Does intradisciplinary conflict influence to outcomes of emergency medicine residency program? a mixed methods study

Objective: to explore impact of emergency medicine residency program on patient waiting times in emergency department [ED] and determine the associated factors

Methods: a two-phased sequential exploratory mixed-methods approach was used. The first phase was comprised of retrospective before-after design of ED encounters for a 3-month period, six months before and six months after the introduction of an emergency medicine residency program in an Iranian teaching hospital. The second phase included semi-structured interviews with five individuals which purposively selected to participate in qualitative design. Quantitative data were analysed descriptively and qualitative data were analysed using an iterative framework approach

Results: the most patients were admitted to the hospital in night shift, both before and after the resident EMS. No statistically significant differences were found among all of the waiting times during the two time periods except for the average time interval between admission and physician start time [p<0.0001], which increased [instead of reducing], and the average time interval between physician start time and first treatment measure [p<0.0001], which decreased during the year the residents began. The interviewees revealed the intradisciplinary conflicts and interferences existing between ED and other specialist departments, are main important factor to delayed processing of patients visits

Conclusion: this study has shown that intradisciplinary conflict would affect the outcomes of emergency medicine residency program and ED process. These new findings enhance the understanding of the nature of conflicts and will persuade policy makers that design a set of clinical practice guidelines to clarify the duties and responsibilities of parties involved in ED

RORA and autism in Isfahan population: is there an epigenetic relationship

Objective: Autism is a neurodevelopmental disorder characterized by difficulty in verbal and non-verbal communication, impaired social interaction, and restricted and repetitive behavior. It has been recently introduced as a multigenic disorder with significant epigenetic effects on its pathology. Recently, epigenetic silencing of retinoic acid receptor-related orphan receptor alpha [ROR alpha] gene [which has an essential role in neural tissue development] was shown to have occurred in autistic children due to methylation of its promoter region. This may thus explain a significant part of the molecular pathogenesis of autism. Therefore, we aimed to confirm this finding by implementing a case-control [experimental] study in the population of Isfahan

Materials and Methods: The methylation status of a 136 bp sequence of a GpG island [encompassing 13 CpG sites] in the RORA promoter region [positions -200 to -64] as an experimental study was examined in the lymphocyte cells of 30 autistic children after sodium bisulfite treatment using the melting curve analysis-methylation [MCA-Meth] assay compared with normal children. Also, quantitative reverse transcriptase-polymerase chain reaction [qRT-PCR] analysis was used to estimate the level of mRNA transcripts and to evaluate MCA-Meth analysis results

Results: This study revealed no methylation in the examined promoter regions in both autistic and normal children, with the melting curve of all studied samples being comparable to that of the non-methylated control. The results of MCA-Meth analysis were also consistent with qRT-PCR results. We therefore observed no significant difference in the levels of ROR alpha transcripts in the blood lymphocytes between autistic and healthy children

Conclusion: The methylation of the RORA promoter region may not be considered as a common epigenetic risk factor for autism in all populations. Hence, the molecular pathogenesis of autism remains unclear in the population investigated

Osteogenic differentiation and mineralization on compact multilayer nHA-PCL electrospun scaffolds in a perfusion bioreactor

Background: Monolayer electrospun scaffolds have already been used in bone tissue engineering due to their high surface-tovolume ratio, interconnectivity, similarity to natural bone extracellular matrix [ECM], and simple production

Objectives: The aim of this study was to evaluate the dynamic culture effect on osteogenic differentiation and mineralizationi into a compact cellular multilayer nHA-PCL electrospun construct. The dynamic culture was compared with static culture

Materials and Methods: The calcium content, alkaline phosphatase [ALP] activity and cell viability were investigated on days 3 and 7

Results: When the dynamic culture compared to static culture, the mineralization and ALP activity were increased in dynamic culture. After 7 days, calcium contents were 41.24 and 20.44 micro g.[cm[3]][-1], and also normalized ALP activity were 0.32 and 0.19 U.mg[-1] in dynamic and static culture, respectively. Despite decreasing the cell viability until day 7, the scanning electron microscopy [SEM] results showed that, due to higher mineralization, a larger area of the construct was covered with calcium deposition in dynamic culture

Conclusions: The dynamic flow could improve ALP activity and mineralization into the compact cellular multilayer construct cultured in the perfusion bioreactor after 7 days. Fluid flow of media helped to facilitate the nutrients transportation into the construct and created uniform cellular construct with high mineralization. This construct can be applied for bone tissue engineering

Evaluation of antifungal effect of silver nanoparticles against microsporum canis, trichophyton mentagrophytes and microsporum gypseum

Background: Dermatophytosis is the common cutaneous infections in humans and animals, which is caused by the keratinophylic fungus called dermatophytes. In recent years, drugs resistance in pathogenic fungi, including dermatophyte strains to the current antifungals have been increased

Objectives: The aim of this study was to evaluate the antifungal efficacy of AgNPs against Microsporum canis, Trichophyton mentagrophytes, and Microsporum gypseum

Materials and Methods: The antifungal susceptibility of nanosilver particles compared with griseofulvin [GR]. Its efficacy was investigated against three strains of dermatophytes by both agar dilution and broth microdilution test [BMD]

Results: The average minimum inhibitory concentration [MIC] AgNPs on M. canis, T. mentagrophytes and M. gypseum were 200, 180 and 170 micro g.mL[-1], respectively. Whereas these strains showed MIC of 25, 100 and 50 micro g.mL[-1] for GR

Conclusions: Our finding indicated that the AgNPs was less active than GR but it had anti-dermatophytic effect