/541 (11%) in the sofosbuvir/daclatasvir arm versus 55/542 (10%) in the placebo arm (RR 1.09, 95% CI 0.77–1.54, P = 0.615). No differences were observed in time to hospital discharge or time to in-hospital mortality.

Conclusions

We observed no significant effect of sofosbuvir/daclatasvir versus placebo on hospital discharge or survival in hospitalized COVID-19 patients.

Does Size Affect the Rate of Perforation? A Cross-sectional Study of Medical Gloves

OBJECTIVES

Healthcare workers often have unnoticed minor abrasions on their hands, putting them at risk of contracting infectious diseases from patients, if the integrity of the medical gloves is compromised. This study aimed to compare the rate and location of glove perforation between well-fitted and ill-fitted gloves.

METHODS

The participants of this cross-sectional study were 45 midwives in the maternity ward of a hospital in Shiraz city, Iran. A total of nine pairs of medical gloves including three pairs of fit size, three pairs of gloves with one size smaller (tight), and three pairs of gloves with one size larger (loose) were given to subjects, and asked them to use the gloves during episiotomy repair operations. After completing the task, all gloves were collected safely and gloves perforation was investigated based on water test (NF EN 455-1).

RESULTS

The perforation rate of the fit, tight, and loose medical gloves was 20, 37.78, and 34.81%, respectively. The results showed a significant difference between glove perforation of different glove sizes (P < 0.05). In general, there was a significant difference between the perforation rate of the fit glove and ill-fitted gloves (P = 0.013).

CONCLUSIONS

Wearing the wrong size gloves may increase the glove perforation rate. Providing a wide range of glove sizes by the hospital management, and choosing the best glove size can be very effective in reducing the glove perforation and increasing safety for healthcare workers and patients.

Health risk assessment of occupational exposure to heavy metals in a steel casting unit of a steelmaking plant using Monte-Carlo simulation technique

The present work aimed to evaluate the health risks of occupational exposure to heavy metals in a steel casting unit of a steel plant. To determine occupational exposure to heavy metals, personal air samples were taken from the workers' breathing zones using the National Institute for Occupational Safety and Health method. Noncancer and cancer risks due to the measured metals were calculated according to the United States Environmental Protection Agency procedures. The results indicated that the noncancer risks owing to occupational exposure to lead (Pb) and manganese were higher than the recommended value in most of the workstations. The estimated cancer risk of Pb was also higher than the allowable value. Moreover, the results of sensitivity analysis indicated that the concentration, inhalation rate, and exposure duration were the most influencing variables contributing to the calculated risks. It was thus concluded that the present control measures were not adequate and further improvements were required for reducing the exposure levels.

The hierarchy of preventive measures to protect workers against the COVID-19 pandemic: A review

BACKGROUND

The high spread rate of coronaviruses, specifically severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has raised concerns about the spread of the disease in crowded occupational environments. The risk of occupational exposure to coronavirus depends on the type of industry and the nature of work. Currently, most countries are working for reactivating their economies and need to improve working conditions for a safe situation during the COVID-19 pandemic.

OBJECTIVE

The present work aimed to investigate the current engineering and administrative control measures, which are necessary to protect workers against COVID-19 in workplaces.

METHODS

The current strategies, including engineering control, administrative control, personal protective equipment, and their efficiencies, were reviewed and discussed.

RESULTS

Reviewing the literature indicated that a collection of control approaches should be implemented for an effective control of the virus. Control measures could be selected based on the risk of exposure to COVID-19. The results also revealed that relying solely on a specific control measure could not effectively control the outbreak.

CONCLUSION

In conclusion, employers and health professionals must continually monitor international and local guidelines to identify changes in recommendations to make their workplaces safer. Establishment of an expert team in any workplace for the implementation of more effective control measures is warranted, as well.

Probabilistic health risk assessment of occupational exposure to isoflurane and sevoflurane in the operating room

Risk assessment is an important tool in predicting the possible risk to health. It heightens awareness by estimating the probability of adverse health effects in humans who are exposed to chemicals in the course of their work. Therefore, the present work aims to determine the occupational exposure of operating room staff to the volatile anesthetic gases, isoflurane and sevoflurane, and estimates non-cancer risk using the United States Environmental Protection Agency method. Air samples from the breathing zone of staff members were collected using the Occupational Safety and Health Administration Method 103 and analyzed using gas chromatography-mass spectroscopy. The results indicate that the measured concentrations of isoflurane and sevoflurane are below the National Institute of Occupational Safety and Health standard (2 ppm) for technicians and nurses, but not for anesthesiologists and surgeons. Moreover, the estimated non-cancer risk due to isoflurane is above the acceptable value for anesthesiologists (but acceptable for other occupational categories). A sensitivity analysis indicates that exposure time has the most effect on calculated risk (53.4%). Occupational exposure to anesthetic gases may endanger the health of operating room personnel. Therefore, control measures, such as daily testing of anesthetic devices, ensuring the effectiveness of ventilation systems, advanced scavenging methods, and regular training of staff are highly recommended.

