Effect of Dexmedotomdine hydrochloride (Percedex®) on functional outcome of patients with moderate and severe traumatic brain injury.

Traumatic brain injury (TBI) is considered among the leading causes of morbidity and mortality worldwide being associated with significant social and economic burden. The best sedative regimen in TBI patients is yet to be identified. This study was designed to determine the effects of dexmedotomdine hydrochloride (Percedex®, DEX) on functional outcome of patients with moderate and severe traumatic brain injury (TBI). This was a retrospective cohort study including patients with severe (3-8) and moderate (9-13) TBI referring to a level I trauma center. We studied two groups of patients, those receiving DEX or routine sedation regimen in neurointensive care unit (NICU). The main outcome measures were the Glasgow outcome scale extended (GOSE) at 3 and 6-month. We have also recorded ICU and hospital length of stay (LOS) and the tracheostomy rate. We included 138 patients in two study groups (each including 69). The baseline characteristics were comparable between groups. DEX was associated with lower LOS in hospital (p = 0.002) and NICU (p = 0.003). The GOSE was comparable between two study groups at 3 (p = 0.245) and 6-month (p = 0.497). Multivariate regression analysis revealed that after LOS of NICU and hospital stay adjustment, DEX group experienced significantly improved 6-month GOSE with the average improvement in score of 0.92 compared to the control group (p = 0.041). DEX administration in patients with moderate and severe TBI was associated with decreased NICU and hospital LOS and improved functional outcome at 6-month.

Modifications of miRNAs in intervertebral disc degeneration: a key to the future development of genetic-based therapies.

Intervertebral disc degeneration (IDD) is the main cause of low back pain, which is a healthcare concern associated with high social and economic burden. The current medical and surgical therapies are inadequate and ineffective. Several miRNAs have been identified that modulate (via up- or down-regulation) the pathogenesis of IDD through various signaling pathways. Understanding the nature of this regulation and their signaling pathways will enable researchers to manipulate miRNA regulation to develop miRNA-based therapies. The development of miRNA-based therapies opens a future window through which to decrease the IDD process or regenerate the intervertebral disc. In the near future, the obstacles associated with miRNA-based therapies will be overcome and these therapies will move from the bench to the bedside.

Phenol red dye removal from wastewater using TiO2-FSM-16 and Ni-FSM-16 photocatalysts.

In this study, the performance of Ni-FSM-16 and TiO2-FSM-16 photocatalysts in phenol red removal was explored. The XRD, FE-SEM, and BET tests were used to characterize the catalysts. All experiments were performed at ambient temperature and under UV (20 W). The parameters including dye concentration (20-80 mg/L), photocatalyst concentration (0-8 g/L), UV exposure duration, and contact time (0-160 min) were optimized using RSM software. BET values of Ni-FSM-16 and TiO2-FSM-16 were 718.63 m2/g and 844.93 m2/g, respectively. TiO2-FSM-16 showed better performance in dye removal than Ni-FSM-16. At pH 3, the maximum dye removal by TiO2-FSM-16/UV and Ni-FSM-16/UV was obtained 87% and 64%, respectively. The positive hole species had the main role in photocatalytic phenol red removal. The reusability study was done for up to 7 cycles, but the catalysts can be reused effectively for up to 3 cycles. The synergistic factor for the TiO2-FSM-16 and TiO2-FSM-16/UV processes were calculated to be 1.55 and 2.12, respectively. The dye removal efficiency by TiO2-carbon and Ni-carbon was slightly lower than those obtained by the FSM-16 ones. The TiO2-FSM-16 and Ni-FSM-16 catalysts had a suitable surface and acceptable efficiency in phenol red removal.

Co-occurrence of microplastics and organic/inorganic contaminants in organisms living in aquatic ecosystems: A review.

