Cleaning of surgical instruments

Cleaning of surgical instrument

Identifying and Evaluating Smart City Marketing Parameters (Case study: Tabriz)

The main goal of this article is to investigate, identify, and rank the factors that influence the development of a sustainable smart city in Tabriz. The statistical population comprises all of Tabriz Municipality's managers, which number 257 at the moment. The data collected using a standard questionnaire of parameters from "A unique taxonomy of smart sustainable city metrics," which was randomly distributed. In addition, descriptive and inferential statistical techniques were used. Spss software is also used to analyze data using descriptive statistical methods and conclusions from sample tests and Friedman ranking tests, as well as to execute Econometric operations. The findings suggest that all of the variables affecting the improvement of a sustainable smart city in Tabriz have a direct and relatively strong relationship, with four variables affecting the marketing of a sustainable smart city. The socio-cultural parameter, which has an average rank of 3.80, the governance parameter, that has an average rank of 3.18, the second parameter, the environmental parameter with rank of 2.03, and the economic parameter, with rank of 1.00, all impact on the improvement of a sustainable smart city marketing

Study of Long Term Effects of Laser Therapy Versus Local Corticosteroid Injection in Patients with Carpal Tunnel Syndrome

INTRODUCTION: Carpal Tunnel Syndrome (CTS) is the most common compressive neuropathy. Several surgical and nonsurgical treatments have been proposed for this syndrome, but there is no consensus regarding the prioritization of the suggested nonsurgical treatments. The goal of this study was to compare the long term effects of laser therapy versus local corticosteroid injection in the treatment of CTS.METHODS:During this single-blind randomized clinical trial, 65 hands with mild or moderate CTS were divided randomly into two groups. One group received local corticosteroid injection (Hydrocortisone 50 mg) and the other received low level laser therapy (20J/cm² in 11 seconds/session for each of 5 points, 775nm, 10 sessions and 3sessions/week). Furthermore, wrist splints with extension degree of 0° (neutral position) were prescribed simultaneously for 6 weeks in each group.Pain severity and electrodiagnostic measurements were compared from before to 10 months after completing each treatment. Data were analyzed with SPSS 11.5 software and parametric tests.RESULTS: Generally, the mean age of patients was 43.9 years, duration of pain was 7.4 months, male to female ratio was 1:3, pain severity using Visual Analogue Scale (VAS) was 6.1 cm, and functional status measure was 15.5. The severity of the disease based on electrodiagnostic studies was 43.2% mild (41.2% in injection group and 45.2% in laser therapy group) and 56.8% moderate. The electrodiagnostic characteristics of the median nerve prior to treatment were included mean sensory peak latency of 4.3ms, mean sensory amplitude of 23.5μv, mean motor onset latency of 4.3ms and mean motor amplitude of 4.6mv. There was no meaningful difference between two groups regarding the demographic characteristics and electrodiagnostic measures (p>0.05). Ten months after treatments, the mean of pain severity was decreased 1.9cm in injection group and 1.7cm in laser therapy group, the mean of median sensory peak latencies was decreased 0.4ms in injection group and 0.25ms in laser therapy group and the mean of motor onset latencies was decreased 0.15ms in both groups,with no significant difference between the observed treatments variables (P>0.05). The severity of disease based on electrodiagnostic studies became 32.4% normal,23.5% mild, 41.2% moderate and 2.9% severe in the injection group and 38.7% normal,22.6% mild, 35.5% moderate and 3.2% severe in the laser therapy group. There was no meaningful difference between two groups regarding the changes in the pain severity, functional status and electrodiagnostic measures.CONCLUSION: Low level laser therapy can be as effective as local injection in reducing pain and severity of disease (based on electrodiagnostic medicine classification) in patients with mild and moderate CTS even in long term (after 10 months)

Transitoriedad / mutabilidad: lectura de la poesía de Percy Bysshe Shelley a través de Buda

As an ongoing phenomenon, the impermanence of the world has been observed by many people, both in ancient and modern times, in the East and in the West. Two of these authors are Gautama Buddha (an ancient, eastern philosopher from the 6th-5th centuries B.C.) and Percy Bysshe Shelley (a modern Western poet: 1792-1822). The aim of this paper is to examine in the light of Buddhist philosophy what impermanence means or looks in a selection of Shelley’s poems, after considering that this philosophy was not alien to the Europeans of the 18th and 19th centuries. Buddhism, seeing impermanence (anicca) as the foundation of the world, both acquiesces to it and urges the individuals to sway with its ebb and flow. Shelley mainly falters in the incorporation of the phenomenon into his mindset and his poems. However, he often shows a casual acceptance of it; and even, in a few cases, he presents it with a positive assessment.La transitoriedad del mundo ha sido considerada un concepto relevante por muchos autores antiguos y modernos, tanto en el este como en el oeste. Dos de estos autores son Gautama Buda (ss. VI-V a.C.) y Percy Bysshe Shelley (1792-1822), el primero perteneciente a la cultura oriental antigua y el segundo a la cultura occidental moderna. El propósito de este estudio es examinar, a la luz de la filosofía budista, qué significa y cómo se manifiesta el motivo de la transitoriedad en la poesía de Shelley, partiendo del hecho de que la filosofía del budismo se difundió en la Europa de los siglos XVIII y XIX. El budismo, considerando que la “impermanencia” o transitoriedad (anicca) es una de las tres marcas de la existencia, invita al individuo a aceptar y convivir con esa inestabilidad. Por su parte, Shelley adopta normalmente una actitud dudosa respecto a la incorporación de este fenómeno en su ideario y en su poesía. Se detecta, sin embargo, que a menudo muestra una aceptación casual del concepto. En unos pocos casos, incluso presenta una visión positiva del mismo

Using Rasch rating scale model to reassess the psychometric properties of the Persian version of the PedsQLTM 4.0 Generic Core Scales in school children

<p>Abstract</p> <p>Background</p> <p>Item response theory (IRT) is extensively used to develop adaptive instruments of health-related quality of life (HRQoL). However, each IRT model has its own function to estimate item and category parameters, and hence different results may be found using the same response categories with different IRT models. The present study used the Rasch rating scale model (RSM) to examine and reassess the psychometric properties of the Persian version of the PedsQL^TM4.0 Generic Core Scales.</p> <p>Methods</p> <p>The PedsQL^TM4.0 Generic Core Scales was completed by 938 Iranian school children and their parents. Convergent, discriminant and construct validity of the instrument were assessed by classical test theory (CTT). The RSM was applied to investigate person and item reliability, item statistics and ordering of response categories.</p> <p>Results</p> <p>The CTT method showed that the scaling success rate for convergent and discriminant validity were 100% in all domains with the exception of physical health in the child self-report. Moreover, confirmatory factor analysis supported a four-factor model similar to its original version. The RSM showed that 22 out of 23 items had acceptable infit and outfit statistics (<1.4, >0.6), person reliabilities were low, item reliabilities were high, and item difficulty ranged from -1.01 to 0.71 and -0.68 to 0.43 for child self-report and parent proxy-report, respectively. Also the RSM showed that successive response categories for all items were not located in the expected order.</p> <p>Conclusions</p> <p>This study revealed that, in all domains, the five response categories did not perform adequately. It is not known whether this problem is a function of the meaning of the response choices in the Persian language or an artifact of a mostly healthy population that did not use the full range of the response categories. The response categories should be evaluated in further validation studies, especially in large samples of chronically ill patients.</p