Explanatory Model of Diabetes Management; An Experience From Iran

Background: Managing diabetes requires changes in the patients’ life style and health habits which in turn need the comprehensive understanding of the disease and its impact. Objectives: To understand the explanatory model of diabetes in Iran, a qualitative study was performed using the grounded theory method. Patients and Methods: Thirty persons were interviewed: fifteen patients, eleven nurses, three physicians and one dietitian. The semi-structured interviews were transcribed and analyzed in three stages of open, axial and selective coding. Results: The findings showed that patients’ personality can shape their self-care behavior; however, curing, caring and supporting systems are also necessary. The interactions between personality, curing, caring and supporting systems and society makes the outcome, which is the core variable in the designed explanatory model of diabetes. Conclusions: This paper reflects an explanatory model of diabetes management. Understanding the factors that affect self-management behavior is important for nurses as key providers in the health care system

Success rate of brace treatment for juvenile-onset idiopathic scoliosis up to skeletal maturity

Background: Natural history studies have reported that the progression rate of juvenile idiopathic scoliosis (JIS) curves larger than 208 is high and tends to progress. The aim of this study was to investigate the outcome of bracing on JIS and to determine the prognostic factors on the success rate of brace treatment. Methods: From March 1985 to February 2015, the clinical data of all JIS patients with referral age from 4 to 10 years who received brace treatment were reviewed. Those patients with a prebrace Cobb angle.208 and a Risser sign of 0 to 2 were included and followed up a minimum of 2 years after discontinuation of the brace or time of spinal fusion. The Cobb angle was recorded at the time of diagnosis, before initiation of bracing, weaning time, brace discontinuation, and final follow-up. Results: From 297 patients with JIS, a total of 75 cases (18 boys, 57 girls) with an average curve magnitude of 31.98 at the time of diagnosis met the inclusion criteria of the study. For successfully treated patients, the average best in-brace correction was 55 for Lenke I curves, 59 for Lenke II curves, 41 for Lenke III curves, and 62 for Lenke V curves. For a total of 27 patients (36), the brace treatment failed. Of these, 21 patients (78) reached spinal fusion, and curves of 6 patients (22) increased to �508. The progression rate was highest in patients with Lenke type III curves (67), and also in those with a curve magnitude of �468 (94). Conclusions: Brace treatment is an effective strategy for controlling the curve progression and avoiding spinal fusion in JIS. © International Society for the Advancement of Spine Surger

Mutation analysis of KRAS and BRAF genes in metastatic colorectal cancer: A first large scale study from Iran

Background: The investigation of mutation patterns in oncogenes potentially can make available a reliable mechanism for management and treatment decisions for patients with colorectal cancer (CRC). This study concerns the rate of KRAS and BRAF genes mutations in Iranian metastatic colorectal cancer (mCRC) patients, as well as associations of genotypes with clinicopathological features. Materials and Methods: A total of 1,000 mCRC specimens collected from 2008 to 2012 that referred to the Mehr Hospital and Partolab center, Tehran, Iran enrolled in this cross sectional study. Using HRM, Dxs Therascreen and Pyrosequencing methods, we analyzed the mutational status of KRAS and BRAF genes in these. Results: KRAS mutations were present in 33.6 cases (n=336). Of KRAS mutation positive cases, 85.1 were in codon 12 and 14.9 were in codon 13. The most frequent mutation at KRAS codon 12 was Gly12Asp; BRAF mutations were not found in any mCRC patients (n=242). In addition, we observed a strong correlation of KRAS mutations with some clinicopathological characteristics. Conclusions: KRAS mutations are frequent in mCRCs while presence of BRAF mutations in these patients is rare. Moreover, associations of KRAS genotypes with non-mucinous adenocarcinoma and depth of invasion (pT3) were remarkable

Electrical tuning of elastic wave propagation in nanomechanical lattices at MHz frequencies

