A comparison between the effects of simulation of basic CPR training and workshops on firefighters' knowledge and skills: experimental study.

BACKGROUND: One of the most common causes of death worldwide is cardiopulmonary arrest. Firefighters are among the first responders at the scenes of accidents and can, therefore, play a key part in performing basic cardiopulmonary resuscitation (CPR) for victims who need it. The present study was conducted to compare the effects of simulation training against workshops on the CPR knowledge and skills of firefighters in the south of Iran. METHODS: This experimental (Interventional) study was conducted on 60 firefighters of south of Fars province, Iran. The study was undertaken from March to July 2023. Through random allocation, the participants were divided into two groups: simulation-based training (30 members) and traditional workshop training (30 members). The participants' CPR knowledge and practical skills were measured before, immediately after, and three months after intervention. RESULTS: The findings of the study revealed a statistically significant difference between the pretest and posttest CPR knowledge and skill mean scores of the simulation groups as compared to the workshop group (p < 0.001). As measured three months after the intervention, the firefighters' knowledge and skill mean scores were still significantly different from their pretest mean scores (p < 0.001); however, they had declined, which can be attributed to the fact that the study population did not frequently exercise CPR. CONCLUSION: Based on the findings of the study, even though both methods of education were effective on enhancing the firefighters' CPR knowledge and skill, simulation training had a far greater impact than training in workshops. In view of the decline in the participants' knowledge and skill scores over time, it is recommended that short simulation training courses on CPR should be repeated on a regular basis.

Assessment of the effectiveness of Saba shielding with the composition of Cu-Bi in neck CT imaging: a phantom and patient study.

The use of computed tomography (CT) is a very well-established medical diagnostic imaging modality, however, the high radiation dose due to this imaging method is a major concern. Therefore, dose reduction methods are necessary, especially for superficial radiosensitive organs like the thyroid. The aim of this study is to construct and assess a CT shield with composition of 90% Cu and 10% Bi (Saba shield) with regard to dose reduction and image quality. The efficiency of the constructed shields for dose reduction was assessed by measuring entrance skin dose (ESD), using thermoluminescence dosimeters placed on an anthropomorphic phantom. Image quality was assessed quantitatively based on image noise and CT number accuracy by drawing regions of interest on CT images of the anthropomorphic phantom. Image quality was further investigated qualitatively in a patient study. Application of the Saba shield and 100% Bi shield with the thickness of one thickness (1T) reduced ESD by 50.2% and 51.7%, respectively, and using a three-fold thickness reduced ESD by 64.6% and 65.1%, respectively. Saba shield with thickness of 1T had no significant change in image noise in the anterior part, and image noise and mean CT number in the posterior part (P> 0.05). The statistical analysis performed did not find any meaningful difference between the study and control groups in image quality assessment of the patient study (P> 0.05). The 1T Saba shield reduced thyroid dose efficiently during neck CT imaging without causing unwanted effects on image quality.

Assessing Clinically Significant Cognitive Impairment Using the NIH Toolbox in Individuals with Co-occurring Serious Mental Illness and Alcohol Use Disorder.

OBJECTIVE: Serious mental illnesses (SMI) and alcohol use disorder (AUD) co-occurrence (SMI-AUD) is common, yet little is known about the prevalence and risk factors of cognitive impairment for this population. We used the National Institutes of Health (NIH) Toolbox to identify clinically significant cognitive impairment (CSCI), describe the cognitive profile, and investigate whether psychiatric and AUD severity measures are associated with CSCI in individuals with SMI-AUD. METHODS: CSCI was defined as 2 or more fully corrected fluid subtest T scores below a set threshold based on an individual's crystalized composite score. Psychiatric severity measures included the Structured Clinical Interview for DSM-V (SCID-5) for SMI diagnosis and the Positive and Negative Syndrome Scale. AUD severity measures included the SCID-5 for AUD symptom severity score, years of alcohol use, and urine ethyl glucuronide levels. A multivariable logistic regression was used to investigate the adjusted effects of each variable on the probability of CSCI. RESULTS: Forty-one percent (N = 55/135) of our sample had CSCI compared with the base rate of 15% from the NIH Toolbox normative sample. Subtests measuring executive function most frequently contributed to meeting criteria for CSCI (Flanker and Dimensional Change Card Sort). A history of head injury ( P = 0.033), increased AUD symptom severity score ( P = 0.007) and increased negative symptom severity score ( P = 0.027) were associated with CSCI. CONCLUSIONS: Cognition should be considered in the treatment of people with SMI-AUD, particularly in those with history of brain injury, higher AUD symptom severity, and/or negative symptom severity.

