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Road traffic injuries (RTIs) are a leading cause of death and disability worldwide. Head injury is one of the most important causes of death in various types of road users particularly among motorcycle and bicycle riders. Epidemiological pattern of head injury among victims of road traffic injury can improve road safety measures and it is an implication for any intervention. The current study was designed to map epidemiology of head injury as a result of road traffic injury in Iran. A cross-sectional study was designed among fatal road traffic injury those registered in a national database called Forensic Medicine System. Data collection was between 23 March 2011 till 23 March 2014. There were 20069 fatal road traffic injuries in the study period. Finding of study indicated that 88% of fatal RTIs were men and more than 87% of fatal road traffic injury had head injury. Close to 25% of head injured were illiterate and around 44% were at primary and secondary school. Only 10% had higher education. The most important cause of death was head injury (60%) following by multiple-trauma (28%) and internal bleeding (12%). Among them, 58% of death occurred at crash scene and 45% at pre-hospital and hospital phase. Moreover, 76% of fatal road traffic injuries were car riders and 23% of them were pedestrian. Close to 80% of victims were transported by ambulance system. There is various measures for head injury prevention in Iran that are included speed management, wearing helmet and seat belts as well as crashworthiness and improving visibility in all car riders particularly for pedestrian. Severity of injury is one important cause of death. However, regarding post crash care it is also an implication for preventable death study in Iran.

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Sustainable road transportation requires integration with economic, social and environmental aspects of transportation. It depends on term and condition of each society. In the recent decades, transportation is growing fast in Iran and Isfahan follows this scenario. The aim of this study is to study the traffic, parking road properties of Isfahan Metropolitan Area who are actively implementing TDM Plans. Isfahan is the third city in Iranian population and one of Iran metropolis Isfahan contains different types of transportation including airport, metro, intercity public transportation and railroad transport. In the case of transportation in Isfahan is currently under heavy expansion which began during the last decade. Its lengthy construction is due to concerns of possible destruction of valuable historical buildings. Outside the city, Isfahan is connected by modern highways to Tehran. The highways also service satellite cities surrounding the metropolitan area. In this paper firstly try to analyze the definition of road transportation and relationship with transportation demand management TDM. Secondly discuss briefly theory of SWOT analysis for assessment of strengths, weaknesses, opportunities and threats of road transportation.

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Occupational road traffic crashes account for a large portion of killed and seriously injured road traffic victims. Several organizations have introduced driver-training programs in order to determine a safety culture and improve the safety of employees and society, as well as to comply with insurance company requests to reduce risks. The aim of these programs is to identify and promote desirable traits and remove attitudes and behaviors that are associated with higher crash involvement. The factors, which predict involvement in road traffic collisions, were driver personality behavior attitude and personal exposure are important determinants. It does show that driver attitudes and behaviors are a predictor of crash involvement, although their impact seems lower than exposure variables such as mileage, hours driven and having an aggressive personality. Where this is impossible or unpractical, efforts to assess attitudes and behaviors associated with poor driving and to improve these through training and other interventions do appear to be validated as worthwhile. It is useful for greater effort to be taken by organizations to promote a safety culture and make use of education programs to improve driver related attitudes and behavior. Hazard perception and knowledge of the Rules do not appear to be strong predictors of accident involvement, but they are important in underpinning attitude, behavior, personality and exposure. Absolutely, where practical, the attention of safety programs should be directed to those with aggressive, impulsive and impatient personalities. The findings support that drivers with these personality types have greater involvement in road traffic collisions.

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Road traffic injuries as a man-made calamity impose great burden on poor people and needs to be addressed through social justice and end of poverty. Pointing out that around 186,300 children under the age of 18 are killed every year, and much more are injured, urgent need to work on road safety measures will be revealed. Although preventing road traffic crashes from occurring should be the main goal to be pursed, Post crash care as one of the pillars of the decade of action on road safety is important to avoid preventable death and disability, limit the severity of the injury and the suffering caused by it, and ensure the crash survivor’s best possible recovery and reintegration into society. This paper focus on pre-hospital and hospital infrastructure and capacity within the Ministry of Health & Medical Education,  importance of universal access number(UAN) and integrated dispatch center and role of laypeople to prevent death and disability in different age groups and challenges the current system face to handle children as victims of road traffic injuries.

