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Introduction: Vestibular rehabilitation is a treatment option for the management of vertigo and unsteadiness, which are very common in head trauma patients and more challenging in the early months after trauma. This study evaluated the effectiveness of a vestibular rehabilitation program in the recovery of acute and sub-acute head trauma patients. The goal of this study was evaluation of the effect of early vestibular rehabilitation on patients with acute and sub-acute head trauma., Materials and Methods: This study was performed in 20 head trauma patients with vertigo and unsteadiness. The patients were randomly divided into two groups: one group received medical therapy (Betaserc) and the other received rehabilitation and medical therapy. An individualized vestibular rehabilitation program was designed that was then revised and verified by a joint committee of vestibular rehabilitation groups. The effectiveness of interventions was measured using the Dizziness Handicap Inventory (DHI) by comparing the results before and after therapy., Results: The physical conditions and DHI scores of patients in both groups were similar at baseline. After 1 month of rehabilitation, patients receiving vestibular rehabilitation and medication showed greater progress than patients receiving medication only (P=0.000)., Conclusion: Vestibular rehabilitation can aid in the recovery from vertigo and increase the stability of head trauma patients. Simultaneous treatment with medicine and vestibular rehabilitation exercises can result in quicker and better therapeutic effects.

Objective: National estimates of arthritis prevalence rely on a single survey question about doctor-diagnosed arthritis without using survey information on joint symptoms, even though some subjects with only the latter have been shown to have arthritis. The sensitivity of the current surveillance definition is only 53% and 69% in subjects ages 45-64 years and ages ≥65 years, respectively, resulting in misclassification of nearly one-half and one-third of subjects in those age groups. This study was undertaken to estimate arthritis prevalence based on an expansive surveillance definition that is adjusted for the measurement errors in the current definition., Methods: Using the 2015 National Health Interview Survey, we developed a Bayesian multinomial latent class model for arthritis surveillance based on doctor-diagnosed arthritis, joint symptoms, and whether symptom duration exceeded 3 months., Results: Of 33,672 participants, 19.3% of men and 16.7% of women ages 18-64 years and 15.7% of men and 13.5% of women ages ≥65 years affirmed joint symptoms without doctor-diagnosed arthritis. The measurement error-adjusted prevalence of arthritis was 29.9% (95% Bayesian probability interval [95% PI] 23.4-42.3) in men ages 18-64 years, 31.2% (95% PI 25.8-44.1) in women ages 18-64 years, 55.8% (95% PI 49.9-70.4) in men ages ≥65 years, and 68.7% (95% PI 62.1-79.9) in women ages ≥65 years. Arthritis affected 91.2 million adults (of 247.7 million; 36.8%) in the US in 2015, which included 61.1 million persons between 18 and 64 years of age (of 199.9 million; 30.6%). Our arthritis prevalence estimate was 68% higher than the previously reported national estimate., Conclusion: Arthritis prevalence in the US population has been substantially underestimated, especially among adults younger than 65 years of age., (© 2017, American College of Rheumatology.)

This study aimed to provide novel biopolymer-based antimicrobial films as food packaging that may assist in reducing environmental pollution caused by the accumulation of synthetic food packaging. The blend of ZnO nanorods (ZnO-nr) and nanokaolin in different ratios (1:4, 2:3, 3:2 and 4:1) was incorporated into semolina, and nanocomposite films were prepared using solvent casting. The resulting films were characterized through field-emission scanning electron microscopy and X-ray diffraction. The mechanical, optical, physical, and antimicrobial properties of the films were also analyzed. The water vapor permeability of the films decreased with increasing ZnO-nr percentage, but their tensile strength and modulus of elasticity increased with increasing nanokaolin percentage. The UV transmittance of the semolina films were greatly influenced by an increase in the amount of ZnO-nr. The addition of ZnO-nr: nanokaolin at all ratios (except 1:4) into semolina reduced UV transmission to almost 0%. Furthermore, the ZnO-nr/nanokaolin/semolina films exhibited a strong antimicrobial activity against Staphylococcus aureus . These properties suggest that the combination of ZnO-nr and nanokaolin are potential fillers in semolina-based films to be used as active packaging for food and pharmaceuticals.

