Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: The Iranian Project for Assessment of Coronary Events 2 (IPACE2)

Objectives: To assess contemporary data on characteristics, management and 1-year postdischarge outcomes in Iranian patients hospitalised with acute coronary syndrome (ACS). Setting: 11 tertiary care hospitals in 5 major cities in the Islamic Republic of Iran. Participants: Patients aged �20 and �80 years discharged alive with confirmed diagnosis of ACS including ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and high-risk unstable angina (HR-UA). Primary and secondary outcome measures: Patients were followed up regarding the use of medications and the end points of the study at 1 month and 1 year after discharge. The primary end point of the study was 1-year postdischarge major adverse cardiac and cerebrovascular events (MACCEs), defined as mortality (cardiac and non-cardiac), ACS and cerebrovascular attack (stroke and/or transient ischaemic attack). The secondary end points were hospital admission because of congestive heart failure, revascularisation by coronary artery bypass grafting surgery or percutaneous coronary intervention (PCI), and major and minor bleeds. Results: A total of 1799 patients (25.7 STEMI and 74.3 HR-UA/NSTEMI) discharged alive with confirmed diagnosis of ACS were included in the final analysis. During hospitalisation, the majority of the patients received aspirin (98.6), clopidogrel (91.8), anticoagulants (93.4), statins (94.3) and β-blockers (89.3). Reperfusion therapy was performed in 62.6 of patients with STEMI (46.3 thrombolytic therapy and 17.3 primary PCI). The mean door-to-balloon and door-to-needle times were 82.9 and 45.6 min, respectively. In our study, 64.7 and 79.5 of the patients in HR-UA/NSTEMI and STEMI groups, respectively, underwent coronary angiography. During the 12 months after discharge, MACCEs occurred in 15.0 of all patients. Conclusions: Our study showed that the composition of Iranian patients with ACS regarding the type of ACS is similar to that in developed European countries and is unlike that in developing countries of the Middle East and Africa. We found that our patients with ACS are treated with high levels of adherence to guideline-recommended in-hospital medications

Diagnostically Challenging Epithelial Odontogenic Tumors: A Selective Review of 7 Jawbone Lesions

Considerable variation in the clinicopathologic presentation of epithelial odontogenic tumors can sometimes be confusing and increase the chance of misdiagnosis. Seven diagnostically challenging jawbone lesions are described. There were 2 cases of mistaken identity in our ameloblastoma file. One unicystic type, initially diagnosed and treated as a lateral periodontal cyst, showed destructive recurrence 6 years postoperatively. The other globulomaxillary lesion was managed under the erroneous diagnosis of adenomatoid odontogenic tumor and recurred 4 times over an 11-year period. This tumor was found in retrospect to be consistent with an adenoid ameloblastoma with dentinoid. The diagnosis of cystic squamous odontogenic tumor (SOT) occurring as a radicular lesion of an impacted lower third molar was one of exclusion. Of two unsuspected keratocystic odontogenic tumors, one depicted deceptive features of pericoronitis, while the other case has long been in our files with the diagnosis of globulomaxillary SOT. Two cases of primary intraosseous squamous cell carcinoma appeared benign clinically and exhibited unexpected findings; an impacted third molar began to erupt in association with the growth of carcinoma and another periradicular carcinoma showed dentinoid formation. Cases selectively reviewed in this article present challenging problems which require clinical and radiographic correlation to avoid potential diagnostic pitfalls

Cellular proliferation markers in peripheral and central fibromas: a comparative study

OBJECTIVE: To perform a comparative study of the cellular proliferation in the peripheral and central fibromas. MATERIAL AND METHODS: Immunohistochemistry for PCNA and the AgNOR technique were performed in 9 cases of peripheral odontogenic fibroma (POF), in 4 cases of odontogenic fibroma (OdF), in 8 cases of peripheral ossifying fibroma (PEOF) and 7 cases of ossifying fibroma (OsF). The Kruskal-Wallis and Mann-Whitney tests were used for the statistical analyses. RESULTS: Mesenchymal component of the central lesions presented a higher mean number of AgNOR per nucleus and PCNA index than did the peripheral lesions (P≤0.05). The mean number of AgNOR per nucleus in the epithelial component proved to be higher in the OdF than in the POF (P≤0.05). The mesenchymal and epithelial components presented similar mean numbers of AgNOR per nucleus and PCNA index in the OdF, as well as a similar mean number of AgNOR per nucleus in the POF. CONCLUSIONS: The mesenchymal component may well play a role in the differences between the biological behaviour of the central lesions as compared to the peripheral lesions. Moreover, considering that the epithelial and mesenchymal components in odontogenic fibromas presented a similar proliferation index, more research is warranted to understand the true role of the epithelial components, which are believed to be inactive in nature, as well as in the development and biological behaviour of these lesions

