Trauma

Anterior cruciate ligament reconstruction surgery timing with respect to meniscal-chondral damage Mohammadreza Minator Sajjadi, Mohammad Ali Okhovatpour, Adel Ebrahimpour, Reza Zandi, Meysam Jafari Kafi-Abadi, Mehrdad Sadighi Archives of Trauma Research 2018 7(3):87-91 Background: Anterior cruciate ligament (ACL) tear is one of the most common types of knee injuries. Delay in diagnosis and treatment of ACL injuries can lead to further damage of the meniscus and cartilage. In this study, we tried to show the distribution of injuries over time and types. Methods: This retrospective study was performed on 336 patients with the diagnosis of primary ACL tear without other ligament injuries. The data including site and grade of the meniscal tear and cartilage damage, based on the International Cartilage Repair Society Classification, the time between diagnosis and surgical procedure, and the treatment method were collected. In this study, we divided patients into four groups according to injury to surgery time. Groups were 3 months, 3–6 months, 6–12 months, and over 12 months to surgery. Results: The results showed that a rate of cartilage damage had no significant correlation with a time interval between injury and surgery (P = 0.54). Furthermore, no significant correlation was found between the site of cartilage damage and the interval time after injury to surgery. The results indicated that the meniscal tear increases in case of a delay to perform surgery (P = 0.004). However, no significant relation was found between the site and pattern of meniscal injury and time. Moreover, patients with a complete ACL tear had a significantly higher rate of meniscus injury compared to those with a partial ACL tear (0.048). Conclusion: The findings of this study show that there is no significant relationship between the time of surgery and the risk of chondral damage after the ACL tear over time. ACL-ruptured patients should undergo the ACL reconstruction surgery up to 3 months from knee trauma to prevent further meniscal injuries.

Investigation of the role of traffic police function in reducing geographical inequalities in mortality from road traffic accidents Fatemeh Shahbazi, Hamid Soori, Soheila Khodakarim, Mohammad Reza Ghadirzadeh, Ahmad Shojaei, Seyed Saeed Hashemi Nazari Archives of Trauma Research 2018 7(3):92-97 Background and Objectives: Road traffic accident (RTA) is one of the major public health problems. Inequality in this problem and its trend has not been yet investigated in Iran. A better understanding of different contributing factors to RTA like inequalities can be helpful to reduce the negative influence of road crashes. Hence, this study aimed at examining geographical inequality in mortality from RTAs over the previous decades. Materials and Methods: In this cross-sectional study, all people who died from RTAs from March 2006 to February 2015 were selected. The data were taken from Legal Medicine Organization in Iran. The Theil index was used to estimate geographical inequality in mortality from RTA. Data were then analyzed using the Stata software. Results: During the 10-year period of this study, 210,582 people in Iran died due to RTA. The mortality rate that caused by RTAs has decreased during the study. We found a larger reduction in a mortality rate in suburban RTAs. In spite of the reduction in RTAs death, geographical inequality increased during the 10-year study. Conclusions: The findings of this study indicate that there is a geographical inequality in mortality from RTAs in Iran. This implies that effective interventions in reducing the RTAs should be distributed equally among regions of the country. Further research can be performed to investigate the causes of this inequality.

Predictors for emergency hemostasis in severe trauma patients Wongsakorn Chaochankit, Osaree Akaraborworn, Khanitta Kaewsaengrueang Archives of Trauma Research 2018 7(3):98-101 Background: Exsanguination is the main cause of death in trauma patients. Early determination that a patient requires an emergency operation is crucial for saving of life. We challenge the defining predictors that guide the intervention or emergency operation for hemorrhage control in severe trauma patients. Aims: The aim of this study was to define the predictors that guide the intervention or emergency operation to resuscitate severe trauma patients. Methods: This study was a retrospective study in trauma patients from Songklanagarind hospital. Data were retrospectively collected from a prospective collection registry that included 131 trauma patients who met the trauma activation criteria at Songklanagarind Hospital from January 2014 to December 2014. Emergency operation or intervention was defined as the procedures needed to improve hemostasis within 4 h. Categorical data were compared. Logistic regression was used to measure the relationship between dependent and one or more independent variables. Results: The study population was 81.7% male. The age range was 31–35 years. The most frequent mechanism was blunt injury (78%). The emergency hemostasis patients had 27 patients (20.6%). The factors relate to an emergency operation or intervention to improve the hemostasis within 4 h were focused assessment with sonography for trauma (FAST)-positive (P < 0.001), male (P = 0.02), Injury Severity Score (ISS) ≥25 (P = 0.013), and penetrating injury (P = 0.016). The preventive factors to an emergency hemostasis were platelet ≥100,000 (P = 0.039) and age ≥50 (P = 0.005). Conclusion: The palate count, FAST, male, age, ISS, and penetrating injury are factors that relate to an emergency operation or intervention within the first 4 h.

