378 research outputs found

    Field hospital in disasters: A systematic review

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    Background: Field hospitals (FH) can be mobile or fixed. The main goal of FHs is providing health care and preventing injuries caused by disasters or providing emergency medical operations. However, preparing a safe and fast-erupting structure and facility is very important. Objectives: In this systematic review study, field hospitals are reviewed. Methods: In the present study, a systematic review was performed following the PRISMA guideline. To identify the articles, MEDLINE, web of science, Google scholar, PubMed, Persian journals and databases were searched to find related papers. Results: After full text screening as the final screening step, 20 papers were entered in the study. Findings showed that structures used for establishing a FH are usually tents, using vehicles (trucks and buses), pre-fabricated steel, and concrete structures. The FHs were used for war and earthquake disasters. Conex, tent, steel, and concrete structure are the most used structures for FH in wars, while tents are the most common structure used for natural disasters. Conclusions: The present study reviewed available reports on FH to collect useful data that should be focused on establishment of an FH suitable for a disaster. Furthermore, this study provides a list of the most important indexes that must be considered in proposing a type of FH. Tent structure was the most common structure for the establishment of FHs. Copyright © 2018

    The Effects of Temperature and Seasons on Subcutaneous White Adipose Tissue in Humans: Evidence for Thermogenic Gene Induction

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    Context: Although brown adipose tissue (BAT) activity is increased by a cold environment, little is known of the response of human white adipose tissue (WAT) to the cold. Design: We examined both abdominal and thigh subcutaneous (SC) WAT from 71 subjects who were biopsied in the summer or winter, and adipose expression was assessed after an acute cold stimulus applied to the thigh of physically active young subjects. Results: In winter, UCP1 and PGC1 α mRNA were increased 4 to 10-fold (p\u3c0.05) and 1.5 to 2-fold, respectively, along with beige adipose markers, and UCP1 protein was 3-fold higher in the winter. The seasonal increase in abdominal SC WAT UCP1 mRNA was considerably diminished in subjects with a BMI \u3e 30 kg/m2, suggesting that dysfunctional WAT in obesity inhibits adipose thermogenesis. After applying an acute cold stimulus to the thigh of subjects for 30 min, PGC1α and UCP1 mRNA was stimulated 2.7-fold (p \u3c 0.05) and 1.9-fold (p = 0.07), respectively. Acute cold also induced a 2 to 3-fold increase in PGC1α and UCP1 mRNA in human adipocytes in vitro, which was inhibited by macrophage-conditioned medium and by the addition of TNFα. Conclusion: Human SC WAT increases thermogenic genes seasonally and acutely in response to a cold stimulus and this response is inhibited by obesity and inflammation. (J Clin Endocrinol Metab 99: E2772–E2779, 2014

    Anesthesia for the patient with a recently diagnosed concussion: think about the brain!

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    Some patients require emergent, urgent, or elective surgery in the time period immediately following diagnosis of concussion. However, changes in brain homeostatic mechanisms following a concussion and concern for secondary brain injury can complicate the decision as to whether or not a surgery should proceed or be postponed. Given the paucity of available evidence, further evaluation of the use of anesthesia in a patient with concussion is warranted. This article summarizes what is currently known about the relevant pathophysiology of concussion, intraoperative anesthesia considerations, and effects of anesthesia on concussion outcomes in an attempt to help providers understand the risks that may accompany surgery and anesthesia in this patient population. While most contraindications to the use of anesthesia in concussed patients are relative, there are nonetheless pathophysiologic changes associated with a concussion that can increase risk of its use. Understanding these changes and anesthetic implications can help providers optimize outcomes in this patient population

    Survival of Chondrocytes in Rabbit Septal Cartilage After Electromechanical Reshaping

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    Electromechanical reshaping (EMR) has been recently described as an alternative method for reshaping facial cartilage without the need for incisions or sutures. This study focuses on determining the short- and long-term viability of chondrocytes following EMR in cartilage grafts maintained in tissue culture. Flat rabbit nasal septal cartilage specimens were bent into semi-cylindrical shapes by an aluminum jig while a constant electric voltage was applied across the concave and convex surfaces. After EMR, specimens were maintained in culture media for 64 days. Over this time period, specimens were serially biopsied and then stained with a fluorescent live–dead assay system and imaged using laser scanning confocal microscopy. In addition, the fraction of viable chondrocytes was measured, correlated with voltage, voltage application time, electric field configuration, and examined serially. The fraction of viable chondrocytes decreased with voltage and application time. High local electric field intensity and proximity to the positive electrode also focally reduced chondrocyte viability. The density of viable chondrocytes decreased over time and reached a steady state after 2–4 weeks. Viable cells were concentrated within the central region of the specimen. Approximately 20% of original chondrocytes remained viable after reshaping with optimal voltage and application time parameters and compared favorably with conventional surgical shape change techniques such as morselization

