Radiological landscape of natural resources and mining: Unveiling the environmental impact of naturally occurring radioactive materials in Ghana's mining areas

This study provides a general observation of the status of naturally occurring radioactive materials (NORMs) distribution in mining and industrial areas of Ghana in order to establish regional and national data on NORMs. The study includes data on radioactivity concentrations of U-238, Th-232, and K-40 in soils and for water concentrations of Ra-226, Th-228, and K-40 from various mining, oil, and gas communities, as well as water sources used for crop farming and farmlands. The average activity concentrations of U-238, Th-232, and K-40 in the soil samples were found to be 59 ± 16 Bq/kg, 48 ± 15 Bq/kg, and 286 ± 57 Bq/kg, respectively. The average concentration of Ra-226, Th-228, and K-40 in the water samples were found to be 1.62 ± 0.33 Bq/L, 2.08 ± 0.53 Bq/L, and 22.36 ± 3.44 Bq/L, respectively. The estimated average annual effective doses from external and internal exposure pathways in soil and water samples were 0.09 mSv/y and 0.54 mSv/y, respectively. The total annual effective dose resulting from both exposure pathways was calculated to be 0.63 mSv/y, which is below the 1 mSv/y dose limit recommended by the International Commission on Radiological Protection (ICRP) for controlling public radiation exposure. Based on the radiological hazard indices, the majority of the soil samples were found to be suitable as building materials as their respective indices were below the limits except for two sample locations and the sludge and scale samples. The average Excess Lifetime Cancer Risk (ELCR) value of the water samples was 1.6 times greater than the recommended value of 1.16 × 10-3, presenting a relatively higher risk to the public of developing cancer. No significant regional differences in the levels of radioactive elements. The regression models demonstrate strong interrelationships between the studied elements, with high R-squared values suggesting a predictable nature of one element's concentration based on others.

Corpus Callosum Functional Activities in Children with Cerebral Palsy

Background

Since cerebral palsy (CP) is a corollary to brain damage, persistent treatment should accompany an alteration in brain functional activity in line with clinical improvements. In this regard, the corpus callosum (CC), as a connecting bridge between the two hemispheres, plays an essential role.

Objective

This study aimed to investigate the therapeutic effects of occupational therapy (OT) on CC functional activity and walking capacity in children with cerebral palsy.

Material and Methods

In this clinical trial study, 4 children with CP (8.25±1.71 years) received 45 min OT sessions 3 times weekly for 8 weeks. Functional magnetic resonance imaging (fMRI) was acquired while conducting passive motor tasks to quantify CC activation. The pre-post activation changes in CC following therapy were quantified in terms of activated voxels. Walking capacity was evaluated using the timed-up-and-go (TUG), 6-minute walk test (6 MWT), and 10-meter walk test (10 MWT) in pre-and post-treatment.

Results

The number of activated voxels in CC indicated significant improvement in participants. Post-treatment activated voxels substantially exceeded pre-treatment active voxels. Clinical measures, including TUG, 6 MWT, and 10 MWT are improved by 11.9%, 12.6%, and 25.4%, respectively.

Conclusion

Passive task-based fMRI can detect the effects of OT on CC functional activity in children with CP. According to the results, OT improves CC functional activity in addition to gait and balance performance.

The Relationship between Structure of the Corticoreticular Tract and Walking Capacity in Children with Cerebral Palsy

Background

Disruption in the descending pathways may lead to gait impairments in Cerebral Palsy (CP) children. Though, the mechanisms behind walking problems have not been completely understood.

Objective

We aimed to define the relationship between the structure of the corticoreticular tract (CRT) and walking capacity in children with CP.

Material and Methods

This is a retrospective, observational, and cross-sectional study. Twenty-six children with CP between 4 to 15 years old participated. Also, we used existed data of healthy children aged 4 to 15 years old. CRT structure was characterized using diffusion tensor imaging (DTI). The DTI parameters extracted to quantify CRT structure included: fractional anisotropy (FA), mean (MD), axial (AD), and radial (RD) diffusivity. Balance and walking capacity was evaluated using popular clinical measures, including the Berg balance scale (BBS), Timed-Up-and-Go (TUG; balance and mobility), six-minute walk test (6 MWT; gait endurance), and 10-meter walk Test (10 MWT; gait speed).

Results

There are significant differences between MD, AD, and RD in CP and healthy groups. Brain injury leads to various patterns of the CRT structure in children with CP. In the CP group with abnormal CRT patterns, DTI parameters of the more affected CRT are significantly correlated with walking balance, speed, and endurance measures.

Conclusion

Considering the high inter-subject variability, the variability of CRT patterns is vital for determining the nature of changes in CRT structure, their relationship with gait impairment, and understanding the underlying mechanisms of movement disorders. This information is also important for the development or prescription of an effective rehabilitation target for individualizing treatment.

