Potential lethality of suicide attempts in youth.

Rates of suicide in youth have increased over the last 50 years, yet our ability to predict suicidal behaviours has not significantly improved during this time. Examining predictors of suicide attempt lethality can enhance our understanding of suicidality in youth, yet research has focused on actual medical lethality (the actual danger to life resulting from a suicide attempt) rather than potential lethality (the potential for death that is associated with a suicide attempt). Thus, the aim of the present study was twofold: first, we quantified the percentage of youth for whom the severity of suicide attempt was misclassified by considering only actual lethality; second, we tested whether key variables that predict the actual lethality of suicide attempts also predict the potential lethality of suicide attempts in youth. We examined these questions in a sample of children and adolescents admitted to a psychiatric inpatient unit following a suicide attempt. Over 70% of youth who made serious suicide attempts would have been misclassified by assessments relying on only actual lethality. Although several variables relevant to the construct of actual lethality significantly predicted potential lethality (e.g., male sex, substance use disorder), others did not. In addition, we found that the subset of youth who would have been misclassified as low risk based on actual lethality had a disproportionately high need for healthcare resources due to future hospital admissions. The present study provides evidence to suggest that considering potential lethality may lead to improved detection and prediction of suicide risk in youth, and in doing so supports recent calls to broaden considerations of the lethality associated with suicide attempts.

Wrist circumference as a novel negative risk factor for cardiovascular disease among adult men: a median follow-up of 9 years.

PURPOSE: Wrist circumference is an easy to measure anthropometric index of body frame and bone size. The aim of this study was to examine the association of wrist circumference with incidence of cardiovascular disease (CVD) among adult men. METHODS: For this study 2531 male participants aged ≥30 years, without any history of CVD were selected and followed from 1999 to 2011. Cox proportional hazard models and logistic regression were used to examine the relation of wrist circumference with incident CVD. RESULTS: A total of 339 cases of CVD were reported throughout a median follow-up of 9.4 years. In the multi-variable Cox model, 1 unit increase of wrist circumference was inversely associated with incident CVD with a HR (95 % CI) of 0.84 (0.72-0.98, P value = 0.02). The receiver operating characteristics curve in a logistic regression model for wrist circumference in prediction of CVD showed a cutoff of 17.75 cm, beyond which was associated with a lower risk for CVD. CONCLUSION: In a population with a high prevalence of CVD risk factors, it was shown that a higher wrist circumference was associated with lower risk for incident CVD. Further studies are needed to explore the underlying mechanisms of this inverse relation.

PARVB overexpression increases cell migration capability and defines high risk for endophytic growth and metastasis in tongue squamous cell carcinoma.

BACKGROUND: Tongue squamous cell carcinoma (TSCC) is highly diverse, even in its early stages. This cancer is classified into three subtypes (superficial, exophytic, and endophytic) based on macroscopic appearance. Of these subtypes, the endophytic tumours have the worst prognosis because of their invasiveness and higher frequency of metastasis. METHODS: To understand the molecular mechanism underlying the endophytic subtype and to identify biomarkers, we performed a comprehensive gene expression microarray analysis of clinical biopsy samples and also confirmed the clinical relevance of differential gene expression. RESULTS: Expression of the parvin-beta (PARVB) gene and its encoded protein was significantly upregulated in endophytic-type TSCC. PARVB is known to play a critical role in actin reorganization and focal adhesions. Knockdown of PARVB expression in vitro caused apparent decreases in cell migration and wound healing, implying that PARVB has a crucial role in cell motility. Moreover, metastasis-free survival was significantly lower in patients with higher tumour expression of PARVB. CONCLUSIONS: These findings suggest that PARVB overexpression is a candidate biomarker for endophytic tumours and metastasis. This protein may be a clinically useful target for adjuvant TSCC therapy.

Serological Determination of Toxoplasma gondii among Sheep (Ovis aries) in Guilan Province, Iran.

