The trend of changes in depression, anxiety and stress in men with lower limb trauma: A prospective study

Introduction: Activity restrictions can have potential impacts on the prevalence of mental disorders. However, in patients with lower limb traumas the problems and the physical disabilities are usually taken more into consideration than mental status, while they refer for further examinations. Therefore, this study is aimed to investigate the changes in the process of depression, anxiety and stress in men with lower limb traumas. Materials and Methods: In a prospective study the patients with lower limb traumas, who have been hospitalized in Amir Al-Mo�menin and Kowsar hospitals in Semnan since June 2012 to August 2015, were selected randomly and studied. The data was collected by demographic and incident questionnaire and depression, anxiety and stress questionnaire. At first the patients were asked to complete the questionnaires based on their psychological experience of one month prior to the trauma. Then same questionnaires were completed by the patients one and three months after the trauma. The data was analyzed using Friedman and Wilcoxon tests. Results: The data of 157 patients was analyzed. The results showed that there was a significant difference in the severity of depression disorders, anxiety and stress in three stages of the study (P0.05). Conclusion: The prevalence of depression, anxiety and stress is increased in people with lower limb traumas. Therefore it is recommended that the patients with lower limb traumas to be supported mentally, socially and economically. © 2016, Semnan University of Medical Sciences. All rights reserved

Investigating centering, scan length, and arm position impact on radiation dose across 4 countries from 4 continents during pandemic: mitigating key radioprotection issues

Purpose: Optimization of CT scan practices can help achieve and maintain optimal radiation protection. The aim was to assess centering, scan length, and positioning of patients undergoing chest CT for suspected or known COVID-19 pneumonia and to investigate their effect on associated radiation doses. Methods: With respective approvals from institutional review boards, we compiled CT imaging and radiation dose data from four hospitals belonging to four countries (Brazil, Iran, Italy, and USA) on 400 adult patients who underwent chest CT for suspected or known COVID-19 pneumonia between April 2020 and August 2020. We recorded patient demographics and volume CT dose index (CTDIvol) and dose length product (DLP). From thin-section CT images of each patient, we estimated the scan length and recorded the first and last vertebral bodies at the scan start and end locations. Patient mis-centering and arm position were recorded. Data were analyzed with analysis of variance (ANOVA). Results: The extent and frequency of patient mis-centering did not differ across the four CT facilities (>0.09). The frequency of patients scanned with arms by their side (11–40% relative to those with arms up) had greater mis-centering and higher CTDIvol and DLP at 2/4 facilities (p = 0.027–0.05). Despite lack of variations in effective diameters (p = 0.14), there were significantly variations in scan lengths, CTDIvol and DLP across the four facilities (p < 0.001). Conclusions: Mis-centering, over-scanning, and arms by the side are frequent issues with use of chest CT in COVID-19 pneumonia and are associated with higher radiation doses

Iranian joint registry (iranian national hip and knee arthroplasty registry)

Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education. ©BY THE ARCHIVES OF BONE AND JOINT SURGERY

Long-Term Alterations of Cytokines and Growth Factors Expression in Irradiated Tissues and Relation with Histological Severity Scoring

PURPOSE: Beside its efficacy in cancer treatment, radiotherapy induces degeneration of healthy tissues within the irradiated area. The aim of this study was to analyze the variations of proinflammatory (IL-1α, IL-2, IL-6, TNF-α, IFN-γ), profibrotic (TGF-β1), proangiogneic (VEGF) and stem cell mobilizing (GM-CSF) cytokines and growth factors in an animal model of radiation-induced tissue degeneration. MATERIALS AND METHODS: 24 rats were irradiated unilaterally on the hindlimb at a monodose of 30 Gy. Six weeks (n=8), 6 months (n=8) and 1 year (n=8) after irradiation the mediators expression in skin and muscle were analyzed using Western blot and the Bio-Plex® protein array (BPA) technology. Additional histological severity for fibrosis, inflammation, vascularity and cellularity alterations scoring was defined from histology and immnunohistochemistry analyses. RESULTS: A significant increase of histological severity scoring was found in irradiated tissue. Skin tissues were more radio-sensitive than muscle. A high level of TGF-β1 expression was found throughout the study and a significant relation was evidenced between TGF-β1 expression and fibrosis scoring. Irradiated tissue showed a chronic inflammation (IL-2 and TNF-α significantly increased). Moreover a persistent expression of GM-CSF and VEGF was found in all irradiated tissues. The vascular score was related to TGF-β1 expression and the cellular alterations score was significantly related with the level of IL-2, VEGF and GM-CSF. CONCLUSION: The results achieved in the present study underline the complexity and multiplicity of radio-induced alterations of cytokine network. It offers many perspectives of development, for the comprehension of the mechanisms of late injuries or for the histological and molecular evaluation of the mode of action and the efficacy of rehabilitation techniques

Human adipose stem cells cell sheet constructs impact epidermal morphogenesis in full-thickness excisional wounds