Nanoelectromechanical systems (NEMS) that operate in the megahertz (MHz) regime allow energy transducibility between different physical domains. For example, they convert optical or electrical signals into mechanical motions and vice versa. This coupling of different physical quantities leads to frequency-tunable NEMS resonators via electromechanical non-linearities. NEMS platforms with single- or low-degrees of freedom have been employed to demonstrate quantum-like effects, such as mode cooling, mechanically induced transparency, Rabi oscillation, two-mode squeezing and phonon lasing. Periodic arrays of NEMS resonators with architected unit cells enable fundamental studies of lattice-based solid-state phenomena, such as bandgaps, energy transport, non-linear dynamics and localization, and topological properties, directly transferrable to on-chip devices. Here we describe one-dimensional, non-linear, nanoelectromechanical lattices (NEML) with active control of the frequency band dispersion in the radio-frequency domain (10–30 MHz). The design of our systems is inspired by NEMS-based phonon waveguides and includes the voltage-induced frequency tuning of the individual resonators. Our NEMLs consist of a periodic arrangement of mechanically coupled, free-standing nanomembranes with circular clamped boundaries. This design forms a flexural phononic crystal with a well-defined bandgap, 1.8 MHz wide. The application of a d.c. gate voltage creates voltage-dependent on-site potentials, which can significantly shift the frequency bands of the device. Additionally, a dynamic modulation of the voltage triggers non-linear effects, which induce the formation of a phononic bandgap in the acoustic branch, analogous to Peierls transition in condensed matter. The gating approach employed here makes the devices more compact than recently proposed systems, whose tunability mostly relies on materials’ compliance and mechanical non-linearities

Mechanical metamaterials at the theoretical limit of isotropic elastic stiffness

Acknowledgements H.N.G.W. is grateful for support for this work by the ONR (grant number N00014-15-1-2933), managed by D. Shifler, and the DARPA MCMA programme (grant number W91CRB-10-1-005), managed by J. Goldwasser.Peer reviewedPostprintPostprintPostprintPostprin

Anaerobic digestion of screenings for biogas recovery

Screenings comprise untreatable solid materials that have found their way into the sewer. They are removed during preliminary treatment at the inlet work of any wastewater treatment process using a unit operation termed as a screen and at present are disposed of to landfill. These materials, if not removed, will damage mechanical equipment due to its heterogeneity and reduce overall treatment process, reliability and effectiveness. That is why this material is retained and prevented from entering the treatment system before finally being disposed of. The amount of biodegradable organic matter in screenings often exceeds the upper limit and emits a significant amount of greenhouse gases during biodegradation on landfill. Nutrient release can cause a serious problem of eutrophication phenomena in receiving waters and a deterioration of water quality. Disposal of screenings on landfill also can cause odour problem due to putrescible nature of some of the solid material. In view of the high organic content of screenings, anaerobic digestion method may not only offer the potential for energy recovery but also nutrient. In this study, the anaerobic digestion was performed for 30,days, at controlled pH and temperature, using different dry solids concentrations of screenings to study the potential of biogas recovery in the form of methane. It was found screenings have physical characteristics of 30% total solids and 93% volatile solids, suggesting screenings are a type of waste with high dry solids and organic contents. Consistent pH around pH 6.22 indicates anaerobic digestion of screenings needs minimum pH correction. The biomethane potential tests demonstrated screenings were amenable to anaerobic digestion with methane yield of 355,m3/kg VS, which is comparable to the previous results. This study shows that anaerobic digestion is not only beneficial for waste treatment but also to turn waste into useful resources

Phytotherapeutic and naturopathic adjuvant therapies in otorhinolaryngology

Phytotherapeutic pharmaceuticals and herbal medicinal products with its roots in classical phytotherapeutic medicine have a well-established role in otolaryngological therapy, especially for diseases of the upper airways and acute and chronic infections. A thorough selection and application could mean huge benefit for the patient, in particular in cases with contraindications, chemo- and antibiotic resistance or patient request. Besides, it might spare other medications. Phytotherapeutic pharmaceuticals must fulfil the same criteria of quality, effectiveness and harmlessness of evidence-based medicine like chemical pharmaceuticals, although they are often prescribed due to its well established or traditional based use. This review focuses on phytotherapeutic therapies well established within the European Community for otolaryngologic disease patterns by referring to clinical studies or meta-analysis