Guillain-Barré Syndrome in North Eastern Iran; 1999-2005

ObjectiveTo study the clinical presentation, hospital course and outcomes of patients admitted with Guillain-Barre Syndrome (GBS) to three tertiary care hospitals in Mashhad, Iran.Materials and MethodsThe records of all patients admitted with flaccid paralysis between April 1999 and January 2005 were reviewed and those with the diagnosis of GBS were included in the study. Standard questionnaires were used to record clinical data on was recorded on a standardized questionnaire, which included patients' age, sex, antecedent infectious history, neurological signs and symptoms and ventilation requirements. The hospital course, including therapy given and the functional status of patients, was analyzed, including therapy given and the functional status of patients.ResultsNinety-one cases of acute flaccid paralysis were admitted to the hospitals during the study period. Eighty-three cases, age range 10 months to 11 years, were later diagnosed as GBS afterwards, with an age range of 10 months to 11 years. The mean age for disease onset was 4.2 years; there were 47 boys and 34 girls, male to female ratio 1:0.7. Upper respiratory tract infection (62.6%) was the most common antecedent event, followed by gastrointestinal infections (19%), urinary tract infection (1.2%) and chicken pox (2.4%), while the remaining cases (14.8%) had no other cases (14.8%) did not have any reliable history of any preceding antecedent infections. Most patients developed GBS within one month of the preceding infection. Cranial nerve abnormalities (19.3%), autonomic dysfunction (7.2%) and respiratory failure requiring intubation (10.8%) were also common. The in-patient mortality was 2.4% (2 of 83).ConclusionGBS was found to occur slightly more often in male patients, majority of whom had histories of previous infection. Despite persistent disability, in-hospital mortality was low.

Patients’ expectations and satisfaction with their health providers

The growing amount of research into patients’ expectations of medical consultations reflects the view of the patient as an active consumer rather than a passive recipient of care. Patients’ care often diverges from their expectations in important respects. Patients tend to receive more prescription and less information. The fulfillment of certain expectations has been related to satisfaction with the consultation that in turn would improve compliance. Patient satisfaction is also correlated with the patient’s reported intention to change physician. The higher the perceived fulfillment of the expectation is, the higher the satisfaction is. When fulfillment is lower than the expectation, the greater the gap and the lower the satisfaction. Today patient satisfaction is considered a key measure of quality of care and patients reporting higher satisfaction were more likely to have a higher quality of life

Patients’ expectations and satisfaction with their health providers

The growing amount of research into patients’ expectations of medical consultations reflects the view of the patient as an active consumer rather than a passive recipient of care. Patients’ care often diverges from their expectations in important respects. Patients tend to receive more prescription and less information. The fulfillment of certain expectations has been related to satisfaction with the consultation that in turn would improve compliance. Patient satisfaction is also correlated with the patient’s reported intention to change physician. The higher the perceived fulfillment of the expectation is, the higher the satisfaction is. When fulfillment is lower than the expectation, the greater the gap and the lower the satisfaction. Today patient satisfaction is considered a key measure of quality of care and patients reporting higher satisfaction were more likely to have a higher quality of life