Most studies on microplastics (MPs) and organisms, regardless of the MPs type and their presence in the environment and organisms, have been performed on a laboratory scale. In this review, reports of simultaneous analysis of the abundance of MPs and organic/inorganic contaminants in aquatic organisms in the natural environment have been collected and bibliometric analysis was performed. Biological and environmental factors affecting MPs absorption by organisms were discussed. The majority of microplastics were identified as fibrous and black with a small size (<500 µm). A positive correlation was reported between microplastic numbers and organic/inorganic contaminants in the tissue of some species. The most positive linear relationship between heavy metal and MPs was reported for Heniochus acuminatus from the Gulf of Mannar. To preserve biodiversity and the risks of transferring MPs and contaminants to aquatic organisms and humans, it is necessary to control microplastic contamination.

Occurrence and Distribution of Antibiotics in the Water, Sediment, and Biota of Freshwater and Marine Environments: A Review.

Antibiotics, as pollutants of emerging concern, can enter marine environments, rivers, and lakes and endanger ecology and human health. The purpose of this study was to review the studies conducted on the presence of antibiotics in water, sediments, and organisms in aquatic environments (i.e., seas, rivers, and lakes). Most of the reviewed studies were conducted in 2018 (15%) and 2014 (11%). Antibiotics were reported in aqueous media at a concentration of <1 ng/L−100 µg/L. The results showed that the highest number of works were conducted in the Asian continent (seas: 74%, rivers: 78%, lakes: 87%, living organisms: 100%). The highest concentration of antibiotics in water and sea sediments, with a frequency of 49%, was related to fluoroquinolones. According to the results, the highest amounts of antibiotics in water and sediment were reported as 460 ng/L and 406 ng/g, respectively. In rivers, sulfonamides had the highest abundance (30%). Fluoroquinolones (with an abundance of 34%) had the highest concentration in lakes. Moreover, the highest concentration of fluoroquinolones in living organisms was reported at 68,000 ng/g, with a frequency of 39%. According to the obtained results, it can be concluded that sulfonamides and fluoroquinolones are among the most dangerous antibiotics due to their high concentrations in the environment. This review provides timely information regarding the presence of antibiotics in different aquatic environments, which can be helpful for estimating ecological risks, contamination levels, and their management.

High school basic life support training: Is the trainer's experience of cardiopulmonary resuscitation in the actual setting important? A randomized control trial.

BACKGROUND: Although basic life support (BLS) has been taught in school by a variety of professionals, it is still unclear that, whether the instructor's previous cardiopulmonary resuscitation (CPR) experience is an important factor. This study aimed to compare the effect of BLS training, based on trainer experience in actual situations, on knowledge and skills of secondary high school students. MATERIALS AND METHODS: In this randomized controlled trial, 150 high school students were selected based on the inclusion criteria and then assigned into two groups, (76 in Group A), and (74 in Group B) randomly. Both groups were trained according to adult BLS: 2020 American Heart Association guidelines on mannequins in three 60 min in-person training sessions. The knowledge and skill scores were measured for both groups before, immediately, and 1 month after intervention by a questionnaire. Data were analyzed by the SPSS software version 22, using Chi-square, Mann-Whitney U, repeated-measure ANOVA tests, and statistically modeling at a significance level of 0.05. RESULTS: There were no significant differences between groups regarding demographic characteristics. The knowledge and skill scores in both groups increased significantly compared to baseline immediately and 1 month after the intervention (P = 0.001). However, there was no significant difference in knowledge scores between groups (P = 0.076(. However, at the immediacy and 1 month after the intervention, the skill score in "Group A" was significantly higher than the "Group B" (P = 0.001). CONCLUSIONS: The trainer's experience of CPR in the actual setting in the transfer of BLS knowledge is not important, but it improved Student's BSL skill acquisition score.

Study of microplastics pollution in sediments and organisms in mangrove forests: A review.

