Comparison of chest CT scan findings between COVID-19 and pulmonary contusion in trauma patients based on RSNA criteria: Established novel criteria for trauma victims.

PROPOSE: In this study, we re-assessed the criteria defined by the radiological society of North America (RSNA) to determine novel radiological findings helping the physicians differentiating COVID-19 from pulmonary contusion. METHODS: All trauma patients with blunt chest wall trauma and subsequent pulmonary contusion, COVID-19-related signs and symptoms before the trauma were enrolled in this retrospective study from February to May 2020. Included patients (Group P) were then classified into two groups based on polymerase chain reaction tests (Group Pa for positive patients and Pb for negative ones). Moreover, 44 patients from the pre-pandemic period (Group PP) were enrolled. They were matched to Group P regarding age, sex, and trauma-related scores. Two radiologists blindly reviewed the CT images of all enrolled patients according to criteria defined by the RSNA criteria. The radiological findings were compared between Group P and Group PP; statistically significant ones were re-evaluated between Group Pa and Group Pb thereafter. Finally, the sensitivity and specificity of each significant findings were calculated. The Chi-square test was used to compare the radiological findings between Group P and Group PP. RESULTS: In the Group PP, 73.7% of all ground-glass opacities (GGOs) and 80% of all multiple bilateral GGOs were detected (p < 0.001 and p = 0.25, respectively). Single bilateral GGOs were only seen among the Group PP. The Chi-square tests showed that the prevalence of diffused GGOs, multiple unilateral GGOs, multiple consolidations, and multiple bilateral consolidations were significantly higher in the Group P (p = 0.001, 0.01, 0.003, and 0.003, respectively). However, GGOs with irregular borders and single consolidations were more significant among the Group PP (p = 0.01 and 0.003, respectively). Of note, reticular distortions and subpleural spares were exclusively detected in the Group PP. CONCLUSION: We concluded that the criteria set by RSNA for the diagnosis of COVID-19 are not appropriate in trauma patients. The clinical signs and symptoms are not always useful either. The presence of multiple unilateral GGOs, diffused GGOs, and multiple bilateral consolidations favor COVID-19 with 88%, 97.62%, and 77.7% diagnostic accuracy.

Universal Design and Social Sustainability in the City: The Case Study of Tehran Iran.

Following the proposal of Universal Design in 1974, a public society was founded in Iran in 1981, in order to aid the disabled victims of the Iran-Iraq war. Official authorities have also made legislation on this topic. During the last three decades many efforts have been made to apply this concept in public spaces. Unfortunately these have not succeeded. It means despite the existence of inherent rules and regulations and the general will to apply the principles of Universal Design in Tehran, urban spaces are still an improper environment for the independent presence and movement of people with disabilities. This problem is considered a serious threat for social sustainability in Tehran. The main goal of this research is finding solutions for increasing social interaction and greater participation of people with disabilities in public spaces by applying Universal Design. The research is seeking to answer these questions: What is causing inefficiency in the regulation of Universal Design in Tehran? Why is social participation by people with disabilities limited in Tehran? Which factors are contributing to Universal Design in Tehran? The research is based on applied theory, field research methods and a mixed qualitative-quantitative approach. In addition, and the results include both empirical and functional solutions. The consequences show that many of problems are rooted in cultural issues. The people must attend to disability as a public concern which can involve everybody. They must comprehend that all the members of the society, regardless of their physical condition, have the right to use public facilities independently. The second problem is related to lack of any integrated approach to applying Universal Design. This research proposes some solutions such as preparation a Universal Design master plan, an integrated approach for implementation project in all organizations, and public education for improving citizens' knowledge about Universal Design.