On the Application of Multicomplex Algebras in Numerical Integration

In this paper, we propose a methodology to numerically integrate functions using multicomplex algebras and their corresponding matrix representations. The methodology employs multicomplex Taylor series expansion (MCTSE) to adaptively approximate and integrate a function using sufficiently small number of points. We investigate this methodology by presenting three different algorithms for various approximation strategies.We also use numerical studies to demonstrate the performance of the proposed methodology

One-Step Deadbeat Control of a 5-Link Biped Using Data-Driven Nonlinear Approximation of the Step-to-Step Dynamics

For bipedal robots to walk over complex and constrained environments (e.g., narrow walkways, stepping stones), they have to meet precise control objectives of speed and foot placement at every single step. This control that achieves the objectives precisely at every step is known as one-step deadbeat control. The high dimensionality of bipedal systems and the under-actuation (number of joint exceeds the actuators) presents a formidable computational challenge to achieve real-time control. In this paper, we present a computationally efficient method for one-step deadbeat control and demonstrate it on a 5-link planar bipedal model with 1 degree of under-actuation. Our method uses computed torque control using the 4 actuated degrees of freedom to decouple and reduce the dimensionality of the stance phase dynamics to a single degree of freedom. This simplification ensures that the step-to-step dynamics are a single equation. Then using Monte Carlo sampling, we generate data for approximating the step-to-step dynamics followed by curve fitting using a control affine model and a Gaussian process error model. We use the control affine model to compute control inputs using feedback linearization and fine tune these using iterative learning control using the Gaussian process error enabling one-step deadbeat control. We demonstrate the approach in simulation in scenarios involving stabilization against perturbations, following a changing velocity reference, and precise foot placement. We conclude that computed torque control-based model reduction and sampling-based approximation of the step-to-step dynamics provides a computationally efficient approach for real-time one-step deadbeat control of complex bipedal systems

Modulation of the triggered apoptosis by nano emodin transfersome-mediated sonodynamic therapy on head and neck squamous cell carcinoma cell lines

Background: Non-invasive sonodynamic therapy (SDT) is a new treatment modality that uses low-intensity ultrasound to activate a non-toxic sensitizing chemical agent for cancer therapy in a site-directed manner. This study aimed to investigate the anti-cancer effects of ultrasound combined with nano emodin transfersome (NET) on head and neck squamous cell carcinoma (HNSCC) cell lines. Materials and methods: A transfersome form of nano emodin as a novel sono-responsive nanomaterial was synthesized to enhance the accumulation and penetration of nanoparticles. iIn vitro experiments including hemolytic activity, cell proliferation, intracellular reactive oxygen species (ROS) generation, apoptosis induction, DNA fragmentation, and mRNA expressions of caspase 3 and 9 were conducted to explore the anti-cancer effects of NET-SDT on FaDu and CAL-27 cell lines. Results: Characterization tests showed the round and uniform morphology of NET with transfersome structure, resulting in a high drug-loading content and encapsulation ef�ciency. No significant hemolytic activity was observed (P > 0.05). Cytotoxicity gradually increased with increasing concentrations of NET, so that 10 � 10�4 g/L of NET plus 5 min ultrasound irradiation at a frequency of 1 MHz and ultrasonic intensity of 2 W/cm2 effectively killed 98.2 and 97.3 of FaDu and CAL-27 cell lines, respectively (P < 0.05). We found that ROS generation in NET-SDT was dose-dependent and the triggered apoptosis and caspase-3/9 gene expression levels were significantly enhanced as the concentration of NET increased (P < 0.05). No significant difference was found in the rate of apoptosis induction and gene expression between two cell lines. Conclusions: Our data demonstrated that SDT with NET as a sonosensitizer can induce apoptosis and significantly decrease cell viability of HNSCC cell lines, which represents the role of NET-SDT as a potent anti-cancer modality. © 2021 Elsevier B.V

The outcome of requests for empty CCU beds by the hospital from medical emergency headquarters Tehran (Year 2000)

Introduction: Inter-hospital transport constitutes one of the important parts of the emergency system in every country. Materials and methods: To determine the outcome of requested CCU beds from the medical emergency headquarters in year 2000 by the hospitals affiliated to Tehran university of medical sciences, we have reviewed retrospectively 2688 clinical files of patients for whom a request for an empty CCU bed in other hospitals had been sent to the medical emergency headquarters. The main measure was the success rate of being admitted to CCU in other hospitals. Results: On the whole 68.5 percent of requests were followed by a CCU admission to other hospitals. Using logistic regression method, variables including season of the year, shift diagnosis of the patient and the original hospital were shown to be related with the success rate. Conclusion: Increasing the number of available CCU beds and providing the centers with the necessary equipment is of high priority in hospitals located in city of Tehran