Science mapping of "Trauma Surgery" by co-word analysis and thematic clustering in MEDLINE Mohammad Raeeszadeh, Mazyar Karamali, Amin Sohrabi Archives of Trauma Research 2018 7(3):102-108 Background: Trauma surgery has an interdisciplinary nature among the surgical specialties, and trauma surgeons are required to identify its related scientific fields to acquire the needed skills in controlling the injuries. This study was conducted to investigate the science mapping of trauma surgery based on the bibliographic data of MEDLINE. Methodology: Based on the bibliographic data from the MEDLINE database, the visualizing techniques of bibliometric networks and all the scientific products of the trauma surgery realm indexed at MEDLINE from 2008 to 2017 were investigated. Data analysis was performed using co-word analysis and cluster analysis using the VOSviewer. Results: The growth trend of scientific productions in the field of trauma surgery has been on the rise in the past 10 years. The keyword “trauma,” followed by “osteoporosis,” “fracture outcome,” “trauma surgery,” and “mortality” had respectively the highest frequency. The results of cluster analysis identified the most important basic research subjects of trauma surgery published in MEDLINE in the past 10 years and categorized them into five clusters. Trauma surgery field had a close relationship with the field of orthopedics, basic studies, and laboratory research in comparison with its clinical domains. Conclusion: We attempted to identify the vastness of the knowledge subjects of trauma surgery and to conduct educational research, and technological planning so that the managers and stakeholders can trace the path of future scientific activities in the field of trauma surgery. The identification of this important realm and provision of the required information on the core issues for the users can be facilitated by drawing up a science map and visualizing the main traumatic sciences.

Quality of life and knee function in patients with knee dislocation Mohammad Hosein Ebrahimzadeh, Farshid Bagheri, Ali Moradi, Ali Birjandi Nejad Archives of Trauma Research 2018 7(3):109-113 Background: Knee dislocations are uncommon (<0.5% of all dislocations); however, they may result in catastrophic outcomes secondary to their high-energy nature and neurovascular injuries. Objectives: The objective of this study was to evaluate the clinical outcome of knee dislocation management. Subjects and Methods: A total of 20 consecutive adult patients with knee dislocation were enrolled in this cross-sectional study between 2011 and 2014. A single knee surgeon examined all the patients for knee instability for subjective evaluation of knee function using the Lysholm Knee Questionnaire, Knee Society Score (KSS), and Short Form-36 (SF-36). Results: The average Lysholm Knee Scores and KSS were 68 (range: 18–100) and 65 (range: 15–97), respectively. All domains of SF-36 among the studied patients were lower than that of the normal population. We could not find any correlation between age, body mass index, and interval between initial trauma and operation with outcome variables (Lysholm Knee Score, KSS, and SF-36 Physical Component Score, and SF-36 Mental Component Score). Conclusions: The knee function after proper management of dislocation is reasonable, but prolonged course of management and multiple operations may decrease the patients' quality of life.

Comparison of efficacy of nebulized ketamine with morphine and intravenous morphine in pain reduction in patients with traumatic long-bone fractures admitted to emergency department Reza Azizkhani, Kourosh Akhbari, Babak Masoumi, Abdolrahman Parna, Keihan Golshani Archives of Trauma Research 2018 7(3):114-120 Background: Traumatic long-bone fracture is a common cause of referring to the emergency department (ED). The aim of this study was to compare the efficacy of nebulized ketamine and morphine and intravenous (IV) morphine in reducing pain in these patients. Materials and Methods: In this clinical trial study, 88 patients with traumatic long-bone fractures referred to the ED were randomly selected and divided into two groups of nebulized ketamine and morphine and IV morphine using block randomization. Changes in pain intensity according to visual analog scale (VAS), patient satisfaction, and clinical features, including oxygen saturation (O2 sat), systolic blood pressure (SBP), respiratory rate, and pulse rate (PR) were assessed at baseline and 15 and 30 min after the intervention and finally, data were analyzed using the SPSS software. Results: Demographic characteristics including sex, age, and site of fracture were similar in the two groups (P > 0.05). In the IV morphine group, O2 sat (P < 0.001), SBP (P = 0.005), and PR (P < 0.001) significantly decreased, but in the nebulized group, SBP (P < 0.001) and PR (P < 0.001) significantly increased, but O2 sat did not significantly decrease (P > 0.05). The VAS results in the IV group were better at 15 min (P < 0.001), but after 30 min, both methods were equally effective in pain reduction (P = 0.508). Conclusion: According to the results of this study, the pain reduction was similar in both groups after 30 min, but regarding other parameters such as patients' satisfaction and fewer side effects, it can be concluded that the long-term effect of nebulized morphine and ketamine would be more beneficial.

