An Immediate Death by Seat Belt Compression; a Forensic Medicine Report

Although death is a gradual process, sometimes sudden death occurs in a fraction of a minute or seconds. Here we report a 49-year-old man without any underlying disease, which has instantly died in an accident scene due to compression of neck critical elements by a three-point seat belt. The examination of the body and the results of the autopsy, toxicology and pathology tests are described from the viewpoint of forensic medicine

Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients

Introduction: Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. Methods: In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT) scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. Results: 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67), were enrolled (77.6% male). Chest CT scan showed pulmonary contusion in 48 (31.6%) patients, hemothorax in 29 (19.1%), and pneumothorax in 55 (36.2%) cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96), 0.86 (95% CI: 0.78‒0.94), and 0.80 (95% CI: 0.736‒0.88), respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87) for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86) for hemothorax, and 0.58 (95% CI: 0.5‒0.67) for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02) and pulmonary contusion (p < 0.001). However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08). Conclusion: The results of the present study showed that ultrasonography is preferable to radiography in the initial evaluation of patients with traumatic injuries to the thoracic cavity

Immune-related adverse kidney events by immune checkpoint inhibitors; a narrative review on current studies

Chemotherapy-associated renal injury is considered one of the major concerns among nephrological and oncological practice. The use of novel anti-neoplastic therapies that target carcinomas has helped in the detection of this form of renal injury. Immune checkpoint inhibitors (ICPIs) are a group of monoclonal antibodies targeting inhibitory receptors that exist on tumor cells and T cells. ICPIs are able to suppress tumors that might have escaped from the immune surveillance. Meanwhile, although ICPIs have shown promising efficacy in cancer treatment, their immune-related side effects limit their widespread use in cancer therapy schedules. One of the major side effects limiting ICPIs' usage is nephrotoxicity. Glomerular disease, acute interstitial nephritis (AIN), and acute tubular necrosis (ATN) are considered different infusion-related adverse events. Infiltration of eosinophils, T lymphocytes, and plasma cells, as well as interstitial inflammation and edema, leading to acute tubulointerstitial nephritis (ATIN). It is conceivable that the rupture of self-tolerance by ICPIs induces an autoimmune reaction against some specific self-antigens in the organs including kidneys. The exact nature of the antigen is unclear; however, it is possible that it is found in the renal tubular cells, as indicated by a greater frequency of ATIN in kidney biopsies. The current review paper discusses the relationship between ICPIs therapy and kidney disorders or more specifically, their possible role in renal damage along with renal toxicity profile in the setting of ICPIs treatment

Reduction of inositol (1,4,5)–trisphosphate affects the overall phosphoinositol pathway and leads to modifications in light signalling and secondary metabolism in tomato plants

The phosphoinositol pathway is one of the major eukaryotic signalling pathways. The metabolite of the phosphoinositol pathway, inositol- (1,4,5) trisphosphate (InsP3), is a regulator of plant responses to a wide variety of stresses, including light, drought, cold, and salinity. It was found that the expression of InsP 5-ptase, the enzyme that hydrolyses InsP3, also dramatically affects the levels of inositol phosphate metabolites and the secondary metabolites in transgenic tomato plants. Tomato plants expressing InsP 5-ptase exhibited a reduction in the levels of several important inositol phosphates, including InsP1, InsP2, InsP3, and InsP4. Reduced levels of inositol phosphates accompanied an increase in the accumulation of phenylpropanoids (rutin, chlorogenic acid) and ascorbic acid (vitamin C) in the transgenic fruits of tomato plants. The enhanced accumulation of these metabolites in transgenic tomato plants was in direct correspondence with the observed up-regulation of the genes that express the key enzymes of ascorbic acid metabolism (myo-inositol oxygenase, MIOX; L-galactono-γ-lactone dehydrogenase, GLDH) and phenylpropanoid metabolism (chalcone synthase, CHS1; cinnamoyl-CoA shikimate/quinate transferase, HCT). To understand the molecular links between the activation of different branches of plant metabolism and InsP3 reduction in tomato fruits, the expression of transcription factors known to be involved in light signalling was analysed by real-time RT-PCR. The expression of LeHY5, SIMYB12, and LeELIP was found to be higher in fruits expressing InsP 5-ptase. These results suggest possible interconnections between phosphoinositol metabolism, light signalling, and secondary metabolism in plants. Our study also revealed the biotechnological potential for the genetic improvement of crop plants by the manipulation of the phosphoinositol pathway