OBJECTIVE To evaluate a central line care maintenance bundle to reduce central line-associated bloodstream infection (CLABSI) in non-intensive care unit settings. DESIGN Before-after trial with 12-month follow-up period. SETTING A 1,250-bed teaching hospital. PARTICIPANTS Patients with central lines on 8 general medicine wards. Four wards received the intervention and 4 served as controls. INTERVENTION A multifaceted catheter care maintenance bundle consisting of educational programs for nurses, update of hospital policies, visual aids, a competency assessment, process monitoring, regular progress reports, and consolidation of supplies necessary for catheter maintenance. RESULTS Data were collected for 25,542 catheter-days including 43 CLABSI (rate, 1.68 per 1,000 catheter-days) and 4,012 catheter dressing observations. Following the intervention, a 2.5% monthly decrease in the CLABSI incidence density was observed on intervention floors but this was not statistically significant (95% CI, -5.3% to 0.4%). On control floors, there was a smaller but marginally significant decrease in CLABSI incidence during the study (change in monthly rate, -1.1%; 95% CI, -2.1% to -0.1%). Implementation of the bundle was associated with improvement in catheter dressing compliance on intervention wards (78.8% compliance before intervention vs 87.9% during intervention/follow-up; P<.001) but improvement was also observed on control wards (84.9% compliance before intervention vs 90.9% during intervention/follow-up; P=.001). CONCLUSIONS A multifaceted program to improve catheter care was associated with improvement in catheter dressing care but no change in CLABSI rates. Additional study is needed to determine strategies to prevent CLABSI in non-intensive care unit patients. Infect Control Hosp Epidemiol 2016;37:692-698.

Introduction: Patients with bilateral weakness (BW) have many difficulties in gaze stability that interfere with their normal function. The aim of this study was to evaluate ocular motor functions in patients with BW to better understand the problem of gaze instability in these patients., Materials and Methods: Patients were referred from the Otolaryngology Department for Vestibular Assessment to our clinic between November 2014 and March 2015. We assessed ocular motor function (gaze, saccade, and smooth pursuit) in patients over the age of 18 years with BW, as verified by a caloric test., Results: Seventy-eight patients completed all the tests. The mean age of patients was 51.9 (±15.9) years, and 47 (60%) were female. Abnormal results were found in five (6.4%), 32 (41%), and seven (9%) patients with respect to gaze, smooth pursuit, and saccade, respectively. There were positive but relatively weak relationships between age and ocular motor results., Conclusion: Patients with BW suffer from dizziness and unsteadiness. These patients have abnormal function in ocular motor (especially smooth pursuit) tests. The ocular motor dysfunction is responsible for gaze instability in static positions such as standing.

Effects of nano-kaolin incorporation into semolina films on the physical, mechanical, thermal, barrier and antimicrobial properties of the resulting bio-nanocomposite films were investigated. The properties included crystal structure (by X-ray diffraction), mechanical resistance, color, Fourier transform infrared spectra, decomposition temperature, water-vapor permeability (WVP), oxygen permeability (OP), and antimicrobial activity against Staphylococcus aureus and Escherichia coli. Kaolin was incorporated into biofilms at various amounts (1, 2, 3, 4, and 5 %, w/w total solid). All films were plasticized with 50 % (w/w total solid) combination of sorbitol/glycerol at 3:1 ratio. The incorporation of nanokaolin into semolina films decreased OP and WVP. The moisture content and water solubility of the films were found to decrease by nanokaolin reinforcement, and mechanical properties of films were improved by increasing nanokaolin concentration. Tensile strength and Young's modulus increased from 3.41 to 5.44 MPa and from 63.12 to 136.18, respectively, and elongation-at-break decreased. The films did not exhibit UV absorption. In conclusion, nanokaolin incorporation enhanced the barrier and mechanical properties of semolina films, indicating the potential application of these bio-nanocomposites in food-product packaging.

Introduction: The presence of heavy metals such as cadmium in drinking water resources can be dangerous for human because of toxicity and biological accumulation. The consumption of water which contains Cd in high concentration can lead to Bone and Kidney diseases., Material and Methods: In this present study, the researcher collected 432 samples of bottled water in the popular marks in summer and winter from the surface of Bandar Abbas. The cadmium concentration was measured by atomic absorption Spectrophotometer in model DR2800 through the Dithizone method. CDI, R and HQ which are caused by Cd for adult men, women and children, have been calculated and evaluated through the equations of EPA and WHO., Results: Mean of 1.73±0.19 µg/l (M±SE) is lower than the standard of WHO and EPA. However, 33.2% of all the samples have concentrations more than the standard limit of WHO, and the concentrations of 22.4% of the samples are more than EPA's standard. The CDI for different age groups is as following manner; Children>adult women>adult men. The CDI in children is more than twice as much as in the CDI for adult men and women. The mean of HQ order for different age groups is children>adult men>adult women. Since HQ of adult men (34E-5), adult women (31E-5) and children (84E-5), is lower than 1., Conclusion: It can be said that the population of Bandar Abbas is in a safe area regarding the HQ of the bottled water's cadmium.