Characterization of environmental radiological parameters on dose coefficient - Realistic dosimetry compared with epidemiological dosimetry models

Radiation exposure due to all-natural sources amounts to about 2.4 mSv per year. However, this amount might be changed to over 3 mSv y-1 according to the recently introduced ICRP radon dose coefficient factor. Previously, the radon contribution to the total dose from natural sources was about 1.2 mSv y-1. However, after the latest introduced dose conversion factor by ICRP, this value could technically be increased to around 2 mSv y-1. This paper attempts to address the following questions: (i) whether reducing radon concentration to the recommended level could address concerns about radiation exposure in underground workplaces, and (ii) the effects of the difference between the epidemiological dosimetry models and realistic dose estimation. The actual dose conversion factor (DCF) was calculated using measured annual average unattached and equilibrium factors, ranging from 16 ± 9 to 25 ± 10 mSv·WLM-1. Then, the estimated inhalation dose, both from self-calculated DCF and the value reported by ICRP-137, was compared: 5.6 ± 0.7-7.6 ± 0.9 mSv y-1 and 3.3 ± 0.4-3.6 ± 0.5 mSv y-1, respectively. It can be observed that exposure to a radon concentration lower than the recommended level does not guarantee a lower dose than the recommended value. The estimated dose was at least two times greater than the dose using pre-estimated values from epidemiological dosimetry models, specifically in this case study. Further experiments in different underground working environments, excluding caves, are needed for more precise observations. It might also be time to update the data regarding the dose contribution from natural radiation sources, as the radon contribution increased according to ICRP.

Short-Term Therapeutic Effects of Anti-Gravity Treadmill Training on Brain Functional Activities and Walking Capacity in Children With Cerebral Palsy

Introduction: Cerebral Palsy (CP) is one of the most common causes of motor disability in childhood. Since CP is a corollary to brain damage, persistent treatment should accompany an alteration in brain functional activity in line with clinical improvements. Methods: Fourteen children with spastic hemiplegia CP were randomly divided into 2 groups. The study group (8yrs-5mos) underwent 45min AlterG training sessions 3 times/week for 8 weeks, while the control group (8yrs-2mos) received the same amount of occupational therapy (OT). Functional magnetic resonance imaging (fMRI) was conducted to quantify brain activation during the performance of passive tasks including ankle plantarflexion to dorsiflexion and knee flexion to extension over the range of motion. Walking capacity was assessed using the Timed-Up-and-Go, 10-meter, and 6-minute walk tests. All evaluations were performed before and after training and compared between the two groups. Results: We were able to detect the signatures of ankle and knee passive movement tasks in the fMRI and characterize them in terms of activated voxels. The pre-post activation changes following the completion of training course showed that the elicited motor cortex activation was greater for the ankle than the knee tasks. For the ankle, primary motor cortex, precentral gyrus and corpus callosum showed significant enhancement in most study participants. The results indicated 16.1% more active voxels in the study than control groups. Similarly, clinical outcome measures improved over twice as much in this group. Conclusions: AlterG training could be a potentially effective therapeutic intervention for improving gait and balance impairments in children with CP.

Natural radioactivity and radiological risks of common building materials used in Semnan Province dwellings, Iran

Impact assessment of building materials is a focused topic in the field of radioecology. A radiological survey has conducted to monitor radioactivity of most common building materials in Semnan Province, Iran, and assess the radiation risk. Activity concentrations of 226Ra, 232Th, and 40K were measured in 29 samples including nine commonly used building materials that were collected from local suppliers and manufacturers, using a high purity germanium gamma-ray detector. The activity concentrations of 226Ra, 232Th, and 40K varied from 6.7±1 to 43.6±9, 5.9±1 to 60±11, and 28.5±3 to 1085±113 Bq kg-1 with averages of 26.8±5, 22.7±4, and 322.4±4 Bq kg-1, respectively. By applying multivariate statistical approach (Pearson correlation, cluster, and principal component analyses (PCA)), the radiological health hazard parameters were analyzed to obtain similarities and correlations between the various samples. The Pearson correlation showed that the 226Ra distribution in the samples is controlled by changing the 232Th concentration. The variance of 95.58% obtained from PCA resulted that the main radiological health hazard parameters exist due to the concentration of 226Ra and 232Th. The resulting dendrogram of cluster analysis also shows a well coincidence with the correlation analysis.

Contribution of altered corticospinal microstructure to gait impairment in children with cerebral palsy

OBJECTIVE

Corticospinal tract (CST) injury may lead to motor disorders in children with Cerebral Palsy (CP). However, the precise underlying mechanisms are still ambiguous. We aimed to characterize the CST structure and function in children with CP and determine their contributions to balance and gait impairments.

METHOD

Twenty-six children with spastic CP participated. Transcranial magnetic stimulation (TMS) and diffusion tensor imaging (DTI) were utilized to characterize CST structure and function. Common clinical measures were used to assess gait speed, endurance and balance, and mobility.

RESULTS

CST structure and function were significantly altered in children with CP. Different abnormal patterns of CST structure were identified as either abnormal appearance of brain hemispheres (Group-1) or semi-normal CST appearance (Group-2). We found significant correlations between the DTI parameters of the more affected CST and gait features only in Group-1.

CONCLUSION

CST structure and function are abnormal in children with CP and these abnormalities may contribute to balance and gait impairment in some children with CP.

SIGNIFICANCE

Our findings may lead to the development of further investigations on the mechanisms underlying gait impairment in children with CP and on decision-making for more effective rehabilitation.

A brief radiological survey and associated occupational exposure to radiation in an open pit slate mine in Kashan, Iran

A comprehensive radiological survey was carried out in an open-cut slate stone quarry. The activity of 226Ra, 228Ra and 40 K in the ore samples were measured as 38 ± 5, 41 ± 6 and 869 ± 52 Bq kg1, respectively. Outdoor radon and indoor radon concentrations were measured from 37 ± 7 to 193 ± 11 Bq m−3 (77 ± 8 Bq m−3), and 49 ± 6 to 253 ± 23 Bq m−3 (131 ± 13 Bq m−3), respectively. The average indoor and outdoor gamma dose were measured as 116 and 84 nSv h− 1, respectively. The annual effective doses were estimated between 1.0 ± 0.1 and 3.3 ± 0.3 mSv year−1. The annual lung cancer risks were calculated in the range of 3.3 × 10−2 to 13.12 × 10−2 % (7.72 × 10−2%).

