Comparison of gabapentin and ketotifen in treatment of uremic pruritus in hemodialysis patients

Objectives: Uremic pruritus is a common problem in hemodialysis patients. Several treatments have been used for decreasing itching in these patients. Gabapentin and ketotifen are two drugs used for treating uremic patients.The aim of this study was to compare gabapentin and ketotifen in treatment of uremic pruritus in hemodialysis patients. Methods: In this double-blind randomized clinical trial, 52 hemodialysis patients with uremic pruritus referred to 5azarTeaching Hospital in Gorgan in 2013 were studied. Patients were randomly assigned to two groups of 26 subjects (groups G and K). In group G, patients treated with gabapentin capsules 100 mg daily for 2 weeks, and in Group K, patients treated with ketotifen 1 mg twice daily for 2 weeks. Before and at the end of study, pruritus severity was determined based on Shiratori›s severity scores. Collected data were analyzed by SPSS-21 statistical software. Results: There was no significant different between two groups in the age and sex. After two weeks of treatment, severity of pruritus was significantly reduced in both groups (88.4 in group G vs. 76.9 in group K). Gabapentin compared with ketotifen had a better effect on improving itching in the age group of 30-60 years and in males. 5 patients (19.2) in both groups suffered from drowsiness and dizziness, but no serious side effects were observed. Conclusions: The results showed that gabapentin and ketotifen significantly improved pruritus in hemodialysis patients, and no significant difference was observed between two groups. © 2016, Professional Medical Publications. All rights reserved

Laboratory study on inclined desalination discharges in perpendicular cross-flow

To mitigate the ecological impact of dense effluents discharged from diffusers, understanding the influence of ambient currents and discharge characteristics on desalination outfall performance is crucial. For this purpose, a series of laser-induced fluorescence (LIF) experimental tests were conducted to address the combined effects of the flowing current strength and nozzle inclination in the discharge region for dense jets issuing into a plane perpendicular to the cross-flows. Various nozzle discharge angles (30°, 45°, and 60°) and cross-flow Froude numbers (urF=[Formula presented]) are studied to assess 3D jet trajectory and concentration distribution. Empirical equations describing the dilution and geometrical characteristics of the jets are also derived. The findings indicate that deploying the 60° jet can achieve dilutions of over 50 % and 20 % compared to the 30° and 45° jets, respectively, due to its longer trajectory and greater expansion. Thus, the previously reported insensitivity of dilution to the nozzle angles in the range of 40°-70° for stationary ambient water is questioned herein when dealing with flowing currents. Moreover, the 60° jet is more sensitive to the changes in urF compared to the two other shallower angles. The presented outcomes provide valuable insights for safeguarding coastal water bodies through the efficient design of inclined dense outfall discharges

Application of an Improved Neural Network Using Cuckoo Search Algorithm in Short-Term Electricity Price Forecasting under Competitive Power Markets

Accurate and effective electricity price forecasting is critical to market participants in order to make an appropriate risk management in competitive electricity markets. Market participants rely on price forecasts to decide on their bidding strategies, allocate assets and plan facility investments. However, due to its time variant behavior and non-linear and non-stationary nature, electricity price is a complex signal. This paper presents a model for short-term price forecasting according to similar days and historical price data. The main idea of this article is to present an intelligent model to forecast market clearing price using a multilayer perceptron neural network, based on structural and weights optimization. Compared to conventional neural networks, this hybrid model has high accuracy and is capable of converging to optimal minimum. The results of this forecasting method for Market Clearing Price (MCP) of Iranian and Nord Pool Electricity Markets, as well as Locational Marginal Price (LMP) forecasting in PJM electricity market, verify the effectiveness of the proposed approach in short-term price forecasting

Squeezed Josephson plasmons in driven YBa2_2Cu3_3O6+x_{6+x}

The physics of driven collective modes in quantum materials underpin a number of striking non-equilibrium functional responses, which include enhanced magnetism, ferroelectricity and superconductivity. However, the coherent coupling between multiple modes at once are difficult to capture by single-pump probe (one-dimensional) spectroscopy, and often remain poorly understood. One example is phonon-mediated amplification of Josephson plasmons in YBa$_2$Cu$_3$O$_{6+x}$, in which at least three normal modes of the solid are coherently mixed as a source of enhanced superconductivity. Here, we go beyond previous pump-probe experiments in this system and acquire two-dimensional frequency maps using pairs of mutually delayed, carrier envelope phase stable mid-infrared pump pulses, combined with measurements of the time-modulated second-order nonlinear optical susceptibility. We find that the driven zone-center phonons amplify coherent pairs of opposite-momentum Josephson plasma polaritons, generating a squeezed state of interlayer phase fluctuations. The squeezed state is a potentially important ingredient in the microscopic physics of photo-induced superconductivity in this and other materials.Comment: 20 pages, 7 figure