N-doped mesoporous carbon as a new sorbent for ultrasonic-assisted dispersive micro-solid-phase extraction of 1-naphthol and 2-naphthol, the biomarkers of exposure to naphthalene, from urine samples

This study aimed to optimize a new sample preparation method using N-doped mesoporous carbon sorbent for simultaneous measurement of 1-naphthol and 2-naphthol, the biomarkers of exposure to naphthalene. The samples were analyzed using high-performance liquid chromatography supplied with ultraviolet detector (HPLC-UV). N-doped mesoporous carbon sorbent was obtained via the hard template procedure. The synthesized nanosorbent was then characterized by transmission electron microscopy (TEM), Brunauer-Emmett-Teller (BET), and elemental analysis (CHN). The effective factors in the extraction of the studied biomarkers were examined by the Box-Behnken (BBD) methodology. Regarding the optimum conditions, the sketched calibration curve for naphthols was linear in the concentration levels of 1-600 µg L^-1 for human urine samples. The accuracy and reproducibility of the introduced method were determined using the relative recovery (RR %) and relative standard deviation (RSD %) tests on the fortified urine samples. RR% and RSD% were found to be 97.0-101.2% and 3.1-9.0%, respectively. The calculated method detection limit of the optimized procedure was 0.3 µg L^-1 and 0.5 µg L^-1 for 1-naphthol and 2-naphthol, respectively.

Training through fit test and its role in knowledge, attitude and performance of workers regarding respiratory protective equipment: a case study in a petrochemical company

Background. Providing workers with respiratory protective equipment (RPE) is not enough to protect them. RPE should be selected correctly, worn properly and fitted adequately. The aim of the present study was to assess the effect of training through fit test (TTFT) on knowledge, attitude and performance (KAP) of workers regarding a respiratory protection program. Methods. This cross-sectional study was conducted on 110 respirator users in a petrochemical wastewater treatment plant. A structured questionnaire was developed to assess the KAP of workers before any intervention. After that, all participants were trained with a 15-min video-based training intervention and then the qualitative fit test was performed. Participants who failed in the fit test were retrained and the test was repeated. To assess the effect of TTFT, the KAP questionnaire was completed after 3 months. SPSS version 22.0 was used to analyze data. Results. There was a significant difference between knowledge, attitude and some of the unsafe behavior before and after TTFT. There was no person with a poor or very poor knowledge status after TTFT. Conclusion. TTFT could improve some unsafe behaviors associated with the user seal check. Moreover, TTFT could be considered an opportunity to improve workers' KAP regarding RPE.

Effect of palliative care training on perceived self-efficacy of the nurses

Background

Nurses are involved in providing end-of-life care for end stage individuals and their self-efficacy is one of the key factors bearing on such care. The purpose of this study was to determine the effect of palliative care on perceived self-efficacy of the nurses.

Methods

This is a quasi-experimental study with pretest-posttest design. Sampling was randomized and included 40 individuals. The intervention consisted of palliative care training for four sessions, each lasting 45 min. Data were collected using demographic and perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed by SPSS 16 software using descriptive and inferential statistics.

Results

The mean age of the participants was 38.6 and their work experience was 14.25 years. The majority of the participants were female (85%) and had a bachelor level of education (92.5%). The findings showed that “perceived self-efficacy”, “psychosocial support” and “symptom management” improved significantly after intervention (p < 0.05).

Conclusion

Based on the results, palliative care education has the potential to increase nurses’ perceived self-efficacy. Since all members of the health care team Including nurses play an important role in providing palliative care, nursing managers can take an effective step to maximize the capacity of nurses by planning and supporting training in this regard.