Multivariate statistical approach on distribution of natural and anthropogenic radionuclides and associated radiation indices along the north-western coastline of Aegean Sea, Greece

A comprehensive radiological survey using multivariate statistical analysis was carried out to evaluate the distribution of ⁴⁰K, ²³²Th, ²²⁶Ra, ²³⁵U, and ¹³⁷Cs, and associated radiation indices in beach sand samples of the coastal area of the Aegean Sea. The activity concentration of selected radionuclides was measured and no clue of recent migration of radiocaesium by not only precipitation but also through an indirect way, such as ocean runoff, was found. As part of radiological risk assessment, external radiation hazard index, radium equivalent activity, effective dose, and absorbed dose rate were estimated. Pearson correlation, cluster, and PCA analysis were used by processing observed radiological parameters to determine the correlation between the radiological parameters and locations. Pearson correlation shows a strong association between all parameters and activity of ²²⁶Ra and ²³²Th. A spatial distribution map was provided to a distinct visual representation of the distribution of radionuclide contents in the study area.

High level of natural ionizing radiation at a thermal bath in Dehloran, Iran

It has been proven that more than half of the exposure to natural background radiation originates from radon isotopes and their decay products. The inhalation of radon and its decay products causes the irradiation of respiratory tracts, thus increasing the risk of lung cancer. In this study, the concentrations of radon and thoron in thermal baths at a spa in Dehloran (Iran) were investigated. The concentrations of dissolved ²²⁶Ra in samples of water from thermal baths were also measured. Additionally, the activity concentrations of abundant naturally occurring radionuclides in farmland soils irrigated with water from hot springs was measured and compared with other soil samples irrigated with water from other sources to estimate possible radioecological effects of natural radiation staff, patients and tourists at the spa are exposed to. In addition, the search for a link between the concentration of naturally occurring radionuclides in soil and the use of water from hot springs for irrigation was one of the main goals of the study. The activity concentrations of three major naturally occurring radionuclides in soil samples were measured; the ranges for ⁴⁰K, ²²⁶Ra and ²²⁸Ra were 101 ± 8 to 240 ± 12, 276 ± 7 to 322 ± 12 and 20 ± 7 to 80 ± 10 Bq.kg⁻¹, respectively. Higher activity concentrations of ²²⁶Ra and ²²⁸Ra were recorded in soil samples irrigated with hot spring water. The water from the same spring was used in all thermal baths so concentrations of dissolved ²²⁶Ra in water samples from different thermal baths were approximated to also be 0.42 ± 0.20 Bq.l⁻¹. The indoor radon concentrations in the private thermal baths over a period of 45 days (including both occupied and vacant time) were measured to be between 1880 ± 410 and 2450 ± 530 Bq.m⁻³ and the radon concentrations in the spa galleries were measured to be between 790 ± 135 and 1050 ± 120 Bq.m⁻³, however, thoron concentrations were below the detection limit. The ventilation and centralized heating systems at the spa under investigation are inefficient so the radon concentrations in the therapy rooms and baths are high.

The maximum radiation doses originating from the inhalation of radon for tourists and the staff were estimated to be 0.13 and 5.5 mSv.yr⁻¹, respectively, which is slightly over the national limit in Iran (5 mSv.yr⁻¹). The exposure duration was estimated 15 and 1468 h per year for visitors and workers, respectively.

Do NICU developmental care improve cognitive and motor outcomes for preterm infants? A systematic review and meta-analysis

Background

The aim of this study was to review the effects of developmental care in neonatal intensive care unit (NICU) setting on mental and motor development of preterm infants.

Method

We searched PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane library until October 8th 2017, and included randomized controlled trials that assessed effects of developmental care in NICU on mental and motor development of preterm infants at 12 and 24 months of age, using the Bayley scale of infant development in this systematic review. In addition, data were pooled by random effects model and Standardized Mean Difference (SMD) with 95% confidence intervals (CI), calculated for meta-analysis.

Results

Twenty one studies were eligible to be included in this systematic review; however, only thirteen studies had data suitable for meta-analysis. According to statistical analysis, developmental care in NICU improved mental developmental index (MDI) (standardized mean difference [SMD] 0.55, 95% confidence interval [CI] 0.23–0.87; p < 0.05), and psychomotor developmental index (PDI) (SMD 0.33, [CI] 95% CI 0.08–0.57; p < 0.05) of BSID at 12 months of age and PDI at 24 months of age (SMD 0.15, 95% CI -0.02–0.32; p < 0.1) of preterm infants. However, the benefit was not detected at 24 months of age on MDI (SMD 0.15, 95% CI -0.05–0.35; p = 0.15).

Conclusion

Current evidence suggests that developmental care in only NICU setting could have significant effect on mental and motor development of preterm infants, especially at 12 months of age. However, because of clinical heterogeneity, more studies are needed to evaluate the effects of developmental NICU care in the development of preterm infants.