CEP78, a novel centrosomal protein

Contexte: Le centrosome est un petit organite bien connu pour son rôle dans l'établissement du fuseau bipolaire pendant la division cellulaire. Les déficiences de la fonction du centrosome donnent souvent lieu à des maladies humaines, y compris le cancer et la formation de kystes rénaux. Nous sommes intéressés à étudier la fonction d'une nouvelle protéine centrosomale nommée CEP78, identifiée dans un criblage protéomique pour de nouveaux composants centrosomaux. Méthodes et résultats : Le traitement des cellules avec le nocodazole, un agent qui dépolymérise spécifiquement les microtubules cytoplasmiques mais pas les microtubules stabilisés du centrosome, a montré que CEP78 est un composant centrosomal stable. La colocalisation de cette protéine avec d'autres marqueurs centrosomaux tels que CEP164, SAS6, Centrine, tubuline polyglutamylée et POC5, à différentes phases du cycle cellulaire a indiqué que CEP78 est précisément à l'extrémité distale des centrioles, mères et filles. Il existe deux pointts CEP78 au cours de l’interphase et les cellules passent par la mitose, procentrioles maturent, et le nombre de points de CEP78 augmente à 4 par cellule et, à la fin de la télophase chaque cellule fille possède 2 points CEP78. La caractérisation des domaines fonctionnels de CEP78 a montré que des répétitions riches en leucine sont nécessaires pour la localisation centrosomale de la protéine. En outre, nous avons constaté que la surexpression de CEP78 ne change pas le nombre de mères/procentrioles mais diminue le nombre et l'intensité des points de CEP170 (protéine d'appendice sous-distal) sans diminution du niveau d'expression de cette protéine. D'autres études ont montré qu'il n'y a pas d'interaction entre ces deux protéines. Enfin, la surexpression de CEP78 protège des microtubules contre la dépolymérisation en présence de nocodazole, ce qui suggère qu'il possède la capacité de lier les microtubules. Conclusion : Nos résultats suggèrent que CEP78 est destiné à l'extrémité distale des centrioles matures par ses répétitions riche en lecuine, où il pourrait être impliqué dans la maturation ou la régulation de l'assemblage ou de la rénovation de l'appendice sous-distal centriolaire, une structure connue dans la nucléation des microtubules et d'ancrage. Comprendre la fonction de Cep78 contribuera à éclaircir le rôle du centrosome dans le cycle cellulaire.Background: The centrosome is a tiny organelle well-known for its role in establishing the bipolar spindle during cell division. Defects in centrosome function often give rise to human diseases including cancer and kidney cyst formation. We are interested in studying the function of one novel centrosomal protein named CEP78, identified in a proteomic screen for novel centrosomal components. Methods and results: Treatment of cells with nocodazole, a microtubule-depolymerizing agent that specifically depolymerizes cytoplasmic microtubules but not the stabilized centrosome microtubules, showed that CEP78 is a stable centrosomal component. Colocalization of this protein with other centrosomal markers such as CEP164, SAS6, Centrin, Polyglutamylated tubulin and POC5 at different phases of the cell cycle indicated that CEP78 specifically localizes to the distal end of the mother and daughter centrioles. There are 2 CEP78 dots during the interphase and as the cells go through mitosis, procentrioles mature, and the number of CEP78 dots increases to 4 dots per cell and by the end of telophase each daughter cell has 2 CEP78 dots. Characterization of CEP78 functional domains showed that Leucine-rich repeats are necessary for centrosomal localization of the protein. In addition, we found that overexpression of CEP78 did not change the number of centrioles and centrosomes but decreased the number and intensity of CEP170 dots (sub-distal appendage protein) without a decrease in the expression level of this protein. Further studies showed that there is no interaction between these 2 proteins. Finally, overexpression of CEP78 protects microtubules from depolymerization in the presence of nocodazole, suggesting its ability to bind microtubules. Conclusion: Our findings suggest that CEP78 is targeted to the distal end of mature centrioles via its lecuine-rich repeats, where it could be involved in centriolar maturation or regulation of sub-distal appendage assembly and/or remodeling, a structure known to nucleate and anchor microtubules. Understanding the function of CEP78 will shed light on the role of the centrosome in cell cycle

Intangible Cultural Heritage and Tourism in Protected Areas

Following the new paradigm of protected areas (PAs) most parts of the literature focus on the importance of the local community and their cultural heritage for a PA in achieving its conservation and development goals. However, few studies have addressed the intangible cultural heritage (ICH) of a local community living within a PA and its possible relationship with tourism. In addition, the notion of ICH is taken as an emerging topic in the academic environments; therefore, up to know there is little indication of the role and manifestation of ICH in tourism within the boundaries of PAs. In many cases, tourism and the local community usually are considered as two fundamental aspects for the development and prosperity of a PA. Also, a considerable part of ICH of the local community living in a PA is linked to the surrounding natural features in many ways. Regarding these relationships, a tripartite interconnection between the concepts of ICH, tourism, and PAs is identifiable. With regard to this interconnection, a question arises about what the possible role and manifestation of ICH are in tourism in a PA. In fact, this question addresses the possible ways that ICH contributes to tourism within the territories of PAs. To answer this question and to fill a part of the gap in the literature, this research project is an attempt to explore the potential and possible role, and the manifestation of ICH in tourism in a PA from the perspective of locals and visitors. The empirical phase of this research project was conducted in the first declared geopark in the Middle-East; Qeshm Island Geopark (QIG) is located in the Persian Gulf in the south of Iran. Applying an ethnography, qualitative semi-structured interviews and participant observation were used over six months to explore the research objective among the natural and cultural landscapes of QIG. Applying thematic network analysis to analyse the rich empirical information, two global themes supported by six organizing themes were identified. In general, the intangible cultural asset is presented as a set of “opportunities” for a tourism setting in a PA. This thesis also outlines a set of “challenges” in the way of ICH promotion in tourism in a PA. Exploring the roles that the intangible aspect of local culture can take in a PA’s tourism, as well as the existing, and potential challenges in the way, this thesis provides an avenue towards a greater understanding of the area of the relationship between tourism in PAs and culture of the local community. Notably, this understanding supports the principles and objectives of the new paradigm of PAs. I believe that the implication of this research is transferable and applicable to different types of PAs across the world, PAs that are populated by a human community (ies), and also are open to tourism

