A new biomechanical method for objective measurement of spasticity: A preliminary study

The assessment of the various impairments in brain damage including spasticity is important. The purpose of this study was to develop a new biomechanical method based on quantification of velocity reduction (VR) suitable for clinical use. A highly reliable system was developed to apply a constant torque perturbation at the elbow. This system was used to measure the VR in 30 healthy adults and 10 hemiplegic patients. In healthy subjects, the mean VR was 3.02 (SE (standard error) = 0.29). In hemiplegic patients, the mean VR in the impaired arm (81.47, SE= 2.87) was significantly higher than the VR () either in the nonimpaired arm (9.86, SE= 0.92) (WSRT (Wilcoxon Signed Ranks Test): Z = -12.74; p<0.001), or the normal (3.02) p<0.001). The interaction between the associated reaction (AR) and the asymmetrical tonic neck reflex (ATNR) with head away from the impaired arm made a significant higher VR (90.41, SE=3.43) (p<0.001). The correlation between the VR () and the Modified Ashworth Scale scores was significant (Spearman�s rho = 0.77, p<0.001). It is concluded that the quantification of velocity reduction may be used as an objective method of measuring spasticity in neurological conditions. © MA Healthcare Limited 2014

Appropriateness of physicians' lumbosacral MRI requests in private and public centers in Tehran, Iran

Background: Back pain is a common patients' complaint, and its etiology is important because of different potential treatment approaches (based on causes). For a better diagnosis, magnetic resonance imaging (MRI) is widely used in clinical settings that may result in inappropriate requests. This study aims to evaluate the appropriateness of the lumbosacral MRI requests in patients with back pain in two public/referral and private imaging centers in Tehran. Methods: In this cross-sectional study, 279 patients from both centers were recruited in 2014. A checklist was developed based on the internationally recognized clinical guidelines (NICE, and AHRQ) for determining the indications. An expert panel of related specialties finalized them. Patients' demographic and some anthropometric measures, as well as MRI reports, were collected. Results: The mean±SD age of patients was 47.9±14.78 years with a dominance of females (M/F=38.4/61.6). About 77 (n=214) of lumbosacral MRIs were requested in accordance with the guidelines. Indicated MRI requests were significantly higher in the private imaging center (p=0.019, OR=2.087, CI 95: 1.13-3.85). In the private center, 80.6 and in the public center, 70.4 of the MRI requests were in accordance with the guidelines. Conclusion: The proportion of non-indicated MRI requests based on the valid guidelines is about 1/4 of all requests that is compatible with some other studies mostly from developed countries

Association between Epstein-Barr virus infection and gastric cancer: A systematic review and meta-analysis

Background: Numerous studies conducted over the past 30 years have pointed to the presence of Epstein-Barr virus (EBV) in gastric cancer samples. This study was aimed to provide a meta-analytic review of the prevalence of EBV in gastric cancer patients, and to clarify the relationship between EBV infection and gastric cancer. Methods: A literature search was performed electronically using online databases for English language publications until July 1, 2019. The pooled EBV prevalence and 95 confidence intervals (CIs) were estimated using a random-effects model. To determine the association between EBV and gastric cancer, pooled odds ratio (OR) and its 95 CI were computed for case-control studies. Two separate analyses were performed on data from case-control studies with matched and non-match pairs designs to calculate the pooled estimates of ORs. Results: The pooled prevalence of EBV in 20,361 gastric cancer patients was 8.77 (95 CI: 7.73-9.92; I2 = 83.2). There were 20 studies with matched pairs design, including tumor and tumor-adjacent normal tissue pairs from 4116 gastric cancer patients. The pooled ORs were 18.56 (95 CI: 15.68-21.97; I2 = 55.4) for studies with matched pairs design and 3.31 (95 CI: 0.95-11.54; I2 = 55.0) for studies with non-matched pairs design. The proportion of EBV-associated gastric cancer among male cases was significantly higher than among female cases (10.83, vs. 5.72) (P &lt; 0.0001). However, the pooled OR estimate for EBV-associated gastric cancer was significantly higher among females (21.47; 95 CI: 15.55-29.63; I2 = 0) than in males (14.07; 95 CI: 10.46-18.93; I2 = 49.0) (P = 0.06). EBV was more prevalent in the cardia (12.47) and the body (11.68) compared to the antrum (6.29) (P = 0.0002). Conclusions: EBV infection is associated with more than 18 times increase the risk of gastric cancer. Although the prevalence of EBV was higher in male patients than in female patients with gastric cancer, women are more likely than men to develop EBV-associated gastric cancer. Our findings showed that using tumor-adjacent normal tissues as the control group provides more robust and accurate results regarding the relationship between EBV infection and gastric cancer. © 2020 The Author(s)

Association of polymorphisms in inflammatory cytokines encoding genes with severe cases of influenza A/H1N1 and B in an Iranian population

