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Characterization, possible sources and health risk assessment of PM2.5-bound Heavy Metals in the most industrial city of Iran
Get PDFAir pollution associated with particulate matters results in different types of disease including allergy, lung destruction, heart failure, and related problems. This study has been designed and performed to examine the concentration of PM2.5-bound heavy metals, risk assessment, possible sources and effect of meteorological parameters on 17 sites of the air of the most industrial city of Iran (Karaj) in 2018-19. For this purpose, four samples were taken from every point of Karaj air over one year using a pump (Leland Legacy (SKC)) with flow rate of 3 L/min on PTFE filter for 24 h. Overall, 68 samples of PM2.5-bound heavy metals were collected. Note that during the sampling, atmospheric parameters including temperature, pressure, humidity, and wind speed were regularly recorded using PHB318 portable device. In examining the chemical composition of these particles, the concentration of metals (Al-Zn- Ar-Cd-Cr-Cu-Fe-Hg-Mn-Ni-Pb) was determined after digestion of the collected samples and through injection into ICP-OEC device. The results indicated that the mean annual concentration of PM2.5 particles range from 21.84 to 72.75 µg/m3. The mean concentration of heavy metals lied within the range of 25.63 to 336.27 ng/m3. Among heavy metals, the maximum concentration belonged to aluminum (277.95 ng/m3) and iron (336.27 ng/m3), which are known as elements with a ground source (sources such as car fuels, exhaust gases, decorative materials, batteries, indoor smoking, the paint used for painting walls, erosion and corrosion of rubber of cars). Meanwhile, there was a positive relationship between heavy metals and temperature(r: 0.418, p < 0.019), pressure (r: 0.184, p < 0.0.402), as well as wind speed (r: 0.38, p < 0.017), while an inverse relationship was observed with relative humidity (r: -0.219, p < 0.018). The ecological risk of the metals calculated was very notable, with the maximum environmental risk being related to cadmium in children (6.61) and manganese in adults (0.82). The largest HQ in children and adults was associated with Cr. Finally, ILCR values for cadmium in both children (1.19 E-04) and adult (4.81 E-04) groups indicated high risk of developing cancer in humans. © 2021, Springer Nature Switzerland AG
B Cell Epitopes of Four Fimbriae Antigens of Klebsiella pneumoniae: A Comprehensive In Silico Study for Vaccine Development
Get PDFKlebsiella pneumoniae is one of the major causes of nosocomial infections worldwide which can cause several diseases in children and adults. The globally dissemination of hyper-virulent strains of K. pneumoniae and the emergence of antibiotics-resistant isolates of this pathogen narrows down the treatment options and has renewed interest in its vaccines. Vaccine candidates of Klebsiella pneumoniae have not been adequately protective, safe and globally available yet. In K. pneumoniae infection, it is well known that B cells that induce robust humoral immunity are necessary for the host complete protection. Identifying the B cell epitopes of antigens is valuable to design novel vaccine candidates. In the present study using immunoinformatics approaches we found B cell epitopes of four K. pneumoniae type 1 fimbriae antigens namely FimA, FimF, FimG, and FimH. Linear and conformational B cell epitopes of each antigen were predicted using different programs. Subsequently, many bioinformatics assays were applied to choose the best epitopes including prediction antigenicity, toxicity, human similarity and investigation on experimental records. These assays resulted in final four epitopes (each for one Fim protein). These final epitopes were modeled and their physiochemical properties were estimated to be used as potential vaccine candidates. Altogether, we found four B cell epitopes of K. pneumoniae Fim antigens that are immunogen, antigenic, not similar to human peptides, not allergen and not toxic. Also, they have suitable physiochemical properties to administrate as vaccine, although their complete efficacy should be also shown in vitro and in vivo. © 2020, Springer Nature B.V
Erratum to: Decellularized Extracellular Matrices in Bone Tissue Engineering: From Cells to Tissues. Mini-Review (Cell and Tissue Biology, (2020), 14, 6, (399-406), 10.1134/S1990519X20060127)
Get PDFAffiliation of the first author should read as follows: a Department of Tissue Engineering and Regenerative Medicine, School of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran The original article can be found online at https://doi.org/10.1134/S1990519X20060127 © 2021, Pleiades Publishing, Ltd
Vitamin E and selenium improve mesenchymal stem cell conditioned media immunomodulatory effects