The presence of heavy metals such as lead in drinking water resources can be dangerous for human because of toxicity and biological accumulation. The consumption of water or food which contains lead in high concentration can lead to prevent from Hemoglobin Synthesis (Anemia) and Kidney diseases. In this present study, the researcher collected 432 samples of bottled water in the popular marks in summer and winter from the surface of Bandar Abbas. The lead concentration was measured by atomic absorption Spectrophotometer in model DR2800 through the Dithizone method. CDI, R and HQ which are caused by lead for adult men, women and children, have been calculated and evaluated through the equations of EPA and WHO. The mean concentration of lead, which is 3.46± 0.47 µg/l, and its range, which is 1.9-17.6 µg/l, are lower than the guideline of WHO (10 µg/l) and MPC of EPA is (15 µg/l). But the 40 samples of the bottled water (9.2%) have the concentration higher than guideline WHO and 8 samples (1.85%) has the concentration higher than the permissible limits of the EPA. CDI in different age groups is as following manner: Children>adult men>adult women. CDI in children is more than twice as much as in the adult men and women. The R of lead for children (24E-7), adult men (11E-7) and for adult women (10E-7) are more than the acceptable level of R in EPA (1E-6) but less than the acceptable level of R in WHO (1E-4). Since HQ of adult men (34E-5), adult women (31E-5) and children (84E-5), is lower than 1, it can be said that the population of Bandar Abbas is in a safe area regarding the HQ of the bottled water's lead.

Background: The Auditory steady state response (ASSR) provides a frequency-specific and automatic assessment of hearing sensitivity and is used in infants and difficult-to-test adults., Objectives: The aim of this study was to compare the ASSR thresholds among various types (normal, conductive, and sensorineural), degree (normal, mild, and moderate), and configuration (flat and sloping) of hearing sensitivity, and measuring the cutoff point between normal condition and hearing loss for different frequencies., Patients and Methods: This clinical trial was performed in Iran and included patients who were referred from Ear, Nose, and Throat Department. A total of 54 adults (27 with sensorineural hearing loss, 17 with conductive hearing losses, and 10 with normal hearing) were randomly chosen to participate in our study. The type and degree of hearing loss were determined through testing by otoscopy, tympanometry, acoustic reflex, and pure tone audiometry. Then the ASSR was tested at carrier frequencies of 500, 1000, 2000, and 4000 Hz., Results: The ASSR accurately estimates the behavioral thresholds as well as flat and sloping configurations. There was no correlation between types of hearing loss and difference of behavioral and ASSR thresholds (P = 0.69). The difference between ASSR and behavioral thresholds decreased as severity of hearing loss increased. The 40, 35, 30, and 35 dB could be considered as cutoffs between normal hearing and hearing loss for 500, 1000, 2000, and 4000 Hz, respectively., Conclusions: The ASSR can accurately predict the degree and configuration of hearing loss and discriminate the normal hearing from mild or moderate hearing loss and mild from moderate hearing loss, except for 500 Hz. The Air-conducted ASSR could not define the type of hearing loss.

The presence and characteristics of a connected network of polyaniline (PANI) within a composite coating based on polyester acrylate (PEA) has been investigated. The bulk electrical conductivity of the composite was measured by impedance spectroscopy. It was found that the composite films containing PANI have an electrical conductivity level in the range of semiconductors (order of 10(-3) S cm(-1)), which suggests the presence of a connected network of the conductive phase. The nanoscopic distribution of such a network within the cured film was characterized by PeakForce tunneling atomic force microscopy (AFM). This method simultaneously provides local information about surface topography and nanomechanical properties, together with electrical conductivity arising from conductive paths connecting the metallic substrate to the surface of the coating. The data demonstrates that a PEA-rich layer exists at the composite-air interface, which hinders the conductive phase to be fully detected at the surface layer. However, by exposing the internal structure of the composites using a microtome, a much higher population of a conductive network of PANI, with higher elastic modulus than the PEA matrix, was observed and characterized. Local current-voltage (I-V) spectroscopy was utilized to investigate the conduction mechanism within the nanocomposite films, and revealed non-Ohmic characteristics of the conductive network.

