Determinants of Neonatal, Infant and Child Mortalities in Iran: A Systematic Review

Background

Children mortality is considered as one of the main indicators of population development and health, while most of the children's deaths are preventable. This study systematically reviewed the determinants of children mortality in Iran.

Methods

This systematic review was conducted to summarize all the factors associated with children mortality in three age groups; Neonate (0-28 d), Infant (28 d-1 yr old) and children (<5 yr old), based on the PRISMA guideline. Many of the electronic international and national databases, in addition to hand searching of reference of selected articles, grey literature, formal and informal reports and government documents were screened to identify potential records up to Jan 2022. We included all studies that identified determinants of child mortality in any province of Iran or the whole country, without any restriction.

Results

Overall, 32 studies were included, published between 2000 and 2022, of which 23 were cross-sectional and 15 published in Farsi language. The associations between several risk factors (n=69) and the child mortality were examined. Among the identified factors, 'birth weight', 'mother's literacy', 'socioeconomic status', 'delivery type', 'gestational age', 'pregnancy interval', 'immaturity', 'type of nutrition', and 'stillbirth' were the most important mentioned determinants of child mortality in Iran.

Conclusion

Appropriate interventions and policies should be developed and implemented in Iran, addressing the main identified associated factors, resulting from this review study, with the aim of minimizing preventable child deaths, based on their age categories.

Effect of Monovalent Copper Oxide and Potentiated Zinc Oxide on Growth Performance and Gut Morphology of Broiler Chickens Challenged with Coccidiosis

An experiment was conducted to evaluate the effect of copper oxide (Cu₂O) and potentiated zinc oxide (ZnO) on performance, intestinal morphology, oocyst excretion, coccidial lesion scores, and antioxidant properties in broilers during an Eimeria spp. challenge. A total of 288 1-day-old male broiler chickens (Ross 308) were divided into 18 treatments. Treatments included three levels of Cu (0, 15, or 150 mg/kg) from Cu₂O and three levels of Zn (0, 80, or 160 mg/kg) from potentiated ZnO which were added to the basal diet and fed to broilers with or without challenge, using a completely randomized design in a factorial arrangement for 42 days. Live body weight, feed intake, mortality, and the cause of death were recorded weekly and histomorphology of jejunum was measured at the end of the experiment. Results showed that birds fed Cu and Zn linearly decreased (P < 0.0001) oocyst shedding. The number of excreted oocysts was reduced eight times in broilers fed a diet containing 150 mg/kg copper from Cu₂O and 160 mg/kg zinc from potentiated ZnO, compared to the infected group without Cu and Zn supplementation (P < 0.0001). Microscopic features of both non-challenged and challenged broiler jejunum revealed significant improvement along with increased Cu₂O and potentiated ZnO doses. Supplementation of Cu₂O and potentiated ZnO decreased the jejunum structure damages and intestinal lesion score (P < 0.002). Eimeria caused a decrease (P < 0.006) in total antioxidant capacity. Superoxide dismutase increased by dietary zinc supplementation (P < 0.05). Results suggested that a combination of Cu₂O and potentiated ZnO could exhibit efficient anticoccidial activity.

Ph3P-mediated decarboxylative ring-opening of maleic anhydride by thiolic compounds: formation of two carbon-sulfur bonds

In this study, a simple and efficient method for the formation of carbon-sulfur bonds is described. In this process, ring opening of maleic anhydride by thiols or disulfides and triphenylphosphine led to the formation of sulfide products via formation of two carbon-sulfur bonds.

The relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine patients: the mediating role of pain self-efficacy

BACKGROUND

Migraine is a neurological disease that has several physical and psychological complications, which is characterized by disability and impaired quality of life.

AIMS

The aim of this study was to explore the mediating role of pain self-efficacy in the relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine sufferers. The relationship between these factors with quality of life (QOL) was not fully explored in migraine patients.

METHOD

This study was a correlational study of structural equations. Therefore, 300 patients with migraine who referred to one of the specialized neurological treatment centers in Zanjan in 2021 were recruited based on the inclusion criteria. Patients also completed the World Health Organization Quality of Life Scale (WHOQOL-BREF), Meaning in Life Questionnaire, Multidimensional Scale of Perceived Social Support, Spiritual Well-Being Scale, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire. Finally, the hypotheses were then analyzed with correlation coefficient and path analysis method by using SPSS-26 and LISREL-10.2 programs.

RESULTS

The results of the present study showed that pain self-efficacy has a mediating role in the relationship between meaning of life and quality of life (B = 0.015), perceived social support with quality of life (B = 0.022), spiritual well-being with quality of life (B = 0.021), as well as pain catastrophizing with quality of life (B = - 0.015).

