Friday, 23 February 2018

Forensic Engineering of Advanced Polymeric Materials

Polymers are everywhere, also inside of the human body. Why polymers are so important? The most general answer is: because they are solid. With the term “polymer” we describe long chains consisted with repetitive structure, and longer chains tend to be solid. Classical forensic polymer engineering concerns a study of failure in solid polymer products. This area of science comprises fracture of plastic products, or any other reason why such a product fails in service, or fails to meet its specification. Environmental stress cracking (ESC) is one of the most common causes of unexpected brittle failure of thermoplastic (especially amorphous) polymers. The rate of ESC is dependent on many factors, including, for example, the polymer’s chemical composition, bonding, crystallinity, surface roughness, molar mass and residual stress. It also depends on the chemical nature of liquid media and the temperature of the system.

The most familiar synthetic polymers include nylon, polyethylene, polyvinyl chloride, polytetrafluoroethylene and polyesters, whereas proteins, nucleic acids, cellulose, starch, glycogen, silk, wool and aliphatic biopoliesters (PHA) are the polymers occurring in nature. So far, most of the reported forensic polymer engineering case studies concern ex-post investigations of traditional polymeric materials or their thermoplastic composites. (Bio)polyesters are recently of particular importance due to their biodegradation opportunity and potential medical applications. When the development of biodegradable polymers was in its infancy the most crucial features were concentrated on the effect of macromolecular architecture, new monomer systems, polymerization mechanisms, and different polymerization techniques on the final biodegradable properties. Significant eforts have been directed towards specific areas, such as mechanisms of biodegradation, biocompatibility, processing conditions and potential applications in medicine, protection of environment and agro chemistry. However, such aspects like bio-safety of such advanced polymers or nano-safety of their composites were and still are frequently neglected. The knowledge and impetus for development of forthcoming advanced polymeric materials comes from identification of problems before they arise. 

This novel viewpoint focuses on prediction, evaluation and indication on potential complications arising from the use of advanced polymers. Associations between polymeric materials’ structures, properties and behaviors before, during and after practical applications can be evaluated by the use of the methodology developed by Forensic Engineering of Advanced Polymeric Materials (FEAPM). Optimization and characterization of the polymers’ properties are very important for their production, usage and utilization. The connecting of all these elements in the FEAPM methodology constitutes the novelty of this approach. This should help to project new advanced polymeric materials, avoiding the product defects generated during production and usage.  

Thursday, 22 February 2018

Some Pain Patients Can Cut Opioid Dose and Still Get Relief


Some conceivably uplifting news for people taking opioids for incessant torment: It's conceivable to gradually decrease the measurement without expanding inconvenience, new research proposes. That is even valid for individuals who've taken the medications for quite a while. One patient in the new investigation had utilized opioids for a long time, the specialists said. "For a few people, long haul opioids are vital, however it's truly outstanding that there has been a high rate of overprescribing of opioids for perpetual agony, and there are gigantic wellbeing dangers for opioids over the long haul," said the examination's lead creator, Beth Darnall. 

"Patients have a considerable measure of dread and worry around opioids. What's been missing is an approach to decrease these medications on an outpatient premise, and our investigation found a conceivably feasible arrangement," said Darnell, a clinical educator at Stanford University. That arrangement? "Collaborate with patients and let them feel in charge, enabling them to stop the decreasing of the opioid whenever," she clarified. However, the new investigation found that at any rate a few people taking the remedy torment drugs need to get off them, or to at any rate lessen the sum they take. 

The specialists asked individuals with non-disease torment who were going to a torment facility on the off chance that they might want to partake in a trial to decrease down their opioid use more than four months. Eighty-two consented to partake. Their normal age was 52. The specialists avoided anybody with a substance utilize scatter. The individuals who remained in the investigation gradually decreased their measurements of opioids. At to start with, they could decrease up to 5 percent of the measurement they were taking up to twice in a month. By going this gradually, the analysts said they could limit withdrawal side effects and any negative physical or passionate reaction. In months two to four, individuals were permitted to drop their measurements by as much as 10 percent for each week. Once more, it was up to the patients to choose how far down they needed to go.