Background: The increased levels of blood cytokines is the main immunopathological process that were attributed to severe clinical outcomes in cases of influenza A, influenza B and people with influenza-like illness (ILI). Functional genetic polymorphisms caused by single nucleotide polymorphisms (SNPs) in inflammatory cytokines genes can influence their functions either qualitatively or quantitatively, which is associated with the possibility of severe influenza infections. The aim of the present case-control study was to investigate the association of polymorphisms in inflammatory cytokines genes with influenza patients and ILI group in an Iranian population. Methods: Total number of 30 influenza B, 50 influenza A (H1N1) and 96 ILI inpatient individuals were confirmed by Real-time RT-PCR and HI assays. The genotype determination was assessed for defined SNPs in IL-1β, IL-17, IL-10 and IL-28 genes. Results: The frequencies of the IL-1β rs16944 (P = 0.007) and IL-17 rs2275913 (P = 0.006) genotypes were associated with severe influenza disease, while the frequencies of IL-10 rs1800872 and IL-28 rs8099917 were not associated with the disease (P > 0.05). Also, the absence of A allele in IL-17 rs2275913 SNP increased the risk of influenza A (H1N1) infection (P = 0.008). Conclusions: This study demonstrated that influenza A-(H1N1) and B-infected patients and also ILI controls have different profiles of immune parameters, and individuals carrying the specific cytokine-derived polymorphisms may show different immune responses towards severe outcome

Effects of lateral retinacular release on the lateral stability of the patella.

Accepted versio

The molecular epidemiology of respiratory viruses in military trainees in Iran

Background: Military populations are more prone to respiratory infections worldwide. There is a dearth of research about the role of viral pathogens in the etiology of respiratory infections in military trainees in Iran. Hence, we aimed to investigate the molecular epidemiology and clinical symptoms of respiratory viruses among this population. Methods: This cross-sectional study was performed on 400 military trainees with symptoms of respiratory infection, referred to the military medical clinic center in the basic military training camp of the General Staff of the Armed Forces of the Islamic Republic of Iran. Nucleic acid extraction from the throat or nasopharyngeal swab samples was performed by an automated extraction system. The extracts were then analyzed by the CLART® PneumoVir array system for the detection of respiratory viruses. Results: All military trainees were male, aged between 18 and 57 years (mean: 21.69 years). Sore throat (75.5), rhinorrhea (63.2), cough (59.2), fever (59.2), and nasal congestion (50.5) were amongst the most common symptoms. Overall, viral pathogens were detected in a total count of 124 (31). The most commonly detected viruses were rhinovirus (7.2), respiratory syncytial virus A (7.2) and influenza B virus (6). Conclusion: This study was an important first step for understanding the etiological role of viral pathogens in respiratory infection among military trainees population in Iran. Our results indicated that rhinovirus, respiratory syncytial virus A and influenza B virus are important viral pathogens causing respiratory infection in military trainees, respectively. However, further multi-center studies with larger sample size are strongly recommended to confirm our findings. © Iran University of Medical Sciences

Designing an information system for updating land records in Bangladesh: action design ethnographic research (ADER)

Open Access. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.This article has been made available through the Brunel Open Access Publishing Fund.Information Systems (IS) has developed through adapting, generating and applying diverse methodologies, methods, and techniques from reference disciplines. Further, Action Design Research (ADR) has recently developed as a broad research method that focuses on designing and redesigning IT and IS in organizational contexts. This paper reflects on applying ADR in a complex organizational context in a developing country. It shows that ADR requires additional lens for designing IS in such a complex organizational context. Through conducting ADR, it is seen that an ethnographic framework has potential complementarities for understanding complex contexts thereby enhancing the ADR processes. This paper argues that conducting ADR with an ethnographic approach enhances design of IS and organizational contexts. Finally, this paper aims presents a broader methodological framework, Action Design Ethnographic Research (ADER), for designing artefacts as well as IS. This is illustrated through the case of a land records updating service in Bangladesh

An Analytical Model to Predict and Minimize the Residual Stress of Laser Cladding Process

Laser Cladding is one of the advanced thermal techniques used to repair or modify the surface properties of high value components such as tools, military and aerospace parts. Tensile residual stresses are formed in the thermally treated area of this process. This work focuses on to find out key factors of formation and minimization of tensile residual stresses in dissimilar materials. In order to predict the tensile residual stress, one dimensional analytical model has been adopted. Four cladding materials (Al2O3, TiC, TiO2, ZrO2) on the H13 tool steel substrate and a range of preheating temperature of the substrate, from 300K to 1200K, have been investigated. The thermal strain and Young’s modulus are found as key factors of formation and minimization of residual stresses. Additionally, the investigation of preheating temperature of the substrate showed the reduction of residual stress with increasing the preheating temperature of the substrate