The Inhibitory Effect of KCN, NaN3 and some Bivalent Ions on Lipoxygenase Activity of the Purified Human Placental: Effect of bivalent ions on lipoxygenase activity

Lipoxygenase (LOX) catalyzes irreversible transfer of oxygen molecule to Arachidonic and Linoleic acid to produce 13 Hydroproxy Octadecadienoic acid. Recent studies showed that the involvement of Lipoxygenase products, leukotrienes, in inflammations and Lipoxygenase pathways acts as mediators of early inflammatory events in atherosclerosis. The aim of the present study is purification and characterization of Lipoxigenase from Human placental.For this aim, the human placental Lipoxigenase was extracted and purified by normal butanol, acetone, ammonium sulphate (30-80%), and gel permeation chromatography on Sephadex G-150. After purification and characterization of LOX, the in vitro inhibitory effect of KCN, NaN3 and some selected bivalent ions such as Co2+, Ni2+, Cu2+, and Zn2+ were checked on the activity of purified LOX. Results showed that specific activity was 123.16 u/mg proteins and the yield of purification was 21.84 percent. Also, it was found that Co2+, Ni2+, KCN, and NaN3 at concentration of 20 mM had inhibitory effect on LOX activity and their inhibitory was 72.4, 58.2, 56.5 and 42.3% respectively. However, Cu2+ stimulated the lipoxygenase activity at the same concentration whereas Zn2+ has no significant effect on LOX activity. With respect to increase of LOX activity in the patient with cardiovascular diseases, Alzheimer disease, cancer, chronic obstructive pulmonary disease (COPD), artherogenesis, and also airway inflammation diseases, suggesting that LOX inhibition may have beneficial effects as a potential target to limit the severity of related symptoms of these diseases and therefore these inhibitors could be considered as an agent for decreasing the enzyme activity in association with the disease

Incidence of cervical collar-related pressure injury in patients with head and neck trauma: A scoping review study

The use of the cervical collar to support the head and neck is inevitable in many patients with head and spinal cord injuries. One of the consequences of using this instrument is the development of pressure injuries. Therefore, in this review study, the incidence of as well as the risk factors for cervical collar-related pressure injury in this group of patients was evaluated. The current study is a scoping review conducted in 2022. Five scientific databases (PubMed, Scopus, Web of Science, ProQuest, and CINAHL), as well as Google Scholar, were searched for relevant studies published from 1990 to 2022 using the following keywords: trauma, spinal cord injury, head injury, head trauma, collar, cervical collar, cervical immobilization, risk factors, incidence, pressure injury, pressure ulcer, and bed sore. The search was performed independently by two researchers. Articles from the initial search were first recorded in special tables, and then, were reviewed and analyzed separately by two researchers. After extraction, information from each article was entered into a special table categorized by year, country, study design, study population, the incidence of cervical collar-related pressure injury, risk factors for cervical collar-related pressure injury, and grades of pressure injury. Of the 10 articles, 6 were retrospective cohort studies, 3 were cross-sectional descriptive studies, and 1 was a case report study. In terms of the study population, one study was conducted on pediatric patients, one was conducted on elderly patients, and eight were conducted on adults with head and neck trauma. In eight articles, the incidence of cervical collar-related pressure injury was reported. The reported incidence varied between 1.1% and 78.4%. In eight articles, risk factors for cervical collar-related pressure injury were reported. The most common risk factors were duration of cervical collar use, hospitalization in intensive care units, low level of consciousness, and longer hospital stay. The current review study showed that a significant percentage of head and neck trauma patients for whom cervical collar is used suffer from different grades of pressure injuries. Hence, healthcare providers should consider this issue when caring for this group of patients and take the necessary preventive measures in this regard. It should be noted that previous studies in this field had significant limitations, and thereby, it is strongly recommended to conduct further studies with a stronger methodology