Toxoplasma gondii is one of the most common foodborne protozoan parasite causing congenital infection, abortion, and stillbirth in humans and animals. The temperate and humid climate is one of the most important factors in the high prevalence of T. gondii. Sheep are among the important sources of meat production in Guilan province, Iran. Therefore, the consumption of raw and half-cooked meat is one of the major risk factors for T. gondii infection. Toxoplasmosis in patients with intact immune systems is usually asymptomatic; however, it but can be life-threatening in patients with a weak immune system (for example, patients with the human immunodeficiency viruses/acquired immunodeficiency syndrome or cancer and transplant recipients). Guilan is divided into three geographical regions of plains with a temperate climatic condition, hillsides with a semi-humid climate, and heights with cold mountainous climate. Climate situations play a role in the prevalence of toxoplasmosis. The present study aimed to investigate the seroprevalence of T. gondii infection among sheep in Guilan province, north of Iran. In the current cross-sectional study, a total of 400 sheep sera samples were tested for the determination of immunoglobulin G (IgG) antibody against T. gondii using the enzyme-linked immunosorbent assay. The samples were divided into different groups according to the geographical location and animal age. T. gondii antibody (i.e., IgG) was detected in 166 sheep (41.5%). The highest frequency of T. gondii infection (72.7%; n=56) was observed for the age group of > 4 years; the difference was statistically significant in this regard (P=0.0001) in comparison to that reported for other groups. In addition, the seroprevalence of T. gondii was significantly higher in the plains (53.9%) than that of the hillsides and heights (P=0.0001). Consequently, the seroprevalence of T. gondii infection in Guilan was high indicating a significant relationship with geographical location and animal age.

Viscoplastic fingering in rectangular channels.

We experimentally study the viscous fingering problem of viscoplastic fluids in channels of rectangular cross section. We find that a yield stress-dependent capillary number (Ca^{*}) and an aspect ratio-dependent Bond number (Bo^{*}) can classify the finger shape into ramified and unified fingering patterns, and the finger flow regime into yield stress, viscosity, and aspect ratio-buoyancy-dominated regimes. For these regimes, we provide the transition boundaries using Ca^{*} and Bo^{*} and propose simple relations to predict the finger width, for a wide range of flow parameters, versus the capillary number, the channel aspect ratio, and the rheology of the viscoplastic fluid.

A survey of social cognitive determinants of physical activity among Iranian women using path analysis method.

INTRODUCTION: This cross-sectional study was carried out on 400 women selected from urban health centers in Isfahan through stratified sampling. The study was designed to evaluate the social cognitive theoretical model in explaining the determinants of physical activity among women using path analysis method. METHODS: In a hypothetical framework, the relationship between self-efficacy, outcome expectation, social support and self-regulation and physical activity were assessed using path analysis and indices of fitness. Furthermore, the predictive power of the model was evaluated. RESULTS: The social cognitive theoretical model had a good predictive power for physical activity. Confirmatory factor analysis revealed the suitability of the theoretical model; this model is able to cover 80% of the physical activity variance. Evaluation of the social cognitive theoretical model using path analysis showed that self-regulation was the strongest determinant of physical activity. Social support and outcome expectation had very weak effects on physical activity; nonetheless, their effect was enhanced by the presence of self-regulation. Self-efficacy had a weak effect on physical activity, however, as an intermediate variable, it reinforced the impact of social support and outcome expectation on physical activity. CONCLUSIONS: The use of the present hypothetical model is suggested as an appropriate framework in research related to physical activity among women as well as to strengthening self-regulation skills in designing and implementing programs promoting physical activities.

Assessment of annual effective dose due to natural gamma radiation in Zanjan (Iran).

The outdoor and indoor measurement of natural gamma radiation in Zanjan province (Iran) was made using a Geiger-Muller dosemeter. The average outdoor and indoor dose rates were determined as 127 +/- 20 and 135 +/- 23 nSv h(-1), respectively. The average annual effective dose was calculated as 0.82 mSv, which is more than the same value worldwide.

Removal of dibutyl phthalate from aqueous environments using a nanophotocatalytic Fe, Ag-ZnO/VIS-LED system: modeling and optimization.

An (Fe, Ag) co-doped ZnO nanostructure was synthesized by a simple chemical co-precipitation method and used for the degradation of dibutyl phthalate (DBP) in aqueous solution under visible light-emitting diode (LED) irradiation. (Fe, Ag) co-doped ZnO nanorods were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, UV-VIS diffuse reflectance spectroscopy, elemental mapping, Field emission scanning electron microscopy, transmission electron microscope and Brunauer-Emmett-Teller surface area analysis. A Central Composite Design was used to optimize the reaction parameters for the removal of DBP by the (Fe, Ag) co-doped ZnO nanorods. The four main reaction parameters optimized in this study were the following: pH, time of radiation, concentration of the nanorods and initial DBP concentration. The interaction between the four parameters was studied and modeled using the Design Expert 10 software. A maximum reduction of 95% of DBP was achieved at a pH of 3, a photocatalyst concentration of 150 mg L-1 and a DBP initial DBP concentration of 15 mg L-1. The results showed that the (Fe, Ag) co-doped ZnO nanorods under low power LED irradiation can be used as an effective photocatalyst for the removal of DBP from aqueous solutions.

