Evaluation of Teaching Methods in Mass CPCR Training in Different Groups of the Society,an Observational Study

To determine the efficacy of different methods of cardiopulmonary resuscitation (CPCR) training in 3 different groups of the society.In a prospective and observational study of 2000 individuals in 3 different groups including G1, G2, and G3 4 different protocols of CPCR training were applied and their efficacy was compared between the groups. Also, 12 months after the study course, 460 participants from 3 groups were asked to take apart in a theoretical and practical examination to evaluate the long-term efficacy of the 4 protocols.Among 2000 individuals took a parted in the study, 950 (47.5%) were G1, 600 (30%) were G2, and 450 (22.5%) were G3. G1 in 4 groups were 2.37 and 2.65 times more successful in pretest theoretical and 2.61 and 18.20 times more successful in practical examinations compared with G2 and G3 and gained highest improvement in CPCR skills. Other groups also showed significantly improved CPCR skills. Comparison of different methods of CPCR learning showed that the workshop using interactive lecture as well as human model, educational film, and reference CPCR book has the highest efficacy in all groups. This protocol of CPCR training showed more efficacy in long-term postdelayed evaluation. On the contrary, medical students had better long-term outcomes from the course.Although G1 and G2 obtained better results in learning CPCR skills, in G3 also the theoretical and practical knowledge were improved significantly. This course increased confidence for doing CPCR in all groups of the study. Considering that the most of the bystanders at emergency states are general population, training this group of the society and increasing their confidence about performing CPCR can be so effective and lifesaving at emergency states. (Clinical trial. Gov registration: {"type":"clinical-trial","attrs":{"text":"NCT02120573","term_id":"NCT02120573"}}NCT02120573)     

Investigating the relationship between myocardial infarction and the ratio of glycated albumin to glycated hemoglobin in patients admitted to cardiac ward

International Journal of Diabetes in Developing Countries - Diabetes mellitus is an associated risk factor for coronary artery disease (CAD). There is a growing interest in myocardial infarction...     

Magnesium β-ketoiminates as CVD precursors for MgO formation

The synthesis and characterization of bis(ketoiminato)magnesium(ii) complexes of composition [Mg(OCR²CH₂CHR¹NCH₂CH₂X)₂] (X = NMe₂: 3a, R¹ = R² = Me; 3b, R¹ = Me, R² = Ph. X = OMe: 3c, R¹ = R² = Me) are reported. Complexes 3a–c are accessible by the reaction of C(O)R²CH₂CHR¹N(H)CH₂CH₂X (X = NMe₂: 1a, R¹ = R² = Me; 1b, R¹ = Me, R² = Ph. X = OMe: 1c, R¹ = R² = Me) with MgⁿBu₂. The structure of 3b in the solid state was determined by a single crystal X-ray diffraction study, confirming that the Mg(ii) ion is hexa-coordinated by two ketoiminato ligands, while each of the latter coordinates with its two N- and one O-donor atom in an octahedral MgN₆O₂ coordination environment in the OC-6-33 stereo-isomeric form. The thermal behavior of 3a–c was studied by TG and DSC under an atmosphere of Ar and O₂ respectively. The respective Me-substituted complexes 3a,c decompose at lower temperatures (3a, 166 °C; 3c, 233 °C) than the phenyl derivative 3b (243 °C). PXRD studies indicate the formation of MgO. Additionally, TG-MS studies were exemplarily carried out for 3a, indicating the release of the ketoiminato ligands. Vapor pressure measurements were conducted at 80 °C, whereby 3a,c possess with 5.6 mbar (3a) and 2.0 mbar (3c) significantly higher volatilities than 3b (0.07 mbar). Complexes 3a–c were used as MOCVD precursors for the deposition of thin MgO films on silicon substrates. It was found that only with 3a,c thin, dense and rather granulated MgO layers of thicknesses between 28–147 nm were produced. The as-deposited MgO layers were characterized by SEM, EDX, and XPS measurements and the thicknesses of the as-deposited layers were measured by Ellipsometry and SEM cross-section images. Apart from magnesium and oxygen a carbon content between 3–4 mol% was determined.

The synthesis and characterization of bis(ketoiminato)magnesium(ii) complexes of composition [Mg(OCR²CH₂CHR¹NCH₂CH₂X)₂] (X = NMe₂: 3a, R¹ = R² = Me; 3b, R¹ = Me, R² = Ph. X = OMe: 3c, R¹ = R² = Me) are reported.     