Ultrasound-assisted dispersive micro-solid-phase extraction based on N-doped mesoporous carbon and high-performance liquid chromatographic determination of 1-hydroxypyrene in urine samples

In this research, a new ultrasound-assisted dispersive micro-solid-phase extraction method based on N-doped mesoporous carbon sorbent followed by high-performance liquid chromatography equipped with diode array detector for trace measurement of 1-hydroxypyrene as a metabolite of exposure to polycyclic aromatic hydrocarbons was optimized. Herein, the hard template method was used for the preparation of N-doped mesoporous carbon sorbent. The prepared sorbent was characterized using the Brunauer-Emmett-Teller method, transmission electron microscopy, and elemental analysis. Parameters affecting the extraction of the target metabolite were investigated using the Box-Behnken design method. Considering optimum parameters, the plotted calibration curve for 1-hydroxypyrene was linearly correlated with the concentration span of 0.1-50 μg/L for urine media. The accuracy of the optimized procedure was examined through the relative recovery tests on the fortified urine specimens. The relative recoveries fell between 95 and 101%. The method detection limit of the proposed procedure was also calculated to be 0.03 μg/L.

Materials and manufacturing perspectives in engineering heart valves: a review

Valvular heart diseases (VHD) are a major health burden, affecting millions of people worldwide. The treatments for such diseases rely on medicine, valve repair, and artificial heart valves including mechanical and bioprosthetic valves. Yet, there are countless reports on possible alternatives noting long-term stability and biocompatibility issues and highlighting the need for fabrication of more durable and effective replacements. This review discusses the current and potential materials that can be used for developing such valves along with existing and developing fabrication methods. With this perspective, we quantitatively compare mechanical properties of various materials that are currently used or proposed for heart valves along with their fabrication processes to identify challenges we face in creating new materials and manufacturing techniques to better mimick ​the performance of native heart valves.

Using fuzzy logic approach to predict work-related musculoskeletal disorders among automotive assembly workers

Background: Musculoskeletal disorders (MSDs) are considered an important health concern, particularly in automotive assembly industries. Evaluation of the effects of all MSDs risk factors is difficult due to its multifactorial nature. In addition, the risk factors cannot be detected accurately when they are only based on individual opinions. Thus, in this study, fuzzy logic tool was used to evaluate the combined effects of all risk factors on MSDs.

Methods: This cross sectional study was conducted on 100 male workers in an automotive industry. Job satisfaction, job stress, job fatigue, and body posture were evaluated by a self-reported questionnaire. Body posture was evaluated using Rapid Entire Body Assessment (REBA). Primary data analysis on extracting the input variables of MATLAB was performed by SPSS 22, with a significant level of 0.05. T test, one-way Anova, and Pearson correlation analysis were used to extract the input variables for the fuzzy logic model. The results obtained from the Nordic questionnaire was selected as the output of the fuzzy model. Fuzzy logic assessment was performed using MATLAB software version 7.0.

Results: There were significant differences between WMSDs factors, including job fatigue, strain, working posture, and the REBA final score, and pain in all limbs of the body (p<0.05). A significant difference was also found between working posture with wrist score (p<0.05). The findings on defuzzification showed a strong correlation between real and modelling results.

Conclusion: The results showed that many factors such as posture, fatigue, and strain affect MSDs. Based on the obtained results, all categories of risk factors, including personal, psychosocial, and occupational, should be considered to predict MSDs, which can be achieved by a modeling approach.

Single-walled and multiwalled carbon nanotubes induce oxidative stress in isolated rat brain mitochondria

Single-walled carbon nanotubes (SWCNTs) and multiwalled carbon nanotubes (MWCNTs) are broadly applicable across a variety of industrial fields. Despite their usefulness in many different applications, oxidative stress-induced toxicity of SWCNTs and MWCNTs has not been widely investigated. The present study examined the effects of SWCNTs and MWCNTs on rat brain mitochondria using the 3,4 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay and indices of reactive oxygen species (ROS), based on measurements of malondialdehyde (MDA), glutathione (GSH), and mitochondrial membrane potential. Based on the MTT assay, exposure to SWCNTs and MWCNTs decreased mitochondrial survival and viability in a dose-dependent manner. Findings also indicated that MWCNTs and SWCNTs could damage mitochondrial membranes and induce the formation of ROS, as indicated by increased levels of MDA and decreased GSH content. The results of this study suggest that SWCNTs and MWCNTs likely damage brain tissue mitochondria by increasing oxidative stress and possibly activating the apoptosis pathway as well as other pathways of cytotoxicity.

Morphology of maxilla in patients with palatally displaced canines

OBJECTIVES

The aim of this study was to investigate the possible relationship between the morphology of maxilla and the palatally displaced canines (PDC).

MATERIALS AND METHODS

In this cross-sectional study, there were 101 patients (45 males, 56 females) aged 12 to 16years, referred to Hamadan school of dentistry in 2014. They were divided into 3 groups: the bilateral PDC (PDCb) group (male=15, female=21), the unilateral PDC (PDCu) group (male=16, female=19), and the control group (male=14, female=16). Five morphology related variables including intermolar width, maxillary arch length, palatal vault depth, palatal intermolar area, and nasal width were measured using CBCT images with Dolphin Imaging software, version 11.5. Statistical analysis was performed with ANOVA and the Dunnett test using SPSS software, version 16.0.

