The relation of NCCR variations and host transcription factors gene regulation in BK polyomavirus infected kidney transplant patients.

BACKGROUND: BK polyomavirus (BKPyV) infection in immunocompromised patients can led to polyomavirus-associated nephropathy (BKPyVAN) especially after kidney transplantation. The polyomavirus genome contains enhancer elements that are important transcription activators. In this study, the association between viral and host gene expression and NCCR variations was evaluated in kidney transplant recipients (KTRs) with BKPyV active, and BKPyV in-active infection. METHODS AND RESULTS: Blood samples were collected from selected KTRs who divided to patients with active and in-active BKPyV infection. Transcriptional control region (TCR) anatomy was compared to the genomic sequence of archetype BKPyV strain WW using nested PCR method and sequencing. The expression level of some transcription factor genes was evaluated using in-house Real-time PCR (SYBR Green) technique. Most changes were observed after TCR anatomy detection in the Q and P blocks. The expression level of VP1 and LT-Ag viral genes were significantly higher in patients with active infection compared with non-infected ones. Transcription factor genes SP1, NF1, SMAD, NFκB, P53, PEA3, ETS1, AP2, NFAT and AP1 were significantly higher in BKPyV active group in comparison in-active and control groups. The analyses revealed that viral load level and mutations frequency has significant correlation. CONCLUSIONS: Based on the results, increasing of NCCR variations were associated with higher viral load of BKPyV especially in Q block. Host transcriptional factors and viral genes all had higher express level in active BKPyV patients versus no in-active ones. Detection of the relation between NCCR variation and BKPyV severity in KTRs need to be confirmed in further complicated studies.

Thermal cycles behavior and microstructure of AZ31/SiC composite prepared by stir casting.

In the present work, the effect of thermal cycles on the physical and thermal properties of AZ31 alloy and AZ31/5wt%SiC and AZ31/10wt%SiC composites was investigated. Samples were prepared using the stir casting method and then subjected to precipitation hardening. Thermal cycles were done for as-cast and aged samples with V-shaped notch under 300, 600, and 900 heating and cooling cycles at 150 and 350 °C. The crack length (CL) was evaluated using optical microscope (OM), scanning electron microscope (SEM), and energy-dispersive scanning electron (EDS) analysis. Also, density, porosity, thermal expansion coefficient of the samples were evaluated. X-ray diffraction (XRD) analysis was employed to assess the phases present in the material. The results demonstrated that by increasing the number of thermal cycles up to 600 at 150 °C and 350 °C, the porosity and density of the as-cast and aged AZ31 alloy decreased and increased, respectively; however, the density and open porosity were remained constant for the composite samples. The crack's length enlarged with increasing the thermal cycles from 300 to 600 µm at 150 °C and 300 to 900 µm at 350 °C. It was found that the reinforcement and precipitates prevented the rapid growth of the crack in the magnesium matrix. All in All, composite and the aged samples demonstrated better thermal fatigue resistance compared with that of the unreinforced alloy and as-cast samples, respectively.

The Provision of Palliative Care for Noncancer Patients With Advanced Disease: Equity Does Matter.

According to the World Health Organization, the main mission of palliative care is to optimize the quality of life of patients with serious chronic disease, as well as their caregivers, by providing biopsychosociospiritual care. However, historically, the primary focus of palliative care is on providing care only for cancer diseases. Based on the current literature, it is assumed that palliative care is not provided for many chronic diseases on a regular basis and in many cases, a clinical guideline does not exist for providing palliative care.

Effect of ZnO nanoparticles on the mechanical, barrier and optical properties of thermoplastic cationic starch/montmorillonite biodegradable films.