Research Article Presenting a Framework for Ranking Identification System in the Chain Store: Real Case Study of the Iran SHAHRVAND Department Store

Abstract: The purpose of this research is to specify and rank the appropriate automatic identifying goods system for a real case of a department store (Shahrvand department store). The ideas of the experts about the most appropriate identifying goods system in the department store are evaluated and collected by the brainstorming method, the three types of identification system which are specified by the brainstorming method are: RFID (Radio Frequency IDentification), Barcode and OCR (Optical Character Recognition). In order to ranking the achieved automatic identification systems and helping the management of the department store for decision making, the promethee (Preference Ranking Organization Method for Enrichment Evaluations) method is selected which has the most conformity with this research between the all MCDM (Multi Criteria Decision Making) method. Therefore, by consideration of two approaches: "efficiency of identification systems" and "convenience of customer purchase" eight criteria are extracted for ranking the identification system. Finally, the RFID system is preferred to other automatic identifying good systems by the used method in the research

Outcomes of chronic total occlusion percutaneous coronary intervention from the RAIAN (RAjaie - Iran) registry

Objective: While most of the evidence in CTO interventions emerge from Western and Japanese studies, few data have been published up today from the Middle East. Objective of this study was to evaluate technical success rates and clinical outcomes of an Iranian population undergoing CTO PCI in a tertiary referral hospital. Moreover, we sought to evaluate the efficacy of our CTO teaching program. Methods: This is a retrospective single-center cohort study including 790 patients who underwent CTO PCI performed by operators with different volumes of CTOs PCI performed per year. According to PCI result, all patients have been divided into successful (n = 555, 70.3 %) and unsuccessful (n = 235, 29.7 %) groups. Study endpoints were Major Adverse Cardiovascular Events and Health Status Improvement evaluated using the Seattle Angina Questionnaire at one year. Results: A global success rate of 70 % for antegrade and 80 % for retrograde approach was shown despite the lack of some CTO-dedicated devices. During the enrollment period, the success rate increased significantly among operators with a lower number of CTO procedures per year. One-year MACE rate was similar in both successful and unsuccessful groups (13.5 % in successful and 10.6 % in unsuccessful group, p = 0.173). One year patients' health status improved significantly only in successful group. Conclusions: No significant differences of in-hospital and one-year MACE were found between the successful and unsuccessful groups. Angina symptoms and quality of life significantly improved after successful CTO PCI. The RAIAN registry confirmed the importance of operator expertise for CTO PCI success

The role of hypoxia in the tumor microenvironment and development of cancer stem cell: a novel approach to developing treatment

Hypoxia is a common feature of solid tumors, and develops because of the rapid growth of the tumor that outstrips the oxygen supply, and impaired blood flow due to the formation of abnormal blood vessels supplying the tumor. It has been reported that tumor hypoxia can: activate angiogenesis, thereby enhancing invasiveness and risk of metastasis; increase survival of tumor, as well as suppress anti-tumor immunity and hamper the therapeutic response. Hypoxia mediates these effects by several potential mechanisms: altering gene expression, the activation of oncogenes, inactivation of suppressor genes, reducing genomic stability and clonal selection. We have reviewed the effects of hypoxia on tumor biology and the possible strategiesto manage the hypoxic tumor microenvironment (TME), highlighting the potential use of cancer stem cells in tumor treatment. © 2021, The Author(s)

Educational supervision and the impact of workplace-based assessments: a survey of psychiatry trainees and their supervisors