Microplastics (MP) are an emerging and lesser-known pollutant that has attracted the attention of researchers around the world in recent decades. Size of PM is smaller than 5 mm and can be entered in different ways into marine environments like mangrove forests and interfere with the health of the environment and organisms. The present study reviews 53 studies in the field of microplastics in different parts (sediments and organisms) of mangrove forests. About 26% of the 53 studies was published in 2020. In most studies, MP particles were categorized based on the shape, color, size, and polymer genus. The number of microplastics per kilogram of mangrove sediments has been reported as 1.22-6390. The effect of sediment texture on the frequency of microplastic particles and the relationship between sediment pH and MP abundance were also discussed. The fiber and bright color PMs were more common in living organisms (mollusks, crustaceans, and fish). The PM particles with different genus (polypropylene, polyethylene, polystyrene, and polyethylene terephthalate) were reported for sediment samples. In sediments with smaller sizes and lower pH, microplastics have been detected more frequently. It was reported that sediments and roots of mangrove forests act as livestock and retain microplastics for a long time. The highest concentration of MP in different parts of mangrove forests (sediment and organisms) has been reported for China. Few reports were observed on microplastics in water in mangrove forests. Also, the concentration of microplastics in sediments and organisms in mangrove forests exposed to fishing, coastal tourism, urban, and industrial wastewater was higher than those in pristine areas. It is necessary to conduct comprehensive studies to monitor, control, and evaluate the MP pollution in sediments and various organisms in mangrove forests worldwide.

Optimization of Crude Oil Biodegradation by Brevibacterium sp. Isolated from the Native Sponges of the Persian Gulf.

BACKGROUND: The native sponges of Persian Gulf are unique species facing difficult climate conditions and environmental contamination. It is necessary to investigate these native sponges because global warming most probably destroyed many of these creatures. Therefore, the study of the microorganisms associated with sponges will introduce new bacterial strains with various industrial and environmental applications and, in this way, a part of the Persian Gulf biodiversity will be preserved for posterity. OBJECTIVE: The aim of this study was the isolation and molecular identification of bacteria associated with the ability of biodegrading crude oil from the native sponges of the Persian Gulf. Also, optimization of crude oil biodegradation was done for one of the most efficient bacterial strains. MATERIALS AND METHODS: Isolated species were compared in terms of E24 index and growth rate in a culture medium containing at least 2% of oil as the sole carbon source. Molecular identification was done for five bacterial strains. Using the Taguchi experimental design, the effects of 4 factors, namely, carbon source auxiliary, organic and inorganic nitrogen sources, salinity and pH, were evaluated at 3 levels. GC-Mass analysis was performed on the remaining oil in the culture medium. RESULTS: In the initial screening of two native species of sponges, 22 bacterial strains were isolated which were capable of decomposing oil. Five bacterial strains showed the best results and were recorded in NCBI with access numbers KY283126, KY283128, KY285290, KY285289, and KY285288. Brevibacterium sp. (KY283128) showed the highest level of oil degradation (about 97%) and growth rate. The results showed that the optimal oil degradation occurs in the absence of carbon source auxiliary, at 0.5% of salinity, with NH4Cl as the nitrogen source and at a pH of 6.5. CONCLUSIONS: This bacterial strain can be used for biodegradation in oil-contaminated areas and oil refineries. By isolating the oil degrading gene in this bacterial strain and cloning it in other bacterial strains, the efficiency of eliminating oil contamination can be increased.

Microplastics accumulation in sediments and Periophthalmus waltoni fish, mangrove forests in southern Iran.

This investigation was aimed to identify microplastics in the sediment and mudskipper fish (Periophthalmus waltoni) in mangrove forests in southern Iran. Sediments and mudskipper samples were collected at high, mid, and low tidal points of five stations. A total of 2657 plastic particles in different size, color, shape, and genera were identified from sediment samples and 15 microplastic were isolated from mudskippers. The highest and lowest abundance of isolated microplastics from sediments was observed in mangrove forests of Bidkhoun (urban area) and Bordkhon, respectively while no microplastics were found in the fish tissue in those stations. The black (60%) and white (7%) color microplastics in the mudskipper had the highest and the lowest frequency. The highest and lowest polymers in mangrove forest sediments were corresponded to polystyrene (26%) and polycarbonate (3%), respectively. Raman and Fourier transform infrared spectroscopy (FT-IR) techniques were used to identify the type of the polymer. Most of the microplastics found were made of polystyrene, polypropylene, and polyethylene terephthalate. The type of studied area and texture of sediment separately affected the frequency of microplastic and mesoplastic (P-value <0.05) in the sediment samples. The abundance of microplastics in the sediment samples of the Bidkhoun mangrove forest was higher than other studied stations due to proximity to urban and industrial areas. The findings of this study raised concerns about microplastic pollution in the mangrove forests of southern Iran, a threat to the ecosystem and public health, which requires careful actions to prevent and diminish its adverse effects.

