Monolithic shape-programmable dielectric liquid crystal elastomer actuators

Macroscale robotic systems have demonstrated great capabilities of high speed, precise, and agile functions. However, the ability of soft robots to perform complex tasks, especially in centimeter and millimeter scale, remains limited due to the unavailability of fast, energy-efficient soft actuators that can programmably change shape. Here, we combine desirable characteristics from two distinct active materials: fast and efficient actuation from dielectric elastomers and facile shape programmability from liquid crystal elastomers into a single shape changing electrical actuator. Uniaxially aligned monoliths achieve strain rates over 120%/s with energy conversion efficiency of 20% while moving loads over 700 times the actuator weight. The combined actuator technology offers unprecedented opportunities towards miniaturization with precision, efficiency, and more degrees of freedom for applications in soft robotics and beyond

Successful Suicide in a Child: Depression-Related or Paroxetine-Induced?

Background: Children and adolescents are prone to develop psychiatric problems after stressful life events. These problems need appropriate treatment because of negative consequences like disease-related suicide. Antidepressants (especially "Serotonin Selective Reuptake Inhibitors") are common treatments for psychiatric problems of children and adolescents; but different side effects, including drug-induced suicide, have been reported.Case Report: In this article, we describe a nine-year-old girl who developed depression after parental divorce and was prescribed paroxetine. During pharmacotherapy, she had suicidal thoughts and several unsuccessful attempts which have been neglected and finally last attempt was successful. This report is an evidence for physicians to prescribe antidepressants cautiously with reasonable indication. As still there is no certain contraindication of using antidepressants in pediatric patients, importance of follow-ups and screening of suicide in pediatric patients during treatment with antidepressants seems essential.Conclusion: This study discloses the magnitude of explaining the side effects of antidepressants to caregivers of children with psychiatric problems

Characteristics of absconders from a general health service, Rasoul Akram Hospital in 2013

Introduction Absconding is an important health and security concern because of its adverse effect on patients, care providers, and the community. Studies are limited. Aim This study aimed to describe the characteristics of absconding events in Tehran. Material and methods In this analytical cross-sectional study, 334 absconders from 34 192 patients who were admitted to the Rasoul Akram Hospital in 2013 and escaped from the hospital were recruited. These patients were evaluated based on variables that included age, sex, marital status, hospitalization duration, smoking, alcohol use, addiction, psychiatric disorders or underlying disease, type of insurance, cause of hospitalization, time of scape, and cost of treatment. Results and discussion The study group consisted of 260 (77.8) males and 74 (22.2) females, with a mean age of 37.4 (SD = 17.1). Mean duration of hospitalization was 99 h (SD = 14.8). A total of 70 (21) patients were smokers, 14 (4.2) consumed alcohol, and 65 (19.5) were drug addicts. Psychiatric disorders were observed in 18 (5.4) patients, and underlying diseases were detected in 87 (26). Higher rates of escape were observed in single men (N = 162; 62.30) as well as married women (N = 52; 70.27). The most common time of escape was 12:00 PM. The highest number of escapes was observed in the month of July. Conclusions The present study identified single males, younger patients, psychiatric disease, underlying illness, and addiction as common features of escapees. Particular attention in observing, improvement in observation methods, and staff focusing on engagement could be helpful in decreasing the number of absconding events. © 2015 Warmi�sko-Mazurska Izba Lekarska w Olsztynie. Published by Elsevier Sp. z o.o. All rights reserved

Review of Fall Injuries and Related Factors in Patients Admitted to a Trauma Referral Hospital in Tehran, Iran