<p>Abstract</p> <p>Background</p> <p>Educational supervision (ES) is considered to be an essential component of basic specialist training in psychiatry in the UK. However, previous studies have indicated variation in its provision, and uncertainty about structure and content. Workplace-based assessments (WPBAs) were introduced in 2007 as part of major postgraduate medical training reform. Placing considerable time demands on trainees and supervisors alike, the extent to which WPBAs should utilise ES time has not been specified. As ES and WPBAs have discrete (although complementary) functions, there is the potential for this increased emphasis on assessment to displace other educational needs.</p> <p>Methods</p> <p>All junior doctors and their educational supervisors in one UK psychiatry training scheme were surveyed both before and after the introduction of WPBAs. Frequency and duration of ES were established, and structure, content and process were ascertained. Opinions on usefulness and responsibility were sought. The usage of ES for WPBAs was also assessed.</p> <p>Results</p> <p>The response rate of 70% showed general agreement between trainees and supervisors, but some significant discrepancies. Around 60% reported 1 hour of ES taking place weekly or 3 times per month. Most agreed that responsibility for ES should be shared equally between trainees and supervisors, and ES was largely seen as useful. Around 50% of trainees and supervisors used 25–50% of ES time for WPBAs, and this did not appear to affect the usefulness of ES or the range of issues covered.</p> <p>Conclusion</p> <p>ES continues to be an important component of psychiatric training. However, using ES for WPBAs introduces the potential for tension between trainees' education and their assessment by emphasising certain training issues at the expense of others. The impact of reduced training time, WPBAs and uncertainties over ES structure and content should be monitored to ensure that its benefits are maximised by remaining tailored to individual trainees' needs.</p

More mentoring needed? A cross-sectional study of mentoring programs for medical students in Germany

<p>Abstract</p> <p>Background</p> <p>Despite increasing recognition that mentoring is essential early in medical careers, little is known about the prevalence of mentoring programs for medical students. We conducted this study to survey all medical schools in Germany regarding the prevalence of mentoring programs for medical students as well as the characteristics, goals and effectiveness of these programs.</p> <p>Methods</p> <p>A definition of mentoring was established and program inclusion criteria were determined based on a review of the literature. The literature defined mentoring as a steady, long-lasting relationship designed to promote the mentee's overall development. We developed a questionnaire to assess key characteristics of mentoring programs: the advocated mentoring model, the number of participating mentees and mentors, funding and staff, and characteristics of mentees and mentors (e.g., level of training). In addition, the survey characterized the mentee-mentor relationship regarding the frequency of meetings, forms of communication, incentives for mentors, the mode of matching mentors and mentees, and results of program evaluations. Furthermore, participants were asked to characterize the aims of their programs. The questionnaire consisted of 34 questions total, in multiple-choice (17), numeric (7) and free-text (10) format. This questionnaire was sent to deans and medical education faculty in Germany between June and September 2009. For numeric answers, mean, median, and standard deviation were determined. For free-text items, responses were coded into categories using qualitative free text analysis.</p> <p>Results</p> <p>We received responses from all 36 medical schools in Germany. We found that 20 out of 36 medical schools in Germany offer 22 active mentoring programs with a median of 125 and a total of 5,843 medical students (6.9 - 7.4% of all German medical students) enrolled as mentees at the time of the survey. 14 out of 22 programs (63%) have been established within the last 2 years. Six programs (27%) offer mentoring in a one-on-one setting. 18 programs (82%) feature faculty physicians as mentors. Nine programs (41%) involve students as mentors in a peer-mentoring setting. The most commonly reported goals of the mentoring programs include: establishing the mentee's professional network (13 programs, 59%), enhancement of academic performance (11 programs, 50%) and counseling students in difficulties (10 programs, 45%).</p> <p>Conclusions</p> <p>Despite a clear upsurge of mentoring programs for German medical students over recent years, the overall availability of mentoring is still limited. The mentoring models and goals of the existing programs vary considerably. Outcome data from controlled studies are needed to compare the efficiency and effectiveness of different forms of mentoring for medical students.</p

Comparative study of the functional properties of three legume seed isolates: adzuki, pea and soy bean

The aim of this work was to compare functional properties including solubility, emulsifying and foaming properties of native and thermally treated adzuki, soy and pea protein isolates prepared under the same conditions. These functional properties were tested at four pH values: pH 3.0, pH 5.0, pH 7.0 and pH 8.0. The lowest solubility at all pH values were obtained for isolate of adzuki whereas isolates of soybean had the highest values at almost all pHs. Thermal treatment reduced solubility of soy and pea isolates at all pH values, whereas solubility of adzuki isolate was unchanged, except at pH 8. Native isolate of adzuki had the best emulsifying properties at pH 7.0 whereas at the other pH values some of native pea and soybean protein isolates were superior. After thermal treatment, depending on tested pH and selected variety all of three species could be a good emulsifier. Native soy protein isolates formed the most stable foams at all pHs. Thermal treatment significantly improved foaming properties of adzuki isolate, whereas reduced foaming capacity of soy and pea isolates, but could improve foam stability of these isolates at specific pH. Appropriate selection of legume seed as well as variety could have great importance in achievement of desirable functional properties of final products. All three tested species could find specific application in wide range of food products