Toxic heavy metals and nutrient concentration in the milk of goat herds in two Iranian industrial and non-industrial zones.

This work aimed to explore the concentration of nickel, manganese, iron, copper, chromium, and lead in the milk of goat herds in the industrial area of Asaluyeh (southern Iran) and the non-industrial area of Kaki. The milk of 16 goat herds (each herd had at least ten goats) was collected in several villages in each area, and at the same time, the drinking water and forage of goats were sampled. The concentration of elements in the samples was determined by ICP-OES. The mean concentrations of chromium, copper, iron, manganese, lead, and nickel in milk samples of the Asaluyeh area were 16.423 ± 0.349, 0.146 ± 0.118, 6.111 ± 0.501, 0.239 ± 0.016, 0.141 ± 0.030, and 1.447 ± 0.101 mg/kg, respectively. Concentrations of heavy metals (except for copper) in the milk of goats in the industrialized area of Asaluyeh were significantly higher than that of Kaki (P < 0.05). Also, the content of heavy metals was significantly correlated with lactose levels (P < 0.05). The hazard index for drinking the goat milk was computed to be 0.444 and 0.386 for the Asaluyeh and Kaki area, respectively, which shows a minimal effect of this exposure pathway.

Comparison of blood lead concentrations in patients with acute ischemic stroke and healthy subjects.

BACKGROUND AND OBJECTIVES: Stroke is the main cause of mortality and long-term disability in the general population. With the increased application of metals in industries and human environment, lead has become a health hazard. In this study, we aimed to evaluate the relationship between the blood concentration of lead and the incidence of acute stroke. MATERIALS AND METHODS: We performed this study during 2016-17 at Vali-e-Asr Hospital in Birjand, Iran, among 80 ischemic stroke patients visiting the hospital and 80 healthy gender- and age-matched controls. Blood lead concentration (BLC) was measured using graphite furnace atomic absorption spectrometry. RESULTS: BLC medians in the case and control groups were 20.65 [5.37-34.87] µg/dL and 2.65 [1.75-13.85] µg/dL, respectively (p < 0.05). The case group had significantly lower mean levels of HDL and phosphors, whereas the mean levels of white blood cells and uric acid were higher in this group. After adjusting for lipid profile and fasting blood sugar, multiple logistic regression indicated that the serum levels of uric acid and BLC were significant for predicting ischemic stroke. It is estimated that the odds ratio of ischemic stroke increases by 1.04 per 1 µg/dl increase in BLC. CONCLUSION: This study showed that lead can be a risk factor for ischemic stroke. Since it does not have any beneficial effects on the health of individuals, screening serum concentrations of lead can be considered as a preventive strategy for those at risk of stroke.

Green tea catechins inhibit microglial activation which prevents the development of neurological disorders.

The over-activated microglial cells induce neuroinflammation which has the main role in neurological disorders. The over-activated microglia can disturb neuronal function by releasing inflammatory mediators leading to neuronal dysfunctions and death. Thus, inhibition of over-activated microglia may be an effective therapeutic approach for modulating neuroinflammation. Experimental studies have indicated anti-neuroinflammatory effects of flavonoids such as green tea catechins. The current research was aimed to review the effect of green tea catechins in inhibiting microglial cells, inflammatory cascades, and subsequent neurological diseases.

The Role of Ultrasonography in Patients Referring to the Emergency Department with Acute Abdominal Pain.