Background: Dizziness as a common symptom affecting many aspects of the patient's life and it is hard to be fully evaluated. The dizziness handicap inventory (DHI) is a reliable self-perceived questionnaire in the evaluation of dizziness impacts. The purposes of this study are translation of the DHI to Persian language and measuring its psychometric properties, including face, content, discriminate and construct validity, internal consistency and reliability., Materials and Methods: The English version of the DHI is translated to Persian language based on international quality of life assessment protocol. 97 participants, including 57 patients with mean age of 44.5-year-old and 40 healthy people (mean age of 34.1) participated in this study during the period of November 2012 to June 2013 in audiology clinics of Tehran University of medical sciences., Results: The Persian version of DHI showed good face and content validity. The internal consistency of DHI-P was good, the Cronbach's alpha was 0.79, 0.82, 0.83, and 0.90 for total and emotional, physical and functional subscales; respectively, in reliability, There was a high correlation between test re-test scores (r = 0.90, P = 0.000). Intraclass correlation coefficient (ICC) was 0.96 for total score and 0.92, 0.92, and 0.96 for emotional, physical and functional subscales; respectively., Conclusion: Considering good psychometric properties, we suggest that DHI-P can use for evaluating the dizziness effects on quality of life in Persian population.

The interactions between polyaniline particles and polyaniline surfaces in polyester acrylate resin mixed with 1,6-hexanediol diacrylate monomer have been investigated using contact angle measurements and the atomic force microscopy colloidal probe technique. Polyaniline with different characteristics (hydrophilic and hydrophobic) were synthesized directly on spherical polystyrene particles of 10 μm in diameter. Surface forces were measured between core/shell structured polystyrene/polyaniline particles (and a pure polystyrene particle as reference) mounted on an atomic force microscope cantilever and a pressed pellet of either hydrophilic or hydrophobic polyaniline powders, in resins of various polymer:monomer ratios. A short-range purely repulsive interaction was observed between hydrophilic polyaniline (doped with phosphoric acid) surfaces in polyester acrylate resin. In contrast, interactions between hydrophobic polyaniline (doped with n-decyl phosphonic acid) were dominated by attractive forces, suggesting less compatibility and higher tendency for aggregation of these particles in liquid polyester acrylate compared to hydrophilic polyaniline. Both observations are in agreement with the conclusions from the interfacial energy studies performed by contact angle measurements.

Testing of composite fecal (environmental) samples from high traffic areas in dairy herds has been shown to be a cost-effective and sensitive method for classification of herd status for Mycobacterium avium subsp. paratuberculosis (MAP). In the National Animal Health Monitoring System's (NAHMS) Dairy 2007 study, the apparent herd-level prevalence of MAP was 70.4% (369/524 had ≥ 1 culture-positive composite fecal samples out of 6 tested). Based on these data, the true herd-level prevalence (HP) of MAP infection was estimated using Bayesian methods adjusting for the herd sensitivity (HSe) and herd specificity (HSp) of the test method. The Bayesian prior for HSe of composite fecal cultures was based on data from the NAHMS Dairy 2002 study and the prior for HSp was based on expert opinion. The posterior median HP (base model) was 91.1% (95% probability interval, 81.6 to 99.3%) and estimates were most sensitive to the prior for HSe. The HP was higher than estimated from the NAHMS Dairy 1996 and 2002 studies but estimates are not directly comparable with those of prior NAHMS studies because of the different testing methods and criteria used for herd classification., (Published by Elsevier B.V.)

The present study describes the possibility to polymerize aniline within wood veneers to obtain a semi-conducting material with solid wood acting as the base template. It was determined that it is possible to synthesize the intrinsically conductive polymer (ICP) polyaniline in situ within the wood structure of Southern yellow pine veneers, combining the strength of the natural wood structure with the conductivity of the impregnated polymer. It was found that polyaniline is uniformly dispersed within the wood structure by light microscopy and FT-IR imaging. A weight percent gain in the range of 3-12 wt % was obtained with a preferential formation in the wood structure and cell wall, rather than in the lumen. The modified wood was found to be less hydrophilic with the addition of phosphate doped polyaniline as observed by equilibrium water swelling studies. While wood itself is insulating, the modified veneers had conductivities of 1 × 10(-4) to 1 × 10(-9) S cm(-1), demonstrating the ability to tune the conductivity and allowing for materials with a wide range of applications, from anti-static to charge-dispersing materials. Furthermore, the modified veneers had lower total and peak heat releases, as determined by cone calorimetry, because of the char properties of the ICP. This is of interest if these materials are to be used in building and furniture applications where flame retardance is of importance., (© 2012 American Chemical Society)