Wednesday, 21 February 2018

The Cytomorphological Spectrum of Papillary Lesions in the Breast

The objective of this review is to illustrate the broad spectrum of papillary lesions that can be found in breast fine needle aspirations (FNAC). Papillary tumors of the breast comprise lesions of variable morphology and include entities ranging from benign to high grade malignant. Features of papillary neoplasms invariably describe branching three-dimensional papillary clusters with delicate fibrovascular cords. Cytomorphological criteria for benign and low-grade malignant entities overlap and a definite cytological diagnosis is not always possible. Cellular papillomas may harbor areas of ductal carcinoma in situ (DCIS), atypical ductal hyperplasia (ADH) or lobular neoplasia. DCIS can be both high grade and non-high grade. Immunocytochemistry (ICC) can be helpful, providing there is adequate material for ICC. Relatively high error rates, false negatives as well as false positive diagnoses can be found. In general, papillary lesions may be recognized as such. Reporting strategies will often recommend caution if trying to differentiate benign, cellular papillomas from low-grade carcinomas.

Papillary tumors of the breast comprise lesions of variable morphology and include entities ranging from benign to high grade malignant (table 1). A papillary neoplasm is histologically one that exhibits an arborescent epithelial proliferation with fibrovascular cores and is attached by a stalk to the wall of a dilated duct. They constitute < 2 % of all breast lesions.

Cytomorphological criteria for benign and low-grade malignant entities overlap and a definite cytological diagnosis is not always possible. Features of papillary neoplasms invariably describe branching three-dimensional papillary clusters with delicate fibrovascular cords. Additional features of papillary carcinomas include moderate to abundant cellular material small papillae arranged in cell balls, tall columnar cells, isolated naked nuclei and hemosiderin laden macrophages irregular groups of predominantly monolayered (two-dimensional) epithelium composed of small, polygonal or cuboidal cells with eosinophilic cytoplasm and rounded, eccentrically placed nuclei. Features indicating a benign papillary lesion include less cell material, papillae with cohesive stalks surrounded by columnar cells in a honeycomb pattern, apocrine metaplasia, bipolar naked nuclei as well as fewer small papillae and isolated columnar cells. Myoepithelial cells within clusters and inconspicuous naked, bipolar nuclei in the background also indicate a benign lesion.

Tuesday, 20 February 2018

Evolution of the Septoplasty: Maximizing Functional and Aesthetic Outcomes in Nasal Surgery

Correction of a severely deviated nasal septum remains one of the most challenging operations for the facial plastic surgeon. As understanding of nasal anatomy and physiology advanced over time, so have septoplasty techniques, which have evolved in sophistication and capability to correct increasingly complex nasoseptal deformities. Consequentially, the term “septoplasty” has become fraught with confusion, even among physicians, as it broadly encompasses a number of different surgical techniques that all attempt to correct septal deviations. Accurate pre-operative assessment of septal deformities and selection of the most appropriate surgical procedure can help maximize functional and aesthetic outcomes. In this article, we will review the evolution of septal surgery and the differences between the various surgical septoplasty techniques.

Septal deviation is one of the most common causes of nasal obstruction. In a cadaveric study of 2000 subjects, over 75% were found to have some degree of septal deviation. Approximately 33% of patients who visit an otolaryngologist report nasal obstruction, with up a quarter of these patients seeking surgical intervention. Septoplasty is the third most commonly performed otolaryngologic surgery in the United States, preceded only by ear tube placement and adenotonsillectomy. In the United States, 340,000 septoplasties were performed in 2006 alone. The term “septoplasty” is fraught with confusion, even among physicians, as it broadly describes any technique that attempts to correct a deviated septum, and these techniques may vary considerably in complexity and effectiveness. This confusion may contribute to the selection of inappropriate surgical techniques. Despite being one of the most commonly performed surgeries, septal deviations often persist following primary septoplasty, with persistent anterior septal deviation noted in 51-72% of revision septoplasties and patient dissatisfaction rates upwards of 35%. In this article, we will review the evolution of the nasal septal surgery and the examine the differences between the described septoplasty techniques. 

