ONE-TWO criteria: Improving the approach to electrocardiogram

The electrocardiogram (EKG) is one of the major Para-clinic exams for evaluating patients suspected to cardiac or non-cardiac disease which could be very informative especially when assessed by experienced clinicians. To improve and accelerate the approach to EKG interpretation, simple and accurate criteria are useful and save the physician's time especially in emergent situations. In this article, we introduce our criteria which determine whether the electrical axis of heart is normal or not and if abnormal, what kind of deviation it has. These criteria say that "if the mean QRS complex in leads I and II are positive, the axis will be accu-rately in the normal range (-30 to +90); unless, the axis is abnormal necessitating a more complex evaluation". These criteria could simplify the first step of the approach to EKG interpretation especially in emergent situations. They can also be proper substitute for current methods of heart axis determination in clinical practice and for educational goals. © 2010 Motaharsadat Hosseini et al

Vasopressin attenuates ischemia-reperfusion injury via reduction of oxidative stress and inhibition of mitochondrial permeability transition pore opening in rat hearts

Aim of this study was to investigate the involvement of the mitochondrial permeability transition pore (MPTP) and oxidative stress in the cardioprotective effect of vasopressin (AVP) on ischemia/reperfusion (I/R) injury. Anesthetized male wistar rats were subjected to regional 30 min ischemia and 120 min reperfusion and randomly divided into nine groups: (1) Control; saline was administered intravenously before ischemia, (2) vasopressin was administrated 10 min prior to ischemia, (3, 4) Atractyloside as MPTP opener, was injected 5 min prior to reperfusion without and with vasopressin, (5, 6) Cyclosporine A as a MPTP closer, was injected 5 min prior to reperfusion without and with vasopressin, (7) mitochondria were isolated from control group and CaCl2 was added as MPTP opener and swelling inducer, (8) isolated mitochondria from Control hearts was incubated with Cyclosporine A before adding the CaCl2 (9) CaCl2 was added to isolated mitochondria from vasopressin group. Infusion of vasopressin decreased infarct size (18.6±1.7% vs. control group 37.6±2.4%), biochemical parameters [LDH (Lactate Dehydrogenase), CK-MB (Creatine Kinase-MB) and MDA (Malondialdehyde) plasma levels, PAB (Prooxidant-antioxidant balance)] compared to control group. Atactyloside suppressed the cardioprotective effect of vasopressin (32.5±1.9% vs. 18.6±1.7%) but administration of the Cyclosporine A without and with vasopressin significantly reduced infarct size to 17.7±4% (P<0.001) and 22.7±3% (P<0.01) respectively, vs. 37.6±2.4% in control group. Also, vasopressin, similar to Cyclosporine A, led to decrease in CaCl2-induced swelling. It seems that vasopressin through antioxidant effect and MPTP inhibition has created a cardioprotection against ischemia/reperfusion injuries. © 2015 Elsevier B.V. All rights reserved

A preliminary mechanical design evaluation of the Wikispeed car: for light-weighting implications

Purpose Road passenger transportation faces a global challenge of reducing environmental pollution and greenhouse gas emissions because of the vehicle weight increases needed to enhance passenger safety and comfort. This paper aims to present a preliminary mechanical design evaluation of the Wikispeed Car (with a focus on body bending, body torsion and body crash) to assess light-weighting implications and improve the vehicle’s environmental performance without compromising safety. Design/methodology/approach For this research, finite element analysis (FEA) was performed to examine the Wikispeed chassis for light-weighting opportunities in three key aspects of the vehicle’s design, namely, for body bending the rockers (or longitudinal tubes), for body torsion (again on the rockers but also the chassis as a whole) and for crash safety – on the frontal crash structure. A two-phase approach was adopted, namely, in phase one, a 3D CAD geometry was generated and in phase, two FEA was generated. The combination of analysis results was used to develop the virtual model using FEA tools, and the model was updated based on the correlation process. Findings The research revealed that changing the specified material Aluminium Alloy 6061-T651 to Magnesium EN-MB10020 allows vehicle mass to be reduced by an estimated 110 kg, thus producing a concomitant 10 per cent improvement in fuel economy. The initial results imply that the current beam design made from magnesium would perform worst during a crash as the force required to buckle the beam is the lowest (between 95.2 kN and 134 kN). Steel has the largest bandwidth of force required for buckling and also requires the largest force for buckling (between 317 kN and 540 kN). Originality/value This is the first study of its kind to compare and contrast between material substitution and its impact upon Wikispeed car safety and performance

Estimation of landfill gas generation in a municipal solid waste disposal site by LandGEM mathematical model