RESULTS

Only the palatal intermolar area and the palatal vault depth values were significantly less in the PDCu and the PDCb groups than those in the control group (the palatal intermolar area: 376.17, 381.93, and 423.75mm², the palatal vault depth: 13.19, 13.42, and 14.59mm; respectively; P<0.05). For all the variables, there was no statistically significant difference between the PDCu and PDCb groups.

CONCLUSION

Decreased palatal vault depth and palatal intermolar area may be correlated with greater chance of palatal displacement of canines. Future prospective studies in mixed dentition patients are needed as a predictive factor to find the probability of PDC.

Comparing the Effectiveness of Three Ergonomic Risk Assessment Methods-RULA, LUBA, and NERPA-to Predict the Upper Extremity Musculoskeletal Disorders

Background:

Musculoskeletal disorders are a major problem in all jobs. Several methods are available for assessing the exposure to risk factors associated with musculoskeletal disorders. This study is aimed at comparing three different ergonomic risk assessment methods—rapid upper limb assessment (RULA), loading on the upper body assessment (LUBA), and new ergonomic posture assessment (NERPA) method—to predict upper extremity musculoskeletal disorders.

Materials and Methods:

The study was conducted on 210 workers from three different industries including pharmaceutical, automotive, and assembly in the Isfahan province. A Nordic questionnaire was used for determining the levels of musculoskeletal disorders. Then, selected postures were evaluated with RULA, LUBA, and NERPA methods. Finally, data were analyzed with Kolmogorov–Smirnov test to check the normality distribution of data, Spearman's correlation test to investigate the correlation between the assessed levels with musculoskeletal disorders, and Wilcoxon test to identify significant differences between the values with SPSS version 16.

Results:

Wilcoxon test revealed a significant difference between the values related to NERPA and RULA (P < 0.001), whereas no significant relation between LUBA and RULA was shown by this test (P = 0.914). The correlation coefficients of the musculoskeletal disorders' level with RULA level, NERPA level, and LUBA level were 0.74, 0.73, and 0.69, respectively.

Conclusion:

Low-risk levels in NERPA, medium-risk levels in LUBA, and high-risk levels in RULA are evaluated better. The results showed that RULA was the best method for assessing musculoskeletal disorders among the three methods.

An assessment of the stressors and ways of coping in Iranian medical sciences students

Background:

Several studies have reported that medical sciences students are usually dealing with severe stress. However, no study is available on ways of coping in medical sciences students in Iran. As socio-cultural factors may affect the students’ responses toward stress, this study aimed to investigate the stressors and ways of coping among students of Guilan University of Medical Sciences (GUMS).

Materials and Methods:

A cross-sectional study was conducted on 487 randomly selected students in GUMS in 2012. The student stress scale and Lazarus ways of coping scale were used for data collection. Descriptive statistics were calculated. Also, Chi-square and Fisher's exact tests, Kruskal–Wallis and Mann–Whitney U tests, and logistic regression analysis were utilized for data analysis. cross-sectional study was conducted on 487 randomly selected students in GUMS in 2012. The student stress scale and Lazarus ways of coping scale were used for data collection. Descriptive statistics were calculated. Also, Chi-square and Fisher's exact tests, Kruskal–Wallis and Mann–Whitney U tests, and logistic regression analysis were utilized for data analysis.

Results:

In the majority of students (61.4%), interpersonal factors were the dominant stressor. Most of the students used problem-focused ways of coping (79.7%). Chi-square test showed a significant relationship between gender and ways of coping (P = 0.03).

Conclusions:

Interpersonal sources of stress were the most common stressors among the medical sciences students. Establishing workshops on communication skills and effective counseling system are suggested.