The effect of cardiopulmonary resuscitation clinical audit on the patient survival in the emergency room Jafar Moridi, Hosein Mahmoudi, Abbas Ebadi, Ali Rahmani, Seyed Tayeb Moradian Archives of Trauma Research 2018 7(3):121-126 Background: The ability to perform cardiopulmonary resuscitation (CPR) is among the most important professional skills for physicians and nurses. There is a wide difference among different countries respecting resuscitation success rate. Studies show weaknesses in performing resuscitation. Objectives: This study aimed at assessing the effects of clinical audit of CPR in the emergency room based on the Situation Stabilization Model (SSM). Materials and Methods: This quasi-experimental study was done in 2017 in the emergency room of Baqiyatallah Hospital, Tehran, Iran. Using the Adib checklist, 35 resuscitations were assessed based on the steps of clinical audit. Then, a 1-month educational program was held for the resuscitation staffs in the study setting. Then, 35 new resuscitations were assessed using the same checklist. Finally, the results of the two measurements were compared. Results: There were significant differences between two measurement time points regarding the mean scores of different resuscitation skills (P < 0.001). Primary resuscitation success rate increased from 6 (17.1%) cases at baseline to 8 (22.9%) of the cases after the intervention. This increase was not statistically significant (P = 0.47). Conclusions: Clinical audit in the emergency room based on the SSM improves the quality and the success rate of CPR. The success rate is in our study increased. Furthermore, the reported data were not statistically significant for improving the success rate; it is clinically important. Because primary resuscitation success rate increased from 6 (17.1%) cases at baseline to 8 (22.9%) cases after the intervention. These findings highlight the necessity and the importance of the clinical audit of care services as well as the implementation of educational interventions based on the existing weaknesses. Given the great importance and sensitivity of resuscitation, health-care staffs need to receive regular theoretical and practical in-service resuscitation-related training.

Chest tube malposition inserted in thorax increases morbidity at thoracoabdominal injury Cem Donmez, Ahmet Korkut Belli, Sercan Subasi Archives of Trauma Research 2018 7(3):127-129 Thoracoabdominal penetrating trauma management is challenging when diaphragm injuries are involved. Thorax tube is golden standard for penetrating thoracoabdominal injuries. It has some complications. A 27-year-old male had stabbed thoracoabdominal penetrating trauma thorax tube inserted at another hospital. We decided to explore abdomen laparoscopy when he has symptoms at abdomen. We saw thorax tube ruptured diaphragm. We saturated diaphragm intracorporeally with laparoscopic protege. The clinician should not insert tube from penetrating trauma area. Tube must be inserted from its usual anatomical intercostal space.

