Prevalence and genetic characterization of Cryptosporidium spp. In diarrheic children from Gonbad Kavoos city, Iran

Background: Cryptosporidium is an intestinal protozean parasite causing water-borne and foodborne outbreaks of diarrheal diseases. The present study was per-formed in order to find prevalence and subtypes of Cryptosporidium among children with diarrhea in Gonbad Kavoos City, Northern Iran. Methods: Diarrheic samples were collected from 547 children. The initial parasi-tological diagnosis was made based on detection of oocysts using the modified Ziehl-Neelsen acid-fast staining method. The positive microscopically samples were selected for sequence analysis of partial 60 kDa glycoprotein (gp60) gene. Results: Out of 547 collected samples, 27 (4.94) were positive for Cryptosporid-ium oocysts. Fifteen from 27 positive samples successfully amplified in PCR. Se-quences analysis of gp60 gene in 15 Cryptosporidium isolates revealed that all of them (100) were C. parvum. The results showed three subtypes of IIa subtype family (7 cases) including IIaA16G2R1, IIaA17G1R1, IIaA22G3R1 and one subtype of IId subtype family (8 cases). The most common allele was IId A17G1d (53.3). Conclusion: The predominance of zoonotic subtype families of C. parvum species (IIa, IId) in the present study is in concordance with previous studies in Iran and emphasizes the significance of zoonotic transmission of cryptosporidiosis in the country. © 2015, Tehran University of Medical Sciences (TUMS). All rights Reserved

Optic nerve sonography in the diagnostic evaluation of pseudopapilledema and raised intracranial pressure: A cross-sectional study

Introduction. Differentiating pseudopapilledema from papilledema which is optic disk edema and a result of increased ICP (intracranial pressure) is important and can be done with noninvasive methods like orbital ultrasound examination. Method. This was a cross-sectional study in which patients with optic nerve head swelling were referred for LP exam after optic nerve head swelling diagnosis confirmation and having normal brain imaging (CT scan). Before LP (lumbar puncture) exam the patients were referred for optic nerve ultrasound test of both eyes. Results. Considering 5.7 mm as the upper limit for normal ONSD (optic nerve sheath diameter), sensitivity and negative predictive value of optic sonography in diagnosis of pseudopapilledema are 100 for both eyes. Calculated accuracy validity of ONSD measurement in detecting pseudopapilledema is 90 for the right eye and 87 for the left eye. Conclusion. Our study demonstrated a close correlation between optic nerve sheath dilation on ocular ultrasound and evidence of elevated ICP with optic disk swelling. With the aid of noninvasive diagnostic tests we can avoid unnecessary concerns along with expensive and invasive neurological investigations while targeting the correct diagnosis in bilateral optic disk swelling. Our study showed optic nerve sonography as a reliable diagnostic method for further usage. © 2015 Masoud Mehrpour et al

Improved acoustics for semi-enclosed spaces in the proximity of residential buildings

Continuous urban densification exacerbates acoustic challenges for residents of housing complexes. They are confronted with higher noise immission from railway, road traffic, construction, as well as louder neighborhood acoustic environments. Thereby, not only noise immission indoors is associated with stress, annoyance, and sleep disturbance, but also the immediate outdoor living environment (e.g., courtyards, private gardens and playgrounds, etc.) can be acoustically unpleasant and annoying. This non-exhaustive narrative review paper elaborates on the role of a number of design parameters on improving the quality of the outdoor soundscape of housing complexes: architectural and morphological design, facade material characteristics, balconies, greenery, ground, background sounds, and several factors concerning quality of sounds (e.g., multisensory perception, holistic design, the relevance of space, context, social factors, co-creation, etc.). It mainly covers literature including both acoustical (e.g., sound pressure level and room acoustical parameters) and human/perceptual (e.g., comfort and annoyance) factors. A series of recommendations are presented here as to how the semi-enclosed outdoor spaces in the proximity of residential complexes can be acoustically improved

Durations required to distinguish noise and tone: Effects of noise bandwidth and frequency.

