A systematic review of cerebral microdialysis and outcomes in TBI: relationships to patient functional outcome, neurophysiologic measures, and tissue outcome

OBJECTIVE: To perform a systematic review on commonly measured cerebral microdialysis (CMD) analytes and their association to: (A) patient functional outcome, (B) neurophysiologic measures, and (C) tissue outcome; after moderate/severe TBI. The aim was to provide a foundation for next-generation CMD studies and build on existing pragmatic expert guidelines for CMD. METHODS: We searched MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library (inception to October 2016). Strength of evidence was adjudicated using GRADE. RESULTS: (A) Functional Outcome: 55 articles were included, assessing outcome as mortality or Glasgow Outcome Scale (GOS) at 3-6 months post-injury. Overall, there is GRADE C evidence to support an association between CMD glucose, glutamate, glycerol, lactate, and LPR to patient outcome at 3-6 months. (B) Neurophysiologic Measures: 59 articles were included. Overall, there currently exists GRADE C level of evidence supporting an association between elevated CMD measured mean LPR, glutamate and glycerol with elevated ICP and/or decreased CPP. In addition, there currently exists GRADE C evidence to support an association between elevated mean lactate:pyruvate ratio (LPR) and low PbtO2. Remaining CMD measures and physiologic outcomes displayed GRADE D or no evidence to support a relationship. (C) Tissue Outcome: four studies were included. Given the conflicting literature, the only conclusion that can be drawn is acute/subacute phase elevation of CMD measured LPR is associated with frontal lobe atrophy at 6 months. CONCLUSIONS: This systematic review replicates previously documented relationships between CMD and various outcome, which have driven clinical application of the technique. Evidence assessments do not address the application of CMD for exploring pathophysiology or titrating therapy in individual patients, and do not account for the modulatory effect of therapy on outcome, triggered at different CMD thresholds in individual centers. Our findings support clinical application of CMD and refinement of existing guidelines

Child-report measures of occupational performance: A systematic review

© Copyright 2016 Cordier et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Improving occupational performance is a key service of occupational therapists and client-centred approach to care is central to clinical practice. As such it is important to comprehensively evaluate the quality of psychometric properties reported across measures of occupational performance; in order to guide assessment and treatment planning. Objective To systematically review the literature on the psychometric properties of child-report measures of occupational performance for children ages 2-18 years. Methods A systematic search of the following six electronic databases was conducted: CINAHL; Psy-cINFO; EMBASE; PubMed; the Health and Psychosocial Instruments (HAPI) database; and Google Scholar. The quality of the studies was evaluated against the COSMIN taxonomy of measurement properties and the overall quality of psychometric properties was evaluated using pre-set psychometric criteria. Results Fifteen articles and one manual were reviewed to assess the psychometric properties of the six measures-the PEGS, MMD, CAPE, PAC, COSA, and OSA- which met the inclusion criteria. Most of the measures had conducted good quality studies to evaluate the psychometric properties of measures (PEGS, CAPE, PAC, OSA); however, the quality of the studies for two of these measures was relatively weak (MMD, COSA). When integrating the quality of the psychometric properties of the measures with the quality of the studies, the PAC stood out as having superior psychometric qualities. Conclusions The overall quality of the psychometric properties of most measures was limited. There is a need for continuing research into the psychometric properties of child-report measures of occupational performance, and to revise and improve the psychometric properties of existing measures

Removal of Methylene Blue Dye from Synthetic Wastewater with Bone Char

"n "n "nBackgrounds and Objectives: Dyes  are  organic  materials  with  complex structures, toxic,  carcinogenic, teratogenic,nonbiodegredable properties and!the most!important pollutants of textile industrial wastewaters. The goal of this study was to survey the feasibility application of bone char (BC) as a sorbent for the  of methylene blue (MB) from synthetic wastewater.The sub goals of the research!were to determine!the adsorption isotherm, !effects of primary concentration of dye, adsorbent!dose, contact!time, and pH for the adsorption of MB with BC."nMaterials and Methods: BC was prepared under laboratory conditions by using of electrical furnace at 400°C for 2h. The prepared BC was crushed and pulverized by standard ASTM sieves with range of 10-16mesh(1.18-2mm).The  chemical composition  and  solid  structure  of BC was  analyzed using X-ray diffraction(XRD) and  scanning  electronic  microscopy (SEM). Measurement  of  the surface area was carried out by N2 gas via BET isotherm and Belsorb software. The concentration of dye was measured by photometric!method (663nm)."nResults: Predominant!compositionof BC is calcium hydroxyl apatite (Ca5 (PO4)3OH with 14m2/g surface area. The results of this study showed that increasing of primary concentration of dye, adsorbent dose and pH (5 to12) would lead to increasing of adsorption/removal of MB dye.Equilibration of dye adsorption was reached at lapse of 2h andoptimum pH for adsorption of MB with BC found in the rage of 8.5-12.Adsorption of MB witht BC complies witht freundlich isotherm(R2:0.99)."nConclusion: Bone char is a cheap component that can be used as an adsorbent in water and wastewater treatment. Based on optimum pH of 8.5-12 found for the removal of MB and the fact that many of textile!industrial wastewaters have an alkaline pH, this adsorbent can be!used for the removal of dyes from these wastewaters

Attitude of broiler breeders toward the production of antibiotics-free chickens (case study: Tehran province)

Abstract: This research aimed to investigate the attitude of broiler breeders toward the production of antibiotics-free chickens in Tehran province. The statistical population in this study included all broiler breeders (N=450) in Tehran province. Using stratified-random-sampling method 136 breeders were selected. The main tool for data gathering was a questionnaire contained 44 questions and items. Results showed that 52.9% of the respondents had “positive” or “relatively positive” viewpoints about the production of antibiotic-free chicken. The results also indicated that there were a significant (p < 0.05) positive relationship between the attitude of  production of antibiotic-free chicken with the education level, job satisfaction, second job as well as having technical supervisor. Moreover, a significant (p < 0.01) positive relationship was observed between the participation in training courses related to the production of antibiotic-free chicken and the viewpoint of studied broiler producers. On the other hand, no significant correlation was observed between the “viewpoint of chicken producers” and the variables such as: “age”, “job background”, “frequency of progeny”, “production/non-production of antibiotic-free chicken”, “consumption/non-consumption of antibiotic-free chicken” and “knowledge on breeding the antibiotic-free chicken”

Comprison of the Assessment of Professors by Students Based on Two Different Protocols Asadabad Medical Sciences Faculty, Hamadan University of Medical Sciences

Aims: The process of evaluating the professors by the students, as a common method of evaluating, has many strengths and weaknesses in performance. Thus, the aim of this study was to investigate the stability of the evaluation of the professors by students using two different protocols. Instrument & Methods: In this interventional study in Asadabad Medical Sciences School in 2013-2014, 174 students assessed 26 professors in 53 courses at two semesters using two different methods paper-based at one week before the end of semester (protocol A) and computer-based on the currently methods (protocol B) after the final exam. The questionnaire was the pre-defined tool in Hamadan University of Medical Sciences. Data analysis was performed using SPSS 20 and Excel 2013 software with paired T, independent T and Pearson correlation coefficient tests. Findings: The mean score of assessments in protocol A (68.99&plusmn;17.73) was significantly less than the mean score of assessments in protocol B (91.78&plusmn;5.40 p0.05). Conclusion: Paper-based assessment of professors by students one week before the end of semester is better than the computer-based method and it can discriminate the professors better