    Naked Singularity Formation In f(R) Gravity

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    We study the gravitational collapse of a star with barotropic equation of state p=wρp=w\rho in the context of f(R)f({\mathcal R}) theories of gravity. Utilizing the metric formalism, we rewrite the field equations as those of Brans-Dicke theory with vanishing coupling parameter. By choosing the functionality of Ricci scalar as f(R)=αRmf({\mathcal R})=\alpha{\mathcal R}^{m}, we show that for an appropriate initial value of the energy density, if α\alpha and mm satisfy certain conditions, the resulting singularity would be naked, violating the cosmic censorship conjecture. These conditions are the ratio of the mass function to the area radius of the collapsing ball, negativity of the effective pressure, and the time behavior of the Kretschmann scalar. Also, as long as parameter α\alpha obeys certain conditions, the satisfaction of the weak energy condition is guaranteed by the collapsing configuration.Comment: 15 pages, 4 figures, to appear in GR

    Coffee consumption, genetic susceptibility and risk of latent autoimmune diabetes in adults : A population-based case-control study

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    Export Date: 31 October 2018Aim. - Coffee consumption is inversely related to risk of type 2 diabetes (T2D). In contrast, an increased risk of latent autoimmune diabetes in adults (LADA) has been reported in heavy coffee consumers, primarily in a subgroup with stronger autoimmune characteristics. Our study aimed to investigate whether coffee consumption interacts with HLA genotypes in relation to risk of LADA. Methods. - This population-based study comprised incident cases of LADA (n = 484) and T2D (n = 1609), and also 885 healthy controls. Information on coffee consumption was collected by food frequency questionnaire. Odds ratios (ORs) with 95% CIs of diabetes were calculated and adjusted for age, gender, BMI, education level, smoking and alcohol intake. Potential interactions between coffee consumption and high-risk HLA genotypes were calculated by attributable proportion (AP) due to interaction. Results. - Coffee intake was positively associated with LADA in carriers of high-risk HLA genotypes (OR: 1.14 per cup/day, 95% CI: 1.02-1.28), whereas no association was observed in non-carriers (OR: 1.04, 95% CI: 0.93-1.17). Subjects with both heavy coffee consumption (>= 4 cups day) and high-risk HLA genotypes had an OR of 5.74 (95% Cl: 3.34-9.88) with an estimated AP of 0.36 (95% CI: 0.01-0.71; P = 0.04370). Conclusion. - Our findings suggest that coffee consumption interacts with HLA to promote LADA. (C) 2018 Elsevier Masson SAS. All rights reserved.Peer reviewe

    Parental willingness to pay for child safety seats in Mashad, Iran

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    <p>Abstract</p> <p>Background</p> <p>Iran has one of the highest rates of road traffic crash death rates throughout the world and road traffic injuries are the leading cause of years of life lost in the country. Using child car safety seats is not mandatory by law in Iran. The purpose of this research was to determine the parental willingness to pay (WTP) for child restraints in Mashad, the second most populated city in Iran with one of the highest rates of road traffic-related deaths.</p> <p>Methods</p> <p>We surveyed 590 car-owner parents of kindergarten children who were willing to participate in the study in the year 2009. We asked them about the maximum amount of money they were willing to pay for car safety seats using contingent valuation method.</p> <p>Results</p> <p>The mean age of children was 33.5 months. The median parental WTP for CSS was about $15. Considering the real price of CSSs in Iran, only 12 percent of responders could be categorized as being willing to pay for it. Family income level was the main predictor of being willing to pay.</p> <p>Conclusions</p> <p>The median parental WTP was much lower than the actual price of the safety seats, and those who were of lower socio-economic class were less willing to pay. Interventions to increase low-income families' access to child safety seats such as providing free of charge or subsidized seats, renting or health insurance coverage should be considered.</p

    Shear Wave Splitting Analysis to Estimate Fracture Orientation and Frequency Dependent Anisotropy

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    Shear wave splitting is a well-known method for indication of orientation, radius, and length of fractures in subsurface layers. In this paper, a three component near offset VSP data acquired from a fractured sandstone reservoir in southern part of Iran was used to analyse shear wave splitting and frequency-dependent anisotropy assessment. Polarization angle obtained by performing rotation on radial and transverse components of VSP data was used to determine the direction of polarization of fast shear wave which corresponds to direction of fractures. It was shown that correct implementation of shear wave splitting analysis can be used for determination of fracture direction. During frequency- dependent anisotropy analysis, it was found that the time delays in shear- waves decrease as the frequency increases. It was clearly demonstrated throughout this study that anisotropy may have an inverse relationship with frequency. The analysis presented in this paper complements the studied conducted by other researchers in this field of research
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