Anaerobic decomposition of organic compounds in landfills is responsible for generation of greenhouse gases. The present study aimed to determine the total gas and methane emission from a landfill located in Hamedan (west of Iran) from 2011 to 2030. LandGEM 3.02 model was used to estimate the gas emission with the volumetric methane percent of 60%, production potential of 107, and methane generation rate of 0.2. Spatial distribution of annual methane and total landfill gas emission rate in the study area at three decades were provided through ArcGIS software. The results showed that organic and food wastes had the maximum amounts in the solid waste stream (over 75%). The results showed that 4.371×108 m3 methane would be produced after 20 years, mostly (4.053×106m3) in the first year. In addition, methane production capacity in Hamedan landfill site was 107 m3/Mg. According to the results, the maximum and minimum gas generation rates are in summer (the hottest season) and winter (the coldest season) respectively. The results of the LandGEM model represented that the total gas and methane generation rates will be significant in the first 10 years. The potential of rapidly degradable organic compounds for gas emission will be higher than that of slowly degradable organic compounds. The results obtained in the present study can be beneficially used in planning for energy production and other applications in landfill sites

CenoDerm vs. fascia lata for the prevention of dorsal nasal irregularities in rhinoplasty

Introduction: Dorsal nasal irregularity is a complication of rhinoplasty surgery, mostly seen in patients with thin skin. Acellular dermis (CenoDerm) and homologous fascia lata covering the nasal bone cartilage structure have been used to achieve a smooth surface. In this study, we aimed to investigate clinical outcomes using these two materials. Materials and Methods: After a standard rhinoplasty procedure, a layer of the acellular dermis or homologous fascia lata was placed in the pocket of the dorsum. Patients were evaluated for clinical outcomes at 3, 6, and 12 months after the procedure. Results Forty-two of 68 patients completed the follow-up period. Patient satisfaction was higher in the homologous fascia lata group. Similarly, nasal dorsum inspection and palpation results were better in the homologous fascia lata group compared with the CenoDerm group but was significant in palpation (P=0.00). There was no complete absorption in the homologous fascia lata group 6 months after surgery (P= 0.04 vs. CenoDerm) but no significant difference was observed at 12 months. Conclusion: Homologous fascia lata is better than acellular dermis in preventing dorsal nasal irregularity after rhinoplasty in thin-skinned patients

CenoDerm vs. fascia lata for the prevention of dorsal nasal irregularities in rhinoplasty

Introduction: Dorsal nasal irregularity is a complication of rhinoplasty surgery, mostly seen in patients with thin skin. Acellular dermis (CenoDerm) and homologous fascia lata covering the nasal bone cartilage structure have been used to achieve a smooth surface. In this study, we aimed to investigate clinical outcomes using these two materials. Materials and Methods: After a standard rhinoplasty procedure, a layer of the acellular dermis or homologous fascia lata was placed in the pocket of the dorsum. Patients were evaluated for clinical outcomes at 3, 6, and 12 months after the procedure. Results Forty-two of 68 patients completed the follow-up period. Patient satisfaction was higher in the homologous fascia lata group. Similarly, nasal dorsum inspection and palpation results were better in the homologous fascia lata group compared with the CenoDerm group but was significant in palpation (P=0.00). There was no complete absorption in the homologous fascia lata group 6 months after surgery (P= 0.04 vs. CenoDerm) but no significant difference was observed at 12 months. Conclusion: Homologous fascia lata is better than acellular dermis in preventing dorsal nasal irregularity after rhinoplasty in thin-skinned patients

PLGA/TiO2 nanocomposite scaffolds for biomedical applications: Fabrication, photocatalytic, and antibacterial properties

Introduction: Porous 3D scaffolds synthesized using biocompatible and biodegradable materials could provide suitable microenvironment and mechanical support for optimal cell growth and function. The effect of the scaffold porosity on the mechanical properties, as well as the TiO2 nanoparticles addition on the bioactivity, antimicrobial, photocatalytic, and cytotoxicity properties of scaffolds were investigated. Methods: In the present study, porous scaffolds consisting poly (lactide-co-glycolide) (PLGA) containing TiO2 nanoparticles were fabricated via air-liquid foaming technique, which is a novel method and has more advantages due to not using additives for nucleation compared to former ways. Results: Adjustment of the foaming process parameters was demonstrated to allow for textural control of the resulting scaffolds and their pore size tuning in the range of 200-600 μm. Mechanical properties of the scaffolds, in particular, their compressive strength, revealed an inverse relationship with the pore size, and varied in the range of 0.97-0.75 MPa. The scaffold with the pore size 270 μm, compressive strength 0.97 MPa, and porosity level 90, was chosen as the optimum case for the bone tissue engineering (BTE) application. Furthermore, 99 antibacterial effect of the PLGA/10 wt. TiO2 nanocomposite scaffolds against the strain was achieved using Escherichia coli. Besides, no negative effect of the new method was observed on the bioactivity behavior and apatite forming ability of scaffolds in the simulated body fluid (SBF). This nanocomposite also displayed a good cytocompatibility when assayed with MG 63 cells. Lastly, the nanocomposite scaffolds revealed the capability to degrade methylene blue (MB) dye by nearly 90 under the UV irradiation for 3 hours. Conclusion: Based on the results, nanocomposite new scaffolds are proposed as a promising candidate for the BTE applications as a replacement for the previous ones. © 2020 Tabriz University of Medical Sciences. All rights reserved