Manipulating the morphology of the nano oxide domain in AuCu–iron oxide dumbbell-like nanocomposites as a tool to modify magnetic properties

We report the colloidal synthesis of hybrid dumbbell-like nanocrystals (NCs) which feature a plasmonic metal domain (M) attached to a morphologically-tunable magnetic oxide domain (MOx). We highlight how the modulation of the amount of oleic acid (OlAc) in the synthesis mixture influences the final composition of the M domain, the morphology of the MOx domain and, consequently, the magnetic properties of the hetero-structures. In the presence of high amounts of OlAc, a crystalline, magnetite MOx is mainly formed, coupled with a partial dealloying between Au and Cu in the M domain. Decreasing the amount of OlAc preserved the AuCu alloy and resulted in the formation of core–shell structures in the MOx. Here, a disordered, poorly crystalline, glass-like maghemite shell was coupled with a highly disordered iron rich core. An investigation into the magnetic properties revealed that the disordered phase was likely responsible for the observed exchange bias, rather than the interfacial stress between the M and MOx.

We highlighted the effects of oleic acid on the structural and magnetic properties of colloidal nanodumbbells.     

Cellular events during arthritis-induced hyperalgesia are mediated by Interleukin-6 and p38 MAPK and their effects on the expression of spinal mu-opioid receptors

Activation of mitogen-activated protein kinase (MAPK) enzymes in nociceptive plasticity has been extensively studied. P38 MAPK enzyme, which can be activated by cytokines, acts as a crucial intracellular regulator of environmental changes. The aim of this study was to elucidate the cellular events during arthritis-induced hyperalgesia that are mediated by interleukin-6 and p38 MAPK, and their effects on the expression of spinal mu-opioid receptors (MORs), in different stages of arthritis in male Wistar rats. Complete Freund’s adjuvant (CFA)-induced arthritis (AA) was caused by subcutaneous injection of CFA into the rats’ hindpaw. Anti-IL-6 antibody and p38 MAPK phosphorylation inhibitor were administered during 21 days of study. Spinal MOR, p38, and phosphorylated-p38 (pp38) proteins expressions were detected by Western blotting. Daily treatment with anti-IL-6 antibody and p38 MAPK phosphorylation inhibitor, SB203580, significantly decreased paw edema in AA group. Daily anti-IL-6 and SB203580 administration caused a significant reduction in hyperalgesia in the first week of the study, but increased hyperalgesia in the next 2 weeks in experimental groups compared to the AA control group. Expression of pp38 MAPK protein significantly decreased on the 3, 7, 14, and 21 days in AA+SB203580 and AA+anti-IL6 groups compared to AA group. Additionally, daily treatment with anti-IL6 antibody and SB203580 in AA group caused significantly decrease in spinal MOR expression compared to AA control group. The results of our study can confirm that activated spinal p38 MAPK enzyme may play an important role in cellular IL-6 signaling pathways in hyperalgesia variation during different stages of AA inflammation. Also, it can be suggested that at least a part of p38 MAPK effects on hyperalgesia is mediated by spinal MOR expression variation.     

Primary hepatic malignant fibrous histiocytoma: clinicopathologic characteristics and prognostic value of ezrin expression

Primary hepatic malignant fibrous histiocytoma (MFH) is a rare entity with ill-defined clinicopathologic characteristics. We present the largest series to date (7 cases) of primary hepatic MFH, a systematic review of 27 cases published in the English literature, and an analysis of prognostic factors including ezrin expression. The 2 men and 5 women in our series were 34 to 80 years old (average 61 y) and presented with abdominal pain (6/7), systemic symptoms of low-grade fever, malaise, anorexia and weight loss (4/7), and spiking fever (1/7). One case was an incidental finding. Computed tomography and ultrasound revealed a well-demarcated solitary heterogeneous low-density mass ranging from 5.5 to 20 cm (average 12 cm) in largest dimension (5/7), or multiple small nodules up to 2 cm in diameter (1/7) or a 10 cm multiloculated cystic lesion owing to extensive necrosis (1/7). Histologically, a storiform-pleomorphic pattern with variable degrees of necrosis predominated (6/7). A myxoid pattern was seen in only 1 case and this case lacked necrosis. Lymphoplasmacytic infiltration was seen in 3/7 of the cases. Tumors were grade I (1/7), grade II (2/7), grade III (4/7), stage pT1 (4/7), pT2 (1/7), pT4 (1/7), and pT4, cM1 (1/7) at diagnosis. Three patients with tumor cell ezrin immunoreactivity score >or=1 died of tumor within 1 year. Two patients with tumor cell ezrin immunoreactivity score <1 survived >4 years after surgery. Combined analysis of our series and previously reported cases suggest that primary hepatic MFH possess certain characteristic clinicopathologic features that may help in making the diagnosis and in differentiating it from other more common neoplasms in the liver. The prognosis of hepatic MFH depends primarily on tumor size and stage at the time of diagnosis. Ezrin expression in tumor cells can provide additional prognostic information and may be a potential target for new adjuvant therapies.     

