A comparison between the risk of needle stick injuries among nurses in emergency wards and nurses in other wards of hospitals

Background and Aim: Nursing work in emergency departments is tangled with unbearable hardship and high working pressure as well as an increased risk of occupational injuries. Needle stick injury is among such risks. Incidence of these injuries differs in different hospital wards. This study aimed to determine needle stick injury risks in emergency ward in comparison with other wards of Qazvin hospitals in 2010. Materials and Methods: This historical cohort study was done on nursing staff working in Qazvin hospitals. Statistical population included nursing staffs at Qazvin hospitals who were responsible for direct patient care. From among nurses working in the emergency wards, 52 were selected. Control group consisted of 258 nurses who had worked in other wards of the same hospitals. The research instrument was a self-administered questionnaire. To determine validity and reliability of the Instrument, content validity and test-retest were performed. The collected data was analyzed using Independent t test, Mann-Whitney, Chi-Square, Fisher Exact Test, and Logistic Regression through SPSS (version 16) at 0.05. Results: Risk of injury in emergency ward was three times more than other wards (p<0.01). The average numbers of beds in emergency wards and in other wards were 24.2±.6.7 and 18.1± 10.7 respectively. Nonetheless, number of nurses on different shifts in emergency wards, especially in the evening shift, was significantly lower (p<0.05). However, according to logistic regression analysis, the work in emergency ward was an independent risk factor for needle stick injuries (p<0.05). Conclusion: The risk of needle stick injuries among nurses in emergency wards is dramatically higher than other wards. It seems that more beds per nurse affects this increased risk. It is proposed that the number of nurses in emergency departments be increased, especially in the evening shift so that the risk of this serious injury may be reduced

Genotype-Phenotype Correlations in Charcot-Marie-Tooth Disease Due to MTMR2 Mutations and Implications in Membrane Trafficking

Charcot-Marie-Tooth type 4 (CMT4) is an autosomal recessive severe form of neuropathy with genetic heterogeneity. CMT4B1 is caused by mutations in the myotubularin-related 2 (MTMR2) gene and as a member of the myotubularin family, the MTMR2 protein is crucial for the modulation of membrane trafficking. To enable future clinical trials, we performed a detailed review of the published cases with MTMR2 mutations and describe four novel cases identified through whole-exome sequencing (WES). The four unrelated families harbor novel homozygous mutations in MTMR2 (NM_016156, Family 1: c.1490dupC; p.Phe498IlefsTer2; Family 2: c.1479+1G>A; Family 3: c.1090C>T; p.Arg364Ter; Family 4: c.883C>T; p.Arg295Ter) and present with CMT4B1-related severe early-onset motor and sensory neuropathy, generalized muscle atrophy, facial and bulbar weakness, and pes cavus deformity. The clinical description of the new mutations reported here overlap with previously reported CMT4B1 phenotypes caused by mutations in the phosphatase domain of MTMR2, suggesting that nonsense MTMR2 mutations, which are predicted to result in loss or disruption of the phosphatase domain, are associated with a severe phenotype and loss of independent ambulation by the early twenties. Whereas the few reported missense mutations and also those truncating mutations occurring at the C-terminus after the phosphatase domain cause a rather mild phenotype and patients were still ambulatory above the age 30 years. Charcot-Marie-Tooth neuropathy and Centronuclear Myopathy causing mutations have been shown to occur in proteins involved in membrane remodeling and trafficking pathway mediated by phosphoinositides. Earlier studies have showing the rescue of MTM1 myopathy by MTMR2 overexpression, emphasize the importance of maintaining the phosphoinositides equilibrium and highlight a potential compensatory mechanism amongst members of this pathway. This proved that the regulation of expression of these proteins involved in the membrane remodeling pathway may compensate each other's loss- or gain-of-function mutations by restoring the phosphoinositides equilibrium. This provides a potential therapeutic strategy for neuromuscular diseases resulting from mutations in the membrane remodeling pathway

Predictors of quality of life in breast cancer patients under chemotherapy

Background: Today, the quality of life studies has an important role in health care especially in chronic diseases. Breast cancer has third order among women′s malignancies. Now, survival rate for this cancer is long. However breast cancer has several complications that affected the patient′s life. Aims : The aim of this study was to assess the quality of life in Breast cancer patients under chemotherapy. Setting and Design: A cross-sectional study conducted on 119 breast cancer patients that were admitted and treated in chemotherapy ward of Namazi hospital in Shiraz city, south of Iran, between Jan and Feb 2006. Materials and Methods: The QLQ-C30 questionnaire was used to assess quality of life in these patients. Statistical Analysis: We used univariate methods. A multiple regression analysis was performed to identify predictors of quality of life. Results: Mean age of patients was 48.27±11.42 with quality of life total score 64.92±24.28. All symptoms scales had reverse association with quality of life except appetite loss (P>0.05) and diarrhea (P=0.752). The results of the regression analyses showed that only grade of tumor, occupational status, menopausal status, financial difficulties and dyspnea were statistically significant in predicting patients′ quality of life. Conclusion: In conclusion, this study demonstrates the strength of the relationship between clinical and sociodemographical factors and breast cancer patients′ quality of life. Psychological and financial support for women experiencing breast cancer diagnosis may improve quality of life