A sugar-based phase-transitioning delivery system for bone tissue engineering

Bone tissue engineering approaches commonly involve the delivery of recombinant human bone morphogenetic proteins (rhBMPs). However, there are limitations associated with the currently used carriers, including the need for surgical implantation and the associated increase in infection risk. As an alternative to traditional porous collagen sponge, we have adopted a solution of the injectable sucrose acetate isobutyrate (SAIB) as a carrier for rhBMP-2. The ability to deliver rhBMP-2 and other agents by injection reduces the infection risk and lesion size whilst in surgery, with the potential to avoid open surgery altogether in some indications. The primary methodology used for this in vivo study was a C57BL6/J mouse ectopic bone formation model. Specimens were examined by x-ray, microCT, and histology at 3 weeks. SAIB was delivered non-invasively and produced up to 3-fold greater bone volume compared to collagen. To further refine and improve upon the formulation, SAIB containing rhBMP-2 was admixed with candidate compounds including ceramic microparticles, anti-resorptives, and cell signalling inhibitors and further tested in vivo. The formulation combining SAIB/rhBMP-2, the bisphosphonate zoledronic acid (ZA), and hydroxyapatite (HA) microparticles yielded a 10-fold greater bone volume than SAIB/rhBMP-2 alone. To investigate the mechanism underlying the synergy between ZA and HA, we used in vitro binding assays and in vivo fluorescent biodistribution studies to demonstrate that ceramic particles could bind and sequester the bisphosphonate. These data show the utility of SAIB as a non-invasive rhBMP delivery system as well as describing an optimised formulation for bone tissue engineering.

The effect of propolis as a biological storage media on periodontal ligament cell survival in an avulsed tooth: an in vitro study

OBJECTIVE

Both the length of extra-alveolar time and type of storage media are significant factors that can affect the long-term prognosis of replanted teeth. This study aims to compare propolis 50%, propolis 10%, Hank's balanced salt solution (HBSS), milk and egg white on periodontal ligament (PDL) cell survival for different time points.

MATERIALS AND METHODS

: In this in vitro experimental study, we divided 60 extracted teeth without any periodontal diseases into five experimental and two control groups that consisted each experimental group with 10 and each control group with 5 teeth. The storage times were one and three hours for each media. The controls corresponded to 0-minute (positive) and 12-hour (negative) dry time. Rinsing in the experimental media, the teeth were treated with dispase and collagenase for one hour. Cell viability was determined by using trypan blue exclusion. Statistical analysis of the data was accomplished by using two-way analysis of variance (ANOVA) complemented by the Tukey's HSD post-hoc.

RESULTS

Within one hour, there was no significant difference between the two propolis groups, however these two groups had significantly more viable PDL cells compared to the other experimental media (p<0.05). The results of the three-hour group showed that propolis 10% was significantly better than egg white, whereas both propolis 10% and 50% were significantly better than milk (p<0.05).

CONCLUSION

Based on PDL cell viability, propolis could be recommended as a suitable biological storage media for avulsed teeth.

Improving the bioactivity of bioglass/ (PMMA-co-MPMA) organic/inorganic hybrid

Binary system of CaO-SiO(2) glasses enables the apatite formation in simulated body fluid (SBF). However, the presence of phosphate content in SiO(2)-CaO-P(2)O(5) glasses leads to the formation of orthophosphate nanocrystalline nuclei, which facilitates the generation of carbonate hydroxyapatite; this compound is more compatible with natural bone. The brittle and less flexible properties of bioactive glasses are the major obstacle for their application as bone implant. The hybridization of essential constituents of bioactive glasses and glass-ceramics with polymers such as PMMA can improve their poor mechanical properties. The aim of this study was to improve the bioactivity of nanocomposites fabricated from poly(methyl metacrylate) (PMMA) and bioglass for bone implant applications. Bioglass compounds with various phosphate contents were used for the preparation of PMMA/bioglass hybrid matrices. Since the lack of adhesion between the two phases impedes the homogenous composite formation, a silane coupling agent such as 3-(trimethoxysilyl)propyl methacrylates (MPMA) was incorporated into the polymer structure. The effect of addition of MPMA on the molecular structure of composite was investigated. Furthermore, the presence of MPMA in the system improved the homogeneity of sample. Increasing phosphate content in the inorganic segment of hybrid up to 10 mol% resulted in the formation of apatite layer on the surface; hence the hybrid was bioactive and suitable candidate for bone tissue engineering.

Immunomodulatory activities of chitin microparticles on Leishmania major-infected murine macrophages

BACKGROUND

Chitin microparticles (CMPs) are found to be potent macrophage stimulators; however, their immunomodulatory effects on the parasite-infected macrophages have not yet been studied. To address this issue, we used a Leishmania major-infected murine macrophage model and characterized the regulatory effects of CMPs on the parasite-infected cells.

METHODS

Mouse peritoneal macrophages were prepared and infected with L. major (MRHO/IR/1975/ER) standard strain. Following cell treatment with CMPs (500 μg/mL) for 48 h, percent of infected macrophages was determined by Giemsa staining and compared with untreated cells. To find the potential mechanisms of the activity of CMPs, TNF-α and accumulated nitrite in the culture supernatants of the treated and untreated cells were also measured by ELISA and colorimetric Griess assays, respectively.