In this study, various amounts of nanoclay montmorillonite (MMT) and ZnO nanopowders were used to analyze the properties of biodegradable nanocomposites of cationic starch (CS). Nanocomposites are produced by solvent casting method. The structure of CS-MMT nanocomposite films that contain 3% montmorillonite was exfoliated and was proved by XRD test. New hydrogen bonds were successfully formed between the CS hydroxyl groups and nanofillers and this was proved by FTIR test. The water vapor permeability and the UV light transmittance of the nanocomposites reduced after the contents of MMT and ZnO increased. ∆E and opacity of the nanocomposites enhanced after the amount of ZnO increased. Tensile strength (TS) of nanocomposites increased after the incorporation of ZnO and MMT nanoparticles although the elongation at break was diminished. Results showed that the 3 and 0.7 wt% amounts of montmorillonite and ZnO nanopowders were sufficient in order to acquire a well-moderated mechanical behavior in plastic and elastic regions, and they also cause good improvements in barrier and optical properties.

The Effect of Dexmedetomidine on the Acute Pain After Cardiothoracic Surgeries: A Systematic Review.

INTRODUCTION: Acute post-operative pain remains a troublesome complication of cardiothoracic surgeries. Several randomized controlled trials have examined the efficacy of dexmedetomidine as a single or as an adjuvant agent before, during and after surgery. However, no evidence-based conclusion has been reached regarding the advantages of dexmedetomidine over the other analgesics. OBJECTIVE: To review the effect of dexmedetomidine on acute post-thoracotomy/sternotomy pain. METHODS: Medline, SCOPUS, Web of Science, and Cochrane databases were used to search for randomized controlled trials that investigated the analgesia effect of dexmedetomidine on post-thoracotomy/sternotomy pain in adults' patients. The outcomes were postoperative pain intensity or incidence, postoperative analgesia duration, and the number of postoperative analgesic requirements. RESULTS: From 1789 citations, 12 trials including 804 subjects met the inclusion criteria. Most studies showed that pain score was significantly lower in the dexmedetomidine group up to 24 hours after surgery. Two studies reported the significant lower postoperative analgesia requirements and one study reported the significant lower incidence of acute pain after surgery in dexmedetomidine group. Ten studies found that the total consumption of narcotics was significantly lower in the dexmedetomidine group. The most reported complications of dexmedetomidine were nausea/vomiting, bradycardia and hypotension. CONCLUSION: Dexmedetomidine can be used as a safe and efficient analgesic agent for reducing the postoperative pain and analgesic requirements up to 24 hours after cardiothoracic surgeries. However, further well-designed trials are needed to find the optimal dosage, route, time, and duration of dexmedetomidine administration.

The effect of dexmedetomidine on the acute pain after cardiothoracic surgeries: a systematic review

Abstract Introduction: Acute post-operative pain remains a troublesome complication of cardiothoracic surgeries. Several randomized controlled trials have examined the efficacy of dexmedetomidine as a single or as an adjuvant agent before, during and after surgery. However, no evidence-based conclusion has been reached regarding the advantages of dexmedetomidine over the other analgesics. Objective: To review the effect of dexmedetomidine on acute post-thoracotomy/sternotomy pain. Methods: Medline, SCOPUS, Web of Science, and Cochrane databases were used to search for randomized controlled trials that investigated the analgesia effect of dexmedetomidine on post-thoracotomy/sternotomy pain in adults' patients. The outcomes were postoperative pain intensity or incidence, postoperative analgesia duration, and the number of postoperative analgesic requirements. Results: From 1789 citations, 12 trials including 804 subjects met the inclusion criteria. Most studies showed that pain score was significantly lower in the dexmedetomidine group up to 24 hours after surgery. Two studies reported the significant lower postoperative analgesia requirements and one study reported the significant lower incidence of acute pain after surgery in dexmedetomidine group. Ten studies found that the total consumption of narcotics was significantly lower in the dexmedetomidine group. The most reported complications of dexmedetomidine were nausea/vomiting, bradycardia and hypotension. Conclusion: Dexmedetomidine can be used as a safe and efficient analgesic agent for reducing the postoperative pain and analgesic requirements up to 24 hours after cardiothoracic surgeries. However, further well-designed trials are needed to find the optimal dosage, route, time, and duration of dexmedetomidine administration.

The application of response surface methodology on the synthesis of conductive polyaniline/cellulosic fiber nanocomposites.