Lack of evidence for conducting meta-analysis of prevalence of drug-resistant Pseudomonas aeruginosa in iranian burned patients Amir Emami, Fatemeh Javanmardi, Mahrokh Rajaee, Neda Pirbonyeh Archives of Trauma Research 2018 7(3):130-131 ORIGINAL ARTICLES   Anterior cruciate ligament reconstruction surgery timing with respect to meniscal-chondral damage p. 87 Mohammadreza Minator Sajjadi, Mohammad Ali Okhovatpour, Adel Ebrahimpour, Reza Zandi, Meysam Jafari Kafi-Abadi, Mehrdad Sadighi DOI:10.4103/atr.atr_29_18   Background: Anterior cruciate ligament (ACL) tear is one of the most common types of knee injuries. Delay in diagnosis and treatment of ACL injuries can lead to further damage of the meniscus and cartilage. In this study, we tried to show the distribution of injuries over time and types. Methods: This retrospective study was performed on 336 patients with the diagnosis of primary ACL tear without other ligament injuries. The data including site and grade of the meniscal tear and cartilage damage, based on the International Cartilage Repair Society Classification, the time between diagnosis and surgical procedure, and the treatment method were collected. In this study, we divided patients into four groups according to injury to surgery time. Groups were 3 months, 3–6 months, 6–12 months, and over 12 months to surgery. Results: The results showed that a rate of cartilage damage had no significant correlation with a time interval between injury and surgery (P = 0.54). Furthermore, no significant correlation was found between the site of cartilage damage and the interval time after injury to surgery. The results indicated that the meniscal tear increases in case of a delay to perform surgery (P = 0.004). However, no significant relation was found between the site and pattern of meniscal injury and time. Moreover, patients with a complete ACL tear had a significantly higher rate of meniscus injury compared to those with a partial ACL tear (0.048). Conclusion: The findings of this study show that there is no significant relationship between the time of surgery and the risk of chondral damage after the ACL tear over time. ACL-ruptured patients should undergo the ACL reconstruction surgery up to 3 months from knee trauma to prevent further meniscal injuries. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Investigation of the role of traffic police function in reducing geographical inequalities in mortality from road traffic accidents p. 92 Fatemeh Shahbazi, Hamid Soori, Soheila Khodakarim, Mohammad Reza Ghadirzadeh, Ahmad Shojaei, Seyed Saeed Hashemi Nazari DOI:10.4103/atr.atr_46_18   Background and Objectives: Road traffic accident (RTA) is one of the major public health problems. Inequality in this problem and its trend has not been yet investigated in Iran. A better understanding of different contributing factors to RTA like inequalities can be helpful to reduce the negative influence of road crashes. Hence, this study aimed at examining geographical inequality in mortality from RTAs over the previous decades. Materials and Methods: In this cross-sectional study, all people who died from RTAs from March 2006 to February 2015 were selected. The data were taken from Legal Medicine Organization in Iran. The Theil index was used to estimate geographical inequality in mortality from RTA. Data were then analyzed using the Stata software. Results:During the 10-year period of this study, 210,582 people in Iran died due to RTA. The mortality rate that caused by RTAs has decreased during the study. We found a larger reduction in a mortality rate in suburban RTAs. In spite of the reduction in RTAs death, geographical inequality increased during the 10-year study. Conclusions: The findings of this study indicate that there is a geographical inequality in mortality from RTAs in Iran. This implies that effective interventions in reducing the RTAs should be distributed equally among regions of the country. Further research can be performed to investigate the causes of this inequality. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Predictors for emergency hemostasis in severe trauma patients p. 98 Wongsakorn Chaochankit, Osaree Akaraborworn, Khanitta Kaewsaengrueang DOI:10.4103/atr.atr_19_18   Background: Exsanguination is the main cause of death in trauma patients. Early determination that a patient requires an emergency operation is crucial for saving of life. We challenge the defining predictors that guide the intervention or emergency operation for hemorrhage control in severe trauma patients. Aims: The aim of this study was to define the predictors that guide the intervention or emergency operation to resuscitate severe trauma patients. Methods: This study was a retrospective study in trauma patients from Songklanagarind hospital. Data were retrospectively collected from a prospective collection registry that included 131 trauma patients who met the trauma activation criteria at Songklanagarind Hospital from January 2014 to December 2014. Emergency operation or intervention was defined as the procedures needed to improve hemostasis within 4 h. Categorical data were compared. Logistic regression was used to measure the relationship between dependent and one or more independent variables. Results: The study population was 81.7% male. The age range was 31–35 years. The most frequent mechanism was blunt injury (78%). The emergency hemostasis patients had 27 patients (20.6%). The factors relate to an emergency operation or intervention to improve the hemostasis within 4 h were focused assessment with sonography for trauma (FAST)-positive (P < 0.001), male (P = 0.02), Injury Severity Score (ISS) ≥25 (P = 0.013), and penetrating injury (P = 0.016). The preventive factors to an emergency hemostasis were platelet ≥100,000 (P = 0.039) and age ≥50 (P = 0.005). Conclusion: The palate count, FAST, male, age, ISS, and penetrating injury are factors that relate to an emergency operation or intervention within the first 4 h. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Science mapping of "Trauma Surgery" by co-word analysis and thematic clustering in MEDLINE p. 102 Mohammad Raeeszadeh, Mazyar Karamali, Amin Sohrabi DOI:10.4103/atr.atr_48_18   Background: Trauma surgery has an interdisciplinary nature among the surgical specialties, and trauma surgeons are required to identify its related scientific fields to acquire the needed skills in controlling the injuries. This study was conducted to investigate the science mapping of trauma surgery based on the bibliographic data of MEDLINE. Methodology: Based on the bibliographic data from the MEDLINE database, the visualizing techniques of bibliometric networks and all the scientific products of the trauma surgery realm indexed at MEDLINE from 2008 to 2017 were investigated. Data analysis was performed using co-word analysis and cluster analysis using the VOSviewer. Results: The growth trend of scientific productions in the field of trauma surgery has been on the rise in the past 10 years. The keyword "trauma," followed by "osteoporosis," "fracture outcome," "trauma surgery," and "mortality" had respectively the highest frequency. The results of cluster analysis identified the most important basic research subjects of trauma surgery published in MEDLINE in the past 10 years and categorized them into five clusters. Trauma surgery field had a close relationship with the field of orthopedics, basic studies, and laboratory research in comparison with its clinical domains. Conclusion: We attempted to identify the vastness of the knowledge subjects of trauma surgery and to conduct educational research, and technological planning so that the managers and stakeholders can trace the path of future scientific activities in the field of trauma surgery. The identification of this important realm and provision of the required information on the core issues for the users can be facilitated by drawing up a science map and visualizing the main traumatic sciences. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Quality of life and knee function in patients with knee dislocation p. 109 Mohammad Hosein Ebrahimzadeh, Farshid Bagheri, Ali Moradi, Ali Birjandi Nejad DOI:10.4103/atr.atr_2_18   Background: Knee dislocations are uncommon (<0.5% of all dislocations); however, they may result in catastrophic outcomes secondary to their high-energy nature and neurovascular injuries. Objectives: The objective of this study was to evaluate the clinical outcome of knee dislocation management. Subjects and Methods: A total of 20 consecutive adult patients with knee dislocation were enrolled in this cross-sectional study between 2011 and 2014. A single knee surgeon examined all the patients for knee instability for subjective evaluation of knee function using the Lysholm Knee Questionnaire, Knee Society Score (KSS), and Short Form-36 (SF-36). Results: The average Lysholm Knee Scores and KSS were 68 (range: 18–100) and 65 (range: 15–97), respectively. All domains of SF-36 among the studied patients were lower than that of the normal population. We could not find any correlation between age, body mass index, and interval between initial trauma and operation with outcome variables (Lysholm Knee Score, KSS, and SF-36 Physical Component Score, and SF-36 Mental Component Score). Conclusions: The knee function after proper management of dislocation is reasonable, but prolonged course of management and multiple operations may decrease the patients' quality of life. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Comparison of efficacy of nebulized ketamine with morphine and intravenous morphine in pain reduction in patients with traumatic long-bone fractures admitted to emergency department p. 114 Reza Azizkhani, Kourosh Akhbari, Babak Masoumi, Abdolrahman Parna, Keihan Golshani DOI:10.4103/atr.atr_13_18   Background: Traumatic long-bone fracture is a common cause of referring to the emergency department (ED). The aim of this study was to compare the efficacy of nebulized ketamine and morphine and intravenous (IV) morphine in reducing pain in these patients. Materials and Methods: In this clinical trial study, 88 patients with traumatic long-bone fractures referred to the ED were randomly selected and divided into two groups of nebulized ketamine and morphine and IV morphine using block randomization. Changes in pain intensity according to visual analog scale (VAS), patient satisfaction, and clinical features, including oxygen saturation (O2sat), systolic blood pressure (SBP), respiratory rate, and pulse rate (PR) were assessed at baseline and 15 and 30 min after the intervention and finally, data were analyzed using the SPSS software. Results: Demographic characteristics including sex, age, and site of fracture were similar in the two groups (P > 0.05). In the IV morphine group, O2 sat (P < 0.001), SBP (P = 0.005), and PR (P < 0.001) significantly decreased, but in the nebulized group, SBP (P < 0.001) and PR (P < 0.001) significantly increased, but O2 sat did not significantly decrease (P > 0.05). The VAS results in the IV group were better at 15 min (P < 0.001), but after 30 min, both methods were equally effective in pain reduction (P = 0.508). Conclusion: According to the results of this study, the pain reduction was similar in both groups after 30 min, but regarding other parameters such as patients' satisfaction and fewer side effects, it can be concluded that the long-term effect of nebulized morphine and ketamine would be more beneficial. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta The effect of cardiopulmonary resuscitation clinical audit on the patient survival in the emergency room p. 121 Jafar Moridi, Hosein Mahmoudi, Abbas Ebadi, Ali Rahmani, Seyed Tayeb Moradian DOI:10.4103/atr.atr_58_18   Background: The ability to perform cardiopulmonary resuscitation (CPR) is among the most important professional skills for physicians and nurses. There is a wide difference among different countries respecting resuscitation success rate. Studies show weaknesses in performing resuscitation. Objectives: This study aimed at assessing the effects of clinical audit of CPR in the emergency room based on the Situation Stabilization Model (SSM). Materials and Methods: This quasi-experimental study was done in 2017 in the emergency room of Baqiyatallah Hospital, Tehran, Iran. Using the Adib checklist, 35 resuscitations were assessed based on the steps of clinical audit. Then, a 1-month educational program was held for the resuscitation staffs in the study setting. Then, 35 new resuscitations were assessed using the same checklist. Finally, the results of the two measurements were compared. Results: There were significant differences between two measurement time points regarding the mean scores of different resuscitation skills (P < 0.001). Primary resuscitation success rate increased from 6 (17.1%) cases at baseline to 8 (22.9%) of the cases after the intervention. This increase was not statistically significant (P = 0.47). Conclusions: Clinical audit in the emergency room based on the SSM improves the quality and the success rate of CPR. The success rate is in our study increased. Furthermore, the reported data were not statistically significant for improving the success rate; it is clinically important. Because primary resuscitation success rate increased from 6 (17.1%) cases at baseline to 8 (22.9%) cases after the intervention. These findings highlight the necessity and the importance of the clinical audit of care services as well as the implementation of educational interventions based on the existing weaknesses. Given the great importance and sensitivity of resuscitation, health-care staffs need to receive regular theoretical and practical in-service resuscitation-related training. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta CASE REPORT Chest tube malposition inserted in thorax increases morbidity at thoracoabdominal injury p. 127 Cem Donmez, Ahmet Korkut Belli, Sercan Subasi DOI:10.4103/atr.atr_74_18   Thoracoabdominal penetrating trauma management is challenging when diaphragm injuries are involved. Thorax tube is golden standard for penetrating thoracoabdominal injuries. It has some complications. A 27-year-old male had stabbed thoracoabdominal penetrating trauma thorax tube inserted at another hospital. We decided to explore abdomen laparoscopy when he has symptoms at abdomen. We saw thorax tube ruptured diaphragm. We saturated diaphragm intracorporeally with laparoscopic protege. The clinician should not insert tube from penetrating trauma area. Tube must be inserted from its usual anatomical intercostal space. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta LETTER TO EDITOR Lack of evidence for conducting meta-analysis of prevalence of drug-resistant Pseudomonas aeruginosa in iranian burned patients p. 130 Amir Emami, Fatemeh Javanmardi, Mahrokh Rajaee, Neda Pirbonyeh DOI:10.4103/atr.atr_64_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