Get PDFBackground: Mesenchymal stem cells (MSCs) with immunoregulatory properties affect immune systems. Many studies showed that antioxidants such as vitamin E (Vit E) and selenium (Se) could improve stem cells survival. This study aims to investigate the effects of MSC conditioned media (CM) treated with Vit E and Se on immune cells. Methods: MSCs were isolated and cultured with Vit E and Se. Immature dendritic cells (DCs) and peripheral blood mononuclear cells (PBMCs) were cultured with MSC CM treated with Vit E and Se. The expression of HLA-DR, CD86, CD40, and CD83 on mature DC were evaluated. DC supernatant and PBMCs supernatant was collected for the study of TGF-β, IL-10, and IL-12. PBMCs evaluated for the expression of T-bet, GATA3, RORγt, and FOXP3. Results: MSC CM increased CD40 on myeloid DC (mDC). CD40 has been decreased in DC treated with MSC (Vit E) and MSC (Se) CM. HLA-DR expression on DCs and IL-12 level were significantly reduced in MSC (Vit E) CM. IL-10 concentration increased in DCs treated with MSC (Vit E) and MSC (Se) CM. Treatment of PBMCs with MSC CM decreased IL-10 level, FOXP3, and RORγt expression. On the other hand, the MSC (Vit E) CM and MSC (Se) CM decreased the IL-10 level and increased IL-12, T-bet, and RORγt. Conclusions: According to the results, the treatment of MSC with Vit E and Se enhanced the ability of MSCs to inhibit DCs and improved immunomodulatory effects. Concerning the effect of MSC on PBMC, it seems that it increased RORγt expression through monocytes. © Stem Cell Investigation. All rights reserved
Reduction of the rate of hospitalization in patients with acute coronary syndrome: An action research
Get PDFBackground: Readmission of patients with Acute Coronary Syndrome (ACS) causes many problems for them and their family. This study aimed to improve the quality of care provided to patients with ACS and discover solutions to reduce the rate of readmission among them. Materials and Method: This participatory action research study was done based on Streubert and Carpenter approach. This study included 45 participants (31 patients and 14 stakeholders) and carried out in a hospital affiliated to Isfahan University of Medical Sciences, Iran, from 2013 to 2014. Solutions with high and moderate feasibility, flexibility, and suitability were implemented in each cycle until reaching <15 readmission rate. Data were analyzed using SPSS (V.16) and running descriptive and inferential statistics. Results: In this study, several actions were performed in each cycle such as assigning a free and 24-h telephone line was patients to contact nurses and face-to-face patient's education. Second cycle actions included active participation of all nurses in the education of patients and involvement of families in patient care. By carrying out the first action cycle, the readmission rate reached 35, which was not favorable. By completing the second action cycle, the readmission rate reached 12, which was desirable and significantly lower than the first cycle. Conclusion: Discovering possible solutions with the participation of stakeholders in therapeutic settings that have feasibility, flexibility, and suitability can lead to improved care quality and reduced readmission rate in patients with ACS, especially if the families of the patients also participate in action cycles. © 2021 Wolters Kluwer Medknow Publications. All rights reserved
Concentration, sources, and inhalation-based risk assessment of PM2.5-bound PAHs and trace elements in ambient air of areas with low and high traffic density in Tehran
No full textIn the current work, the concentration, sources, and inhalation-based risk assessment of PM2.5-bound PAHs and heavy metals was assessed in ambient air of areas with low and high traffic density in Tehran, Iran. To this end, a total of 64 air samples�28 samples in low and moderate traffic areas (LTA), and 32 samples in high traffic areas (HTA))�were taken from March 2018 to March 2019 during warm and cold seasons and analyzed by gas chromatography equipped with mass spectrometry (GC-MS) and inductively coupled plasma-optical emission spectrometry (ICP-OES) to determination of PAHs and metals, respectively. The findings showed that the mean concentration of PM2.5, PAHs, and heavy metals were 61.08 ± 8.69 μg/m3, 28.69 ± 20.14, and 15,392.7 ± 20,073.0 ng/m3 in the low traffic areas, and 83.00 ± 9.7 μg/m3, 41.1 ± 29.6, and 19,378.2 ± 20,038.0 ng/m3 in the high traffic areas, respectively. Furthermore, the concentration of pollutants in cold season was significantly higher than those of warm season (p < 0.05). The results of source apportionment using Unmix.6 model indicated that 41.1 of PAHs is emitted through industrial activities and diesel vehicles, which are followed by traffic and transportation sources (34.2) as well as burning coal and heating devices (26.3). Additionally, risk assessment showed that the risk values of carcinogenicity and non-carcinogenicity resulting from PM2.5-bound PAHs and metal had exceeded the recommended safe limit by EPA. © 2021, Saudi Society for Geosciences
How Can We Differentiate Local Recurrence From Heterotopic Ossification After Resection and Implantation of an Oncologic Knee Prosthesis in Patients with a Bone Sarcoma?