The Therapeutic Effects of Low-Amplitude, High-Frequency Perturbations on Neuromuscular Abnormalities Associated with Spasticity in Children with Cerebral Palsy

We aimed to investigate the impact of ankle joint therapy with low-amplitude, high-frequency perturbation training on neuromuscular abnormalities associated with spasticity in children with Cerebral Palsy (CP). Four spastic CP children (2 males and 2 females) received a 10-session training of high-frequency and low-amplitude perturbations superimposed on passive stretches over the range of motion of their ankle as well as local perturbations at dorsiflexion position. The associated passive parameters, including total passive range of motions, passive range of motions toward dorsiflexion, stiffness, energy loss and torque dynamic gain were evaluated at the baseline and after a 10 session training. Our findings indicate that passive range of motion increased, and passive reflex stiffness, which usually increases in CP children, decreased following the completion of training. Our results demonstrate that intensive sessions of perturbation therapy could be considered an effective therapeutic mean for the management of spasticity and contracture, and eventually the enhancement of mobility of CP children.

Impact of anti-gravity locomotion (AlterG) training on structure and function of corticospinal tract and gait in children with cerebral palsy

We aimed to characterize the impact of anti-gravity locomotion training on the structure and function of the corticospinal tract (CST) in cerebral palsy (CP). Fourteen CP children participated. Nine children were trained with an antigravity treadmill (Alter-G) and five children received occupational therapy (OT). Treatments were provided for 45 min each session, 3 sessions per week for 8 weeks. Diffusion tensor imaging (DTI) was used, and fractional anisotropy (FA), mean diffusivity (MD), radial (RD) and axial (AD) diffusivity was extracted to characterize the structure of the CST. Transcranial magnetic stimulation (TMS) was used and threshold, latency, and peak-peak amplitude of the MEP signal, elicited by the TMS, were used to quantify the function of the CST. Walking ability was evaluated by measuring gait speed, endurance, balance, and mobility. The evaluations were performed before and after the interventions. The results showed that FA improved in both sides of the brain for the AlterG group, but enhanced only in the less affected side of the OT group. MD, RD, and AD mostly improved in the more affected side of the AlterG group. The enhancement of the CST function was similar in both groups. Walking speed and endurance also enhanced in both groups, but the improvement was greater in the AlterG group. Our findings demonstrate that AlterG training can improve gait ability, and simultaneously result in brain neuroplasticity. The clinical implication is that AlterG training can be used as an effective rehabilitation approach to improve gait persistently.

Therapeutic Effects of repetitive Transcranial Magnetic Stimulation on Corticospinal Tract Activities and Neuromuscular Properties in Children with Cerebral Palsy

The objective of this research was to study the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) on corticospinal tract (CST) activities, reflex hyper-excitability, muscle stiffness, and the clinical status of children with spastic hemiplegic cerebral palsy (CP). Three children participated in this study. The treatment lasted for 6 weeks. Two of the patients, the experimental group, received rTMS therapy 4 days a week during the first 3 weeks, and then received typical occupational therapy (OT) after each rTMS session during the second 3 weeks. One patient, the control group, received the same treatment except that a sham coil was used. Each rTMS session lasted for 20 minutes and each OT session lasted for 45 minutes. We evaluated CST activities by transcranial magnetic stimulation (TMS), reflex hyperexcitability by H-reflex response, and muscle stiffness by sonoelastography images. The tests were taken before and after the treatment. Major TMS parameters (i.e., motor evoked potential (MEP) latency, MEP p-p amplitude, cortical silent period (cSP), and intensity of pulse) for experimental patients were improved in comparison with the control patient. H response latency and max H response on max M-wave (H/M) were improved for the experimental group compared to the control group. Two parameters of texture analysis of the sonoelastography images (i.e., entropy and contrast) were improved for the experimental group. Clinical evaluations such as 10 meter walk test (10MWT), timed up and go (TUG), and 6 minute walk test (6MWT) were performed before and after the course of treatment and were improved for the experimental group compared to the control group. These results indicated that rTMS therapy can improve CST activities, reflexes, muscle stiffness, and walking capacity of spastic hemiplegic CP. Therefore, it can be considered as an effective therapeutic tool for enhancing neuromuscular abnormalities resulting from CP.

The impact of AlterG training on balance and structure of vestibulospinal tract in cerebral palsy children

We aimed to investigate the effects of an antigravity treadmill (AlterG) on the balance and structure of the vestibulospinal tract. The AlterG can reduce the weightbearing of patients and hence can facilitate their locomotion. Three children with cerebral palsy (CP) received AlterG training three days per week for eight weeks with each session lasting 45 minutes. The balance of children was evaluated using the Berg balance test and the Timed Up and Go (TUG) test. The diffusion tensor imaging (DTI) method was employed to quantify changes of the structure of the vestibulospinal tract. Evaluations were performed before and after the 8-week training. DTI metrics including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were measured to evaluate the vestibulospinal tract structure. The results showed that the mean FA of the vestibulospinal tract increased and other metrics decreased for all subjects. Our findings indicated that the balance and structure of the vestibulospinal tract were improved up to 30% for all children following the 8-week AlterG training. This indicates that the balance improvement of the CP children following the AlterG training was accompanied with persistent neuroplasticity in their brain. The clinical implication is that the AlterG training has a potential to be used as an effective therapeutic tool for the treatment of balance impairment in CP children.