"Beijing Da Xue Xue Bao"[jour]; +32 new citations

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A negative feedback loop between XBP1 and Fbw7 regulates cancer development

A negative feedback loop between XBP1 and Fbw7 regulates cancer development

A negative feedback loop between XBP1 and Fbw7 regulates cancer development, Published online: 19 February 2019; doi:10.1038/s41389-019-0124-4

A negative feedback loop between XBP1 and Fbw7 regulates cancer development

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Dihydroartemisinin inhibits prostate cancer via JARID2/miR-7/miR-34a-dependent downregulation of Axl

Dihydroartemisinin inhibits prostate cancer via JARID2/miR-7/miR-34a-dependent downregulation of Axl

Dihydroartemisinin inhibits prostate cancer via JARID2/miR-7/miR-34a-dependent downregulation of Axl, Published online: 19 February 2019; doi:10.1038/s41389-019-0122-6

Dihydroartemisinin inhibits prostate cancer via JARID2/miR-7/miR-34a-dependent downregulation of Axl

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An FBXW7-ZEB2 axis links EMT and tumour microenvironment to promote colorectal cancer stem cells and chemoresistance

An FBXW7-ZEB2 axis links EMT and tumour microenvironment to promote colorectal cancer stem cells and chemoresistance

An FBXW7-ZEB2 axis links EMT and tumour microenvironment to promote colorectal cancer stem cells and chemoresistance, Published online: 19 February 2019; doi:10.1038/s41389-019-0125-3

An FBXW7-ZEB2 axis links EMT and tumour microenvironment to promote colorectal cancer stem cells and chemoresistance

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Breaking the Law Under Competitive Pressure

Abstract

When a business has competitors that break a burdensome law, is it morally required to obey this law, or may it break the law to avoid an unfair competitive disadvantage? Though this ethical question is pervasive in the business world, many non-skeptical theories of the obligation to obey the law cannot give it a clear answer. A broadly Kantian account, by contrast, can explain why businesspeople ought to obey laws of a certain type even under competitive pressure, namely laws that play a direct role in defining rights to use physical or financial resources free from substantial interference. Businesspeople must obey these laws even at the cost of allowing their businesses to fail and even when the acts proscribed are mala prohibita. This argument for obeying the law in competitive contexts has limited scope. Considerations of fairness or self-preservation may justify violating laws of other types under competitive pressure.

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Investigation on synthesis of ion-imprinted mesoporous adsorbents by using ultrasound- and microwave-assisted preparation and their dynamic adsorption properties on heavy metals

Abstract

Removal of the heavy metal ions in aqueous solution is an important technology for waste water treatment. The effects of using ultrasonic and microwave on synthesizing Pb²⁺, Zn²⁺, and Cu²⁺ imprinted mesoporous adsorbents (Pb-IMA-UM, Zn-IMA-UM, and Cu-IMA-UM) and their dynamic adsorption properties were studied. The microstructure and composition of the ion-imprinted mesoporous adsorbents were discussed in detail by TEM, FTIR, N₂ adsorption-desorption, XRD, and EDS. The pore sizes of mesoporous absorbents were improved more uniformly by using ultrasonic agitation than magnetic stirring. The elution efficiency of imprinting ions can be enhanced by microwave elution. Prepared Pb-IMA-UM, Zn-IMA-UM, and Cu-IMA-UM were used for dynamic adsorption study of heavy metals. The detected optimal feed rate was 20.0 mL/min and the influent concentration was 60 mg/L; the equilibrium adsorption capacities of Pb-IMA-UM, Cu-IMA-UM, and Zn-IMA-UM could reach 198 mg/g, 51.5 mg/g, and 57.3 mg/g, respectively. The dynamic regeneration performance of the adsorbent was also investigated with the Cu-IMA-UM sample. The adsorption rate remained above 89% after five dynamic regeneration experiments. At last, the actual wastewater from an electroplating industry was used as the research object. Three groups of dynamic adsorption coefficient contours of Pb-IMA-UM, Zn-IMA-UM, and Cu-IMA-UM were obtained when influents flowed into three adsorption columns separately. The experimental results showed that an ion-imprinted adsorbent had a much better adsorption capacity of imprinted ions under the various metals mixed conditions.