EYE RADIATION DOSE SAVING IN HEAD CT EXAMINATIONS USING COPPER-BISMUTH RADIATION SHIELD.

The aim of the present study is to fabricate a new shield with an optimal combination of copper and bismuth to protect the eyes in the head computed tomography (CT) examinations without compromising image quality. Radiation shields with different compositions were constructed. Computed Tomography Dose Index phantom was used to evaluate the effectiveness of shields in dose reduction and their impact on image quality quantitatively. The shield that caused the least noise in the phantom study was selected for human study. The 10%Bi-90%Cu shield had the least effect on increasing the image noise, and also no remarkable artifact was seen in the CT image of the phantom. The patient study showed that only in 25% of the study group the artifact was observed so that it did not distort the interpretation of the image. It can be concluded that the 10%Bi-90%Cu shield is flexible and durable and would be safely used in the clinic to reduce the eye radiation dose in head CT imaging without compromising image quality.

Modified Bismuth Nanoparticles: A New Targeted Nanoprobe for Computed Tomography Imaging of Cancer.

OBJECTIVE: Recently, development of multifunctional contrast agent for effective targeted molecular computed tomography (CT) imaging of cancer cells stays a major problem. In this study, we explain the ability of Triptorelin peptide-targeted multifunctional bismuth nanoparticles (Bi2S3@ BSA-Triptorelin NPs) for molecular CT imaging. MATERIALS AND METHODS: In this experimental study, the formed nanocomplex of Bi2S3@ BSA-Triptorelin NPs was characterized using different methods. The MTT cytotoxicity test was performed to determine the appropriate concentration of nanoparticles in the MCF-7 cells. The X-ray attenuation intensity and Contrast to Noise Ratio (CNR) of targeted and non-targeted nanoparticles were measured at the concentrations of 25, 50, and 75 µg/ml and X-ray tube voltages of 90, 120 and 140 kVp. RESULTS: We showed that the formed Bi2S3@ BSA-Triptorelin NPs with a Bi core size of approximately ~8.6 nm are nontoxic in a given concentration (0-200 µg/ml). At 90, 120, and 140 tube potentials (kVp), the X-ray attenuation of targeted cells were 1.35, 1.36, and 1.33-times, respectively, more than non-targeted MCF-7cells at the concentration of 75 µg/ml. The CNR values at 90, 120, and 140 kVp tube potentials were 171.5, 153.8 and 146.3 c/Ï­, respectively. CONCLUSION: These findings propose that the diagnostic nanocomplex of Bi2S3@ BSA-Triptorelin NPs can be applied as a good contrast medium for molecular CT techniques.

Assessment of some factors of cellular and humoral immunity in radiology workers.

Radiation workers in medical diagnostic departments are occupationally exposed to long-term low-dose ionizing radiation, which may cause radiation-induced side effects. This study investigated subtypes of peripheral blood lymphocytes and immunoglobulin levels in workers who were occupationally exposed to X-ray radiation at the Department of Radiology. Seventeen radiology workers received low levels of ionizing radiation as the study group and 18 individuals who were not exposed to radiation were included as the control group. The percentage of lymphocyte subtypes (CD4+, CD8+ and CD4+/CD8+) and serum levels of immunoglobulins (IgA, IgG and IgM) were measured using peripheral blood samples. Considering all lymphocyte subtypes and serum levels of IgA, IgG and IgM, there was no significant difference between the study and control groups (P > 0.05). There were no significant differences in all mentioned parameters regarding gender (P > 0.05). For the length of employment period, there was a significant difference concerning CD4+/CD8+ (P < 0.05). The findings showed that exposure to low levels of ionizing radiation does not affect the immune system of workers in diagnostic radiology dose level. Because of relatively small samples of workers, it is suggested that these factors be investigated on larger samples of radiology workers.