The effect of vestibular rehabilitation on dizziness and headache in patients with vestibular migraine

Background and Aim: Vestibular rehabilita­tion is suggested as one of the effective treat­ments for vestibular-originated dizziness and vertigo. As there is a proven biologic link bet­ween vestibular symptoms and headache, head­ache improvement with vestibular improvement after vestibular rehabilitation is expected. The aim of the present study was examining vesti­bular rehabilitation effects on dizziness and hea­dache in 9−15 year old subjects with a vestibu­lar migraine. Methods: Eight subjects with vestibular migra­ine were referred to Rofeideh Rehabilitation Hospital after diagnosis by a pediatric neurolo­gist. They were evaluated via dizziness handi­cap inventory (DHI), headache impact test-6 (HIT-6) and dizziness and headache frequency. Then they received a home-based vestibular reh­abilitation and after one month they were ree­valuated. Results: After vestibular rehabilitation for one month, changes in the DHI and HIT-6 score were statistically significant (p < 0.01). In addition, reduction in the dizziness and hea­dache frequency in a month was statistically significant. Conclusion: As vestibular rehabilitation has noticeable effects on dizziness and headache, this treatment is introduced as an effective and non-invasive treatment in children and adoles-cents with a vestibular migraine.  

The Effects of Low Frequency Repetitive Transcranial Magnetic Stimulation on White Matter Structural Connectivity in Children with Cerebral Palsy

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive treatment technique for recovery of movement disorders by altering cortical plasticity. In this research, we studied the effects of low-frequency rTMS on white matter (WM) structural connectivity and clinical parameters in children with cerebral palsy (CP).,Four spastic hemiplegic CP children were randomly divided into experimental and control groups. In the experimental group, at first, 1Hz rTMS treatment was performed 4 days/week for 3 weeks on two hemiplegia patients over a contralesional primary motor cortex (M1). Then, 1Hz rTMS treatment was performed 4 days/week for 3 weeks followed by a 30min occupational therapy (OT). In the control group, two CP children received sham rTMS for 3 weeks and then sham rTMS combined with OT for 3 weeks in the same schedule as the experimental group. Evaluations performed using diffusion tensor imaging (DTI), and clinical measurements of gait performance before and after the treatment. Graph theoretical analysis was used to characterize topological changes of structural connectivity. Our findings demonstrate the 1Hz rTMS is effective in improving motor activity in spastic hemiplegic CP children, and is more effective when combined with OT.

Therapeutic effects of an anti-gravity locomotor training (AlterG) on postural balance and cerebellum structure in children with Cerebral Palsy

We evaluated the therapeutic effects of anti-gravity locomotor treadmill (AlterG) training on postural stability in children with Cerebral Palsy (CP) and spasticity, particularly in the lower extremity. AlterG can facilitate walking by reducing the weight of CP children by up to 80%; it can also help subjects maintain an appropriate posture during the locomotor AlterG training. Thus, we hypothesized that AlterG training, for a sufficient period of time, has a potential to produce cerebellum neuroplasticity, and consequently result in an effective permanent postural stability. AlterG training was given for 45 minutes, three times a week for two months. Postural balance was evaluated using posturography. The parameters of the Romberg based posturography were extracted to quantify the Center of Balance (CoP). The neuroplasticity of Cerebellum was evaluated using a Diffusion Tensor Imaging (DTI). The evaluations were done pre- and post-training. The Fractional Anisotropy (FA) feature was used for quantifying structural changes in the cerebellum. The results showed that AlterG training resulted in an increase in average FA value of the cerebellum white matter following the training. The results of the posturography evaluations showed a consistent improvement in postural stability. These results were consistent in all subjects. Our findings indicated that the improvement in the posture was accompanied with the enhancement of the cerebellum white matter structure. The clinical implication is that AlterG training can be considered a therapeutic tool for an effective and permanent improvement of postural stability in CP children.

Determination of Po-210 content in cigarette smoke using a smoking machine: A case study of Iranian cigarettes

The Po-210 content of tobacco has been known for a long time, however, different results can be found about the estimated amount of Po-210 that is inhaled by humans as a result of smoking cigarettes. Because of the unique properties of Po-210, the smoking machines available on the market are not suitable because of their failure to quantitatively collect Po-210 for measurement. Therefore, to estimate precisely the amount of Po-210 entering the lungs as a result of smoking, a smoking machine and sampling protocol based on relevant ISO standards - ISO-3308, ISO-3402 and ISO-4387 - was developed. A 5% HCl solution was found to be the best absorber of Po-210 from smoke. Seventeen different brands of cigarettes distributed in Iran were used to validate the new machine and sampling protocol. The Po-210 concentration was determined by alpha spectrometry; the cigarette smoke solution underwent combined acid treatment after adding a Po-209 tracer. The Po-210 activity concentration of cigarettes sold in Iran was between 9.7 ± 1.2 and 26.5 ± 4.6 mBq/cigarette and it was determined that there was no relationship between the Po-210 and nicotine contents of cigarette smoke. Additionally, it was found that 15 ± 10% of the cigarette Po-210 was transferred to the mainstream smoke.

Association of the Single Nucleotide Polymorphisms of the Genes Encoding IL-2 and IFN-γ With Febrile Seizure

Inflammatory elements and genetics have major roles in febrile seizures (FS) pathogenesis. Seventy patients were enrolled and compared with 139 controls. The allele and genotype frequency of the IL-2 gene at -330 and +166 positions and the IFN-γ at +874 position were determined. A significant positive association with GG genotype at position -330 in the patient group was found (P=0.003). Further, a positive association was detected in simple and complex FS groups at the same position (P=0.03, P=0.004). IL-2 GT haplotype was significantly more common in the patients compared to controls (P=0.0008). Higher frequency of GT haplotype was detected in simple FS patients in comparison to controls (P=0.0003). Contrary, IL-2 TG haplotype frequency was lower in complex FS group (P=0.005). Overrepresentation of certain alleles, genotypes and haplotypes in IL-2 gene in FS patients could predispose individuals to this disease.