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Assessment of the water resource carrying capacity based on the ecological footprint: a case study in Zhangjiakou City, North China

Abstract

With the rapid economic development in the past decades, industrialization and urbanization in China has also rapidly developed and will continue in the next decades. However, the regional water shortage has posed great challenges for the sustainable development of big cities especially in north China. Here, we used the water ecological footprint model combined with the system dynamic model to assess the water resource carrying capacity and its sustainability in Zhangjiakou City, a typical water shortage city in north China. The calculated results showed that irrigation was the largest water consumer in Zhangjiakou. There existed a clear gap between water supply and water consumption in this city and such a gap is demonstrated by the high water resource pressure index. Our predicted results based on the water resource ecological footprint and the system dynamic model showed that although the improving water use efficiency has relieved the regional water shortage pressure, the efficiency gained would be to a large degree offset by increased water demands due to the increasing economic development. The annual average water shortage in Zhangjiakou in 2007–2050 would be up to 8.53 × 10⁸ m³, nearly half of the total local average annual water resource. To deal with the severe water shortage over the next three decades, great attention should be paid to scientific water resource managements and water pollution control. This research provides a long-term view of water resource pressure and provides recommendations for a sustainable water use under the rapid regional socioeconomic development.

from Energy Ecology Environment Ambio via Terpsi Hori on Inoreader https://ift.tt/2TWlcI4

Prediction of O 3 in the respiratory system of children using the artificial neural network model and with selection of input based on gamma test, Ahvaz, Iran

Abstract

In recent years, concerns over the issue of air pollution have increased as one of the significant environmental and health problems. Air pollutants can be toxic or harmful to the life of plants, animals, and humans. Contrast to primary pollutants, ozone is a secondary pollutant that is produced by the reaction between primary precursors in the atmosphere. The average of air pollutant data was compiled for the purpose of analyzing their correlation with the pulmonary function of students and the FENO biomarker from the air pollutants of the Environmental Protection Agency. According to the average of 3 days, the concentration of ozone in the (S₃) region was higher than the other regions, and this level was significantly different from the ANOVA test (p < 0.05). The results of artificial neural network modeling for three particular combinations in the cold season, two hidden layers with 9 and 12 neurons, with R² = 0.859 and in the warm season, layer with 13 neurons, with R² = 0.74, showed the best performance.

from Energy Ecology Environment Ambio via Terpsi Hori on Inoreader https://ift.tt/2BDohWn

Evaluation of the environmental noise problems in holiday villages: a case study from Antalya, Turkey

Abstract

Not only the appeal of the sun, natural, and historical beauties but also architectural features and business advantages of the accommodation facilities emerge as important factors in tourism development. Holiday villages differ from other types of accommodation facilities in terms of their functions and services. It is important to provide tourists acceptable levels of comfort in holiday villages offering various functions. One of these comfort conditions is acoustic comfort, which involves noise control. Noise emitted from various indoor and outdoor facilities is the main component impacting acoustic comfort in holiday villages. In this study, a holiday village in Antalya, Turkey with an open area of 120,000 m² was examined to identify noise exposure conditions of outdoor areas. Pools, restaurants, animation areas, playgrounds, and courts are the main outdoor noise sources in this holiday village. The noise emitted by these sources during daytime (Ld) and evening time (Le) are shown in noise maps. The open areas affected by 65 L_Aeq noise level extend to an area of 55,500 and 21,000 m² during Ld and Le, respectively. With the noise barriers around the main noise sources, impacted open areas are reduced by 13% in Ld and 12% in Le. The results of this study clearly reveals the importance of resolving the issue of environmental noise in the most efficient and cost-effective way in terms of settlement and planning, especially in areas with dominant noise sources like holiday villages.

from Energy Ecology Environment Ambio via Terpsi Hori on Inoreader https://ift.tt/2TWAexl

Beneficial effects of Enterococcus faecalis in hypercholesterolemic mice on cholesterol transportation and gut microbiota

Abstract

Hypercholesterolemia plays a critical role in the development of atherosclerosis and cardiovascular diseases. Many works have been reported that gut microbiota could affect hypercholesterolemia through cholesterol metabolism. However, the role of gut microbiota on cholesterol transportation remains unclear. In this study, 8-week-old C57BL/6J mice were fed with high-cholesterol diet to build the hypercholesterolemic mice. Then, the hypercholesterolemic mice got the oral administration of Enterococcus faecalis ATCC19433 at a dose of 10⁹ CFU/mL/day or PBS with high-cholesterol diet for 4 weeks. Serum was collected to detect the concentration of total cholesterol (TC). Meanwhile, pathology, histology, real-time polymerase chain reaction, Western blot, and immunofluorescence were used to evaluate the expression of ABCG5 and ABCG8 in the liver and small intestine. We also analyzed the composition of gut microbiota through high-throughput sequencing method. Oral administration of E. faecalis ATCC19433 significantly decreased the concentration of serum cholesterol in hypercholesterolemic mice. Furthermore, E. faecalis ATCC19433 reduced the concentration of liver cholesterol and improved cholesterol by increasing the expression of ABCG5 and ABCG8. Moreover, oral administration of E. faecalis ATCC19433 modulated the composition of gut microbiota and increased the counts of Lactobacillus, Bifidobacterium, and Akkermansia. Our results showed that E. faecalis ATCC19433 could exert hypocholesterolemic effect on hypercholesterolemic mice by improving transporter ABCG5 and ABCG8. E. faecalis ATCC19433 maybe contribute to the transportation of cholesterol potentially and modulate the composition of gut microbiota.

