Identification of occupational accidents reporting components and developing a new national pattern for recording and reporting occupational accidents

Background and Aims:. Identification of the most important components of occupational accidents coupled with precise and accurate documentation of them enable us to analyze occupational accidents on both macro- and micro-scale. These analyses play a key role in drawing a policy and application for prevention of occupational accident. The present study aimed to identify important parameters in occupational accident documentation and to develop a new national pattern for recording and reporting of occupational accidents.Materials and Methods: In this descriptive-analytical study, nine important occupational accident reporting models belonging to valid organizations were selected and the distinctive features and similarities of these models were determined through meta-analytic analysis. , The important native elements involved in models of occupational accidents reporting were then determined using the Delphi technique and validated by three criteria including usability, relevancy, and necessity. All stages of this research were conducted ethically.Results: In general, 42 components for reporting and documentation of occupational accidents were determined. The proposed final model encompasses five categories including injured worker information, accident information, accident causes information, and information about accident time.Conclusion: Applying the obtained results and customized model in the present study make it possible to analyze occupational accidents in the micro- and macro-scal

شناسایی مولفه های حائز اهمیت حوادث شغلی و ارائه مدل بومی ثبت و گزارش‌دهی حوادث شغلی

Background and Aims:. Identification of the most important components of occupational accidents coupled with precise and accurate documentation of them enable us to analyze occupational accidents on both macro- and micro-scale. These analyses play a key role in drawing a policy and application for prevention of occupational accident. The present study aimed to identify important parameters in occupational accident documentation and to develop a new national pattern for recording and reporting of occupational accidents. Materials and Methods: In this descriptive-analytical study, nine important occupational accident reporting models belonging to valid organizations were selected and the distinctive features and similarities of these models were determined through meta-analytic analysis. , The important native elements involved in models of occupational accidents reporting were then determined using the Delphi technique and validated by three criteria including usability, relevancy, and necessity. All stages of this research were conducted ethically. Results: In general, 42 components for reporting and documentation of occupational accidents were determined. The proposed final model encompasses five categories including injured worker information, accident information, accident causes information, and information about accident time. Conclusion: Applying the obtained results and customized model in the present study make it possible to analyze occupational accidents in the micro- and macro-scaleزمینه و اهداف: ثبت تعیین مولفه­های حائز اهمیت حوادث شغلی و ثبتِ دقیق و صحیح آنها، امکان تحلیل حوادث شغلی در مقیاس خرد و کلان را فراهم می­نماید. این تحلیل­ها در سیاست گذاری و برنامه ریزی پیشگیری از حوادث نقش کلیدی را ایفا می‌کنند. مطالعه حاضر با هدف شناسایی پارامترهای حائز اهمیت در ثبت حوادث شغلی و ارائه مدل بومی گزارش آن به انجام رسید. مواد و روش‌ها: در این مطالعه توصیفی- تحلیلی، 9 مدل گزارش حادثه مربوط به سازمان‌های معتبر در این حوزه انتخاب و با آنالیز فراتحلیلی وجوه تمایز و تشابه آنها تعیین گردید. سپس با استفاده از تکنیک دلفی، مولفه­های بومی حائز اهمیت در گزارش­دهی حوادث تعیین و توسط سه معیار (کاربردی بودن)، (مرتبط بودن) و(ضروری بودن) اعتبار سنجی شدند. تمامی مراحل مطالعه حاضر طبق موازین اخلاقی اجرا گردید.  یافته‌ها: تعداد 42 مولفه برای ثبت و گزارش حوادث شغلی حاصل گردید و بر اساس آنها مدل نهایی برای ثبت و گزارش حادثه شغلی در پنج حیطه ارائه شد. این حیطه‌ها عبارتند از: مولفه‌های حادثه دیده، مولفه‌های حادثه ایجاد شده، مولفه‌های علل حادثه، مولفه پیامد حادثه، مولفه‌های زمانی. نتیجه‌گیری: ثبت حادثه، حادثه شغلی، مولفه های گزارشدهی حادث