RESULTS

According to the obtained results, chitin microparticles reduced the ex vivo parasite infectivity by ∼12%. However, this inhibitory effect was not directly related to the increased biosynthesis and release of nitric oxide (NO) by macrophages. Instead, we observed a significant increase in the level of TNF-α secretion due to cell treatment with CMPs. Interestingly, this overexpression of TNF-α did not impair cell viability, suggesting the anti-apoptotic effects of the CMPs.

CONCLUSIONS

These findings show that chitin microparticles have immunomodulatory effects on L. major-infected macrophages and further provide motivations for future studies on their in vivo effects.

Inhibition of microglial and astrocytic inflammatory responses by the immunosuppressant mycophenolate mofetil

AIMS

Nucleotide depletion induced by the immunosuppressant mycophenolate mofetil (MMF) has been shown to exert neuroprotective effects. It remains unclear whether nucleotide depletion directly counteracts neuronal demise or whether it inhibits microglial or astrocytic activation, thereby resulting in indirect neuroprotection.

METHODS

Effects of MMF on isolated microglial cells, astrocyte/microglial cell co-cultures and isolated hippocampal neurones were analysed by immunocytochemistry, quantitative morphometry, and elisa.

RESULTS

We found that: (i) MMF suppressed lipopolysaccharide-induced microglial secretion of interleukin-1β, tumour necrosis factor-α and nitric oxide; (ii) MMF suppressed lipopolysaccharide-induced astrocytic production of tumour necrosis factor-α but not of nitric oxide; (iii) MMF strongly inhibited proliferation of both microglial cells and astrocytes; (iv) MMF did not protect isolated hippocampal neurones from excitotoxic injury; and (v) effects of MMF on glial cells were reversed after treatment with guanosine.

CONCLUSIONS

Nucleotide depletion induced by MMF inhibits microglial and astrocytic activation. Microglial and astrocytic proliferation is suppressed by MMF-induced inhibition of the salvage pathway enzyme inosine monophosphate dehydrogenase. The previously observed neuroprotection after MMF treatment seems to be indirectly mediated, making this compound an interesting immunosuppressant in the treatment of acute central nervous system lesions.

The serine protease Omi/HtrA2 is involved in XIAP cleavage and in neuronal cell death following focal cerebral ischemia/reperfusion

Omi/HtrA2 is a pro-apoptotic mitochondrial serine protease involved in both forms of apoptosis, caspase-dependent as well as caspase-independent cell death. However, the impact of Omi/HtrA2 in the apoptotic cell machinery that takes place in vivo under pathological conditions such as cerebral ischemia remains unknown. The present study was monitored in order to examine whether Omi/HtrA2 plays a decisive role in apoptosis observed after focal cerebral ischemia in rats. Male adult rats were subjected to 90min of focal cerebral ischemia followed by reperfusion and treated with vehicle or ucf-101, a novel and specific Omi/HtrA2 inhibitor, prior reperfusion. Focal cerebral ischemia/reperfusion induced a mitochondrial up-regulation of Omi/HtrA2 and significantly increased cytosolic accumulation of Omi/HtrA2. Furthermore, ischemia led to activation of caspase-3 and degradation X-linked inhibitor of apoptosis protein (XIAP). Treatment of animals prior ischemia with ucf-101, the specific inhibitor of Omi/HtrA2, was able to (1) reduce the number of TUNEL-positive cells, to (2) attenuate the XIAP-breakdown and to (3) reduce the infarct size. This study shows for the first time that focal cerebral ischemia in rats results in Omi/HtrA2 translocation from the mitochondria to the cytosol, where it participates in neuronal cell death. Blocking the proteolytic activity of Omi/HtrA2 with specific inhibitors, such as the ucf-101, could be a novel way to afford neuroprotection and minimize cellular damage in cerebral ischemia/reperfusion.

The bisphosphonate clodronate depletes microglial cells in excitotoxically injured organotypic hippocampal slice cultures