Effect of multivitamin and mineral supplementation on episodes of infection in nursing home residents: a randomized, placebo-controlled study

OBJECTIVES: To evaluate the effect of vitamin and mineral supplementation on infections in an elderly institutionalized population. DESIGN: Eighteen-month, randomized, placebo-controlled trial. SETTING: Twenty-one long-term care facilities. PARTICIPANTS: Seven hundred sixty-three subjects from 21 long-term care facilities. INTERVENTION: Participants were randomized to receive one multivitamin and mineral supplementation daily or placebo. MEASUREMENTS: The primary outcome was number of infections per subject. Secondary outcomes were antibiotic use and hospitalization rates. Infection control surveillance was conducted over 18 months using standardized criteria. RESULTS: Outcome data from 748 subjects, mean age 85, were included in the intention-to-treat analysis. Using univariate analyses, there was no difference in infectious episodes between the supplemented and placebo groups (3.5 infections per 1,000 resident-days vs 3.8 infections per 1,000 resident-days, odds ratio (OR)=0.92, 95% confidence interval (CI)=0.82-1.03, P=.12). There was a reduction in antibiotic usage in the supplementation group, but this was not significant in the multivariate model. There was no difference in the number of hospital visits. In the multivariate analysis, the effect of multivitamin use on total number of infections was not significant (OR=0.77, 95% CI=0.54-1.1). Subjects without dementia had a greater rate of infections than those with dementia (OR=1.44, 95% CI=1.19-1.76). In post hoc subgroup analysis, subjects without dementia who received supplementation had a significantly lower rate of infections than those who received placebo (relative risk=0.81, 95% CI=0.66-0.99). CONCLUSION: Overall, multivitamin and mineral supplementation does not have a significant effect on the incidence of infections in institutionalized seniors, although the subgroup of residents in long-term care without dementia may benefit from supplementation. Further research is needed to determine its effect in high-risk subgroups within the nursing home population.     

Early olfactory deprivation and the mitral cells of the olfactory bulb: A Golgi study

Golgi impregnation was used to study the morphology, morphometry and number of mitral cells in control and stimulus-deprived olfactory bulbs (OB) of 25-day-old albino rats. The rats were made unilaterally anosmic by closure of one nostril in the early neonatal period. The previously described reductions in the size of OB and thickness of OB layers were confirmed. Quantitative comparison of the control and anosmic OB revealed that in the odor deprived OB the number of Golgi impregnated mitral cells was 40% less and the impregnation of dendritic neuropil in the external plexiform layer was greatly reduced. Of the remaining mitral cells of the odor-deprived OB, a small portion exhibited an 'atrophic' appearance with markedly reduced impregnation of the intracellular material, while the majority showed relatively 'normal' morphology. Morphometric measurements and statistical comparison of the means revealed that in the remaining 'normal' mitral cells, there were significant reductions in the following parameters: (1) the size of the cell soma as measured by the vertical and transverse diameters (17 and 12%); (2) length of the apical dendrite (27%); (3) diameter of the glomerular tuft (22%); (4) total length of the basal dendrites (18%); (5) diameter of the dendritic field of the basal dendrites (22%). The pattern of impregnation did not differ between the control OB of the experimental rats and the normal OB of normal rats. The results indicate that an absence of olfactory stimulation during the postnatal period exerts deleterious transneuronal influences on the developing mitral neurons, leading to atrophy and loss for some and diminished somatic and dendritic growth for others.