Treatment of Ankyloglossia with Carbon Dioxide (CO2) Laser in a Pediatric Patient

INTRODUCTION: Laser surgery as an alternative for conventional surgical procedure has gained special attention. Using Carbon Dioxide (CO2) laser has some benefits like less post-operative pain, swelling and infection, decrease in risk of metastasis and edema, and less bleeding providing dry sites for surgery.CASE REPORT: A 12 years old boy with lingual frenum with indication for excision was referred to the laser department of Tehran University of medical sciences dental school. CO2 laser was used with 10600 nm wavelength, 1.5 W output power, 100 Hz frequency and 400 μsec pulse duration in non-contact mode.RESULTS: The result of using CO2 laser was dry and bloodless field during operation, no post operative swelling, no pain or discomfort, with normal healing process.CONCLUSION: We suggest and stimulate the use of CO2 laser for soft tissue surgery because of elimination of suture, convenient coagulation, time saving, patients’ comfort and easy manipulation

A unit-based symbolic execution method for detecting memory corruption vulnerabilities in executable codes

Memory corruption is a serious class of software vulnerabilities, which requires careful attention to be detected and removed from applications before getting exploited and harming the system users. Symbolic execution is a well-known method for analyzing programs and detecting various vulnerabilities, e.g., memory corruption. Although this method is sound and complete in theory, it faces some challenges, such as path explosion, when applied to real-world complex programs. In this paper, we present a method for improving the efficiency of symbolic execution and detecting four classes of memory corruption vulnerabilities in executable codes, i.e., heap-based buffer overflow, stack-based buffer overflow, use-after-free, and double-free. We perform symbolic execution only on test units rather than the whole program to avoid path explosion. In our method, test units are considered parts of the program's code, which might contain vulnerable statements and are statically identified based on the specifications of memory corruption vulnerabilities. Then, each test unit is symbolically executed to calculate path and vulnerability constraints of each statement of the unit, which determine the conditions on unit input data for executing that statement or activating vulnerabilities in it, respectively. Solving these constraints gives us input values for the test unit, which execute the desired statements and reveal vulnerabilities in them. Finally, we use machine learning to approximate the correlation between system and unit input data. Thereby, we generate system inputs that enter the program, reach vulnerable instructions in the desired test unit, and reveal vulnerabilities in them. This method is implemented as a plugin for angr framework and evaluated using a group of benchmark programs. The experiments show its superiority over similar tools in accuracy and performance

Level of Moral Distress in Operating Room Technologist Students in Iran: A Cross‑Sectional Study

AbstractIntroduction: Moral distress is one of the issues considered in the educational environment. That it can affect the physical, psychological, and social dimensions of individuals and access to ethical and educational goals. This study aimed to investigate the moral distress in operating room technologist students of Iran University of Medical Sciences.Methods: This cross-sectional study was performed on Iran University of Medical Sciences' operating room technologist students in 2017. Data were collected with two questionnaires, including demographic information and a moral distress questionnaire. Data were analyzed by SPSS software using an independent t-test and one-way ANOVA (P < 0.05).Results: In this study, 121 operating room technologist students participated. The mean score of moral distress in the scores' severity and frequency dimensions was (3.5 ± 1.76) and (3.11 ± 1.6), respectively. The results showed that only age and semester had a significant relationship with the total score of moral distress, and with increasing age and semester, students’ moral pain has decreased.Conclusions: This study's results indicated that the moral distress in operating room technologist students was moderate, which requires investigating the factors involved in creating moral distress and providing strategies and measures to reduce its adverse effects in the educational setting

Fibroblast growth factor-23 in patients with systemic sclerosis: A case–control study

AbstractBackgroundFibroblast growth factor-23 (FGF-23) is actively involved in phosphate homeostasis and skeletogenesis.Aim of the workTo assess the serum level of FGF-23 in systemic sclerosis (SSc) patients (both diffuse dSSc and limited lSSc subtypes) in order to find if it has a role in the pathogenesis of the disease and study its relation to the clinical manifestations.Patients and methodsThe study included 30 dSSc patients, 30 lSSc and 28 age and sex matched controls. In patients, clinical examination and laboratory investigations were performed and Medsger severity scale assessed. Serum FGF-23 was measured using ELISA.ResultsThe age of dSSc patients was 36.94±9.89years and the lSSc 38.36±10.04years. The serum FGF-23 level was 23.44±14.86pg/ml in dSSc patients, 20.01±13.92pg/ml in lSSc patients and 23.09±11.45pg/ml in the control (p=0.58). No significant difference in the FGF-23 level was found according to the presence of lung fibrosis (p=0.6). There was no significant difference in FGF levels among patients according to the severity (p=0.39). In SSc patients there was a significant correlation between FGF and serum phosphorus especially in dSSc patients (r=0.6, p=0.003). Serum urea significantly correlated with FGF-23 in those with dSSc (r=0.46, p=0.037). There was no significant difference in the FGF-23 levels (p=0.18) between those with a normal and impaired glomerular filtration rate.ConclusionThe mean serum level of FGF-23 in this study showed no significant difference between systemic sclerosis patients and their subtypes with the normal subjects. It seems to have no role in the clinical manifestations of the disease

Relationship between Social Support and Mental Health of Novice Nurses during Coronavirus Epidemic