Synthesis and Application of Fe3O4@Au Composite Nanoparticles as Magnetic Resonance/Computed Tomography Dual-Modality Contrast Agent.

BACKGROUND: None of the molecular imaging modalities can produce imaging with both anatomical and functional information. In recent years, to overcome these limitations multimodality molecular imaging or combination of two imaging modalities can provide anatomical and pathological information. METHODS: Magnetic iron oxide nanoparticles were prepared by co-precipitation method and then were coated with silica according to Stober method. Consequently, silica-coated nanoparticles were amino-functionalized. Finally, gold nanoparticles assembled onto the surfaces of the previous product. Cytotoxicity effects of prepared Fe3O4@Au nanoparticles were evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human hepatocellular carcinoma cells. Their ability as a dual-mode contrast agent was investigated by magnetic resonance (MR) and computed tomography (CT) imaging. RESULTS: Fe3O4@Au nanoparticles were spherical undersize of 75 nm. X-ray diffraction analysis confirmed the formation of Fe3O4@Au nanoparticles. The magnetometry result confirmed the superparamagnetism property of prepared nanoparticles, and the saturation magnetization (Ms) was found to be 33 emu/g. Fe3O4@Au nanoparticles showed good cytocompatibility up to 60 µg/mL. The results showed that the Fe3O4@Au nanoparticles have good r2 relaxivity (135.26 mM-1s-1) and good X-ray attenuation property. CONCLUSION: These findings represent that prepared Fe3O4@Au nanoparticles in an easy and relatively low-cost manner have promising potential as a novel contrast agent for dual-modality of MR/CT imaging.

Targeted radiation energy modulation using Saba shielding reduces breast dose without degrading image quality during thoracic CT examinations.

OBJECTIVE: Breasts dose during thoracic computed tomography examinations is a serious challenge and practical dose reduction strategies is needed. The bismuth shielding is an available method for dose reduction; however, its use is on debate due to degrading effects on image quality. The aim of this study is to explore and evaluate the efficiency of a new composition of the X-ray absorbing material to achieve a shield with a lower impact on image quality. MATERIALS AND METHODS: Different shields were manufactured with combinations of various weight percentage of copper and bismuth. Dose reduction ratio and image quality were evaluated in phantom studies. A controlled trial with 20 female participants was conducted for image quality assessment. The shield with a lower impact on image quality, named Saba shielding, was used in the clinical trial. RESULTS: Shielding by one (1 T) and three thickness (3 T) of the constructed shields reduced the mean entrance skin dose of breasts about 52% and 73%, respectively. The shield with a composition of 90% Cu and 10% Bi (Saba shielding) had the lowest while the shield with 100% bismuth had the highest degrading effect on image quality. The Saba shielding could provide 21% higher dose reduction than the Bi shielding at the equivalent image quality. The 1 T Saba shielding did not cause artifacts in the reconstructed images. CONCLUSION: The Saba shielding is flexible, cheap and user-friendly for shielding breasts in thoracic CT examinations while do not have the degrading effect of the Bi shielding on image quality.

Aptamer-conjugated Magnetic Nanoparticles as Targeted Magnetic Resonance Imaging Contrast Agent for Breast Cancer.