Radon exhalation study of manganese clay residue and usability in brick production

The reuse of by-products and residue streams is an important topic due to environmental and financial aspects. Manganese clay is a residue of manganese ore processing and is generated in huge amounts. This residue may contain some radionuclides with elevated concentrations. In this study, the radon emanation features and the massic exhalation rate of the heat-treated manganese clay were determined with regard to brick production. From the manganese mud depository, 20 samples were collected and after homogenization radon exhalation characteristics were determined as a function of firing temperatures from 100 to 750 °C. The major naturally occurring radionuclides ⁴⁰K, ²²⁶Ra and ²³²Th concentrations were 607 ± 34, 52 ± 6 and 40 ± 5 Bq kg^-1, respectively, comparable with normal clay samples. Similar to our previous studies a strong correlation was found between the internal structure and the radon emanation. The radon emanation coefficient decreased by ∼96% from 0.23 at 100 °C to 0.01 at 750 °C. The massic radon exhalation rate of samples fired at 750 °C reduced by 3% compared to samples fired at 100 °C. In light of the results, reusing of manganese clay as a brick additive is possible without any constraints.

A Psychometric Study of the Bayley Scales of Infant and Toddler Development in Persian Language Children

OBJECTIVE

Bayley Scales of infant & toddler development is a well-known diagnostic developmental assessment tool for children aged 1-42 months. Our aim was investigating the validity & reliability of this scale in Persian speaking children.

MATERIALS & METHODS

The method was descriptive-analytic. Translation- back translation and cultural adaptation was done. Content & face validity of translated scale was determined by experts' opinions. Overall, 403 children aged 1 to 42 months were recruited from health centers of Tehran, during years of 2013-2014 for developmental assessment in cognitive, communicative (receptive & expressive) and motor (fine & gross) domains. Reliability of scale was calculated through three methods; internal consistency using Cronbach's alpha coefficient, test-retest and interrater methods. Construct validity was calculated using factor analysis and comparison of the mean scores methods.

RESULTS

Cultural and linguistic changes were made in items of all domains especially on communication subscale. Content and face validity of the test were approved by experts' opinions. Cronbach's alpha coefficient was above 0.74 in all domains. Pearson correlation coefficient in various domains, were ≥ 0.982 in test retest method, and ≥0.993 in inter-rater method. Construct validity of the test was approved by factor analysis. Moreover, the mean scores for the different age groups were compared and statistically significant differences were observed between mean scores of different age groups, that confirms validity of the test.

CONCLUSION

The Bayley Scales of Infant and Toddler Development is a valid and reliable tool for child developmental assessment in Persian language children.

Can an anti-gravity treadmill improve stability of children with cerebral palsy?

We aimed to study the effects of an anti-gravity treadmill (AlterG) training on balance and postural stability in children with cerebral palsy (CP). AlterG training was performed 3 days/week for 8 weeks, with up to 45 minutes of training per session. The subject was evaluated before and after the 8-week training. The effects of training on the balance and postural stability was evaluated based on the Romberg test that was performed by using a posturography device. The parameters quantifying Center-of-Pressure (CoP) were calculated using different analytical approaches including power spectral density and principal components analyses. All of the key parameters including the Stabilogram, the Fast Fourier Transform (FFT) Energy, the Eigenvectors, and the Eigenvalues of CoP were modified between 14%-84%. The results indicated that the balance features were improved substantially after training. The clinical implication is that the AlterG has the potential to effectively improve postural stability in children with cerebral palsy.

Is the Bayley Scales of Infant and Toddler Developmental Screening Test, Valid and Reliable for Persian Speaking Children?

Background

Advances in perinatal and neonatal care have substantially improved the survival of at-risk infants over the past two decades.

Objectives

The purpose of this study was to assess the reliability and validity of the Bayley Scales of infant and toddler developmental Screening test in Persian-speaking children.

Methods

This was a cross-sectional prospective study of 403 children aged 1 - 42-months. The Bayley scales screening instrument, which consists of five domains (cognitive, receptive, and expressive communication and fine and gross motor items), was used to measure infants’ and toddlers’ development. The psychometric properties examined included the face and content validity of the scale, in addition to cultural and linguistic modifications to the scale and its test-retest and inter-rater reliability.

Results

An expert team changed some of the test items relating to cultural and linguistic issues. In almost all the age groups, cultural or linguistic changes were made to items in the communication domains. According to Cronbach’s alpha for internal consistency, the reliability of the cognitive scale was r = 0.79, and the reliability of the receptive scale was r = 0.76. The reliability for expressive communication, fine motor, and gross motor scales was r = 0.81, r = 0.80, and r = 0.81, respectively. The construct validity of the tests was confirmed using a factor analysis and comparison of the mean scores of the age groups. The intra- and inter-rater reliabilities of the Bayley Scales were good-to-excellent.

Conclusions

The results indicated that the Bayley Scales had a high level of reliability in the present study. Thus, the scale can be used in a Persian population.

