Pediatric Elbow Fractures in a Major Trauma Center in Iran

Background: Elbow fractures are one of the most common traumatic fractures in the pediatric population. Since severe complications may occur, appropriate diagnosis and treatment are imperative when dealing with this type of fracture. Objectives: The aim of this study was to evaluate the epidemiology of elbow fracture in children admitted in Alzahra hospital, Isfahan, IR Iran over a one year period. Patients and Methods: During a one year period, a prospective study was conducted on 300 patients under the age of 16 who had sustained elbow fractures. Data included age, gender, mechanism of trauma, type of elbow fractures, complications, and outcomes. Results: The mean age of the patients was 8.1 ± 2.31 years old. Boys were injured 2.6 times more often than the girls. Falling was the major cause of pediatric elbow fractures (86%). Supra condylar were the most common type of fracture. There was a significant association between gender and type of injury (P < 0.01). Conclusions: Supracondylar fracture is the most common fracture type resulting from 4 - 8 year old boys’ falls. Our findings indicate the critical nature of appropriate treatment in order to prevent severe complications

Evaluation of the Safe Ischemic Time of Clamping During Intermittent Pringles Maneuver in Rabbits

Background: The liver is the most commonly injured organ in blunt abdominal trauma. Although major hepatic bleeding may be partially controlled with portal triade clamping (the Pringle’s maneuver), continuous prolonged clamping results in liver ischemia. Objectives: The purpose of this study was to determine the safe time of Pringle maneuver based on pathologic changes of liver in rabbit models. Materials and Methods: In an experimental study, 20 New-Zealand white rabbits were selected. In laparotomy, a blunt dissector was passed through the foramen of Winslow and the hepato-duodenal ligament encircled with an umbilical tape. En masse Pringle maneuver was performed using atraumatic flexible clamps. Rabbits were divided into four groups based on Pringle maneuver time (30 minutes, 45 minutes, 60 minutes, and 75 minutes). A hepatic biopsy was performed at the beginning of operation. The degree of tissue injury was evaluated using blood markers. Results: There were five rabbits in each group. At the end of 60 minutes ischemia, only minor alterations were observed in pathological specimens. At the end of 75 minutes, hepatocyte damage and necrosis were observed. The serum levels of alanine aminotransferase (Group A: P = 0.02; Group B: P = 0.01; Group C: P = 0.0002; Group D: P = 0.01) and Aspartate aminotransferase (Group A: P = 0.03; Group B: P = 0.002; Group C: P = 0.0004; Group D: P = 0.0003) were significantly increased post-operatively. The maximum level was in the first day after operation. Conclusions: Continuous portal triade clamping (the Pringle maneuver) during liver ischemia (30 and 45 minutes) in rabbits resulted in no ischemic change. Increasing time of clamping to 30 minutes was safe in intermittent Pringle maneuver

Detection of On-Chip Generated Weak Microwave Radiation Using Superconducting Normal-Metal SET

The present work addresses quantum interaction phenomena of microwave radiation with a single-electron tunneling system. For this study, an integrated circuit is implemented, combining on the same chip a Josephson junction (Al/AlO /Al) oscillator and a single-electron transistor (SET) with the superconducting island (Al) and normal-conducting leads (AuPd). The transistor is demonstrated to operate as a very sensitive photon detector, sensing down to a few tens of photons per second in the microwave frequency range around 100 GHz. On the other hand, the Josephson oscillator, realized as a two-junction SQUID and coupled to the detector via a coplanar transmission line (Al), is shown to provide a tunable source of microwave radiation: controllable variations in power or in frequency were accompanied by significant changes in the detector output, when applying magnetic flux or adjusting the voltage across the SQUID, respectively. It was also shown that the effect of substrate-mediated phonons, generated by our microwave source, on the detector output was negligibly small

Minimally Disruptive Cooperative Lane-change Maneuvers

A lane-change maneuver on a congested highway could be severely disruptive or even infeasible without the cooperation of neighboring cars. However, cooperation with other vehicles does not guarantee that the performed maneuver will not have a negative impact on traffic flow unless it is explicitly considered in the cooperative controller design. In this letter, we present a socially compliant framework for cooperative lane-change maneuvers for an arbitrary number of CAVs on highways that aims to interrupt traffic flow as minimally as possible. Moreover, we explicitly impose feasibility constraints in the optimization formulation by using reachability set theory, leading to a unified design that removes the need for an iterative procedure used in prior work. We quantitatively evaluate the effectiveness of our framework and compare it against previously offered approaches in terms of maneuver time and incurred throughput disruption.Comment: 6 pages, 2 figure

Analgesic effects of intravenous ketamine during spinal anesthesia in pregnant women undergone Caesarean section; a randomized clinical trial

Suitable analgesia after cesarean section helps mothers to be more comfortable and increases their mobility and ability to take better care of their infants. Objectives: Pain relief properties of ketamine prescription were assessed in women with elective cesarean section who underwent spinal anesthesia with low dose intravenous ketamine and midazolam and intravenous midazolam alone. Patients and Methods: Sixty pregnant women scheduled for spinal anesthesia for cesarean section were randomized into two study groups. Ketamine (30 mg) + midazolam (1 mg = 2CC) or 1mg midazolam (2CC) alone, was given immediately after spinal anesthesia. Pain scores at first, second and third hours after CS operation, analgesic requirement and drug adverse effects were recorded in all patients. Results: Ketamine group had significant pain relief properties in compare with control group in first hours after cesarean section (0.78 ± 1.09 vs. 1.72 ± 1.22, VAS score, P = 0.00). Total dose of meperidine consumption in women of ketamine group was significantly lower than women of control group (54.17 ± 12.86 vs. 74.44 ± 33.82 mg, P = 0.02). There were no significant drug side effects in participated patients. Conclusions: Intravenous low-dose ketamine combined with midazolam for sedation during spinal anesthesia for elective Caesarean section provides more effective and long lasting pain relief than control group. © 2013 Iranian Society of Regional Anesthesia and Pain Medicine