Background: Falls are important causes of mortality and morbidity in urban areas and put a high burden on societies. We investigated patterns of fall traumas and related factors in a referral trauma hospital in Tehran, Iran.Methods: In this routine-data-based study, all documents of fall cases in Hazrate-Rasool hospital, Tehran, Iran, during October 2014-2015 were investigated. Information on demographic factors of patients, fall conditions and outcomes were collected. Data were analyzed by SPSS 11.5. The statistically significant level was considered ≤ 0.05.Results: Of the 307 cases, 70% were male. Median (interquartile range) age was 32 (22-51) years. Of cases, 91% were undergraduates. The mortality rate was 2.6%. Suicide attempts reported in 17 (5.5%) cases and only 2 (12%) of them were successful. Injured body organs in order of frequency were extremities, head and neck, thorax, vertebras, abdomen and pelvis. Outcome (in terms of injured body organs) was related to age and gender of patients alongside with height and reason of the fall. Falls at workplaces, in suicide attempts and among males happened for significantly higher distances. High distance falls and low GCS at admission were related to higher mortality. Majority of falls on a same level happened at home among old women.Conclusion: In our region, fall was a problem of people with low socioeconomic status. Our mortality rate is similar to the highest mortality rates in the world. Personal characteristics along with trauma-related factors are both important in the outcomes of fall cases. Safety equipment at high risk jobs is essential to prevent falls

Delayed Onset Brain Hypoxia and Subsequent Seizures: a Rare Fatal Consequence of Undiagnosed Foreign Body Aspiration

Background: Foreign body aspiration is a common medical emergency among children that can lead to lethal complications especially in neglected or misdiagnosed cases.Case Report: This article is a report of a 15-month-old child who aspirated food materials and after chocking crisis, she presented with unspecific respiratory symptoms and treated for respiratory tract infections. After five days, sudden airway obstruction led to hypoxic brain damage and seizure. Due to unavailability of bronchoscopic facilities, extraction of foreign body was postponed and persistent hypoxia led to irreversible brain damage, seizures and finally death. This report reveals the key role of physicians in prompt diagnosis and the importance of early extraction of aspirated foreign bodies, even in asymptomatic cases, to prevent later complications and related mortality and morbidity.Conclusion: This report contains warning hints for professionals in different fields of medicine that deal with pediatric patients

Gender Determination Using Diagnostic Values of Foramen Magnum

Background: Foramen magnum is a big hole in the base of the skull. Its appearance can be useful in gender determination. So far, no study has been conducted in Iran that evaluates the value of foramen magnum in sex determination and calculates the cut-off points. This study aimed to evaluating of diagnostic value of the foramen magnum and to calculate the cut-off points for sex determination.Methods: In this cross sectional study 50 male and 50 female patients referring to the radiology department of Rasol Akram Hospital in Tehran were evaluated. The required information about the sagittal diameter, transverse diameter, and diameter of foramen magnum were assessed by brain CT scan. Chi-square and independent t test was used for the comparison of different shapes and diameters between the sexes. ROC curve was used to determine the optimal cut-off point for each indicator.Results: The best cut-off point to distinguish males from females along the anterior-posterior foramen magnum was calculated as 36.45 mm, at the transverse diameter of 30.4 mm. The proper cut-off points for the area of the foramen magnum were 877.477 mm2 and 870.29 mm2, based on the Teixeria formula and Routal formula respectively. Overall, the accuracy of these indicators was calculated as 85%.Conclusion: Based on the results of this study using CT scans images, the diameter of the foramen magnum and its area had a high accuracy in sex determination

