S100B Protein as a Post-traumatic Biomarker for Prediction of Brain Death in Association With Patient Outcomes

Background: S100B is a calcium-binding protein, belonging to the S100 family proteins which are characterized by their high solubility and, currently, comprises 21 members which are expressed in a cell-specific manner. If we can predict the possibility of definite brain death after brain injury, we will rescue some organs of body to transplant proposes. Objectives: In this regard our study focused on the S100B protein value in predicting brain death after head trauma. In this study, the use of serum level of protein S100, 24 hours after trauma has been considered as a reliable index for predicting brain death. Patients and Methods: 72 patients (50 male and 22 female) aged 5 - 80 years old (median 40 ± 17.72 years) with severe head traumas (GCS ≤ 8) were recruited in this cross-sectional study. Glasgow Coma Scale (GCS) and computed tomography (CT) scan findings were recorded for all patients, and then a single 5mL blood sample was obtained from each patient on admission, after 48 hours and a week later or after brain death to determine the level of S100B protein. Results: Primary and the last GCS of patients had a predictive value in determining brain death (P < 0.0005), also there was a significant correlation between GCS and level of S100B protein. There was a significant correlation between CT scan findings and S100B protein only after 48 hours of trauma. Conclusions: Changes in S100B protein, especially the levels of this dimer 48 hours after trauma can be used as marker to predict brain death. Alongside other known prognostic factors such as age, GCS and diameters of the pupils, however, this factor individually can not conclusive predict the patient's clinical course and incidence of brain death. However, it is suitable to use GCS, CT scan, clinical symptoms and biomarkers together for a perfect prediction of brain death

Complications and carcinogenic effects of mustard gas - A systematic review and meta-analysis in Iran

Background: Catastrophic effects of mustard gas as a chemical warfare agent have always been a major problem for those exposed to this agent. In this meta-analysis it was tried to evaluate carcinogenesis, ocular, cutaneous and respiratory complications of mustard gas exposure among Iranians who had been exposed to this agent during the Iran-Iraq war. Materials and Methods: In this meta-analysis, the required data were collected using keywords "mustard gas", "sulfur mustard", "cancer", "neoplasm", "respiratory complications", "ocular complications", "lung disease", "chronic complication", "eye", "skin", "cutaneous complication", "carcinogenesis" and their combination with keywords "Iran", "Iranian", "prevalence", "mortality" and their Farsi equivalent terms from the databases of SID, Iranmedex, Magiran, Pubmed, Science Direct, Google Search engine, Gray Literature and Reference of References. To determine the prevalence of each complication and perform meta-analysis, CMA: 2 (Comprehensive Meta-Analysis) software with a randomized model was used. Results: Of the 542 articles found, 7 national articles, consistent with the aims of this study were selected. Metaanalysis of seven papers revealed that cancer risk, especially cancer of the respiratory system was elevated, so that the relative risk (RR) of cancer role of mustard gas was inconsistent from 2/1 to 4 in this survey. Also prevalence of delayed skin disorders due to sulfur mustard was 94.6, pulmonary complications 94.5 and ocular complications 89.9. The incidence of various cancers in victims exposed to mustard gas was 1.7 worldwide where the rate was 2.2 in Iranian victims of the Iraq-Iran war. Conclusions: Based on present study the prevalence of delayed mustard gas related cutaneous, pulmonary and ocular complications is above 90 and risk of carcinogenesis is higher in comparison to worldwide statistics. This may suggest need for long-term and persistent follow-up and rehabilitation procedures es for populations exposed to this agent

Partitioning of a wide bubbling fluidized bed with vertical internals to improve local mixing and bed material circulation

Industrial scale fluidized bed reactors are characterized by limited mixing rates, either local or global, especially when using low-pressure drop gas distributors to reduce operational costs. In this work, partitioning of wide beds using vertical internals is proposed as an effective technique to improve local mixing in large reactors, i.e., mixing in specific zones of the bed. The effect of the vertical internals height on local solids mixing within partitions was experimentally evaluated in a pseudo-2D bed by analyzing the velocity and flow structure of the solids and the circulation time within individual partitions. In the presence of internals, global mixing, i.e., mixing between neighboring partitions and across the entire reactor, may be reduced as vertical internals compartmentalize the bed. Thus, the effect of the internals height on global mixing was also quantified while using bed materials with the same properties, but differing in color, in the different partitions, and analyzing the time evolution of the concentration of solids. Furthermore, the effect of internals on bubbles was also evaluated for different internal heights. It was found that internals with a height between the gulf-stream height and the fixed bed height promote the appearance of vortex pair structures in each partition of the wide bed. These structures substantially improve local mixing within each partition, while global mixing between partitions is practically unaffected by the presence of these short internals.The research that led to this publication was conducted with the support of a US-Spain Fulbright grant co-sponsored by the Spanish Ministry of Universities ("Ministerio de Educación, Cultura y Deporte en el marco del Programa Estatal de Promoción del Talento y su Empleabilidad en I+D+i, Subprograma Estatal de Movilidad, del Plan Estatal de I+D+I"). The authors acknowledge the financial support by the Foundation Seed Fund MIT - Spain "la Caixa". Eduardo Cano-Pleite also acknowledges support from the CONEX-Plus program funded by Universidad Carlos III de Madrid and the European Union's Horizon 2020 program under the Marie Sklodowska-Curie grant agreement No. 801538

Influence of case definition on incidence and outcome of acute coronary syndromes