[Rectal pentobarbital sedation for children undergoing auditory brainstem response testing]. / Sédation au pentobarbital par voie rectale pour enregistrement des PEA chez l'enfant.

OBJECTIVES: The aim of our study was to determine if rectal sedation with pentobarbital sodium provides safe and effective sedation for children undergoing auditory brainstem response (ABR) testing. MATERIAL AND METHODS: A prospective study was conducted in the ENT pediatric department of Robert Debre's hospital (APHP, Paris). 68 children under 8 years of age were given rectal pentobarbital for ABR testing at a dosage of about 5 mg/kg. RESULTS: 61 children of 68 (89.7%) were adequately sedated with rectal pentobarbital. The mean elapsed time from drug administration to full sedation was 36,1 minutes. No adverse event was reported in 84.1% of children. CONCLUSION: Pentobarbital provides safe and effective sedation. Rectal administration is easy, painless and with brief duration of action. It's a good alternative to general anesthesia for young children undergoing ABR testing.

Different combinations of glucose tolerance and blood pressure status and incident cardiovascular disease and all-cause mortality events.

The purpose of this study was to evaluate the effect of combinations of blood pressure and glucose tolerance status on cardiovascular and all-cause mortality. A total of 7619 participants aged ⩾30 years old were stratified to nine categories as follows: (1) normotension (NTN) and normal glucose tolerance (NGT) (reference group), (2) NTN and pre-diabetes mellitus (pre-DM), (3) NTN and DM, (4) pre-hypertension (pre-HTN) and NGT, (5) pre-HTN and pre-DM, (6) pre-HTN and DM, (7) HTN and NGT, (8) HTN and pre-DM and (9) HTN and DM. Cox proportional hazards were applied to calculate the multivariate hazard ratios (HRs) of different groups for outcomes. For all-cause mortality outcomes, prevalent cardiovascular disease (CVD) was also adjusted. In a median follow-up of 11.3 years, 696 CVD and 412 all-cause mortality events occurred. Among the population free from CVD at baseline (n=7249), presence of HTN was associated with increased risk of CVD, regardless of glucose tolerance status with HRs of 1.97 (95% confidence interval (CI), 1.49-2.61), 2.25 (1.68-3.02) and 3.16 (2.28-4.37) for phenotypes of HTN and NGT, HTN and pre-DM and HTN and DM for CVD, respectively; corresponding HRs for all-cause mortality were 1.65 (95% CI, 1.15-2.37), 1.69 (1.15-2.49) and 2.73 (1.80-4.14), respectively. Phenotypes of NTN and pre-DM (1.48; 1.03-2.14) and NTN and DM (2.04; 1.06-3.92) were also associated with CVD and all-cause mortality, respectively. HTN was significantly associated with CVD/mortality events, regardless of glucose tolerance status. Blood pressure <120/80 mm Hg among pre-diabetic/diabetic population, not on antihypertensive medications, was generally associated with worse outcomes.

A microfluidic method and custom model for continuous, non-intrusive biofilm viscosity measurements under different nutrient conditions.

Straight, low-aspect ratio micro flow cells are used to support biofilm attachment and preferential accumulation at the short side-wall, which progressively reduces the effective channel width. The biofilm shifts downstream at measurable velocities under the imposed force from the constant laminar co-flowing nutrient stream. The dynamic behaviour of the biofilm viscosity is modeled semi-analytically, based on experimental measurements of biofilm dimensions and velocity as inputs. The technique advances the study of biofilm mechanical properties by strongly limiting biases related to non-Newtonian biofilm properties (e.g., shear dependent viscosity) with excellent time resolution. To demonstrate the proof of principle, young Pseudomonas sp. biofilms were analyzed under different nutrient concentrations and constant micro-flow conditions. The striking results show that large initial differences in biofilm viscosities grown under different nutrient concentrations become nearly identical in less than one day, followed by a continuous thickening process. The technique verifies that in 50 h from inoculation to early maturation stages, biofilm viscosity could grow by over 2 orders of magnitude. The approach opens the way for detailed studies of mechanical properties under a wide variety of physiochemical conditions, such as ionic strength, temperature, and shear stress.

The predatory capability of Arthrobotrys cladodes var. macroides in the control of Haemonchus contortus infective larvae.