The chemical oxidation polymerization was used in situ aimed at preparing polyaniline/cellulosic fiber nanocomposites that are highly intrinsic and conductive in nature. The prepared composites were characterized by Fourier transform infrared (FTIR) thermal Gravimetric analysis (TGA), and their morphology was investigated using field emission scanning electron microscope (FE-SEM) to elucidate the mechanism of conductivity decay of the paper nanocomposite. Box-Behnken experimental design method was applied to determine the optimum synthesis parameters. The optimum conditions were found to be surfactant type: cationic, mass ratio of fibers/aniline: 0.5, and time of polymerization: 12 h. The result of the subsequent investigation of the properties which are mechanical and related to the paper sheets revealed that adding PANi decreases the amounts of breaking length, and tear and burst factors.

Agreement between Heart Failure Patients and Their Primary Caregivers on Symptom Assessment.

BACKGROUND: To decrease the readmission rate of heart failure (HF) patients, patients and their caregivers (CGs) should participate in symptoms assessment. This study aimed to assess the agreement between HF patients and their CGs on symptoms assessment. METHODS: Using a correlational design, 100 HF patients with their CGs (100 dyads) were recruited from Department of Cardiology, Iranshahr, during August-December 2014. Data were collected using modified Heart Failure Symptom Survey (HFSS).Pearson and intra-class correlation coefficients (ICC) were used to analyze the degree of agreement within HF dyads, using SPSS16. The level of significance was set at 0.05. RESULTS: The most frequent and severe symptom assessed equally by partners was shortness of breath (SOB). Dyads had a good agreement on assessment of extremity swelling (r=0.87, P≤0.01, ICC=0.861 CI: 0.798-0.901), SOB at rest (r=0.83, P≤0.01, ICC=0.775, CI: 0.680-0.845), SOB with activity (r=0.81, P≤0.01, ICC=0.795 CI: 0.711-0.858), and feeling depressed (r=0.77, P≤0.01, ICC=0.769, CI: 0.675-0.838). 28.6% of HF dyad had a good, 50% had a moderate, and 21.4 % had a poor agreement in assessment of HF symptoms. CONCLUSION: Most of the HF dyad members did not agree with each other on the assessment of symptoms. Knowledge, skills and ability of each dyad in HF symptoms assessment should be included in the patients' discharge planning and nurses must modify their misunderstanding or inability.

The Effect of Zinc Supplementation on Sleep Quality of ICU Nurses: A Double Blinded Randomized Controlled Trial.

This study examined the effect of zinc supplementation on the sleep quality (SQ) of intensive care unit (ICU) nurses. In a double-blind, randomized controlled trial, 54 ICU nurses were randomly assigned to the intervention group ( n = 27) that received 220 mg zinc sulfate capsules every 72 hours for 1 month and the control group ( n = 26) that received placebo. Sleep quality of ICU nurses was measured by calculating the total quality sleep score using the Pittsburgh Sleep Quality Index (PSQI). The serum zinc level was a secondary outcome. All measurements were calculated at both baseline and 1 month after intervention. The total PSQI, subjective SQ, and sleep latency scores for the intervention group were significantly lower than the control group, which means that the SQ of ICU nurses in the intervention group improved from baseline. The serum zinc level of the intervention group at the end of the study was significantly higher than the control group, which means that zinc supplementation improved participants' serum zinc level. Based on these findings, the researcher suggested that zinc supplementation could be associated with better SQ, subjective SQ, and sleep latency in this group of workers.

Could the Addition of Alexander Technique Improve the Effectiveness of Physical Therapy in Reducing Violinists' Neck Pain in Comparison to Physical Therapy Alone?

One hypothesis for the mechanism of neck pain in musicians, particularly string players, is changed behavior of the superficial neck flexor muscles and impairment of the cervical stabilization system. To restore the supporting capacity of neck muscles and reduce neck pain, various types of physical therapies and pain educational modalities have been recommended. However, considering the physio-psychological nature of violinists' neck pain, its treatment may benefit from addition of therapies that address postural and movement habits. In this regard, we suggest that management of violinists' neck pain might benefit from additional approaches that may help to decrease muscle overactivity during performance movements.