Thoracic Injury Rule out Criteria in Prediction of Traumatic Intra-thoracic Injuries; a Validation Study

Introduction: Doing Chest X Ray (CXR) for all trauma patients is not efficient and cost effective due to its low diagnostic value. The present study was designed aiming to evaluate the diagnostic accuracy of thoracic injury rule out criteria (TIRC) in prediction of traumatic intra-thoracic injuries and need for CXR. Method: The present study is a prospective cross-sectional study that has been carried out to evaluate the accuracy of TIRC model in screening blunt multiple trauma patients in need of CXR for ruling out intra-thoracic injuries. Results: 1518 patients with the mean age of 33.53 ± 15.42 years were enrolled (80.4% male). The most common mechanisms of trauma were motor car accident (78.8%) and falling (13.6%). Area under the ROC curve, sensitivity, and specificity of model in detection of traumatic thoracic injuries was 0.95 (95% CI: 0.93 – 0.97), 100 (95% CI: 87.0 – 100), and 80.1 (95% CI: 78.0 – 82.1), respectively. Brier score for TIRC was 0.02 and its scaled reliability was 0.0002. Conclusion: Findings of the present study showed that TIRC has high accuracy in prediction of traumatic intra-thoracic injuries and screening patients in need of CXR.

Online Teaching of Rural Multi-Grade Classes in the Context of COVID-19: Proposing a Holistic Approach

This study addresses the educational challenges faced by students in rural multi-grade classes in the context of the global epidemic of Covid 19. Rural students in this course face unprecedented challenges in trying to adapt to a new way of life and learning. This study was conducted with the aim of creating a better future for these students and in line with critical research of the current situation. In order to collect data, participatory action research method was used. A total of 12 students from elementary multi-grade classes (fourth, fifth and sixth grades) and 6 teachers participated in this study. This study answers two key questions: What are the learning challenges for rural learners during Covid 19? How can their teaching and learning be enhanced? The results showed that while our education decision-making system promoted online learning as the only alternative at the time, many rural students were deprived of teaching and learning. This is due to reasons such as lack of hardware resources for Internet connection, lack of Internet network coverage in many villages, poor learning management system, economic poverty, heavy financial cost of Internet use, weakness or lack of necessary technological knowledge in some Rural teachers, the lack of Internet cafes in rural areas, the lack of fixed ADSL Internet in rural areas, has not been able to meet the educational needs of rural students

Progressive Susac syndrome with bilateral visual loss and disability

Susac syndrome (SS) is a rare retinal-cochlear-cerebral disease with an unclear etiology. A 35-year-old man presented with sudden painless vision loss in the right eye and 2 months later in the left eye with hemiparesis, behavioral changes, and hearing loss. Ophthalmic examinations revealed multiple branch retinal artery occlusions (BRAOs) in both eyes. Brain magnetic resonance imaging showed inflammatory changes with multiple “punched-out” lesions in the corpus callosum which confirmed the diagnosis of SS. Despite intravenous and oral corticosteroid therapy, the disease progressed with the development of new BRAOs, low vision in both eyes, and disability. Prompt diagnosis and early treatment may save the vision and even patient's life

Optimization of double-layer sound absorber in a broadband frequency range using transfer matrix method and Evolution Strategies algorithm

Curtailment of the ambient noise level for providing a better living environment is immensely important. Accordingly, acoustic isolation via different combinations of porous materials is the most widely used passive soundproofing system. The present study focuses on the optimization of single and double-layer absorbers in different frequencies. To this end, the transfer matrix and the Evolution Strategy (ES) method are firstly explained. Afterward, the optimization of single and double-layer absorbers is considered for up to 10 parameters (material porosity, air gap, perforated plate characteristics among others) at 350 Hz frequency and has been compared with the results obtained through other methods (Genetic Algorithm among others). It has been illustrated that ES algorithm provides better optimization in this field. Subsequently, since the incident sound in most cases is a correlation of different frequencies, the broadband optimization of the single and double-layer absorbers is considered in three frequency ranges (100–800 Hz, 800–1600 Hz, 1600–3000 Hz), with an increment of 1 Hz, for three different materials (polyester, fiber and foam). After the optimization, the resulting optimum parameters are presented in form of characteristics charts of the optimized materials for different frequency ranges, as a reference for material designers and manufacturers. Also, the absorption coefficient of all optimized cases are calculated and presented in range of 100 Hz to 3 kHz as a reference for the absorber selection for different situations. Finally, by presenting the improvement chart of double layer versus single layer combinations, it has been shown that double layer combination can improve the absorption coefficient of different materials up to 4% in different frequencies depending on the material (4% for polyester and foam for under 800 Hz, 3–4% for polyester and fiber for 800–1600 Hz and 2.6% for foam in 1600–3000 Hz)

Comparision of satiety index in low-fat yogurt and bread regiments in healthy adults

Background and Objective: Obesity is a major healthy problem wordwide. The incidence and severity of obesity is incrased in recent years. Satiety is described as a blocker of receiving more food after the end of eating. Satiety index (SI) is considered as index for measerment of ablity of food for losing of hungry and making satiety for more than 2 houres. This study was done to determine satiety index of low-fat yogurt (1.5%) and white bread in healthy adults with normal body mass index. Methods: This quasi - experimental study was conducted on 30 healthy adults with normal body mass index for two consecutive days. In the first day, each subject was consumed 90 grams white bread and in the second day, each subject was consumed 526 grams of 1.5% low-fat yogurt within 15 minutes. The satiety of low-fat yogurt and white bread based on VAS and LIKERT scales was measeared. Cronbach's alpha was determined 0.98 for satiety of white bread and 0.947 for low-fat yogurt Results: Satiety index of low-fat yogurt was 136.66±1.46 in compared to white bread (SI=100). The level of satiety after 120 minutes of consumption of white bread and low-fat yogurt were not significant based on the VAS scale, but according to the LIKERT scale, low-fat yogurt (1.60±0.43) significantly increased the Satiety index (P<0.05). Conclusion: The satiety index of low-fat yogurt in adults with normal body weight was 136.66% compared to white bread that showed higher satiety of low-fat yogurt compared to white bread