The high interest in applications of conducting polymers, especially polyaniline (PANI), makes it important to overcome limitations for effective usage due to poor processability and solubility. One promising approach is to make blends of PANI in polymeric resins. However, in this approach other problems related to the difficulty of achieving a homogeneous PANI dispersion arise. The present article is focused on this general problem, and we discuss how the synthesis method, choice of dopant and solvent as well as interfacial energies influence the dispersibility. For this purpose, different synthesis methods and dopants have been employed to prepare nanostructures of polyaniline. Dynamic light scattering analysis of dispersions of the synthesized particles in several solvents was employed in order to understand how the choice of solvent affects PANI aggregation. Further information on this subject was achieved by scanning electron microscopy studies of PANI powders dried from various solutions. On the basis of these results, acetone was found to be a suitable dispersion medium for PANI. The polymer matrix used to make the blends in this work is a UV-curing solvent-free resin. Therefore, there is no low molecular weight liquid in the system to facilitate the mixing process and promote formation of homogeneous dispersions. Thus, a good compatibility of the components becomes crucial. For this reason, surface tension and contact angle measurements were utilized for characterizing the surface energy of the PANI particles and the polyester acrylate (PEA) resin, and also for calculating the interfacial energy between these two components that revealed good compatibility within the PANI/PEA blend. A novel technique, based on centrifugal sedimentation analysis, was employed in order to determine the PANI particle size in PEA resin, and high dispersion stability of the PANI/PEA blends was suggested by evaluation of the sedimentation data.

Objective: To determine changes in chondrocyte transcription of a range of anabolic, catabolic and signaling genes following simultaneous treatment of cartilage with Insulin-like growth factor-1 (IGF-1) and ramp-and-hold mechanical compression, and compare with effects on biosynthesis., Methods: Explant disks of bovine calf cartilage were slowly compressed (unconfined) over 3-min to their 1mm cut-thickness (0%-compression) or to 50%-compression with or without 300 ng/ml IGF-1. Expression of 24 genes involved in cartilage homeostasis was measured using qPCR at 2, 8, 24, 32, 48 h after compression +/-IGF-1. Clustering analysis was used to identify groups of co-expressed genes to further elucidate mechanistic pathways., Results: IGF-1 alone stimulated gene expression of aggrecan and collagen II, but simultaneous 24h compression suppressed this effect. Compression alone up-regulated expression of matrix metalloproteinase (MMP)-3, MMP-13, a disintegrin and metalloproteinase with thrombospondin motif (ADAMTS)-5 and transforming growth factor (TGF)-beta, an effect not reversed by simultaneous IGF-1 treatment. Temporal changes in expression following IGF-1 treatment were generally slower than that following compression. Clustering analysis revealed five distinct groups within which the pairings, tissue inhibitor of metalloproteinase (TIMP)-3 and ADAMTS-5, MMP-1 and IGF-2, and IGF-1 and Collagen II, were all robustly co-expressed, suggesting inherent regulation and feedback in chondrocyte gene expression. While aggrecan synthesis was transcriptionally regulated by IGF-1, inhibition of aggrecan synthesis by sustained compression appeared post-transcriptionally regulated., Conclusion: Sustained compression markedly altered the effects of IGF-1 on expression of genes involved in cartilage homeostasis, while IGF-1 was largely unable to moderate the transcriptional effects of compression alone. The demonstrated co-expressed gene pairings suggest a balance of anabolic and catabolic activity following simultaneous mechanical and growth factor stimuli.

Electro-tactile based rehabilitation systems must be capable of self-tuning to suit the tactile preference of different users. However, tactile preference is difficult to assess in practice. We propose a Takagi-Sugeno-Kang (TSK) fuzzy logic modeling and control approach for the on-line assessment of tactile preference. The method relies on real-time measurements of voltage and power absorbed by the fingertip. Our results show that the fuzzy logic approach successfully models user tactile preference. We are currently developing an electro-tactile based Braille display (E-Braille) for assisting the Blind and Visually Impaired (BVI) that exploits our fuzzy model.