Abstract Background: Coronavirus has created a confusing and stressful situation around the world. In these circumstances, health care workers are most prone to vulnerability. The goal of this study was to investigate the relationship between social support and mental health of novice nurses during the outbreak of COVID-19 to provide basic information for intervention measures. Study design: cross-sectional study Methods: This study was performed in spring of 2020 in hospital affiliated with Ilam University of Medical Sciences. Data were collected using general information questionnaire, General Health Questionnaire (GHQ) and Phillip’s Social Support Questionnaire and analyzed by SPSS software, as well as descriptive and inferential statistics. Results: The total score of GHQ and social support was 24.58±12.063 and 70.77±9.761, respectively. There was a statistically significant inverse relationship between social support and mental health of participants. Among the demographic variables, there was a significant correlation between work experience, hospital, direct contact with COVID-19 patients and the number of working days in coronavirus ward with mental health and social support. Conclusion: The findings of the present study add to our knowledge obtained from previous studies by discovering the impact of social support on mental health of health care providers with special attention to novice nurses at the forefront. Ongoing monitoring of psychological consequences associated with COVID-19 outbreak and social support of them require further attention

The double burden of age and disease on cognition and quality of life in bipolar disorder

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108337/1/gps4084.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/108337/2/gps4084-sup-0002-TableS1.pd

Removal of Hepatitis B virus surface HBsAg and core HBcAg antigens using microbial fuel cells producing electricity from human urine

© 2019, The Author(s). Microbial electrochemical technology is emerging as an alternative way of treating waste and converting this directly to electricity. Intensive research on these systems is ongoing but it currently lacks the evaluation of possible environmental transmission of enteric viruses originating from the waste stream. In this study, for the first time we investigated this aspect by assessing the removal efficiency of hepatitis B core and surface antigens in cascades of continuous flow microbial fuel cells. The log-reduction (LR) of surface antigen (HBsAg) reached a maximum value of 1.86 ± 0.20 (98.6% reduction), which was similar to the open circuit control and degraded regardless of the recorded current. Core antigen (HBcAg) was much more resistant to treatment and the maximal LR was equal to 0.229 ± 0.028 (41.0% reduction). The highest LR rate observed for HBsAg was 4.66 ± 0.19 h−1 and for HBcAg 0.10 ± 0.01 h−1. Regression analysis revealed correlation between hydraulic retention time, power and redox potential on inactivation efficiency, also indicating electroactive behaviour of biofilm in open circuit control through the snorkel-effect. The results indicate that microbial electrochemical technologies may be successfully applied to reduce the risk of environmental transmission of hepatitis B virus but also open up the possibility of testing other viruses for wider implementation

A Stronger Innate Immune Response During Hyperacute Human Immunodeficiency Virus Type 1 (HIV-1) Infection Is Associated With Acute Retroviral Syndrome.

BACKGROUND: Acute retroviral syndrome (ARS) is associated with human immunodeficiency virus type 1 (HIV-1) subtype and disease progression, but the underlying immunopathological pathways are poorly understood. We aimed to elucidate associations between innate immune responses during hyperacute HIV-1 infection (hAHI) and ARS. METHODS: Plasma samples obtained from volunteers (≥18.0 years) before and during hAHI, defined as HIV-1 antibody negative and RNA or p24 antigen positive, from Kenya, Rwanda, Uganda, Zambia, and Sweden were analyzed. Forty soluble innate immune markers were measured using multiplexed assays. Immune responses were differentiated into volunteers with stronger and comparatively weaker responses using principal component analysis. Presence or absence of ARS was defined based on 11 symptoms using latent class analysis. Logistic regression was used to determine associations between immune responses and ARS. RESULTS: Of 55 volunteers, 31 (56%) had ARS. Volunteers with stronger immune responses (n = 36 [65%]) had increased odds of ARS which was independent of HIV-1 subtype, age, and risk group (adjusted odds ratio, 7.1 [95% confidence interval {CI}: 1.7-28.8], P = .003). Interferon gamma-induced protein (IP)-10 was 14-fold higher during hAHI, elevated in 7 of the 11 symptoms and independently associated with ARS. IP-10 threshold >466.0 pg/mL differentiated stronger immune responses with a sensitivity of 84.2% (95% CI: 60.4-96.6) and specificity of 100.0% (95% CI]: 90.3-100.0). CONCLUSIONS: A stronger innate immune response during hAHI was associated with ARS. Plasma IP-10 may be a candidate biomarker of stronger innate immunity. Our findings provide further insights on innate immune responses in regulating ARS and may inform the design of vaccine candidates harnessing innate immunity

Focal adhesion is associated with lithium response in bipolar disorder: evidence from a network-based multi-omics analysis

Lithium (Li) is one of the most effective drugs for treating bipolar disorder (BD), however, there is presently no way to predict response to guide treatment. The aim of this study is to identify functional genes and pathways that distinguish BD Li responders (LR) from BD Li non-responders (NR). An initial Pharmacogenomics of Bipolar Disorder study (PGBD) GWAS of lithium response did not provide any significant results. As a result, we then employed network-based integrative analysis of transcriptomic and genomic data. In transcriptomic study of iPSC-derived neurons, 41 significantly differentially expressed (DE) genes were identified in LR vs NR regardless of lithium exposure. In the PGBD, post-GWAS gene prioritization using the GWA-boosting (GWAB) approach identified 1119 candidate genes. Following DE-derived network propagation, there was a highly significant overlap of genes between the top 500- and top 2000-proximal gene networks and the GWAB gene list (Phypergeometric = 1.28E–09 and 4.10E–18, respectively). Functional enrichment analyses of the top 500 proximal network genes identified focal adhesion and the extracellular matrix (ECM) as the most significant functions. Our findings suggest that the difference between LR and NR was a much greater effect than that of lithium. The direct impact of dysregulation of focal adhesion on axon guidance and neuronal circuits could underpin mechanisms of response to lithium, as well as underlying BD. It also highlights the power of integrative multi-omics analysis of transcriptomic and genomic profiling to gain molecular insights into lithium response in BD.publishedVersio

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700