Application of evolution strategy algorithm for optimization of a single-layer sound absorber

Depending on different design parameters and limitations, optimization of sound absorbers has always been a challenge in the field of acoustic engineering. Various methods of optimization have evolved in the past decades with innovative method of evolution strategy gaining more attention in the recent years. Based on their simplicity and straightforward mathematical representations, single-layer absorbers have been widely used in both engineering and industrial applications and an optimized design for these absorbers has become vital. In the present study, the method of evolution strategy algorithm is used for optimization of a single-layer absorber at both a particular frequency and an arbitrary frequency band. Results of the optimization have been compared against different methods of genetic algorithm and penalty functions which are proved to be favorable in both effectiveness and accuracy. Finally, a single-layer absorber is optimized in a desired range of frequencies that is the main goal of an industrial and engineering optimization process

Relationship of sodium intake with obesity among Iranian children and adolescents

BACKGROUND: Emerging evidence suggests a relationship between sodium (Na) intake and obesity risk. The aim of this study was to investigate the link between 24-hour (24-h) urinary Na excretion and adiposity measures in a sample of Iranian children and adolescents. METHODS: This cross-sectional study was performed among 374 healthy individuals aged 11-18 years old. Random cluster sampling method was used to select the participants from 4 districts in Isfahan, Iran. Na excretion was estimated using a 24-h urinary sample. Creatinine (Cr) level was used to confirm the completeness of samples. Anthropometric measures including weight, height and waist circumference (WC) were obtained based on standard protocols. RESULTS: The odds ratio (OR) for overweight/obesity in subjects with the highest tertile of Na excretion compared with the lowest tertile was 8.01 [95% confidence interval (CI) 4.20-15.3] in crude model and 8.33 (95% CI 4.14-16.8) after adjusting for potential confounders. The association was independent of intake of energy and sugar-sweetened beverages (SSBs). The OR for abdominal obesity in the highest tertile of Na excretion compared with the lowest tertile was 9.12 (95% CI 4.78- 17.4) in crude model and 9.75 (95% CI 4.88-19.5) after controlling for potential confounders. The association was independent of energy intake or SSBs consumption. CONCLUSION: Our study showed a positive association between Na excretion and obesity among children and adolescents. Further investigation through longitudinal studies using a more representative sample of children and adolescents is suggested to determine whether this is a causal relationship.&nbsp;</div

Dietary approaches to stop hypertension diet and obesity: A cross-sectional study of Iranian children and adolescents

BACKGROUND: Few studies have investigated the effects of dietary approaches to stop hypertension (DASH) diet on obesity in children. The present study was conducted to examine adherence to the DASH diet in relation to obesity in children and adolescents, Isfahan, Iran. METHODS: A cross-sectional study was carried out among 456 children aged 11-18 years who were selected by random cluster sampling method. Dietary intakes were assessed using a validated Food Frequency Questionnaire (FFQ). The DASH score was constructed based on food items emphasized or minimized in the DASH diet. Anthropometric measurements were conducted based on standard protocols. General and abdominal obesity were defined based on body mass index &ge; 95th percentiles and waist: height ratio of more than 0.5, respectively. RESULTS: Higher adherence to DASH diet was inversely associated with general obesity (odds ratioT1 vs. T3 3.34, 95% confidence interval 1.28-8.75); however, after controlling for confounding factors, this association disappeared. Furthermore, higher adherence to DASH diet was negatively associated with central obesity in children, but the relation was not statistically significant. CONCLUSION: We concluded that there was an inverse nonsignificant association between adherence to DASH diet and general obesity indices after adjustment for potential confounders. Further, well-designed randomized clinical trial studies are suggested to find out the effect of DASH diet on obesity obviously. &nbsp;&nbsp;</p

Knowledge, Attitudes and Practice of Health Care Workers in Oncology, Hemodialysis and Transplantation Towards Influenza Vaccination in Isfahan, Iran

Introduction: Influenza is a viral disease which is self-limited in immunocompetent patients but it can be dangerous in immunocompromised patients. In these patients it may lead to sever viral and/or bacterial infection that often may lead to death. Therefor prevention of influenza in immunocompromised patients is very important and thus health care workers&rsquo; belief is important too. This study is evaluation of knowledge, attitude and practices of health care workers in oncology, hemodialysis and transplantation wards in hospitals of Isfahan in 2017. Methods: In this descriptive cross-sectional study selected health care workers filled a questionnaire&nbsp; which has 2 sections. In first section we asked about demographic characterization of them and in second section we asked the questions about their knowledge, attitude and practices. At the end we evaluate and analyze the data by SPSS software. Results: We evaluate 110 units and they were 72 (65.5%) female and 38 (34.5%) were male. Mean age of individuals was 32.7&plusmn;7 years and mean time of their working acquaintance was 8.49&plusmn;6.8 years. Attitude of the health care workers was well but only 58 units from 110 (52.7%) had been vaccinated. Conclusion: By attention to the knowledge and attitude of the participants and low proportion of vaccination in them it seems that we should have program for improving the vaccination in health care workers in our country. We should take modeling from the countries which have better vaccination coverage in their health care workers