Towards a Rule-driven Approach for Updating Dynamic Road Segments

In recent years, the development of the GIS-T (Geographic Information System for Transportation) applications has gained much attention, providing the transportation planners and managers with in-depth knowledge to achieve better decisions. Needless to say, developing a successful GIS for transportation applications is highly dependent on the design of a well-structured data model. Dynamic segmentation (DS) data model is a popular one being used more and more for different GIS-T analyses, serving as a data model that splits linear features into new set of segments wherever its attributes change. In most cases, the sets of segments presenting a particular attribute change frequently. Transportation managers place great importance on having regular update and revision of segmented data to ensure correct and precise decisions are made. However, updating the segmented data manually is a difficult task and a time-consuming process to do, demanding an automatic approach. To alleviate this, the present study describes a rule-based method using topological concept to simply update road segments and replace the manual tasks that users are to carry out. The proposed approach was employed and implemented on real road network data of the City of Tehran provided by the Road Maintenance and Transportation Organization (RMTO) of Iran. The practical results demonstrated that the time, cost, human-type errors, and complexity involved in update tasks are all reduced. KEYWORDS: GIS-T, dynamic segmentation, segment, automatic update, change type, rul

The Relationship between Osseous Changes of the Temporomandibular Joint and RDC/TMD Groups in CBCT Images

Abstract Introduction: Temporomandibular joint disorders (TMD) are the most common disorders of the jaw, and despite their clinical importance, they are not completely understood. This study was aimed to evaluate the changes of temporomandibular joint (TMJ) on cone beam computed tomography (CBCT) images in disc displacement vs. osteoarthritis of the TMJ. Methods: In this study, 45 patients, including 37 women and 8 men (13-89 years of age), were examined. The patients were selected based on RDC/TMD criteria and group I disorders were excluded from the study. Accordingly, group II consisted of 43 joints with jaw clicking or displaced discs, and group III comprised 46 joints with crepitus. CBCT images in sagittal, coronal, and axial sections were examined to assess osseous changes in terms of flattening, sclerosis, erosion, resorption, and osteophyte formation. Data were analyzed using statistical tests including the chi-square, Mann-Whitney, and Kolmogorov-Smirnov tests with the confidence interval of 95%. Results: Mann-Whitney test for the comparison of mean age between groups II and III was not statistically significant (p value=0.06). A significant differences was found between two (RDC/TMD) groups according to the prevalence of condylar erosion, resorption, and osteophyte (

Improvement of landfill leachate biodegradability with ultrasonic process.

Landfills leachates are known to contain recalcitrant and/or non-biodegradable organic substances and biological processes are not efficient in these cases. A promising alternative to complete oxidation of biorecalcitrant leachate is the use of ultrasonic process as pre-treatment to convert initially biorecalcitrant compounds to more readily biodegradable intermediates. The objectives of this study are to investigate the effect of ultrasonic process on biodegradability improvement. After the optimization by factorial design, the ultrasonic were applied in the treatment of raw leachates using a batch wise mode. For this, different scenarios were tested with regard to power intensities of 70 and 110 W, frequencies of 30, 45 and 60 KHz, reaction times of 30, 60, 90 and 120 minutes and pH of 3, 7 and 10. For determining the effects of catalysts on sonication efficiencies, 5 mg/l of TiO(2) and ZnO have been also used. Results showed that when applied as relatively brief pre-treatment systems, the sonocatalysis processes induce several modifications of the matrix, which results in significant enhancement of its biodegradability. For this reason, the integrated chemical-biological systems proposed here represent a suitable solution for the treatment of landfill leachate samples