One hundred compost samples were examined for the presence of nematophagous fungi on the sheep farms of Mazanderan, province, Iran. Arthrobotrys cladodes var. macroides (IRAN 677C=CBS 143565) was isolated from 3% of the samples examined. Nematophagous activity of this fungus which was shown for the first time in this study, revealed the addition of 1000, 8000, 20000 and 100000 conidia per gram of feces of sheep reduced significantly (P<0.001) the number of Haemonchus contortus infective larvae in the feces by 41.71%, 63, 27%, 73.49% and 94.96%, respectively. These results show that A. cladodes var. macroides is a promising candidate for biological control of H. contortus.

Nasal-continuous positive airway pressure in the treatment of near-drowning in freshwater.

In patients who have experienced near-drowning, hypoxemia is the major clinical consequence. We report two cases of patients who have experienced near-drowning in freshwater who were successfully treated with nasal-continuous positive airway pressure (N-CPAP) plus oxygen therapy. Both patients presented a radiographic appearance of bilateral pulmonary edema. We suggest the use of N-CPAP as an easier and less costly alternative to tracheal intubation for treating near-drowning in patients who are breathing spontaneously and who have not experienced loss of consciousness.

Macrophage activation by N-acetyl-cysteine in COPD patients.

The effect of in vivo and in vitro N-acetylcysteine (NAC) treatment on destructive activity of macrophages against Candida from COPD patients has been evaluated. Patients received NAC (600 mg) or placebo orally 3 times a day for 15 days and bronchoalveolar lavage (BAL) fluid and peripheral blood were collected before and at the conclusion of treatment. In our system, NAC treatment was not able to modulate antifungal activity of alveolar macrophages, peripheral blood monocytes (PBM), and polymorphonuclear leukocytes. On the contrary, in vitro NAC treatment at appropriate doses (10 micrograms/ml) significantly enhanced antifungal activity of PBM from COPD patients. This phenomenon is mediated by augmented phagocytic activity and phagosome-lysosome fusion. The lack of correlation between in vivo and in vitro studies could be ascribed to differences in the intracellular concentration of the drug that in vivo does not reach levels capable of inducing macrophage activation. We speculate that in COPD patients who undergo long-term NAC treatment, appropriate schedules and doses of the drug could augment resistance against microbial infections which are often life-threatening in these patients.

Indication of the presence of two distinct strains of Echinococcus granulosus in Iran by mitochondrial DNA markers.

Sixteen isolates of Echinococcus granulosus, collected from Iranian patients at surgery, and from domestic animals, including sheep, goats, cattle, and camels at slaughterhouses in Tehran and central and southern Iran were analyzed for DNA nucleotide and predicted amino acid sequence variation within regions of the mitochondrial cytochrome c oxidase I (COI) and NADH dehydrogenase subunit I (NDI) genes. A polymerase chain reaction-restriction fragment length polymorphism method, based on the DNA sequence variation in the NDI gene, was also used to rapidly survey the E. granulosus isolates. The isolates were categorized into two distinct and uniform genotype groupings. The analysis clearly indicated that the camel/dog strain (G6 genotype) of E. granulosus as well as the cosmopolitan, common sheep strain (G1 genotype) occur in Iran. The G1 genotype was found present in all four human isolates examined and it was more prevalent in domestic animals than the camel-restricted G6 genotype. In E. granulosus-endemic areas of Iran it is evident, therefore, that the majority of E. granulosus-infected livestock animals can potentially act as reservoirs of human infection, and this has important implications for hydatid control and public health.

Interferon-gamma (r-IFN-gamma) induced activation of alveolar macrophages (AM) from anergic patients with chronic obstructive pulmonary disease (COPD).

Forty-six anergic patients (37 males and 9 females, age range 55-79 yr) were selected from ninety-one patients suffering from COPD due to frequent exacerbations and impaired delayed cutaneous reactivity (43.9%). The phenotype of circulating lymphocytes, their proliferative response to a panel of polyclonal T-cell activators and the candidacidal activity (CA) of circulating PMNs (polymorphonuclear cells) were measured. In 13 patients presenting a defective CA of circulating PMNs, the in vitro response of alveolar macrophage CA to r-IFN-gamma was also determined. We found: 1) a significant reduction in the CL response to PHA in COPD patients vs controls; 2) a low PMN-CA in 23 (57%) COPD patients; 3) a non-significant difference in phenotype analysis in patients and controls; 4) lower CA of AMs in COPD patients than in controls; 5) restoration in vitro of CA by r-IFN-gamma in the group of anergic COPD patients presenting depressed CA. We conclude that a defective cell-mediated immunity could be the basis of the enhanced susceptibility to infectious exacerbations in many COPD patients and that, in vitro, it could be reversed by r-IFN-gamma treatment.