The quality of life in boys with Duchenne muscular dystrophy

We conducted a study to evaluate the quality of life in boys with Duchenne muscular dystrophy aged 8-18 years, compared with that in matched healthy controls. A total of 85 boys with Duchenne muscular dystrophy aged 8-18 years and 136 age, sex and living place matched healthy controls were included in this study. Patients and one of their parents separately completed the 27-item Persian version of KIDSCREEN questionnaire (child and adolescent version and parent version). From the children's perspective, the quality of life in patients was found to be lower in two subclasses: "physical activities and health" (p < 0.001) and "friends" (p = 0.005). Parental estimation of their sick child's quality of life was significantly lower than children's own assessment in two subclasses: "physical activities and health" (p < 0.001) and "general mood and feelings" (p < 0.001). Our results indicate that boys with Duchenne muscular dystrophy have quite a satisfactory quality of life. A happier and more hopeful life can be promoted through increasing social support and improving the parental knowledge regarding their child's more positive life perspective.

Association of Interleukin-1 Gene Cluster and Interleukin-1 Receptor Polymorphisms With Febrile Seizures

Interleukin-1 (IL-1) plays a key role in inflammation, has an effect on a wide variety of cells, and often leads to tissue destruction. While the ratio between IL-1 and IL-1Ra could influence the development of different diseases of the central nervous system, its gene polymorphisms were investigated in a group of patients with febrile seizures. Ninety patients with febrile seizures were enrolled and compared with 140 controls. The allele and genotype frequency of single nucleotide polymorphisms within the IL-1α, β, IL-1 R and IL-1Ra gene were determined. The frequency of the IL-1Ra/C allele at position Mspa-I 11100 was decreased significantly (P= .002) and the IL-1Ra/T frequency was significantly increased in patients (P= .002). In addition, the CT genotype frequency at the same position was significantly overrepresented in controls compared to patients (P= .001). Certain alleles and genotypes in the IL-1 gene were overrepresented in patients with febrile seizures, which possibly could predispose individuals to this disease.

New study on the correlation between carbon dioxide concentration in the environment and radon monitor devices

The influence of high geogenic carbon dioxide concentrations on monitoring devices might present a significant challenge to the measurement of radon concentrations in environments with a high level of carbon dioxide concentration such as volcano sites, mofettes, caves, etc. In this study, the influence of carbon dioxide concentration on several different types of radon monitor devices - including Alpha Spectrometry (Sarad RTM 2200, EQF 3220, RAD7), Ionizing Chamber (AlphaGUARD PQ2000 PRO) and Active Cell (Active scintillation cell, Pylon 300A) - was examined to represent new aspects of radon measuring in environments with carbon dioxide. In light of the results, all measuring devices were exposed to variable conditions affected by carbon dioxide concentration, except for the AlphaGUARD, which was kept in a steady state throughout the experiment. It was observed that alpha spectroscopy devices were affected by carbon dioxide, since measured radon concentrations decreased in the presence of 70% and 90% carbon dioxide concentrations by 26.5 ± 2% and 14.5 ± 2.5% for EQF 3220, and 32 ± 2% and 35.5 ± 2% for RTM 2200. However, the ionizing chamber instrument was unaffected by changes in carbon dioxide concentration. It was determined that the RAD7 performed relatively inefficiently in the presence of carbon dioxide concentrations higher than 67% by an overall efficiency factor of approximately 0.52, confirming that it is not an admissible radon monitor instrument in environments with high carbon dioxide concentrations.

Radionuclide content of NORM by-products originating from the coal-fired power plant in Oroszlány (Hungary)

At the Thermal Power Plant in Oroszlány (Hungary), a huge amount of by-products have been produced since 1961. In this survey, coal and other by-products were examined (fly ash, bottom ash, fluidised bed bottom ash, gypsum and slurry-type ash). The natural isotopes were determined using an HPGe detector. It was found that the radionuclide content of coal was significantly lower ((226)Ra = 45.3±6.3, (232)Th = 26.3±5.7 and (40)K = 210±21 Bq kg(-1)) than that in the case of ashes other than the fluidised type. The average values of the bottom ash-deposited in the largest quantities-were three times higher than those for coal ((226)Ra = 144±18, (232)Th = 84.3±14 and (40)K = 260±25 Bq kg(-1)). In the case of fractionised bottom ash, the radionuclide content of <0.1 mm was 45 % higher than that of >1.6 mm and the massic radon exhalation of <0.1 mm was approximately four times higher than that above this range.

Single nucleotide polymorphisms of TNF-Α gene in febrile seizures

Febrile seizures (FS) is the most common seizure disorder during childhood. This study was performed in 78 patients with FS and 137 control subjects to assess polymorphisms of the TNF-α gene at positions -308 and -238, using the polymerase chain reaction and the sequence specific primers method. The highest positive allelic association that made the patients susceptible to FS was seen for TNF-α -238/G (p<0.0001). The GG genotype at TNF-α -238 was significantly higher in the patients with FS, compared to the controls (p=0.0001). Also, GA genotype at the same position was significantly lower in patients than in controls (P=0.0001). The GG haplotype had a significant positive association at TNF-α (308, 238) while GA haplotype showed a negative association (P<0.001). Our data support the idea that TNF-α single-nucleotide polymorphisms play a role in the pathogenesis of FS.

Association of TGFB, but not IL10, single nucleotide polymorphisms with febrile seizures

PURPOSE

Febrile seizures (FS) are the most common convulsive event in children. Inflammatory elements and genetics seem to have major roles in their pathogenesis.