Perceptual audio coders exploit the masking properties of the human auditory system to reduce the bit rate in audio recording and transmission systems; it is intended that the quantization noise is just masked by the audio signal. The effectiveness of the audio signal as a masker depends on whether it is tone-like or noise-like. The determination of this, both physically and perceptually, depends on the duration of the stimuli. To gather information that might improve the efficiency of perceptual coders, the duration required to distinguish between a narrowband noise and a tone was measured as a function of center frequency and noise bandwidth. In experiment 1, duration thresholds were measured for isolated noise and tone bursts. In experiment 2, duration thresholds were measured for tone and noise segments embedded within longer tone pulses. In both experiments, center frequencies were 345, 754, 1456, and 2658 Hz and bandwidths were 0.25, 0.5, and 1 times the equivalent rectangular bandwidth of the auditory filter at each center frequency. The duration thresholds decreased with increasing bandwidth and with increasing center frequency up to 1456 Hz. It is argued that the duration thresholds depended mainly on the detection of amplitude fluctuations in the noise bursts.MRC (G0701870

Reliability and validity of an iPhone® application for the measurement of lumbar spine flexion and extension range of motion

Background: Measurement of lumbar spine range of motion (ROM) is often considered to be an essential component of lumbar spine physiotherapy and orthopedic assessment. The measurement can be carried out through various instruments such as inclinometers, goniometers, and etc. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for inclinometric functions. Purpose: The main purpose was to investigate the reliability and validity of an iPhone® app (TiltMeter© -advanced level and inclinometer) for measuring standing lumbar spine flexion-extension ROM in asymptomatic subjects. Design: A cross-sectional study was carried out. Setting: This study was conducted in a physiotherapy clinic located at School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran. Subjects: A convenience sample of 30 asymptomatic adults (15 males; 15 females; age range = 18-55 years) was recruited between August 2015 and December 2015. Methods: Following a 2-minute warm-up, the subjects were asked to stand in a relaxed position and their skin was marked at the T12-L1 and S1-S2 spinal levels. From this position, they were asked to perform maximum lumbar flexion followed by maximum lumbar extension with their knees straight. Two blinded raters each used an inclinometer and the iPhone® app to measure lumbar spine flexion-extension ROM. A third rater read the measured angles. To calculate total lumbar spine flexion-extension ROM, the measurement from S1-S2 was subtracted from T12-L1. The second (2 hours later) and third (48 hours later) sessions were carried out in the same manner as the first session. All of the measurements were conducted 3 times and the mean value of 3 repetitions for each measurement was used for analysis. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used to determine the intra-rater and inter-rater reliability, respectively. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone® app. Furthermore, minimum detectable change at the 95 confidence level (MDC95) was computed as 1.96 � standard error of measurement � �2. Results: Good to excellent intra-rater and inter-rater reliability were demonstrated for both the gravity-based inclinometer with ICC values of �0.84 and �0.77 and the iPhone® app with ICC values of �0.85 and �0.85, respectively. The MDC95 ranged from 5.82°to 8.18°for the intra-rater analysis and from 7.38°to 8.66° for the inter-rater analysis. The concurrent validity for flexion and extension between the 2 instruments was 0.85 and 0.91, respectively. Conclusions: The iPhone®app possesses good to excellent intra-rater and inter-rater reliability and concurrent validity. It seems that the iPhone® app can be used for the measurement of lumbar spine flexion-extension ROM. © 2016 Pourahmadi et al

Developing a Questionnaire for Iranian Women's Attitude on Medical Ethics in Vaginal Childbirth

Background: Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear. Objectives: The aim of this study was to develop and validate a questionnaire for the assessment of women’s attitude on medical ethics application in normal vaginal delivery. Patients and Methods: This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ) was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach’s alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth. Results: In the first phase of this study (tool development), by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items) of this tool were obtained (A, B and J). Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of the loading factor and medical ethics principles. The subscales of MEAVDQ showed significant reliability. In parts A, B and J, Cronbach’s alpha coefficients were 0.76, 0.72 and 0.68, respectively and for the total questionnaire, it was 0.72. The results of the test–retest were satisfactory for all the items (ICC = 0.60 - 0.95). Conclusions: The present study showed that the 59-item MEAVDQ was a valid and reliable questionnaire for the assessment of women’s attitudes toward medical ethics application in vaginal childbirth. This tool might assist specialists in making a judgment and plan appropriate for women in vaginal delivery management