The bisphosphonate clodronate, clinically used in the treatment of osteoporosis, is known to deplete cells of the monocytic lineage. Using an in vitro model of excitotoxic damage in organotypic hippocampal slice cultures (OHSC), we investigated whether clodronate can also prevent microglial activation that occurs in CNS pathologies. Lesioning of OHSC was performed by application of 50 microM N-methyl-D-aspartate (NMDA) for 4 h after 6 days in vitro (div). Treatment of lesioned OHSC with clodronate (1000, 100, or 10 microg/ml) resulted in an almost complete abrogation of the microglial reaction after 3 further div: Confocal laser scanning microscopy showed that the number of Griffonia simplicifolia isolectin B(4)-labeled (IB4+) microglial cells in the dentate gyrus (DG) was reduced to 4.25% compared with OHSC treated with NMDA alone. Continuous treatment with clodronate (100 or 10 microg/ml) of lesioned OHSC for 9 days resulted in a further reduction in the number of microglial cells (reduction to 2.72%). The number of degenerating, propidium iodide-labeled (PI(+)) neurons in lesioned OHSC that received clodronate treatment between 6 and 9 div was not significantly different from OHSC treated with NMDA alone. However, the number of PI(+) neurons in lesioned OHSC that received continuous clodronate treatment for 9 div was significantly higher when compared to NMDA-lesioned OHSC. In summary, clodronate is able to reduce microglial activation induced by excitotoxic neuronal injury. Our results demonstrate that clodronate is a useful tool in the investigation of neuron-glia interactions because it induces an efficient depletion of microglial cells that are activated after excitotoxic CNS injury.

Utilization of supercritical carbon dioxide for complex formation of ibuprofen and methyl-beta-cyclodextrin

The dissolution rate of a drug into the biological environment can be enhanced by forming complexes with cyclodextrins and their derivatives. In this study, ibuprofen-methyl-beta-cyclodextrin complexes were prepared successfully by passing ibuprofen-laden CO(2) through a methyl-beta-cyclodextrin packed bed. The maximum drug loading obtained in this work was 10.8 wt.%, which was comparable to that of a 1:1 complex (13.6 wt.% of ibuprofen). The complex exhibited instantaneous dissolution profiles in water solution. The enhanced dissolution rate was attributed to the amorphous character and improved wettability of the product.

Effects of neuroactive substances on the activity of subcommissural organ cells in dispersed cell and explant cultures

The subcommissural organ (SCO), an ependymal (glial) circumventricular organ, releases glycoproteins into the cerebrospinal fluid; however, the regulation of its secretory activity is largely unknown. To identify neuroactive substances that may regulate SCO activity, we investigated immunocytochemically identified bovine SCO cells by means of calcium imaging. This analysis was focused on: (1) serotonin (5HT) and substance P (SP), immunocytochemically shown to be present in axons innervating the bovine SCO; and (2) ATP, known to activate glial cells. 5HT had no effect on the intracellular calcium concentration ([Ca(2+)](i)), and its precise role remains to be clarified. SP elicited rises in [Ca(2+)](i) in approx. 30% and ATP in even 85% of the analyzed SCO cells. These effects were dose-dependent, involved NK(3) and P2Y(2) receptors linked to G protein and phospholipase C (PLC) activation, and could not be mimicked by forskolin or 8-bromo-cAMP. In 50% of the SP-sensitive cells, the increases in [Ca(2+)](i) comprised calcium release from thapsigargin-sensitive intracellular stores and an influx of extracellular calcium via protein kinase C (PKC)-induced opening of L-type voltage-gated calcium channels (VGCCs). In the remaining SP-sensitive cells, the increase in [Ca(2+)](i) was caused exclusively by influx of extracellular calcium via VGCCs of the L-type. In all ATP-sensitive cells the increase in [Ca(2+)](i) involved calcium release from thapsigargin-sensitive intracellular stores and a PKC-mediated influx of extracellular calcium via L-type VGCCs. Our data suggest that SP and ATP are involved in regulation of the activity of SCO cells.

The pituitary adenylate cyclase-activating polypeptide modulates glutamatergic calcium signalling: investigations on rat suprachiasmatic nucleus neurons

Circadian rhythms generated by the hypothalamic suprachiasmatic nucleus (SCN) are synchronized with the external light/dark cycle by photic information transmitted directly from the retina via the retinohypothalamic tract (RHT). The RHT contains the neurotransmitters glutamate and pituitary adenylate cyclase-activating polypeptide (PACAP), which code chemically for 'light' or 'darkness' information, respectively. We investigated interactions of PACAP and glutamate by analysing effects on the second messenger calcium in individual SCN neurons using the Fura-2 technique. PACAP did not affect NMDA-mediated calcium increases, but influenced signalling cascades of non-NMDA glutamate receptors, which in turn can regulate NMDA receptors. On the one hand, PACAP amplified/induced glutamate-dependent calcium increases by interacting with alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA)/kainate signalling. This was not related to direct PACAPergic effects on the second messengers cAMP and calcium. On the other hand, PACAP reduced/inhibited calcium increases elicited by glutamate acting on metabotropic receptors. cAMP analogues mimicked this inhibition. Most neurons displaying PACAPergic neuromodulation were immunoreactive for vasoactive intestinal polypeptide, which is a marker for retinorecipient SCN neurons. The observed PACAPergic effects provide a broad range of interactions that allow a fine-tuning of the endogenous clock by the integration of 'light' and 'darkness' information on the level of single SCN neurons.