Among the wide range of strategies to target skin repair/regeneration, tissue engineering (TE) with stem cells at the forefront, remains as the most promising route. Cell sheet (CS) engineering is herein proposed, taking advantage of particular cell-cell and cell-extracellular matrix (ECM) interactions and subsequent cellular milieu, to create 3D TE constructs to promote full-thickness skin wound regeneration. Human adipose derived stem cells (hASCs) CS were obtained within five days using both thermoresponsive and standard cell culture surfaces. hASCs-based constructs were then built by superimposing three CS and transplanted into full-thickness excisional mice skin wounds with delayed healing. Constructs obtained using thermoresponsive surfaces were more stable than the ones from standard cell culture surfaces due to the natural adhesive character of the respective CS. Both CS-generating strategies lead to prolonged hASCs engraftment, although no transdifferentiation phenomena were observed. Moreover, our findings suggest that the transplanted hASCs might be promoting neotissue vascularization and extensively influencing epidermal morphogenesis, mainly through paracrine actions with the resident cells. The thicker epidermis, with a higher degree of maturation characterized by the presence of rete ridges-like structures, as well as a significant number of hair follicles observed after transplantation of the constructs combining the CS obtained from the thermoresponsive surfaces, reinforced the assumptions of the influence of the transplanted hASCs and the importance of the higher stability of these constructs promoted by cohesive cell-cell and cell-ECM interactions. Overall, this study confirmed the potential of hASCs CS-based constructs to treat full-thickness excisional skin wounds and that their fabrication conditions impact different aspects of skin regeneration, such as neovascularisation, but mainly epidermal morphogenesis.We would like to thank Hospital da Prelada (Porto), in particular, to Dr. Paulo Costa for the lipoaspirates collection and for financial support by Skingineering (PTDC/SAU-OSM/099422/2008), Portuguese Foundation for Science and Technology (FCT) funded project. The research leading to these results has also received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under Grant Agreement No. REGPOT-CT2012-316331-POLARIS

NADPH oxidases in cardiovascular disease: insights from in vivo models and clinical studies

NADPH oxidase family enzymes (or NOXs) are the major sources of reactive oxygen species (ROS) that are implicated in the pathophysiology of many cardiovascular diseases. These enzymes appear to be especially important in the modulation of redox-sensitive signalling pathways that underlie key cellular functions such as growth, differentiation, migration and proliferation. Seven distinct members of the family have been identified of which four (namely NOX1, 2, 4 and 5) may have cardiovascular functions. In this article, we review our current understanding of the roles of NOX enzymes in several common cardiovascular disease states, with a focus on data from genetic studies and clinical data where available

Iranian joint registry (iranian national hip and knee arthroplasty registry)

Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education. ©BY THE ARCHIVES OF BONE AND JOINT SURGERY

Adaptive Bayesian Inference Framework for Joint Model and Noise Identification

Model updating, the process of inferring a model from data, is prone to the adverse effects of modeling error, which is caused by simplification and idealization assumptions in the mathematical models. In this study, an adaptive recursive Bayesian inference framework is developed to jointly estimate model parameters and the statistical characteristics of the prediction error that includes the effects of modeling error and measurement noise. The prediction error is usually modeled as a Gaussian white noise process in a Bayesian model updating framework. In this study, the prediction error is assumed to be a nonstationary Gaussian process with an unknown and time-variant mean vector and covariance matrix to be estimated. This allows one to better account for the effects of time-variant model uncertainties in the model updating process. The proposed approach is verified numerically using a 3-story 1-bay nonlinear steel moment frame excited by an earthquake. Comparison of the results with those obtained from a classical nonadaptive recursive Bayesian model updating method shows the efficacy of the proposed approach in the estimation of the prediction error statistics and model parameters. © 2021 American Society of Civil Engineers

Adaptive Kalman filters for nonlinear finite element model updating

This paper presents two adaptive Kalman filters (KFs) for nonlinear model updating where, in addition to nonlinear model parameters, the covariance matrix of measurement noise is estimated recursively in a near online manner. Two adaptive KF approaches are formulated based on the forgetting factor and the moving window covariance-matching techniques using residuals. Although the proposed adaptive methods are integrated with the unscented KF (UKF) for nonlinear model updating in this paper, they can be alternatively combined with other types of nonlinear KFs such as the extended KF (EKF) or the ensemble KF (EnKF). The performance of the proposed methods is investigated through two numerical applications and compared to that of a non-adaptive UKF and an existing dual adaptive filter. The first application considers a nonlinear steel pier where nonlinear material properties are selected as updating parameters. Significant improvements in parameter estimation results are observed when using adaptive filters compared to the non-adaptive approach. Furthermore, the covariance matrix of simulated measurement noise is estimated from the adaptive approaches with acceptable accuracy. Effects of different types of modeling errors are studied in the second numerical application of a nonlinear 3-story 3-bay steel frame structure. Similarly, more accurate and robust parameter estimations and response predictions are obtained from the adaptive approaches compared to the non-adaptive approach. The results verify the effectiveness and robustness of the proposed adaptive filters. The forgetting factor and moving window methods are shown to have a simpler tuning process compared to the dual adaptive method while providing similar performance. © 2020 Elsevier Lt