METHODS

Seventy nine patients with FS were enrolled in this study and compared with 140 controls. Cytokine genotyping was performed, using polymerase chain reaction with sequence-specific primers. The allele and genotype frequency of three single nucleotide polymorphisms (SNPs) within the IL-10 gene at -1082, -819 and -592 positions (rs1800896, rs1800871, rs1800872), and two SNPs within the TGFB at codons 10 and 25 (rs1982037, rs1800471) were determined.

RESULTS

No significant difference was detected in allelic frequency of IL-10 at -1082, -819 and -592 positions (rs1800896, rs1800871, rs1800872) and TGFB at codon 25 (rs1800471), between patients and controls. A significant negative association was observed at the codon 10/CT (rs1982037) in the patient group (OR, 0.5; 95%CI, 0.27-0.93; p=0.026). Further, a negative association was detected in patients with simple FS at same position (OR, 0.41; 95%CI, 0.18-0.93; p=0.03), thus revealing a protective effects in FS patients. There was no significant difference in allelic and genotype frequency between simple and complex FS samples. Furthermore, haplotype analysis revealed significant difference in frequency of TGFB/TC haplotype in comparison between complex FS patients and controls (p=0.048).

CONCLUSION

Certain alleles, genotypes, and haplotypes in TGFB genes were over represented in patients with FS, which possibly could predispose individuals to this disease.

Association of IL4 single-nucleotide polymorphisms with febrile seizures

As of importance of interleukin-4 (IL-4) in inhibiting the production of proinflammatory cytokines, the IL4 gene polymorphisms were investigated in patients with febrile seizure. This association has not been investigated yet, except 1 study which has been done in Japanese population. Eighty-two patients with febrile seizure were enrolled in this study, compared with 139 controls. The allele and genotype frequency of 3 single-nucleotide polymorphisms of IL4 gene were determined. Frequency of the IL4-590/C allele in the patient group was significantly higher than in the control group (P < .0001). Frequency of the following genotypes was significantly lower in patients compared to controls: IL-4 (-590) TC (P = .0001) and IL-4 (-33) TC (P = .001). The most frequent IL-4 haplotype in the patient group was TCC (P = .00) haplotype. In contrast, frequencies of GCC (P = .01), TTT (P = .009), and TTC (P = .0007) haplotypes were significantly lower in febrile seizure patients. Certain alleles, genotypes, and haplotypes in the IL4 gene were overrepresented in Iranian patients with febrile seizure, which could predispose individuals to this disease, and further investigations in other ethnicities are required.

Calibration of CR-39-based thoron progeny device

Radon isotopes and their progenies have proven significant role in respiratory tumour formation. In most cases, the radiological effect of one of the radon isotopes (thoron) and its progenies has been neglected together with its measurement technique; however, latest surveys proved that thoron's existence is expectable in flats and in workplace in Europe. Detectors based on different track detector measurement technologies have recently spread for measuring thoron progenies; however, the calibration is not yet completely elaborated. This study deals with the calibration of the track detector measurement method suitable for measuring thoron progenies using different devices with measurement techniques capable of measuring several progenies (Pylon AB5 and WLx, Sarad EQF 3220). The calibration factor values related to the thoron progeny monitors, the measurement uncertainty, reproducibility and other parameters were found using the calibration chamber. In the future, the effects of the different parameters (aerosol distribution, etc.) will be determined.

Association of IL6 single nucleotide polymorphisms with febrile seizures

Febrile seizures (FSs) are the most common convulsive event in children. Inflammatory elements and genetics have major roles in their pathogenesis. As of the importance of interleukin-6 (IL-6) in FS, this study was performed to assess IL6 single nucleotide polymorphisms (SNPs) in a group of patients with FS. IL6 gene (-174 and +565) SNPs were studied on genomic DNAs of 90 children with FS, using PCR-SSP method. The results were compared to 139 healthy individuals. The presence of the G allele or the GG genotype at +565 position reduced risk of FS, while the A allele at +565 position of the promoter regions was a constituted risk factor for developing FS. This study could support the idea that IL6 SNPs play a role in the pathogenesis of FS.

Efficacy of intravenous immunoglobulin on the prevention of pneumonia in patients with agammaglobulinemia

Agammaglobulinemia is characterized by failure of B-cell differentiation (hypogammaglobulinemia) and increased susceptibility to bacterial infections. The present study was set up in order to evaluate the effectiveness of intravenous immunoglobulin (IVIG) treatment on the incidence of pneumonia in patients with agammaglobulinemia. We carried out chart reviews of 23 patients with agammaglobulinemia (mean age 11.5+/-5.4 years), who had been observed in a 22-year period (July 1981-January 2003) in Iran's referral center for primary immunodeficiency disorders. Nineteen of these 23 (82.5%) had been infected with pneumonia at least once before receiving the immunoglobulin treatment and 11 of them had experienced multiple episodes. During treatment with gamma-globulin - over a mean period of 6.8+/-4.1 years (range: 0.8-15.3 years) - the incidence of pneumonia requiring treatment or hospitalization decreased from 0.82 to 0.12 per patient per year (P=0.006). During IVIG replacement, hospitalization due to pneumonia decreased from 0.58 to 0.05 per patient per year (P=0.08) and the immunoglobulin G level (mean+/-S.D.) changed from 66.2+/-63.9 (range: 0-210 mg dl(-1)) to 552.4+/-199.1 (range: 136-942 mg dl(-1)) (P<0.001). Treatment of agammaglobulinemia with IVIG significantly reduced the incidence of pneumonia and hospital admission. Intensive management and regular monitoring is required in order to fully prevent severe respiratory complications.