Development of Sensitive Detection of Cryptosporidium and Giardia from Surface Water in Iran

Background: The protozoan parasites Cryptosporidium spp. and Giardia are known to occur widely in both raw and drinking waters. They are two of the causative agents of waterborne out-breaks of gastroenteritis throughout the world. In the present study, a PCR assay and FA were developed for detection of Cryptosporidium oocysts and Giardia cyst in environmental samples. Methods: We have detected Cryptosporidium spp. oocysts and Giardia cysts in seeded and un-seeded environmental water samples by PCR method. Water samples were spiked with oocysts (50, 100,300,500) and filtrated with a 1.2-µm pore size cellulose nitrate and follow by DNA extrac¬tion and purification by QIAamp DNA mini kit. Nested-PCR assay amplified an 850 bp fragment of 18s rRNA gene specific for Cryptosporidium and 435 bp fragment of glutamate dehydrogenase (GDH) target gene for Giardia. Also many river water from north of Iran, be checked by these methods. Results: Cryptosporidium and Giardia DNAs were detected in seeded water sample and Giardia was detected in all 5 water samples from river in north of Iran by nested- PCR and FA. Also in one river water sample, Cryptosporidium was detected.Conclusion: This protocol is effective for detection of these waterborne parasites in treated and untreated water samples. This study can also serve as a platform for further investigations and research water source in Iran

Reliability of real�time ultrasound imaging for the assessment of trunk stabilizer muscles: A systematic review of the literature

Rehabilitative ultrasound (US) imaging is one of the popular methods for investigating muscle morphologic characteristics and dimensions in recent years. The reliability of this method has been investigated in different studies. As studies have been performed with different designs and quality, reported values of rehabilitative US have a wide range. The objective of this study was to systematically review the literature conducted on the reliability of rehabilitative US imaging for the assessment of deep abdominal and lumbar trunk muscle dimensions. The PubMed/MEDLINE, Scopus, Google Scholar, Science Direct, Embase, Physiotherapy Evidence, Ovid, and CINAHL databases were searched to identify original research articles conducted on the reliability of rehabilitative US imaging published from June 2007 to August 2017. The articles were qualitatively assessed; reliability data were extracted; and the methodological quality was evaluated by 2 independent reviewers. Of the 26 included studies, 16 were considered of high methodological quality. Except for 2 studies, all high�quality studies reported intraclass correlation coefficients (ICCs) for intra�rater reliability of 0.70 or greater. Also, ICCs reported for inter�rater reliability in high�quality studies were generally greater than 0.70. Among low�quality studies, reported ICCs ranged from 0.26 to 0.99 and 0.68 to 0.97 for intra� and inter�rater reliability, respectively. Also, the reported standard error of measurement and minimal detectable change for rehabilitative US were generally in an acceptable range. Generally, the results of the reviewed studies indicate that rehabilitative US imaging has good levels of both inter� and intra�rater reliability. © 2018 by the American Institute of Ultrasound in Medicine

Proportional lumbar spine inter-vertebral motion patterns: a comparison of patients with chronic, non-specific low back pain and healthy controls

Introduction: Identifying biomechanical subgroups in chronic, non-specific low back pain (CNSLBP) populations from inter-vertebral displacements has proven elusive. Quantitative fluoroscopy (QF) has excellent repeatability and provides continuous standardised inter-vertebral kinematic data from fluoroscopic sequences allowing assessment of mid-range motion. The aim of this study was to determine whether proportional continuous IV rotational patterns were different in patients and controls. A secondary aim was to update the repeatability of QF measurement of range of motion (RoM) for inter-vertebral (IV) rotation