© 2016, BMJ Publishing Group. All rights reserved. Objective: Acute coronary syndromes (ACS) are common, but their incidence and outcome might depend greatly on how data are collected. We compared case ascertainment rates for ACS and myocardial infarction (MI) in a single institution using several different strategies. Methods: The Hull and East Yorkshire Hospitals serve a population of ∼560 000. Patients admitted with ACS to cardiology or general medical wards were identified prospectively by trained nurses during 2005. Patients with a death or discharge code of MI were also identified by the hospital information department and, independently, from Myocardial Infarction National Audit Project (MINAP) records. The hospital laboratory identified all patients with an elevated serum troponin-T (TnT) by contemporary criteria ( > 0.03 μg/L in 2005). Results: The prospective survey identified 1731 admissions (1439 patients) with ACS, including 764 admissions (704 patients) with MIs. The hospital information department reported only 552 admissions (544 patients) with MI and only 206 admissions (203 patients) were reported to the MINAP. Using all 3 strategies, 934 admissions (873 patients) for MI were identified, for which TnT was > 1 μg/L in 443, 0.04-1.0 μg/L in 435, =0.03 μg/L in 19 and not recorded in 37. A further 823 patients had TnT > 0.03 μg/L, but did not have ACS ascertained by any survey method. Of the 873 patients with MI, 146 (16.7%) died during admission and 218 (25.0%) by 1 year, but ranging from 9% for patients enrolled in the MINAP to 27% for those identified by the hospital information department. Conclusions: MINAP and hospital statistics grossly underestimated the incidence of MI managed by our hospital. The 1-year mortality was highly dependent on the method of ascertainment

2 and 3-dimensional Hamiltonians with Shape Invariance Symmetry

Via a special dimensional reduction, that is, Fourier transforming over one of the coordinates of Casimir operator of su(2) Lie algebra and 4-oscillator Hamiltonian, we have obtained 2 and 3 dimensional Hamiltonian with shape invariance symmetry. Using this symmetry we have obtained their eigenspectrum. In the mean time we show equivalence of shape invariance symmetry and Lie algebraic symmetry of these Hamiltonians.Comment: 24 Page

Investigation of sars-cov-2 ability to pass through the placenta

Context: Recently, a new coronavirus (SARS-CoV-2) as the cause of COVID-19 has made a global health crisis and a great challenge. Pregnant women and fetuses are among the high-risk groups for COVID-19. In this review, we summarize studies regarding SARS-CoV-2 virus-placenta interactions at the maternal-fetal interface by demonstrating the pathogenicity of the virus and defense methods of the placenta. Evidence Acquisition: In the present study, a search was done in domestic and international databases including Google Scholar, Web of Science, PubMed, and Scopus using specific keywords (“Coronavirus” OR “COVID-19” OR “SARS-CoV-2”) AND (“Fetus” OR “Pla-centa”) AND (“Pregnancy”), limited until August 2020. Finally, we reviewed 250 articles. Results: Generally, the pathogenicity and the life cycle of SARS-CoV-2 and virus entry and replication methods allow the virus to pass through the placenta, although there are hormonal and immune barriers in the placenta against SARS-CoV-2, such as placental type interferons. Conclusions: The SARS-CoV-2 can pass through the placenta, but there are defense methods against it. © 2021, Author(s)

The effects of suppressing inflammation by tofacitinib may simultaneously improve glycaemic parameters and inflammatory markers in rheumatoid arthritis patients with comorbid type 2 diabetes: a proof-of-concept, open, prospective, clinical study

Background: A consistent connection has been increasingly reported between rheumatoid arthritis (RA), insulin resistance (IR), and type 2 diabetes (T2D). The β-cell apoptosis induced by pro-inflammatory cytokines, which could be exaggerated in the context of RA, is associated with increased expression pro-apoptotic proteins, which is dependent on JAnus Kinase/Signal Transducer and Activator of Transcription (JAK/STAT) activation. On these bases, we aimed to evaluate if the administration of tofacitinib, a potent and selective JAK inhibitor, could simultaneously improve glycaemic parameters and inflammatory markers in patients with RA and comorbid T2D. Methods: The primary endpoint was the change in the 1998-updated homeostatic model assessment of IR (HOMA2-IR) after 6&nbsp;months of treatment with tofacitinib in RA patients with T2D. Consecutive RA patients with T2D diagnosis were included in this proof-of-concept, open, prospective, clinical study, which was planned before the recent emergence of safety signals about tofacitinib. Additional endpoints were also assessed regarding RA disease activity and metabolic parameters. Results: Forty consecutive RA patients with T2D were included (female sex 68.9%, mean age of 63.4 ± 9.9&nbsp;years). During 6-month follow-up, a progressive reduction of HOMA2-IR was observed in RA patients with T2D treated with tofacitinib. Specifically, a significant effect of tofacitinib was shown on the overall reduction of HOMA2-IR (β = − 1.1, p = 0.019, 95%CI − 1.5 to − 0.76). Also, HOMA2-β enhanced in these patients highlighting an improvement of insulin sensitivity. Furthermore, although a longer follow-up is required, a trend in glycated haemoglobin reduction was also recorded. The administration of tofacitinib induced an improvement in RA disease activity, and a significant reduction of DAS28-CRP and SDAI was observed; 76.8% of patients achieved a good clinical response. In this study, no major adverse events (AEs) were retrieved without the identification of new safety signals. Specifically, no life-threatening AEs and cardiovascular and/or thromboembolic events were recorded. Conclusions: The administration of tofacitinib in RA with T2D led to a simultaneous improvement of IR and inflammatory disease activity, inducing a “bidirectional” benefit in these patients. However, further specific designed and powered studies are warranted to entirely evaluate the metabolic effects of tofacitinib in RA patients with T2D