CONTEXT: Acute abdominal pain is a common clinical problem in emergency and non-emergency cases accounting for 5 to 10% of all referrals to the emergency department. Studies have indicated that these widely differentiated diagnoses are common to these complaints. Considering the high prevalence of this complaint in the patients and the wide range of its differential diagnosis, this review study was designed and evaluated aiming at investigating the causes of acute abdominal pain with a focus on assessing the position of ultrasound as a diagnostic tool in the emergency department. EVIDENCE ACQUISITION: This article was conducted as a narrative review of selected articles from 2005 through 2019. By comparing them, a comprehensive review of ultrasound role was conducted in patients with acute abdominal pain referring to the emergency department. RESULTS: In this review study, we attempted to use the articles of the clinical approach, the required laboratory tests, the disadvantages and advantages of each imaging technique, the differential diagnosis for acute abdominal pain according to the location of the pain, and the position of ultrasound as a diagnostic aid tool. Eventually, the proposed protrusion will be considered in dealing with a patient with acute abdominal pain. CONCLUSION: Regarding the wide range of causes providing multiple differential diagnosis, as well as the limited time of the health team in the emergency department for diagnostic and therapeutic measures, particularly in time-sensitive clinical conditions, ultrasound offered by emergency medicine specialists as a diagnostic aid is considered to improve the overall diagnosis and treatment of patients, thereby reducing complications.

Management of Violence and Aggression in Emergency Environment; a Narrative Review of 200 Related Articles.

CONTEXT: The aim of this study is to reviewing various approaches for dealing with agitated patients in emergency department (ED) including of chemical and physical restraint methods. EVIDENCE ACQUISITION: This review was conducted by searching "Violence," "Aggression," and "workplace violence" keywords in these databases: PubMed, Scopus, EmBase, ScienceDirect, Cochrane Database, and Google Scholar. In addition to using keywords for finding the papers, the related article capability was used to find more papers. From the found papers, published papers from 2005 to 2018 were chosen to enter the paper pool for further review. RESULTS: Ultimately, 200 papers were used in this paper to conduct a comprehensive review regarding violence management in ED. The results were categorized as prevention, verbal methods, pharmacological interventions and physical restraint. CONCLUSION: In this study various methods of chemical and physical restraint methods were reviewed so an emergency medicine physician be aware of various available choices in different clinical situations for agitated patients.

Comparison of Blood Lead Levels in Patients With Alzheimer's Disease and Healthy People.

BACKGROUND: It is argued that breakdown of ß-amyloid in the brain causes deposition of senescent plaques and therefore Alzheimer's disease (AD). One of the influential factors for increasing level of this protein is exposure to lead. Our aim was to compare blood lead levels (BLLs) between patients with AD and healthy controls. METHODS: This case-control study was performed on all patients with cognitive impairment who were referred to the Neurological Clinic of Birjand in 2016 to 2017. Patients were referred to the laboratory for measurement of their serum levels of lead. The controls and patients were matched by age and sex. RESULTS: In the AD case group, the average BLL was 22.22 ± 28.57 µg/dL. Mann-Whitney U test showed that BLLs were significantly higher in the patients than in the controls. The unadjusted odds ratio for BLL among the patients was 1.05 (95% confidence interval: 1.01-1.09; P = .01) compared to the controls. CONCLUSION: In the present study, BLL was associated with AD.

Potential of trees leaf/ bark to control atmospheric metals in a gas and petrochemical zone.