Predictors of quality of life in breast cancer patients under chemotherapy

Background: Today, the quality of life studies has an important role in health care especially in chronic diseases. Breast cancer has third order among women\u2032s malignancies. Now, survival rate for this cancer is long. However breast cancer has several complications that affected the patient\u2032s life. Aims : The aim of this study was to assess the quality of life in Breast cancer patients under chemotherapy. Setting and Design: A cross-sectional study conducted on 119 breast cancer patients that were admitted and treated in chemotherapy ward of Namazi hospital in Shiraz city, south of Iran, between Jan and Feb 2006. Materials and Methods: The QLQ-C30 questionnaire was used to assess quality of life in these patients. Statistical Analysis: We used univariate methods. A multiple regression analysis was performed to identify predictors of quality of life. Results: Mean age of patients was 48.27\ub111.42 with quality of life total score 64.92\ub124.28. All symptoms scales had reverse association with quality of life except appetite loss (P&gt;0.05) and diarrhea (P=0.752). The results of the regression analyses showed that only grade of tumor, occupational status, menopausal status, financial difficulties and dyspnea were statistically significant in predicting patients\u2032 quality of life. Conclusion: In conclusion, this study demonstrates the strength of the relationship between clinical and sociodemographical factors and breast cancer patients\u2032 quality of life. Psychological and financial support for women experiencing breast cancer diagnosis may improve quality of life

Influence of Processing Pipeline on Cortical Thickness Measurement

In recent years, replicability of neuroscientific findings, specifically those concerning correlates of morphological properties of gray matter (GM), have been subject of major scrutiny. Use of different processing pipelines and differences in their estimates of the macroscale GM may play an important role in this context. To address this issue, here, we investigated the cortical thickness estimates of three widely used pipelines. Based on analyses in two independent large-scale cohorts, we report high levels of within-pipeline reliability of the absolute cortical thickness-estimates and comparable spatial patterns of cortical thickness-estimates across all pipelines. Within each individual, absolute regional thickness differed between pipelines, indicating that in-vivo thickness measurements are only a proxy of actual thickness of the cortex, which shall only be compared within the same software package and thickness estimation technique. However, at group level, cortical thickness-estimates correlated strongly between pipelines, in most brain regions. The smallest between-pipeline correlations were observed in para-limbic areas and insula. These regions also demonstrated the highest interindividual variability and the lowest reliability of cortical thickness-estimates within each pipeline, suggesting that structural variations within these regions should be interpreted with caution

Cardiogoniometry can predict positive response to cardiac resynchronization therapy � A proof of concept study

Background: According to American Heart Association guidelines, QRS duration and morphology are used to select patients for cardiac resynchronization therapy (CRT). But still there are some patients who are not responding to this device. We investigated whether the Cardiogoniometry (CGM) as a three-dimensional vectorcardiogram method can improve patient selection. Methods: Echocardiography and CGM were performed for 25 consecutive patients with Left bundle branch morphology who were candidate for CRT implantation and were in sinus rhythm. Patients re-evaluated by echocardiography after 6 months post CRT implantation. Results: The mean age of the patients was 63 ± 13 years and 17 (68) were males. The mean LVEF was 19.4 ± 7.4 and 24.2 ± 11.5 before and after CRT implantation respectively. Median of the duration of the R loop before the R maximum demonstrated a negative correlation with the increase in LVEF, (r = �0.36, P = 0.07) and mean of maximal spatial velocity of the T-loop for all measured showed a positive correlation (r = 0.39, p = 0.04). Other parameters didn't show any significant differences. Conclusions: Three-dimensional vectorcardiogram parameters can be helpful to predict the CRT response. Shorter duration of the R loop before the maximum R and smaller R loop area are predictors for responder patients. © 201

Cardiogoniometry can predict positive response to cardiac resynchronization therapy � A proof of concept study

Background: According to American Heart Association guidelines, QRS duration and morphology are used to select patients for cardiac resynchronization therapy (CRT). But still there are some patients who are not responding to this device. We investigated whether the Cardiogoniometry (CGM) as a three-dimensional vectorcardiogram method can improve patient selection. Methods: Echocardiography and CGM were performed for 25 consecutive patients with Left bundle branch morphology who were candidate for CRT implantation and were in sinus rhythm. Patients re-evaluated by echocardiography after 6 months post CRT implantation. Results: The mean age of the patients was 63 ± 13 years and 17 (68) were males. The mean LVEF was 19.4 ± 7.4 and 24.2 ± 11.5 before and after CRT implantation respectively. Median of the duration of the R loop before the R maximum demonstrated a negative correlation with the increase in LVEF, (r = �0.36, P = 0.07) and mean of maximal spatial velocity of the T-loop for all measured showed a positive correlation (r = 0.39, p = 0.04). Other parameters didn't show any significant differences. Conclusions: Three-dimensional vectorcardiogram parameters can be helpful to predict the CRT response. Shorter duration of the R loop before the maximum R and smaller R loop area are predictors for responder patients. © 201