Biphasic calcium phosphate ceramic combined with fibrillar collagen with and without citric acid conditioning in the treatment of periodontal osseous defects.

The purpose of this study is to determine whether the combination of biphasic calcium phosphate ceramic (BCP) and collagen and citric acid root conditioning would promote accelerated new attachment of periodontal tissue to the root surface in dogs. Intrabony defects were surgically produced for each animal and were made chronic for 16 weeks. These defects were assigned to two study treatment and one control group: ceramic-collagen without citric acid (CO-CE); ceramic-collagen with citric acid (CO-CE-CA); and control (surgical debridement and root planing only). Results showed that all groups gained new attachment level as demonstrated both clinically and histometrically. The treatment groups showed a significant mean gain greater than the control (P less than .005), but no significant difference was found between treatment groups. Small areas of ankylosis was also found in both treatments but there was no evidence of active root resorption. It is concluded that the use of combined BCP and fibrillar collagen is beneficial in promoting new attachment of periodontal tissues to the root surface in dogs. Although citric acid root conditioning did as well or better than ceramic and collagen alone, its benefits are still speculative and need further experimentation.

Prevalence of medical problems in periodontal patients obtained from three different populations.

Data from three different sources of periodontal patients were collected and examined to find if there was a significant difference between these groups relative to the prevalence of medical problems. Data were evaluated to show if age and sex were significantly related to the existence of medical problems and to determine which problems were the most prevalent. A total of 581 periodontal patients' records were obtained. Results of the evaluation showed that the private office group had 27.6% medical problems, the academic dental center had 46.3%, and the hospital dental clinic had 74.1%. Cardiovascular disease was the most prevalent medical problem in all groups and orthopedic disease or injury was second. Within each group, sex was not significantly related to the presence of a medical problem. Age was a highly significant factor, with the prevalence of medical problems increasing with advancing age.

An open, comparative pilot study of thiamphenicol glycinate hydrochloride vs clarithromycin in the treatment of acute lower respiratory tract infections due to Chlamydia pneumoniae.

The aim of this study was to evaluate the efficacy and tolerability of thiamphenicol glycinate hydrochloride (TGH) i.m. versus clarithromycin in acute lower respiratory infections due to Chlamydia pneumonia. 113 patients with suspected pneumonia were screened. 40 patients with IgM and/or IgA titers > or = 1:16 and/or IgG titers > or = 1:512 were assigned to 10 days of treatment with TGH 1500 mg daily or clarithromycin 1000 mg daily. 34 patients were considered a clinical success. 33 patients were a radiological success. 22 patients showed a decrease in IgG values. 3 patients had an increase in IgG values. Blood/urine values presented no clinically significant variations. Clinical efficacy was similar in both treatment groups. These are the first results confirming in vivo the recent in vitro evidence that TGH is effective against acute lower respiratory tract infections due to C. pneumoniae, thus representing an alternative therapy to clarithromycin.

Basis for nebulized antibiotics: droplet characterization and in vitro antimicrobial activity versus Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa.

The aims of this study were to (1) quantify the particle size characteristics of several antibiotics considered suitable for aerosol therapy after aerosolization with the PARI IS/2 nebulizer (Pari GmbH, Sarnberg, Germany) and (2) determine the degree to which in vitro antimicrobial activity of these antibiotics is maintained after nebulization. The aerosolized drugs were tobramycin sulfate, streptomycin, and imipenem, with saline solution as the control. Mean mass aerodynamic diameter of the nebulized drugs was 3.25 microns for tobramycin, 2.26 microns for imipenem, and 2.38 microns for streptomycin. In vitro tests showed that tobramycin and imipenem were unaltered in their bacteriostatic activity against strains of Escherichia coli (American Type Culture Collection [ATCC] 25922) and Staphylococcus aureus (ATCC 29213) as well as against Pseudomonas aeruginosa (ATCC 27853) with minimal inhibitory concentration (MIC) values less than 0.3 microgram/mL. Nebulized streptomycin showed significantly higher MIC values against P. aeruginosa (ATCC 27853). These results suggest that tobramycin and imipenem may be prescribed as an aerosol generated by jet nebulization (PARI IS/2) to treat S. aureus, E. coli, and P. aeruginosa infections without any risk of altering the drugs minimum bacteriostatic activity by the nebulization process. Aerosolization of streptomycin with this nebulizer may not be as effective against P. aeruginosa because it seems to alter the bacteriostatic activity.