Simulation and analysis of load shifting and energy saving potential of CO2-based demand-controlled ventilation in a sports training center

This paper aims to evaluate and characterize the impact of optimizing the operation of the HVAC system through maintaining dynamic CO2-based Demand-Controlled ventilation (DCV) on the electricity load profile and energy consumption of the sports training center of Leibniz University Hannover. The actual ventilation control scheme, in which the operation of the HVAC system is operated with a two-stage volume flow controller based on indoor CO2 concentration is improved through two steps to avoid overventilation and reduce power consumption. For this purpose, a detailed multi-zone model of the sports center and energy supply system has been developed in TRNSYS. In the first step, a multi-stage control scenario is implemented considering the occupancy schedules and indoor CO2 concentration measurement data. In the second step, based on an indoor CO2 concentration model, a predictive control scenario is developed and applied. Aiming at characterizing the influence of these operation scenarios on the power consumption of the building, the annual electricity load profiles of the simulation cases will be analyzed and compared with the actual load profile of the building based on the technical planning documents and data provided by building management system (BMS). Simulation results show that utilizing predictive CO2-based DCV leads to a reduction of the peak load electricity by almost 2 kW and the base load by 5 kW as well as decreasing the annual energy consumption by 40 %

Diode calibration for dose determination in total body irradiation

Background: Total Body Irradiation (TBI) is different from standard radiotherapy in many aspects, so it is not easy to predict the delivered dose to the patient under TBI treatment. Diode dosimetry procedures for surface dose reading can help to define variations of the actually delivered dose from the prescribed one. The aim of this study was to describe the measurements made to calibrate diodes in order to implement as a dosimeter for TBI tratment. An algorithm was also proposed based on diode dosimetry in order to determine the midplane dose. Materials and Methods: In this study, four p-type diodes connected to a MULTIDOSE electrometer were implemented as dosimeter. For diode calibration a water phantom with dimension of 30�30�32cm3 along with a 0.6 cc Farmer ion chamber were used. Directional dependence of diodes, the effects of thickness correction factor and complete backscatter factor were studied. Three algorithms, arithmetic, geometric mean and proposed algorithm were used to investigate midplane dose determination in TBI condition. Results: It was found by measurements that the effect of angle incident on diode response was significant and should have been taken into account. Variation in thickness correction factor was found about 0.7. The accuracy in midplane dose determination in the arithmetic, geometric mean and proposed algorithm was about 3.8, 12.5 and 3.3, respectively. Conclusion: Diode dosimetry is very useful as a check of midplane dose delivered to patients under TBI treatment. When the calibration and correction factors are carefully determined, high precision can be obtained. The proposed algorithm by this study seems to be useful in order to midplane dose determination in TBI condition

Cutaneous vasculitis following COVID-19 vaccination: a case-based review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging virus that causes a disease mainly known by its pulmonary and thrombotic complications. Although cutaneous complications, including vasculitis, have been reported in infected patients, the development of vasculitis after receiving vaccine is a rare clinical finding. Here, we report a case of vasculitis in a female patient who received a COVID-19 vaccine and was later infected with SARS-CoV-2, and was also diagnosed with hepatitis B during hospitalization. Our patient did not have a previous history of similar cutaneous manifestations of vasculitis, and the development of the symptoms approximately one month from the vaccination suggests immune complex hypersensitivity reaction