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Posttraumatic stress disorder (PTSD) is a common response to traumatic events. A cognitive model proposed that PTSD becomes chronic when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as an outcome of excessively negative appraisals of the trauma and its sequel and a disturbance of autobiographical memory. Variations in the negative evaluations and the trauma memory are prevented by a series of problematic behavioral and cognitive strategies. The aim of present study is to examine the efficacy of Cognitive Behavioral Therapy (CBT) intervention following physical injury. A purposive sample of twenty volunteer participants who had car accidents were randomly assigned to experimental (n=10) and control group (n=10). All subjects were assessed using questionnaires designed to establish basic demographic information, levels of functioning and perceptions of the trauma and its impact. The Impact of Event Scale – Revised (IES-R) and Posttraumatic Diagnostic Scale (PDS) were also completed. Experimental group received eight sessions of Cognitive Behavior Therapy (CBT), included education about post-trauma reactions, relaxation training, exposure therapy with cognitive restructuring and instruction for self-directed graduated behavior practice. Pre-assessment was carried for both the group at the beginning of the intervention. Post-assessment was done for both the groups after completing CBT intervention. Third assessment was following up assessment that was done after post-assessment. As predicted by the cognitive model, useful treatment outcome was related to greater changes in dysfunctional posttraumatic cognitions. Some characteristics such as type of trauma, history of previous trauma, or time since the traumatic event was occurred were predicted treatment response. Furthermore, Type of Personality, level of educational and level of socioeconomic status were related to better outcome.

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To investigation of secondary traumatic stress disorder in wives of Iranian war veterans with post-traumatic stress disorder. 43 wives of Iranian war veterans who had participated in Iran-Iraq war and were diagnosed with PTSD, voluntarily entered in this study. The veterans were treated by psychiatrists of veterans’ organization, Tehran, Iran. Each woman completed a short questionnaire to determine socioeconomic data and a modified secondary traumatic questionnaire to appoint the symptoms of secondary traumatic stress. All of 43 women had some symptoms of secondary stress and 54% of   them met the diagnostic criteria for secondary traumatic stress disorder. Women who met the criteria had lower education, were married longer and had lower socioeconomic facilities than those who had not the diagnosis. A major group of wives of Iranian war veterans with PTSD suffer of secondary traumatic stress. They have to support and take care of their disabled husbands for many years. Prolonged marital life, lower level of education and poorer economic status can led to severity of stress in veterans wives. So, any treatment program offered to veterans with PTSD must consider the traumatization of their wives. It seems, despite of familial support given by “Iranian organization of war veterans”, the wives of veterans need to more attention.

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Introduction: Brain-derived neurotrophic factors (BDNF) play a role on induction and maintenance of memory and learning. The BDNF gene Val66Met polymorphism impairs expression of this protein. Due to difference between the neural principles operating during motor memory consolidation and the neural principles operating during practice (acquisition) and the effect of BDNF on both of these processes, the aim of the study was to study the effect of val66met polymorphism on acquisition and motor memory consolidation in the process of learning of throwing motor skill. Materials and Methods: We randomly selected one hundred university students of Kashan , Iran (mean age: 21.6±2.2 years). After blood sampling, extraction of genomic DNA, implementation of polymerase chain reaction, analyzing of PCR by 1.5 percent Electrophoresis Gel, and in the end sequencing by ABI PRISM 7000 Sequencing Analyzer, 46 participants were identified without val66met polymorphism, and 54 participants identified affected by the polymorphism (met-carriers). 10 participants of each genetic group (20 people) after pre-test practiced backhand baseball pitch for six sessions. After 48 and 96 hours they participated in two consecutive retention tests. Results: Our data showed no difference between met-carriers and people without the polymorphism in acquisition and the first retention test. However, met-carriers were significantly weaker than people without the polymorphism in the second retention test. Conclusion: These findings suggest that the BDNF val66met polymorphism has higher impact on motor learning in the consolidation phase than acquisition phase.