The effect of inhalation aromatherapy of geranium on pain and physiological indices after appendectomy: A double-blind randomized clinical trial

Introduction: The aim of the present study was to evaluate the effect of inhalation aromatherapy with sweet-scented geranium essential oil on pain and physiological indices after appendectomy. Methods: This double-blind clinical trial was performed on 120 patients undergoing appendectomy. Aromatherapy was performed with 1 sweet-scented geranium and sweet almond oil in the experimental placebo groups, respectively. Physiological symptoms were recorded before induction of anesthesia, before surgery, 30 min and 4 h after surgery. The control group received no intervention and only pain intensity and physiological indices were recorded in the mentioned stages. The placebo group underwent sweet almond essential oil aromatherapy. Data collection tools included demographic information form, physiological index checklist, and visual pain scale. Results: Results of 7 measurements showed significant differences between the experimental and placebo groups as well as the experimental and control groups in terms of mean heart rate, systolic and diastolic blood pressure, blood oxygen percentage, and pain (P < 0.001). Conclusion: Results of the present study showed that the effect of inhalation aromatherapy with sweet-scented geranium essential oil after appendectomy reduces pain and physiological indices. Therefore, the above aromatherapy can be used as a complementary treatment along with other treatments. © 2020 The Author

Scaling-up a new socio-mental health service model in Iran to reduce burden of neuropsychiatric disorders: an economic evaluation study

Background: The integration of core packages of mental health care into routine primary health care has been introduced as an effective way to achieve universal health coverage in mental health care. Based on the transition of mental health care in Iran, from introducing basic mental health care in PHC to the experience of community-based mental health centers for urban areas, a new socio-mental health service model has been so far proposed. This study aimed to estimate the impact of scaling-up the new socio-mental health model at the national level as well as its associated costs. Methods: This study was a cost-consequence analysis following One Health Tool methodology. The data required for the study were collected in the first quarter of the year 2020 with a time horizon from 2020 to 2030. The selected metric for summarizing health effects is healthy life years gained. Resources used in terms of drug and supply, staff salaries and outpatient visits were documented and associated costs were subsequently estimated in order to estimate the average cost of each intervention per case. Results: The health impacts are calculated in terms of healthy life years gained for 2020�2030, after adjusting the prevalence and incidence rates for each disorder. In total, 1,702,755 healthy life years were expected to be gained. Considering total 1,363,581,654 US dollars cost in base case scenario, each healthy life years gained will cost around 801 US dollars. Based on the WHO criteria for cost-effectiveness threshold, all of the values ranged from 724 to 1119 US dollars obtained through eight different scenarios were considered as cost-effective given the GDP per capita of 5550 US dollars for Iran in 2018. Conclusions: Mental health budget in Iran equals to about three percent of total health expenditure while the mental health cost per capita is estimated to be 1.73 US dollar which are relatively low considering the share of the MNS disorders in the national burden of diseases. The results of current study showing the cost of 16.4 US dollar per capita for scaling up this comprehensive mental health service model can convince high-level policy-makers to increase the share of mental health budget accordingly. The present study demonstrated that the cost in this new socio-mental services model is not substantial compared with GDP per capita of Iran. © 2021, The Author(s)

Isolation of probiotic bacteria from raw camel's milk and their antagonistic effects on two bacteria causing food poisoning

Lactic acid bacteria (LAB) is one of the main classes of acid-producing organisms in the food industry, and they play a vital part in many food and feed fermentations. We isolated and performed molecular identification of LAB from raw camel's milk and assessed their protective effects against pathogenicity induced by Staphylococcus aureus and Escherichia coli. Fourteen samples of camel's milk were obtained from several districts under aseptic conditions. Bacteria isolation was performed by plating the samples on selective media. Isolates were identified by amplification of the 16S ribosomal RNA by PCR and sequencing. A total of 32 isolates were randomly picked, eight of which were analysed in this study. On the basis of phenotypic and genotypic methods, isolated LAB was included Leuconostoc mesenteroides, Lactobacillus plantarum, Weissella paramesenteroides and Weissella confuse. Antagonistic activity of isolated LAB against two pathogenic bacteria showed that they had more inhibitory activity against S. aureus subsp. aureus PTCC 1431 than E. coli ATCC 25922. This study discovered that raw camel's milk obtained from three districts of Kerman province contain LAB bacteria that have antagonistic properties on S. aureus. © 2018 The Author