The nasal septum is a midline structure, composed of membranous, cartilaginous and bony components, which divides the nasal cavity into halves and provides structural support to the external nose. The membranous septum, comprised of fibrofatty tissue, is positioned between the medial crura of the lower lateral cartilages (LLC) anteriorly and the cartilaginous septum posteriorly. The cartilaginous septum articulates with the membranous septum anteriorly, nasal bones superiorly, maxillary crest inferiorly and bony septum posteriorly. 

Monday, 19 February 2018

Fentanyl Test Strips May Help Stem OD Deaths

A thin test strip - like a pregnancy test - can identify whether a road tranquilize contains the risky opioid fentanyl, as indicated by another report. Fentanyl - one of most grounded kinds of opioid painkillers - is frequently blended into road drugs, for example, heroin and cocaine. That makes it difficult for clients to survey the power of the medications and raises the hazard for overdose, as indicated by the report's creators. In any case, their exploration uncovered that numerous individuals who utilize road drugs said they'd be keen on utilizing such testing to help anticipate overdoses. 

The report was introduced as of late at a gathering at Johns Hopkins Bloomberg School of Public Health. Hopkins specialists, alongside those from Brown University and the Rhode Island Hospital, did the examination for the report. It was issued by the Bloomberg American Health Initiative, a push to address disturbing general medical problems. Fentanyl - which is 50 to 100 times more grounded than morphine - is the fundamental driver of a sharp ascent in overdose passings. It was connected to 20,000 of the more than 64,000 overdose passings in the United States in 2016, the specialists noted. 

"We are at a urgent minute in the overdose pestilence, and we have to grasp the full scope of mediations that can spare lives," think about co-creator Susan Sherman said in a Hopkins news discharge. She's an educator in the Bloomberg School's bureau of wellbeing, conduct and society. "Our discoveries convey to the table proof that can educate a general wellbeing way to deal with the fentanyl emergency," she said. "Brilliant techniques that decrease mischief can spare lives." To test a medication for fentanyl, you would blend an example with water, as indicated by a report in The Baltimore Sun. On the off chance that the medication contained fentanyl, two stripes would show up on the test strip. One stripe would show up if the strip didn't recognize fentanyl.

Friday, 16 February 2018

To Develop Iranians’ Social Functioning Conceptual Framework and Indicators: A Mixed Method Approach

In the new public health, the concept of “social functioning” has received particular attention as both a social health asset and a determinant of physical and mental health, in despite the fact that the concept primarily derived from the works of sociologists and psychiatrists. Seeking care for nonpsychotic mental disorders as a consequence of problematic social relationships was one of the first reasons of paying attention to the concept of social roles and similarly, social functions. Several countries, especially developed, and international organizations have made attempts to develop their special indicators of social function. Most of them have integrated social functioning indicators into their health programs such as Americans’ healthy people 2020 program; OECD (Organisation for Economic Co-operation and Development) framework of monitoring health; framework of CIHI (Canadian Institute for Health Information).