No full textBACKGROUND: Heterotopic ossification (HO) is common after total joint arthroplasty and usually does not cause diagnostic problems. However, the occurrence of HO after oncologic prostheses implantation can be troublesome as it may mimic a locally recurrent tumor. Because this distinction could have a profound impact on the surgeon and patient, it is important to distinguish the two entities; to our knowledge, no study has evaluated this after oncologic endoprosthetic reconstruction around the knee after tumor resection. QUESTIONS/PURPOSES: (1) How common is the occurrence of HO compared with local recurrence (LR) after resection of bone sarcoma and the use of an oncologic knee prosthesis? (2) Are there any factors associated with the development of HO after limb salvage procedures with an endoprosthesis? (3) What features allow the surgeon to differentiate HO from a locally recurrent tumor in this setting? METHODS: Between 2002 and 2018, we performed 409 resections of primary bone tumors followed by reconstructions with oncologic endoprostheses. Of these, 17 (71 of 409) died before 2 years and did not have HO at that time, 2 (8 of 409) were lost to follow-up before 2 years, and another 2 (10 of 409) did not have radiographs available at a minimum of 2 years after surgery (and had not developed HO before then), and so could not be analyzed, leaving 320 patients for analysis in this retrospective study. Forty-two patients were excluded; 2 (5 of 320) for a history of failed allograft reconstruction, 3 (8 of 320) for pathologic fracture at presentation, 2 (6 of 320) for inadequate or complicated biopsy, 1 (2 of 320) for stem fractures, 2 (7 of 320) for stem loosening, and 4 (14 of 320) for extracortical bone bridging, leaving 278 patients for final evaluation. Two observers analyzed AP and lateral radiographs for signs of HO at a mean follow-up of 63 ± 33 months after surgery. We defined HO as extraskeletal bone formation in soft tissues. The primary study endpoint was survivorship free from HO, as ascertained by a competing-risks estimator. To identify factors associated with HO appearance, the demographic, radiographic, clinical, pathologic, and surgical characteristics were compared between patients with HO and those who had no lesion. Characteristic features were also compared between patients with HO and those with LR to help their differentiation. Univariate analysis was used for all statistical evaluations. RESULTS: HO developed in 8 (21 of 278) of patients in whom oncologic knee prosthesis was implanted. LR developed in 10 (28 of 278) of the patients. According to survivorship estimates, the HO-free survival rate was not different from the LR-free survival rate at 2 years after oncologic knee reconstruction (76 ± 5 95% CI 63 to 87 versus 74 ± 5% 95% CI 62 to 88; p = 0.19). History of infection was more common in patients with HO than in patients with no lesion (19% 4 of 21 versus 5% 12 of 229, Odds ratio OR 6 95% CI 2 to 17; p < 0.001). The male sex was more common in the HO group as well (76% 16 of 21 versus 55% 128 of 229, OR 2 95% CI 1 to 5; p = 0.03). The Modular Universal Tumor and Revision System prosthesis was more frequently used in patients with HO (67% 14 of 21) compared to those with no lesions (40% 92 of 229; OR 2 95% CI 1 to 5; p = 0.02). The lesion border in radiographs was ill-defined in 19% (4 of 21) of patients with HO and 100% (28 of 28) of patients with LR (OR 8 95% CI 3 to 20; p < 0.001). The median time to the appearance of HO was shorter than the time to LR (8 months 3 to 13 versus 16 months 11 to 21, 95% CI 10 to 13; p < 0.001). Pain at presentation was more frequent in patients with LR than in those with HO (86% 24 of 28 versus 14% 3 of 21, OR 36 95% CI 7 to 181; p < 0.001). CONCLUSION: HO may occur after the use of oncologic knee prostheses for reconstruction after tumor resection. In most patients, HO could be differentiated from local recurrence through identifying a well-defined border on radiographs. Otherwise, factors such as an earlier time of presentation and absence of pain could suggest an HO, rather than an LR. LEVEL OF EVIDENCE: Level III, therapeutic study. Copyright © 2020 by the Association of Bone and Joint Surgeons
High cost of illness in fibromyalgia patients in Iran, irrespective of disease severity: A prospective cost study