Early detection of breast cancer is the most effective way to improve the survival rate in women. Magnetic resonance imaging (MRI) offers high spatial resolution and good anatomic details, and its lower sensitivity can be improved by using targeted molecular imaging. In this study, AS1411 aptamer was conjugated to Fe3O4@Au nanoparticles for specific targeting of mouse mammary carcinoma (4T1) cells that overexpress nucleolin. In vitro cytotoxicity of aptamer-conjugated nanoparticles was assessed on 4T1 and HFFF-PI6 (control) cells. The ability of the synthesized nanoprobe to target specifically the nucleolin overexpressed cells was assessed with the MRI technique. Results show that the synthesized nanoprobe produced strongly darkened T2-weighted magnetic resonance (MR) images with 4T1 cells, whereas the MR images of HFFF-PI6 cells incubated with the nanoprobe are brighter, showing small changes compared to water. The results demonstrate that in a Fe concentration of 45 µg/mL, the nanoprobe reduced by 90% MR image intensity in 4T1 cells compared with the 27% reduction in HFFF-PI6 cells. Analysis of MR signal intensity showed statistically significant signal intensity difference between 4T1 and HFFF-PI6 cells treated with the nanoprobe. MRI experiments demonstrate the high potential of the synthesized nanoprobe as a specific MRI contrast agent for detection of nucleolin-expressing breast cancer cells.

Does nitrogen gas bubbled through a low density polymer gel dosimeter solution affect the polymerization process?

BACKGROUND: On account of the lower electron density in the lung tissue, the dose distribution in the lung cannot be verified with the existing polymer gel dosimeters. Thus, the aims of this study are to make a low density polymer gel dosimeter and investigate the effect of nitrogen gas bubbles on the R2 responses and its homogeneity. MATERIALS AND METHODS: Two different types of low density polymer gel dosimeters were prepared according to a composition proposed by De Deene, with some modifications. In the first type, no nitrogen gas was perfused through the gel solution and water. In the second type, to expel the dissolved oxygen, nitrogen gas was perfused through the water and gel solution. The post-irradiation times in the gels were 24 and 5 hours, respectively, with and without perfusion of nitrogen gas through the water and gel solution. RESULTS: In the first type of gel, there was a linear correlation between the doses and R2 responses from 0 to 12 Gy. The fabricated gel had a higher dynamic range than the other low density polymer gel dosimeter; but its background R2 response was higher. In the second type, no difference in R2 response was seen in the dose ranges from 0 to 18 Gy. Both gels had a mass density between 0.35 and 0.45 g.cm(-3) and CT values of about -650 to -750 Hounsfield units. CONCLUSION: It appeared that reactions between gelatin-free radicals and monomers, due to an increase in the gel temperature during rotation in the household mixer, led to a higher R2-background response. In the second type of gel, it seemed that the collapse of the nitrogen bubbles was the main factor that affected the R2-responses.

Phylogenetic characterization of the fusion genes of the Newcastle disease viruses isolated in Fars province poultry farms during 2009-2011.

Despite routine vaccination programs against Newcastle disease (ND), sporadic cases have occasionally occurred that remain a constant threat to commercial poultry. Ten isolates of Newcastle disease viruses (NDV) from infected broiler chicken cases were obtained from various locations in Fars province during 2009-2011 and genetically analyzed using reverse transcription polymerase chain reaction (RT- PCR) with primers specific to the viral fusion (F) protein- gene. The viruses were confirmed as NDV by hemagglutination inhibition assay and RT- PCR. The isolates based on the sequence and phylogenetic analyses of partial F gene were genotypically analyzed by RT PCR. In the present investigation, the pathogenicity of NDV strains was determined by internationally recognized test mean death time (MDT). Analysis based on F gene showed that characterized isolates possess three different types of protease cleavage site motifs and appear to show maximum identities with isolates in the region. The subsequent phylogenetic analysis was implemented using MEGA and the phylogenetic tree. The results of RT-PCR and MDT showed that 10 isolates were positive for NDV, (60% velogenic, 30% mesogenic and 10% lentogenic). The results of the phylogenetic analysis showed that 10 NDV isolates from Iran belong to the class II, genotype III viruses. This information is fundamental to improve the efficacy of controlling strategies and vaccine development for NDV.