from A via a.sfakia on Inoreader https://ift.tt/2SdeZph

Assessment of the impact of heavy metals in sediments along the Spanish Mediterranean coastline: pollution indices

Abstract

A comprehensive study was carried out to evaluate the occurrence, significance of concentrations and spatial distribution of heavy metals (Cr, Cd, Ni, Cu, Pb, Hg, Zn and As) in sediments along the Valencia coastline (Spain). The sampling campaign covered 476 km of the coastline in a 4-year period. The highest concentrations of metals in the sediments were mainly Cr, Ni, Zn and Cd (up to 28.93 mg Cr kg⁻¹ dw, 15.80 mg Ni kg⁻¹ dw, 57.13 mg Zn kg⁻¹ dw and 0.293 mg Cd kg⁻¹ dw), obtained in the northern areas, some central areas and in an isolated area on the southern coastline. The Sediment Quality Guidelines applied reveal that for all metals studied, none of them reached, or exceed, the "effects of median range" or the "probable effect level". The pollution index reveals that 75% of the stretch coastline has a low priority risk level and the rest "medium-low priority risk level". And, lastly, Potential Ecological Risk Index shows that all but one zone have low ecological risk.

from Energy Ecology Environment Ambio via Terpsi Hori on Inoreader http://bit.ly/2GSFn5Y

Intestinal dysbiosis compromises alveolar macrophage immunity to Mycobacterium tuberculosis

Intestinal dysbiosis compromises alveolar macrophage immunity to Mycobacterium tuberculosis

Intestinal dysbiosis compromises alveolar macrophage immunity to <i>Mycobacterium tuberculosis</i>, Published online: 19 February 2019; doi:10.1038/s41385-019-0147-3

Intestinal dysbiosis compromises alveolar macrophage immunity to Mycobacterium tuberculosis

from A via a.sfakia on Inoreader https://go.nature.com/2txE5oV

Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique

Immune deficiency is usually the underlying predisposing factor for cryptococcal meningitis, though there have been case reports of immunocompetent patients presenting with same. The portal of entry for Cryptococcus neoformans is the respiratory tract, and by hematogenous spread, it causes systemic symptoms. The presence of CSF leak is described to have predisposed our immunocompetent patient to infection by this organism possibly through direct spread. The gold standard for diagnosing CSF leak is by cisternography. In this case, we added a technique where nasal gauze is inserted during the procedure and scanned afterwards for dye, thus increasing the confidence of diagnosis of CSF leak through the nares. Prompt diagnosis and treatment is key to prevent adverse outcomes, and we propose that in patients with cryptococcal meningitis without any identifiable risk factor, evaluation for CSF leak should be considered especially with history of head trauma.

from A via a.sfakia on Inoreader http://bit.ly/2IqR9XD

Evidence That Jeanne Calment Died in 1934—Not 1997

Rejuvenation Research, Volume 22, Issue 1, Page 3-12, February 2019.


from A via a.sfakia on Inoreader http://bit.ly/2DSFVWm

Meetings Calendar 2019

Rejuvenation Research, Volume 22, Issue 1, Page 89-96, February 2019.


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Validated Living Worldwide Supercentenarians 112+, Living and Recently Deceased: February 2019

Rejuvenation Research, Volume 22, Issue 1, Page 79-81, February 2019.


from A via a.sfakia on Inoreader http://bit.ly/2DWCIVS

Cherish Your Exceptions, But Also Your Doubts

Rejuvenation Research, Volume 22, Issue 1, Page 1-2, February 2019.


from A via a.sfakia on Inoreader http://bit.ly/2SJKKvr

Commentary on Some Recent Theses Relevant to Combating Aging: February 2019

Rejuvenation Research, Volume 22, Issue 1, Page 82-88, February 2019.


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Kidney Stone Detection? (There’s an App for That Too)

Mayo Clinic researchers have discovered a way to predict the likelihood that a person might have reoccurring kidney stones. The team's research was published in Mayo Clinic Proceedings. Data was used from the Rochester Epidemiology Project, where a team of researchers explored a sampling of chronic kidney stones formed from Olmsted County between 1984 and 2017. Some common features of patients who had recurrent stone events included younger age, male sex, a higher body mass index, histo...

from A via a.sfakia on Inoreader http://bit.ly/2NfLWke