Physicochemical, Technofunctional, In Vitro Antioxidant, and in Situ Muscle Protein Synthesis Properties of a Sprat (Sprattus Sprattus) Protein Hydrolysate

This study characterized the physicochemical, technofunctional, and in vitro antioxidant properties along with the AA profile and score of a sprat protein enzymatic hydrolysate (SPH). Furthermore, the impact of the SPH on the growth, proliferation, and muscle protein synthesis (MPS) in skeletal muscle (C2C12) myotubes was examined. The SPH displayed good solubility and emulsion stabilization properties containing all essential and non-essential AAs. Limited additional hydrolysis was observed following in vitro-simulated gastrointestinal digestion (SGID) of the SPH. The SGID-treated SPH (SPH-SGID) displayed in vitro oxygen radical antioxidant capacity (ORAC) activity (549.42 μmol TE/g sample) and the ability to reduce (68%) reactive oxygen species (ROS) production in C2C12 myotubes. Muscle growth and myotube thickness were analyzed using an xCELLigenceTM platform in C2C12 myotubes treated with 1mg protein equivalent.mL−1 of SPH-SGID for 4 h. Anabolic signaling (phosphorylation of mTOR, rpS6, and 4E-BP1) and MPS (measured by puromycin incorporation) were assessed using immunoblotting. SPH-SGID significantly increased myotube thickness (p \u3c 0.0001) compared to the negative control (cells grown in AA and serum-free medium). MPS was also significantly higher after incubation with SPH-SGID compared with the negative control (p \u3c 0.05)

Relationship between low-density lipoprotein cholesterol, lipid-lowering agents and risk of stroke: a meta-analysis of observational studies (<i>n</i> = 355,591) and randomized controlled trials (<i>n</i> = 165,988).

IntroductionThe impact of low-density lipoprotein cholesterol (LDL-C) on the risk of different types of strokes is unclear. Therefore, we systematically evaluated the impact of LDL-C levels (cohort studies) and lipid-lowering agents (LLAs) (randomized controlled trials) on the different types of stroke.Material and methodsPubMed, SCOPUS, Web of Science and Google Scholar were searched up to 1st September 2019. The DerSimonian-Laird method and generic inverse variance methods were used for quantitative data synthesis. The leave-one-out method was performed as sensitivity analysis. Trial sequential analysis (TSA) was used to evaluate the optimal sample size to detect a 35% reduction in outcomes after administration of LLAs.ResultsParticipants in the highest category of LDL-C had a lower risk of hemorrhagic stroke (RR = 0.91, 95% CI: 0.85-0.98, I 2 = 0%) compared with the lowest category of LDL-C. Subjects with the highest category of LDL-C had a higher risk of ischemic stroke (RR = 1.11, 95% CI: 1.07-1.14, I 2 = 0%) compared to the lowest LDL-C category. LLAs decreased the risk of all types of strokes for those who achieved LDL-C I 2 = 53%, n = 13). Statin therapy decreased the risk of all strokes (RR = 0.88, 95% CI: 0.80-0.97, ARR = 0.6%, NNT = 167, I 2 = 56%). With regard to ischemic stroke only, LLAs decreased the risk of ischemic stroke for those who achieved LDL-C I 2 = 0%); the same was observed for statins (RR = 0.76, 95% CI: 0.69-0.84, ARR = 1.3%, NNT = 77, I 2 = 32%). TSA indicated that both benefit boundaries and optimal sample size were reached. There was no significant effect of LLAs regardless of the achieved level of LDL-C on the risk of hemorrhagic stroke; however, TSA indicated that further studies are needed to settle the question and most of the effects were subject to high levels of heterogeneity.ConclusionsOur study sheds light on the debatable association between low LDL-C and different type of strokes. This information can help determine the optimal LDL-C range for stroke prevention, and help plan future LLA studies