Astrocytic factors protect neuronal integrity and reduce microglial activation in an in vitro model of N-methyl-D-aspartate-induced excitotoxic injury in organotypic hippocampal slice cultures

Acute CNS lesions lead to neuronal injury and a parallel glial activation that is accompanied by the release of neurotoxic substances. The extent of the original neuronal damage can therefore be potentiated in a process called secondary damage. As astrocytes are known to secrete immunomodulatory and neuroprotective substances, we investigated whether astrocytic factors can attenuate the amount of neuronal injury as well as the degree of microglial activation in a model of excitotoxic neurodegeneration. Treatment of organotypic hippocampal slice cultures with N-methyl-D-aspartate (NMDA) resulted in a reproducible loss of viable granule cells, partial destruction of the regular hippocampal cytoarchitecture and a concomitant accumulation of amoeboid microglial cells at sites of neuronal damage. Astrocyte-conditioned media reduced the amount of NMDA-induced neuronal injury by 45.3%, diminished the degree of microglial activation and resulted in an improved preservation of the hippocampal cytoarchitecture. Transforming growth factor (TGF)-beta failed to act as a neuroprotectant and even enhanced the amount of neuronal injury by 52.5%. Direct effects of astrocytic factors on isolated microglial cells consisted of increased microglial ramification and down-regulated expression of intercellular adhesion molecule-1, whereas incubation with TGF-beta had no such effects. In summary, our findings show that hitherto unidentified astrocyte-derived factors that are probably not identical with TGF-beta can substantially enhance neuronal survival, either by eliciting direct neuroprotective effects or by modulating the microglial response to neuronal injury.

Clock gene protein mPER1 is rhythmically synthesized and under cAMP control in the mouse pineal organ

The mammalian clock gene Per1 is an important element of endogenous oscillators that control daily rhythms in central and peripheral tissues. Although such autonomous clock function is lost in the mammalian pineal gland during evolution, mPer1 mRNA and mPER1 protein were found to be strongly elevated in the mouse pineal organ during the dark period compared to daytime values. In vitro studies showed that mPer1 mRNA and mPER1 protein in mouse pineal gland are induced following the activation of a signalling pathway of fundamental importance for pineal physiology, the norepinephrine/cAMP/phosphoCREB cascade. mPER1 may function in the mouse pineal gland as a time-measuring molecule to participate in regulating rhythmic cellular responses in vivo.

Endothelium-derived hyperpolarizing factor synthase (Cytochrome P450 2C9) is a functionally significant source of reactive oxygen species in coronary arteries

In the porcine coronary artery, a cytochrome P450 (CYP) isozyme homologous to CYP 2C8/9 has been identified as an endothelium-derived hyperpolarizing factor (EDHF) synthase. As some CYP enzymes are reported to generate reactive oxygen species (ROS), we hypothesized that the coronary EDHF synthase may modulate vascular homeostasis by the simultaneous production of ROS and epoxyeicosatrienoic acids. In bradykinin-stimulated coronary arteries, antisense oligonucleotides against CYP 2C almost abolished EDHF-mediated responses but potentiated nitric oxide (NO)-mediated relaxation. The selective CYP 2C9 inhibitor sulfaphenazole and the superoxide anion (O(2-)) scavengers Tiron and nordihydroguaretic acid also induced a leftward shift in the NO-mediated concentration-relaxation curve to bradykinin. CYP activity and O(2-) production, determined in microsomes prepared from cells overexpressing CYP 2C9, were almost completely inhibited by sulfaphenazole. Sulfaphenazole did not alter the activity of either CYP 2C8, the leukocyte NADPH oxidase, or xanthine oxidase. ROS generation in coronary artery rings, visualized using either ethidium or dichlorofluorescein fluorescence, was detected under basal conditions. The endothelial signal was attenuated by CYP 2C antisense treatment as well as by sulfaphenazole. In isolated coronary endothelial cells, bradykinin elicited a sulfaphenazole-sensitive increase in ROS production. Although 11,12 epoxyeicosatrienoic acid attenuated the activity of nuclear factor-kappaB in cultured human endothelial cells, nuclear factor-kappaB activity was enhanced after the induction or overexpression of CYP 2C9, as was the expression of vascular cell adhesion molecule-1. These results suggest that a CYP isozyme homologous to CYP 2C9 is a physiologically relevant generator of ROS in coronary endothelial cells and modulates both vascular tone and homeostasis.