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Introduction: Glioblastoma multiforem (GBM) is the most common primary malignant brain tumor in adults and it is important to identify biomarkers that can predict its prognosis. The aim of this study was to systematically review the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in patients with GBM. Materials and Methods: PubMed, Scopus and EMBASE databases were searched until February 2016 using the following search strategy: neutrophil* AND lymphocyte* AND (glioma OR glioblastoma OR astrocytoma).  Two authors independently screened the retrieved articles to find all the studies that evaluated the prognostic value of NLR in GBM patients. Data extraction and quality assessment for the included studies was performed independently by two authors. Studies using Cox proportional hazards model to compare overall survival (OS) in patients with low and high values of NLR were included in the meta-analysis. Results: Six studies and 827 patients were included in the systematic review. Progression-free survival (PFS) was the primary outcome in two studies. One study identified lower values of NLR as a significant predictor of better PFS, but the other one showed the opposite effect. Performing a meta-analysis was not possible on these two studies. The primary outcome in six studies was OS, four of which reported NLR as a significant prognostic marker. Pooled univariate hazard ratios (HRs) of two studies for predicting OS was 1.903 (95% CI: 1.420-2.551) and pooled multivariate HRs of four studies for predicting OS was 1.564 (95% CI: 1.208-2.024). Negligible heterogeneity was observed between studies. Conclusion: Overall survival of GBM patients can be predicted using NLR, but its application as a predictive marker of PFS is uncertain.

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Traumatic brain injury (TBI) is a common reason of brain tissue loss as a result of tumors, accidents, and surgeries. Renewal of the brain parenchyma is restricted by many reasons such as inimical substances produced as the result of trauma and also inflammatory responses. A strong cascade of inflammatory responses begins as a result of TBI which include recalling peripheral leukocytes into the damaged site of brain. Brain tissue engineering is a new and promising treatment for TBI which includes designing an artificial extracellular matrix (scaffold) and stem cell transplantation into the damaged site of the brain. Tissue scaffolds moderate inflammatory cascades of reactions in tissue around the injury and reduces scar formation as a result of suppressing the amount of glial cells and leukocytes. There are many substances considered as scaffolds .One of the promising and desirable scaffolds is RADA16-I because it induces supportive migration of microglia and astrocytes and also can carry stem cells. Furthermore attaching trophic motifs to the RADA16 scaffold is an effective way for inducing endogenous gliogenesis and neurogenesis. Different type of self-assembling peptide with different peptide sequences like RADA16- IKVAV (Laminin) and RADA16-BMHP (bone marrow homing peptide) are designed. Stem cells showed high viability, differentiation, and important improvement on cell spreading and adhesion on these scaffolds. Although recent studies focused on tissue engineering, using peptide based scaffolds, conjugated with bioactive motifs, still specific attention should be paid to role of the all kinds of scaffold and attaching bioactive motifs in controlling inflammatory reactions to determine their efficacy and finding the best treatment of TBI.

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Traumatic brain injury (TBI) is physical damage to the brain structure which has a high global rate of mortality and morbidity. TBI can cause intense inflammatory response due to accumulation of leukocytes in cerebral matrix and activation of microglia. Microglia can differentiate into M1 macrophages or M2 macrophages following the changes in biochemical properties of brain tissue. M1 sub type release cytodestructive substances that are toxic to neurons but M2 cells are anti-inflammatory neuroprotective subtype. As the time passes after TBI, the amount of M1 cells begin to increase and fraction of M1:M2 rises. Results show that use of Stem Cells can modulate inflammatory responses of immune system. Transplantation of stem cells into injury site increases M2/M1 ratio as a result of inducing M1 macrophages apoptosis. Different types of stem cells have different mechanisms for anti-inflammatory responses. Even exosomes derived from stem cell can affect the functional recovery and reduce neuroinflammation after TBI. Human Mesenchymal stem cells (hMSCs) are most used in TBI cases due to their immunomodulatory impact and therapeutic effects on recovery of motor and cognitive function. Although many studies conducted to determine effects of hMSCs on TBI prognosis, further investigations are required to support clinical use of hMSCs. Specific attention should be paid to role of growth factors and motifs in suppressing inflammatory responses. Future studies are needed to determine the efficacy of combined therapy. 