Characteristics of traumatic brain injury among accident and falling down cases

Motor vehicle and falling down are responsible for the most number of traumatic injuries. This study aimed to compare the characteristics of traumatic brain injury among accident and falling down cases. In this analytical cross- sectional study, data were collected from the records of cadavers who died due to accident or falling down and referred to Kahrizak dissection hall, Tehran forensic medicine organization during 2013. A total of 237 subjects (183 (77.2) accident and 54 (22.8) falling down) with a mean age of 35.62 (SD=15.75) were evaluated. A number of 213 (89.9) were male. From accident group, scalp injury was seen in 146 (79.8), scalp abrasion in 122 (66.7), scalp laceration in 104 (56.8), sub skull bruising in 176 (96.3), skull fracture in 119 (65), hemorrhage in 166 (90.7), Subdural hemorrhage (SDH) in 155 (84.7), Subarachnoid hemorrhage (SAH) in 161 (88), Epidural hemorrhage (EDH) in 41 (22.4), contusion in 140 (76.5), and skull base fracture in 140 (76.5) of cases. In falling down group scalp injury was seen in 42 (77.8) cadavers, scalp abrasion in 38 (70.4), scalp laceration in 30 (55.6), sub skull bruising in 49 (90.7), skull fracture in 39 (72.2), Hemorrhage in 49 (90.7), SDH in 43 (79.6), SAH in 47 (87), EDH in 10 (18.5), contusion in 33 (61.1), and skull base fracture in 39 (72.2) of cases. There was no significant difference between these two groups (P Value> 0.05). Accident and falling down had no difference in terms of any injury or hemorrhage. © 2015 Tehran University of Medical Sciences. All rights reserved

Evaluation of greater sciatic notch parameters in sex determination of hip bone by three-dimensional CT images

Introduction: Sex determination of an anonymous individual is one of the main objective when human skeletal remains are found, both in forensic investigation and archaeological studies. Aim: To evaluate the role of Greater Sciatic Notch (GSN) parameters in sex determination in the Iranian population by means of Three-Dimensional (3D) images reconstructed by multi-slice Computed Tomography (CT). Materials and Methods: In the present cross-sectional study, 237 cases (121 females and 116 males) who received Pelvic CT in radiology department of Rasoul-e-Akram Hospital were included. The GSN parameters including the width, depth and posterior segment were applied to measure the 3D-CT radiographs of participant's hip bone using digital instruments with an accuracy of 0.01º and 0.01 mm. SPSS version 21 was used to analyse the data using the independent sample t-test, chi-square test, Pearson�s correlation test and Roc curve. Results: Among the GSN parameters, depth had no difference among males and females, in both right and left sides (p=0.767 and p=0.561, respectively); thus, was not useful in sex determination. GSN parameters including Depth (p=0.008), Post segment (p=0.017), and Index 2 (p=0.015) were different in right and left sides and cannot be considered for sex determination without considering the sides. Moreover, Post angle (90.3) and Post segment (89.5) were found to have the most accuracy in sex determination. Conclusion: Most of the parameters of GSN except for depth were useful for sex determination. Application of 3D-CT micrographs in the present study helped us to easily quantify sexual dimorphism in the GSN, suggesting 3D-CT can be considered as one of the valuable tools in practical forensic osteology investigation due to the great accuracy to measure the sex differences. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved

Corporate social responsibility and customer loyalty during the Covid-19 pandemic: evidence from pharmacy practice

Purpose: In recent years, corporate social responsibility (CSR) has taken on a more prominent role in both large and small businesses because of its significant impact on various aspects of business performance. To date, a growing body of literature has demonstrated the mechanisms whereby CSR practices affect organizational outcomes; however, there has been little research examining how CSR practices contribute to customer loyalty within the pharmacy context. As such, this study aims to explore how CSR practices influence the loyalty of pharmacy customers, particularly in relation to the mediatory effects of customer-company identification (CCI) and customer trust. Design/methodology/approach: A survey questionnaire was developed and administered to collect the required data from the pharmacy context. The resultant data were subjected to exploratory factor analysis to identify the scale dimensions, followed by multiple regression analysis to test the hypotheses. Findings: Analysis of the results (n = 528) revealed that perceived CSR indirectly impacts loyalty through the mediatory effects of trust and CCI. All hypothesized effects were also confirmed via empirical testing. Originality/value: The findings of this research suggest that not only are CSR activities responsive to societal concerns, but they can also promote customer identification with pharmacies and strengthen customer trust, which can, in turn, lead to long-term customer loyalty