Nutrient Patterns are Associated with Discordant Apolipoprotein B and Low-Density Lipoproteins: A Population-Based Analysis

Individuals with discordantly high ApoB to LDL-C levels carry a higher risk of atherosclerotic cardiovascular disease compared to those with average or discordantly low ApoB to LDL-C. We aimed to determine associations between ApoB and LDL-C discordance in relation to nutrient patterns (NPs) using National Health and Nutrition Examination Survey data. Participants were grouped by established LDL-C and ApoB cut-offs (Group 1: Low ApoB/Low LDL-C, Group 2: Low ApoB/High LDL-C, Group 3: High ApoB/Low LDL-C, Group 4: High ApoB/High LDL-C). Principle component analysis was used to define NPs. Machine learning (ML) and structural equation models were applied to assess associations of nutrient intake with ApoB/LDL-C discordance using the combined effects of ApoB and LDL-C. Three NPs explained 63.2% of variance in nutrient consumption. These consisted of NP1 rich in saturated fatty acids, carbohydrate and vitamins, NP2 high in fibre, minerals, vitamins and PUFA and NP3 rich in dietary cholesterol, protein, and sodium. The discordantly high ApoB to LDL-C group had the highest consumption of the NP1 and the lowest consumption of the NP2. ML showed nutrients which had the greatest unfavourable dietary contribution to individuals with discordantly high ApoB to LDL-C were total fat, saturated fatty acids and thiamine and the greatest favourable contributions were MUFA, folate, fibre and selenium. Individuals with discordantly high ApoB in relation to LDL-C had greater adherence to NP1, whereas those with lower levels of ApoB, irrespective of LDL-C, are more likely to consume NP3

Stevens-Johnson Syndrome From Combined Allopurinol and Angiotensin-Converting Enzyme Inhibitors: A Narrative Review

Stevens-Johnson syndrome (SJS) is a severe and potentially debilitating skin reaction frequently related to medication use. Allopurinol and angiotensin-converting enzyme (ACE) inhibitors are commonly prescribed medications for prevalent health conditions worldwide, and their interaction associated with SJS warrants further investigation. A comprehensive literature search was performed to investigate cases as studies related to SJS occurring in patients with concomitant use of allopurinol and ACE inhibitors. We identified case reports and studies detailing hypersensitivity reactions, including SJS, attributed to a combination of allopurinol and ACE inhibitors. Despite the drug-drug interactions or lack thereof seen in patient populations, there is no definitive evidence of a pharmacokinetic interaction between allopurinol and ACE inhibitors. We were only able to find one case report specifically detailing SJS in a patient on combined ACE inhibitors and allopurinol. While the exact mechanism of the interaction is unclear, those reported cases of severe hypersensitivity reactions suggest a previous history of impaired renal function as a predisposing factor in the development of SJS. The potential risk of SJS with coadministration of ACE inhibitors and allopurinol is a drug-drug interaction that physicians should be aware of. This topic requires additional attention to determine if this drug combination should be avoided entirely in certain patients

Nutrient patterns are associated with discordant apoB and LDL: a population-based analysis