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Introduction: Transcranial Direct Current Stimulation (tDCS) can improve or impair the function of the brain. This has turned tDCS into a tool that can be used for evaluation of hemispheric specialization in motor programming and final position accuracy, as components of motor control and learning. Materials and Methods: Two different studies were designed. 53 male students (21.34±1.61 years) and 43 male students (20.442±1.578 years) were participated in the first and second studies, respectively. Participants were randomly assigned into four groups. C3 /C4 and F3/F4 areas were stimulated with the 2mA current in the first and second studies, respectively. The Repeated Measure test was used to analyze data. Results: In the first experiment, left M1 group (left anode/right cathode stimulation) significantly improved motor programming compared to the other groups. In the second experiment, the right dorsolateral prefrontal cortex group (right cathode/left anode) significantly decreased final position accuracy compared to the other groups. Conclusion: Our data suggested that the left hemisphere is specialized for motor programming whereas the right hemisphere is specialized for final position accuracy. These results are interpretable with hybrid motor control hypothesis.

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Traumatic brain injury (TBI) is one of the main causes of mortality and morbidity worldwide. Despite extensive investigations over the past few decades, no effective therapies exist to improve the brain function in patients with TBI. Neural tissue engineering is an attractive therapeutic approach to restore the brain structure and function of damaged tissue. Bioactive motif of Stromal cell-derived factor-1 (SDF-1) induces neurogenesis by increasing the migration and proliferation of endogenous neural progenitor cells (NPCs) in the lesion sites. We designed the novel scaffold with SDF1 and RADA16. The Aim of this study is to determine in vitro effects of SDF scaffold on neural stem cells behavior including migration, attachment, and differentiation. Neural stem cells were isolated from the hippocampus and subventricular zone of the lateral ventricle of 17-days rat fetus. In this study, Apoptosis, cytotoxicity, proliferation, neurite outgrowth, and differentiation were assessed. Migration, attachment and differentiation of stem cells significantly increased in the SDF scaffold. Our results showed no significant difference between apoptosis, survival and proliferation of cells in SDF and RADA16-IKVAV scaffolds. Although SDF scaffold increased Migration, and attachment of stem cells in vitro, in vivo studies should be conducted to determine the features of SDF scaffold in the brain tissue.

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Introduction: Several investigations on the mechanism of motor control and learning leads to multiple theories in this field. The purpose of this study was to examine these theories and integrate them into a conceptual model for a better understanding of motor control and learning. Conclusion: A series of motor control studies have demonstrated that many movements, especially reaching movement that requires high final position accuracy, consist of two acceleration and deceleration phases. Review of some motor control theories show that they are consist of two parts so that each one controls a particular part of the reaching movement by different mechanisms. Integrating these theories, based on the neural structures involved at each stage, provides a comprehensive understanding of how to control the movement. We suggest conceptual integrated model.

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Introduction: Multiple Sclerosis (MS) is a chronic, debilitating nervous system disease, which damages the myelin of the central nervous system. The purpose of this study was to investigate the effect of 8 weeks Pilates training and direct transcranial stimulation (tDCS) on motor and cognitive functions in women with MS. Materials and Methods: The present study was a semi-experimental one in which the women with MS in Tabriz, Iran were selected and 36 of them were selected as subjects with age range of 20-40 years. They were randomly divided into four groups; Pilates + tDCS, Pilates + Placebo, tDCS, and control groups. The Pilates and tDCS training program consisted of 8 weeks (three sessions/60 minutes) Pilates training plus 20 minutes of electrical stimulation. Results: The results have shown that after exercise and electrical stimulation, the tDCS + exercise and exercise + placebo groups improved motor functions (general endurance, general speed, flexibility, balance). The results also revealed that among the measured cognitive factors, there was a significant improvement in the cognitive flexibility in the tDCS + exercise, the exercise + placebo, and the tDCS groups. Conclusion: Considering the combined effects of exercise with tDCS on motor functions, it seems that the use of these two techniques is helpful in improving motor functions in MS patients. However, this combined therapy can not improve cognitive functions of patients with MS.