Vat polymerization 3D printing of composite acrylate photopolymer-based coated glass beads

Vat photopolymerization-based three-dimensional (3D) printing techniques have been used as an efficient method for complex and special geometries in various applications. Composites are also a group of polymer materials that are obtained by adding a reinforcing component such as filler, fibres with different origins. Therefore, the development of 3D printable composites is paramount due to their high precision and speed of production. Glass beads (GBs) have been favorites as economical reinforcement agents for their chemical stability, water resistance in acidic environments, dimensional stability, and eco-friendly properties. In this study, 3D printable composites based on coated glass beads (CGBs) have been prepared. First, the beads are coated with ultraviolet (UV) curable resins to improve the interface with the polymer matrix. Then, CGBs are mixed with 3D printing resin and formulated for digital light processing (DLP) printing. The coating process is checked by scanning electron microscopy (SEM), and the mechanical properties of the 3D-printed composite structures have been evaluated by bending and compression tests. Also, the fracture behavior of cured resin has been checked with SEM. Mechanical property investigations have shown the success of the 3D printing of the CGBs into a photopolymer resin (PR) composite with behavior modification and compatibility of the interface with the matrix in practice

Inactivation of the Euchromatic Histone-Lysine N-Methyltransferase 2 Pathway in Pancreatic Epithelial Cells Antagonizes Cancer Initiation and Pancreatitis-Associated Promotion by Altering Growth and Immune Gene Expression Networks

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive, painful disease with a 5-year survival rate of only 9%. Recent evidence indicates that distinct epigenomic landscapes underlie PDAC progression, identifying the H3K9me pathway as important to its pathobiology. Here, we delineate the role of Euchromatic Histone-lysine N-Methyltransferase 2 (EHMT2), the enzyme that generates H3K9me, as a downstream effector of oncogenic KRAS during PDAC initiation and pancreatitis-associated promotion. EHMT2 inactivation in pancreatic cells reduces H3K9me2 and antagonizes KrasG12D-mediated acinar-to-ductal metaplasia (ADM) and Pancreatic Intraepithelial Neoplasia (PanIN) formation in both the Pdx1-Cre and P48Cre/+KrasG12D mouse models. Ex vivo acinar explants also show impaired EGFR-KRAS-MAPK pathway-mediated ADM upon EHMT2 deletion. Notably, KrasG12D increases EHMT2 protein levels and EHMT2-EHMT1-WIZ complex formation. Transcriptome analysis reveals that EHMT2 inactivation upregulates a cell cycle inhibitory gene expression network that converges on the Cdkn1a/p21-Chek2 pathway. Congruently, pancreas tissue from KrasG12D animals with EHMT2 inactivation have increased P21 protein levels and enhanced senescence. Furthermore, loss of EHMT2 reduces inflammatory cell infiltration typically induced during KrasG12D-mediated initiation. The inhibitory effect on KrasG12D-induced growth is maintained in the pancreatitis-accelerated model, while simultaneously modifying immunoregulatory gene networks that also contribute to carcinogenesis. This study outlines the existence of a novel KRAS-EHMT2 pathway that is critical for mediating the growth-promoting and immunoregulatory effects of this oncogene in vivo, extending human observations to support a pathophysiological role for the H3K9me pathway in PDAC

Biallelic variants in SLC4A10 encoding a sodium-dependent bicarbonate transporter lead to a neurodevelopmental disorder

Purpose: SLC4A10 encodes a plasma membrane-bound transporter, which mediates Na+-dependent HCO3− import, thus mediating net acid extrusion. Slc4a10 knockout mice show collapsed brain ventricles, an increased seizure threshold, mild behavioral abnormalities, impaired vision, and deafness. // Methods: Utilizing exome/genome sequencing in families with undiagnosed neurodevelopmental disorders and international data sharing, 11 patients from 6 independent families with biallelic variants in SLC4A10 were identified. Clinico-radiological and dysmorphology assessments were conducted. A minigene assay, localization studies, intracellular pH recordings, and protein modeling were performed to study the possible functional consequences of the variant alleles. // Results: The families harbor 8 segregating ultra-rare biallelic SLC4A10 variants (7 missense and 1 splicing). Phenotypically, patients present with global developmental delay/intellectual disability and central hypotonia, accompanied by variable speech delay, microcephaly, cerebellar ataxia, facial dysmorphism, and infrequently, epilepsy. Neuroimaging features range from some non-specific to distinct neuroradiological findings, including slit ventricles and a peculiar form of bilateral curvilinear nodular heterotopia. In silico analyses showed 6 of 7 missense variants affect evolutionarily conserved residues. Functional analyses supported the pathogenicity of 4 of 7 missense variants. // Conclusion: We provide evidence that pathogenic biallelic SLC4A10 variants can lead to neurodevelopmental disorders characterized by variable abnormalities of the central nervous system, including altered brain ventricles, thus resembling several features observed in knockout mice