Reformism, Economic Liberalisation and Popular Mobilisation in Iran

Whereas in other MENA countries the impact of neo-liberal policies has been the subject of intense debate, there are at present few voices that directly analyse or critique its social and political consequences in Iran. This article seeks to address this lacuna by analysing the dynamics of reformism, economic liberalisation and popular mobilisation in Iran. It charts the country’s move from a post-revolutionary populism to a liberalised yet increasingly exclusivist model of politics and compares this to trajectories of economic liberalisation in Egypt. Two distinct outcomes of economic reform are analysed in the first part of the article: Socio-economic exclusion; and the contraction of political rights. In the second half, I investigate the ways successive post-war governments in Iran have packaged neo-liberal reforms, and how their re-imagining of the role of the state has led to differing levels of popular resistance. Finally I argue that under the present administration, political elites increasingly are oriented toward strengthening the state and seeking to limit opposition to their policies. However, the absence of neo-liberal hegemony in Iran means that growing mobilization on socio-economic issues is challenging these policies. The Right in Iranian politics is utilizing this mobilisation to present a populist challenge to the reformists in power

Pre-existing autoimmunity is associated with increased severity of COVID-19: A retrospective cohort study using data from the National COVID Cohort Collaborative (N3C)

Identifying individuals with a higher risk of developing severe COVID-19 outcomes will inform targeted or more intensive clinical monitoring and management. To date, there is mixed evidence regarding the impact of pre-existing autoimmune disease (AID) diagnosis and/or immunosuppressant (IS) exposure on developing severe COVID-19 outcomes.A retrospective cohort of adults diagnosed with COVID-19 was created in the National COVID Cohort Collaborative enclave. Two outcomes, life-threatening disease, and hospitalization were evaluated by using logistic regression models with and without adjustment for demographics and comorbidities.Of the 2,453,799 adults diagnosed with COVID-19, 191,520 (7.81%) had a pre-existing AID diagnosis and 278,095 (11.33%) had a pre-existing IS exposure. Logistic regression models adjusted for demographics and comorbidities demonstrated that individuals with a pre-existing AID (OR = 1.13, 95% CI 1.09 - 1.17; P&lt; 0.001), IS (OR= 1.27, 95% CI 1.24 - 1.30; P&lt; 0.001), or both (OR = 1.35, 95% CI 1.29 - 1.40; P&lt; 0.001) were more likely to have a life-threatening COVID-19 disease. These results were consistent when evaluating hospitalization. A sensitivity analysis evaluating specific IS revealed that TNF inhibitors were protective against life-threatening disease (OR = 0.80, 95% CI 0.66- 0.96; P=0.017) and hospitalization (OR = 0.80, 95% CI 0.73 - 0.89; P&lt; 0.001).Patients with pre-existing AID, exposure to IS, or both are more likely to have a life-threatening disease or hospitalization. These patients may thus require tailored monitoring and preventative measures to minimize negative consequences of COVID-19

Loss of CD4+ T cell-intrinsic arginase 1 accelerates Th1 response kinetics and reduces lung pathology during influenza infection

Arginase 1 (Arg1), the enzyme catalyzing the conversion of arginine to ornithine, is a hallmark of IL-10-producing immunoregulatory M2 macrophages. However, its expression in T cells is disputed. Here, we demonstrate that induction of Arg1 expression is a key feature of lung CD4+ T cells during mouse in vivo influenza infection. Conditional ablation of Arg1 in CD4+ T cells accelerated both virus-specific T helper 1 (Th1) effector responses and its resolution, resulting in efficient viral clearance and reduced lung pathology. Using unbiased transcriptomics and metabolomics, we found that Arg1-deficiency was distinct from Arg2-deficiency and caused altered glutamine metabolism. Rebalancing this perturbed glutamine flux normalized the cellular Th1 response. CD4+ T cells from rare ARG1-deficient patients or CRISPR-Cas9-mediated ARG1-deletion in healthy donor cells phenocopied the murine cellular phenotype. Collectively, CD4+ T cell-intrinsic Arg1 functions as an unexpected rheostat regulating the kinetics of the mammalian Th1 lifecycle with implications for Th1-associated tissue pathologies

A Socio-Technical and Co-Evolutionary Framework for Reducing Human-Related Risks in Cyber Security and Cybercrime Ecosystems

The focus on cyber security as an interaction between technical elements and humans has typically confined consideration of the latter to practical issues of implementation, conventionally those of `human performance factors' of vigilance etc., 'raising awareness' and/or 'incentivization' of people and organizations to participate and adapt their behavior. But this is far too narrow a view that seriously constrains the ability of cyber security as a whole to adapt and evolve to keep up with adaptive, innovative attackers in a rapidly-changing technological, business and social landscape, in which personal preferences of users are also dynamically evolving. While there is isolated research across different research areas, we noticed the lack of a \emph{holistic} framework combining a range of applicable theoretical concepts (e.g., cultural co-evolution such as technological arms races, opportunity management, behavioral and business models) and technological solutions on reducing human-related risks in the cyber security and cybercrime ecosystems, which involve multiple groups of human actors including offenders, victims, preventers and promoters. This paper reports our ongoing work in developing such a socio-technical framework 1) to allow a more comprehensive understanding of human-related risks within cyber security and cybercrime ecosystems and 2) to support the design of more effective approaches to engaging individuals and organizations in the reduction of such risks. We are in the process of instantiating this framework to encourage behavioral changes in two use cases that capture diverse and complicated socio-technical interactions in cyber-physical systems