Individuals with discordantly high apoB to LDL-cholesterol levels carry a higher risk of atherosclerotic CVD compared with those with average or discordantly low apoB to LDL-cholesterol. We aimed to determine associations between apoB and LDL-cholesterol discordance in relation to nutrient patterns (NP) using National Health and Nutrition Examination Survey data. Participants were grouped by established LDL-cholesterol and apoB cut-offs (Group 1: low apoB/low LDL-cholesterol, Group 2: low apoB/high LDL-cholesterol, Group 3: high apoB/low LDL-cholesterol, Group 4: high apoB/high LDL-cholesterol). Principle component analysis was used to define NP. Machine learning (ML) and structural equation models were applied to assess associations of nutrient intake with apoB/LDL-cholesterol discordance using the combined effects of apoB and LDL-cholesterol. Three NP explained 63·2 % of variance in nutrient consumption. These consisted of NP1 rich in SFA, carbohydrate and vitamins, NP2 high in fibre, minerals, vitamins and PUFA and NP3 rich in dietary cholesterol, protein and Na. The discordantly high apoB to LDL-cholesterol group had the highest consumption of the NP1 and the lowest consumption of the NP2. ML showed nutrients that had the greatest unfavourable dietary contribution to individuals with discordantly high apoB to LDL-cholesterol were total fat, SFA and thiamine and the greatest favourable contributions were MUFA, folate, fibre and Se. Individuals with discordantly high apoB in relation to LDL-cholesterol had greater adherence to NP1, whereas those with lower levels of apoB, irrespective of LDL-cholesterol, were more likely to consume NP3

Interventional procedures for refractory neuropathic pain

Neuropathic pain is an increasingly common disease affecting millions of individuals worldwide. Refractory pain poses a significant impact on patients’ quality of life, financial and economic stability, and social interaction. Numerous effective modalities for treatment of refractory neuropathic pain are presently available. Currently, many options provide symptomatic treatment but are associated with an unfavorable side effect profile and increased risk of addiction. The present investigation reviews current medical management for refractory neuropathic pain including the use of antidepressants, anticonvulsants, gabapentinoids and opioid therapy, as well as interventional pain procedures such as spinal cord stimulation (SCS) and intrathecal targeted drug delivery. While multidisciplinary management with lifestyle modification and pharmacologic regimens remains at the forefront of treating many of these patients, interventional modalities are growing in popularity and have been demonstrated to be highly efficacious. In this regard, continued understanding of the pathophysiology surrounding refractory neuropathic pain has led to the development of interventional procedures and better outcomes for patients suffering from refractory neuropathic pain. When and if patients fail conservative therapy, interventional techniques are desirable alternatives for pain management. SCS and intrathecal targeted drug delivery are important tools for the treatment of refractory neuropathic pain. In summary, treatment modalities for refractory neuropathic pain are evolving with demonstrated efficacy. This review aims to outline the efficacy of various interventional procedures for refractory neuropathic pain in comparison to traditional drug therapies

Bupropion Mediated Effects on Depression, Attention Deficit Hyperactivity Disorder, and Smoking Cessation

Bupropion had been in use since the late 1980s as an unconventional treatment for depression. Unlike other antidepressants, bupropion has no serotonergic activity and inhibits the reuptake of norepinephrine and dopamine. The drug has been used to treat depression, Attention Deficit Hyperactivity Disorder (ADHD), and smoking cessation. This investigation reviews the pharmacokinetic and pharmacodynamic effects of bupropion and its mechanisms of action and interactions with other drugs. We evaluated the efficacy of major on and off-label uses of bupropion, focusing on the indications, benefits, and adverse effects. Our review demonstrates that bupropion is superior to placebo and non-inferior to SSRIs such as escitalopram in treating major depressive disorder. More research is needed to determine positive patient-centered outcomes such as increases in quality of life. In the case of ADHD, the evidence for efficacy is mixed with poorly conducted randomized clinical trials, small sample sizes, and a lack of long-term assessments. The same is true in the case of bipolar disorder in which there is still limited and controversial data available on bupropion's safety and efficacy. In the case of smoking cessation, bupropion is found to be an effective anti-smoking drug with synergistic benefits when used as a combination therapy. We conclude that bupropion has the potential to provide benefit for a subset of patients who do not tolerate other typical antidepressants or anti-smoking therapies or for those whose treatment goals align with bupropion's unique side effect profile, such as smokers who wish to quit and lose weight. Additional research is needed to determine the drug's full clinical potential, particularly in the areas of adolescent depression and combination therapy with varenicline or dextromethorphan. Clinicians should use this review to understand the varied uses of the drug and identify the situations and patient populations in which bupropion can lend its greatest benefit