A recently developed framework for monitoring social well-being in Iran, has considered ‘social functioning’ as a main component but there is no detailed indicators to monitor social functioning. In Iran, as a middle-income country, with rapid social, cultural, and political changes, and improvement in social function was increasingly emphasized by government and policy-makers in recent twenty years, following the evidence-based reports of diminishing trend of social health and capital and increasing trend of social problems such as drug abuse, violence, depression, relationship and family breakdown. The last report of global burden of diseases study regarding Iran situation, which estimated burden of 289 diseases with 67 risk factors, ranked drug use, intimate partner violence, and children sexual abuse as 10th, 13th, and 16th risk factor, respectively; and ranked major depressive disorder, anxiety disorder, drug abuse disorder, self-harm, and interpersonal violence as 4th, 10th, 12th, 23th, 25th of diseases, respectively. In addition the trend of divorce and sexual dysfunction among Iranian spouses has been increasing during recent decades. Taken together, the weight of problems with social aspect in Iranian health system is dramatic. Iran Supreme-leader has recently alarm and concern at the impact of social problems and emergent need for governmental interventions. For this reason, policy-makers in different organizations such as Ministry of State, Ministry of Social Affairs and especially Ministry of Health (MOH) made several attempts to deal with the problems. 

Establishment of Social Health Unit in MOH, conducting the first round of “Iranians’ social health survey”, and implementing provincial community-based initiatives to reduce social problems were a number of good illustrations. Following the mentioned attempts, Social Health Unit of MOH decided to develop an evidence-based conceptual framework and indicators to monitor social functioning as a major aspect of social health in national and provincial level since there is no a consensus among sociologists and public health scientists on the concept of social functioning. Indeed, developed indicators would be a valuable instrument in hands of policymakers in different levels to make most effective and efficient attempts. Therefore, the aim of our study was to contribute to this growing area by exploring framework of social functioning, and develop and prioritize indicators through a consensus-building approach.  

Thursday, 15 February 2018

A New Mechanism of Cartilage Growth in mammals “Involvement of CD117 Positive Undifferentiated Cells in Interstitial Growth”

Two types of cartilages growth are commonly described; the appositional growth and interstitial growth. The manner of production of new cartilage matrix is different in both types. Appositional type relies on addition of peripheral matrix upon activation of the perichondrial stem cells and interstitial growth depends on secretion of new cartilage matrix by chondrocytes progeny. The current study described a different type of cartilage growth in different skeletal elements of camel embryos. Camel embryos were collected, fixed, dehydrated, and embedded in paraffin. Paraffin sections of the whole embryos were stained with H&E, Crossman trichrome and Mallory trichrome. Immunohistochemical staining for CD117 and type II collagen were used in embryonic cartilage. Other samples were processed to be examined by scanning electron microscopy. 

An Early Embryonic skeleton represented by cartilaginous elements. Undifferentiated cells continuing with the perichondrium penetrated the growing cartilage of ribs, pelvic bone, scapula, and sternum. The cells were CD117 positive and morphologically resembled the undifferentiated mesenchymal cells; they appeared spindle or flattened in shape with an oval nucleus and were connected by cytoplasmic processes. The orientation of the invaded cells could be as low or high cellular densities or as individual cells. The invaded mesenchymal cells transformed to chondrocytes and produce new cartilage matrix. They were immune-stained for Type II collagen The cellular penetration aimed to supply the developing cartilage by undifferentiated cells destined to become chondrocytes and involved in the interstitial growth of the fetal cartilage.

Cartilages growth occurs by secretion of new cartilage matrix. Appositional growth depends on activation of the perichondrial cells to secrete additional cartilage matrix encompassing the growing cartilage. Chondrocytes propagation and subsequent interstitial secretion of new cartilage matrix by chondrocyte progenies result in interstitial growth. Appositional growth commits growth of the cartilage width while the increase in cartilage length relies on interstitial growth. An Unusual mode of cartilage growth has been described in the cartilage of quail embryos and the air breathing organ of catfish in which the undifferentiated mesenchymal cells participate in the interstitial type of cartilage growth. The mesenchymal cells derived from the perichondrium invade the interior of the growing cartilage and transformed chondrocytes to secrete new cartilage matrix. In femur and tibia of quail embryos, the mesenchymal invasion is limited to the central hypertrophic zone to provide the cartilage templates by a large population of chondrogenic potential cells. In air-breathing organ of catfish, mesenchymal invasion occurs in multiple sites and involved in growth, renewal, and replacement of the existing cartilage.