Leaf and bark of trees are tools for assessing the effects of the heavy metals pollution and monitoring the environmental air quality. The aim of this study was to evaluate the presence of Ni, Pb, V, and Co metals in four tree/shrub species (Conocarpus erectus, Nerium oleander, Bougainvillea spectabilis willd, and Hibiscus rosa-sinensis) in the heavily industrial zone of Asaloyeh, Iran. Two industrial zones (sites 1 and 2), two urban areas (sites 3 and 4), and two rural areas (sites 5 and 6) in the Asaloyeh industrial zone and an uncontaminated area as a control were selected. Sampling from leaf and bark of trees was carried out in spring 2016. The metals content in the washed and unwashed leaf and bark was investigated. The results showed that four studied metals in N. oleander, C. erectus, and B. spectabilis willd in all case sites were significantly higher than that of in the control site (p < 0.05). The highest concentration of metals was found in sites 3, 4, and 6; this was due to dispersion of the pollutants from industrial environments by dominant winds. The highest comprehensive bio-concentration index (CBCI) was found in leaf (0.37) and bark (0.12) of N. oleander. The maximum metal accumulation index (MAI) in the samples was found in leaf of N. oleander (1.58) and in bark of H. rosa-sinensis (1.95). The maximum bio-concentration factor (BCF) was seen for cobalt metal in the N. oleander leaf (0.89). The nickel concentration in washed-leaf samples of C. erectus was measured to be 49.64% of unwashed one. In general, the N. oleander and C. erectus species were found to have the highest absorption rate from the atmosphere and soil than other studied species, and are very suitable tools for managing air pollution in highly industrialized areas.

Protective Effects of Crocetin on Depression-like Behavior Induced by Immobilization in Rat.

BACKGROUND & OBJECTIVE: Crocetin, an active ingredient of saffron, has been recognized as a potent antioxidant. Plant extracts or their components may be useful in ameliorating the various diseases, including neurodegenerative disorders. This study investigated the effects of crocetin on oxidative damage induced by chronic restraint stress in the rat brain. For this reason, rats were kept in the restrainers for 1 hour every day, for 21 consecutive days. The animals were injected crocetin (20, 40, 60 mg/kg) or vehicle daily for 21 days. Findings showed that the immobility time significantly increased in the rodents subjected to the chronic stress compared with the normal group. However, the number of crossing beams in the rats submitted to the chronic stress significantly decreased versus the non-stress rats. Treatment with crocetin ameliorated the immobility time and the number of crossing in the chronic restraint stress rats versus the non-treated stress group. Crocetin also reverted the levels of MDA and GSH and also the activities of antioxidant enzymes to the normal levels in the stress groups. CONCLUSION: The present study suggests that crocetin may be useful for the management of depressantlike effects induced by chronic stress through decreasing oxidative damage in the brain.

Antidotal effects of thymoquinone against neurotoxic agents.

Several plants which contain the active component thymoquinone (TQ) have been traditionally used in herbal medicine to treat various diseases. Several studies indicated the protective effects of TQ against neurotoxic agents. The present study was aimed to highlight the protective effects of TQ against neurotoxic agents. For this reason, the literature from 1998 to 2017 regarding the protective effects of TQ against neurotoxic agents and their involvement mechanisms has been studied. The present review suggests the protective effects of TQ against neurotoxic agents in experimental models. More clinical trial studies are however needed to confirm the antidotal effects of TQ in human intoxication.

Pain Management in the Emergency Department: a Review Article on Options and Methods.

CONTEXT: The aim of this review is to recognizing different methods of analgesia for emergency medicine physicians (EMPs) allows them to have various pain relief methods to reduce pain and to be able to use it according to the patient's condition and to improve the quality of their services. EVIDENCE ACQUISITION: In this review article, the search engines and scientific databases of Google Scholar, Science Direct, PubMed, Medline, Scopus, and Cochrane for emergency pain management methods were reviewed. Among the findings, high quality articles were eventually selected from 2000 to 2018, and after reviewing them, we have conducted a comprehensive comparison of the usual methods of pain control in the emergency department (ED). RESULTS: For better understanding, the results are reported in to separate subheadings including "Parenteral agents" and "Regional blocks". Non-opioids analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are commonly used in the treatment of acute pain. However, the relief of acute moderate to severe pain usually requires opioid agents. Considering the side effects of systemic drugs and the restrictions on the use of analgesics, especially opioids, regional blocks of pain as part of a multimodal analgesic strategy can be helpful. CONCLUSION: This study was designed to investigate and identify the disadvantages and advantages of using each drug to be able to make the right choices in different clinical situations for patients while paying attention to the limitations of the use of these analgesic drugs.