No full textAims: This study aimed to estimate the economic burden of fibromyalgia (FM) in 6 months, using a cost-diary, and to evaluate its relationship with the disease severity. Methods: This is a prospective cost-of-illness study on 62 participants with an FM diagnosis within a 6 month period. Patients completed the questionnaires, including FIQR (Revised Fibromyalgia Impact Questionnaire) and SF-12 (12-item short-form survey). The cost-diary method was used to track the cost of the disease. The participants received six cost-diary booklets during the study period to report their FM-related costs, hours, and days of productivity loss. The final costs are reported in US dollars. Results: Most of the participants were women (90.3) with a mean (±SD) age of 40.80 (±5.50) years and a mean (±SD) FIQR score of 54.38 (±14.13). Moreover, 45.2 of patients fulfilled all six booklets, whereas 24.2 returned only one booklet. The participants showed a mean (±SD) direct healthcare, non-healthcare, and indirect cost of  2817.08 (± 1860.04),  1497.98(± 1358.21), and  1449.05(± 3637.41) per patient for 6 months, respectively. Conclusion: Fibromyalgia is associated with high health-related and non-health-related costs in our country, irrespective of its severity. This study warrants urgent consideration in managing the disease burden on both patients and society. © 2021 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Lt
Iran hospital accreditation standards: challenges and solutions
No full textObjective: The purpose of this study was to identify the challenges of Iranian hospital accreditation standards and provide solutions. Design: A qualitative research design was used in this study. Open and semi-structured interviews were conducted in 2018. Thematic analysis was used to analyse qualitative data. Setting: Public, private, semi-public, charity and military hospitals in Tehran, Iran. Participants: A pluralistic evaluation approach was employed and 151 participants including policy makers, hospital management and staff, accreditation surveyors and university professors participated in this study. Results: Challenges of hospital accreditation standards were grouped into two groups: standards development process and standards content. Lack of an independent standards development committee, insufficient expertise of committee members, inconsistencies among the standards� constructs, inappropriate standard classification, ambiguity of standards, unmeasurable standards, vague and inflexible scoring system, and inability to use some standards were the main challenges of Iran hospital accreditation standards. Establishing a scientific committee consisting of representative from hospitals, health insurance companies, professional and scientific associations and universities for standard development, training the committee members, and utilizing hospital's feedback will help address these problems. Conclusion: Iran's hospital accreditation standards face challenges that prevent them from achieving their goals, that is, improving the quality, safety, effectiveness and efficiency of hospital services. Necessary measures should be taken to solve these problems. © 2021 John Wiley & Sons Ltd
The healing effects of facial BOTOX injection on symptoms of depression alongside its effects on beauty preservation
No full textBackground: Beauty is closely associated with a sense of calm, confidence, and hope for a better life. Therefore, it is expected that improving the appearance or even correcting one's view of appearance can prevent depression and even improve different degrees of depression in individuals. Aims: Investigation of whether using botulinum injections (a common method of improving facial esthetics) can improve the degree of depression in clients. Methods: This prospective interventional before-after study was conducted on 121 consecutive individuals referred for beautifying the face. Before performing the interventional procedure by facial botulinum injection as well as one month later, the depression status was examined by the Beck Depression Inventory II (BDI) questionnaire. Results: The mean baseline depression score dropped from 18.9 ± 4.8 to 10.6 ± 2.9 during the follow-up time (P <.001). Using the multivariable linear regression modeling and with the presence of baseline parameters, the main determinants of improving depression score included young ages (beta = �0.541, P =.001), higher educational level (beta = 0.595, P =.015), and previous experiences of botulinum toxin use (beta = 1.072, P =.036). Conclusion: The improvement in people's moods along with correction of their facial defects following botulinum toxin injections would be expected. © 2021 Wiley Periodicals LL