CONCLUSION

According to the results of this study, by considering the role of self-efficacy of pain, it is possible to develop the programs to strengthen and improve the meaning of life, perceived social support, spiritual well-being and also reduce pain catastrophizing, in order to improve the quality of life of patients with migraine.

POS0198 COVID-19 OUTCOMES IN PATIENTS WITH DERMATOMYOSITIS: A REGISTRY-BASED COHORT ANALYSIS

Background

Dermatomyositis (DM) patients have fewer risks of COVID-19 infection compared to the general population, however, certain subgroups with DM have worse outcomes. Men. African Americans, those with interstitial lung disease, exhibited higher risks of severe COVID-19. DMARD and glucocorticoid use was associated with frequent hospitalisations and severe sepsis.

Objectives

Rheumatic diseases (RDs) like DM, are previously known to be vulnerable towards various types of infections due to its aggressive activity mandating high dose immunosuppressive therapy. The severity of COVID-19 in RDs is limited in literature due to the heterogeneous nature of the condition. Therefore, specific details on mortality is essential to navigate any precautions required in the treatment.

Methods

Retrospective data of individuals with DM and COVID-19 and the general population with COVID-19 between January 2020 to August 2020 was retrieved from the TriNetX database. A one-to-one matched COVID-19 positive control was selected using propensity score (PS) matching. We assessed COVID-19 outcomes such as mortality, hospitalisation, ICU admission, severe COVID-19, mechanical ventilation (MV), acute kidney injury (AKI), venous thromboembolism (VTE), ischemic stroke, acute respiratory distress syndrome (ARDS), renal replacement therapy (RRT) and sepsis. Subgroup analyses included gender, race, ILD, cancer patients, disease-modifying rheumatic drugs (DMARDs) use, and glucocorticoids (GC) use (Figure 1).

Figure 1.

Overview of study

Results

We identified 5,574 DM patients with COVID-19, and 5,574 general population with COVID-19 (controls). DM with COVID-19 had a lower risk of mortality in comparison to controls [RR 0.76], hospitalisation [RR 0.8], severe COVID-19 [RR 0.76], AKI [RR 0.83], and sepsis [RR 0.73]. Males and African Americans were more likely to develop AKI [RR 1.35, 1.65], while African Americans had higher odds for severe COVID-19 [RR 1.62] and VTE [RR 1.54]. DM with ILD group also experienced higher odds for severe COVID-19 infection [RR 1.64], and VTE [RR 2.06] (Figure 1).

DM patients receiving DMARDs and glucocorticoids had higher odds for hospitalisation [RR 1.46, 2.12], and sepsis [RR 3.25] Subgroup analysis of neoplasms amongst DM patients with COVID-19 was inadequate for meaningful comparison (Figure 1).

Conclusion

DM patients are protected for certain aspects of COVID-19 disease, including severe COVID-19, hospitalization, and mortality. The African American race, male gender, ILD, DMARDS and glucocorticoid users, are associated with poor outcomes.

Disclosure of Interests

Latika Gupta: None declared, Haig Pakhchanian: None declared, Hiba Khan: None declared, Rahul Raiker: None declared, Maryam Abbasi: None declared, Charles DeYoung: None declared, Sinan Kardes Grant/research support from: SK has received congress travel, accommodation, and participation fee support (12th Anatolian Rheumatology Days) from Abbvie, Sakir Ahmed Speakers bureau: SA has received honorarium as speaker for Pfizer, Chengappa Kavadichanda: None declared, Parikshit Sen: None declared, Rohit Aggarwal Consultant of: RA has/had a consultancy relationship with and/or has received research funding from the following companies-Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, and Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, Roivant., Grant/research support from: RA has/had a consultancy relationship with and/or has received research funding from the following companies-Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, and Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, Roivant.

The Effects of Nano and Micro Particle Size of Zinc Oxide on Performance, Fertility, Hatchability, and Egg Quality Characteristics in Laying Japanese Quail

The current trial was conducted by using the 288 Japanese quails to evaluate the effects of a zinc-deficient diet supplemented with nano and micro zinc oxide on performance, fertility, hatchability, and egg quality characteristics. In this experiment, birds were randomly allocated to 9 dietary treatments includes diets supplemented with nano or micro particles of zinc oxide (amount of ZnO supplement for each treatment) to supply 49, 74, 99, and 124 mg zinc per kilogram of diet in a factorial arrangement (2 × 4) and a control non supplemented diet (24 mg/kg) with four replicates of eight birds (six females and two males) in each pen. Birds were fed the experimental diets from 47 to 75 days of age and had free access to water and feed during the experimental period. Results showed that Zn supplementation, regardless of particle size, improved the eggshell thickness (P < 0.01). A significant (P < 0.05) interaction was observed between zinc level and ZnO particle size for Shell breaking strength. Quails fed diets supplement with ZnO showed significantly higher egg weight and eggshell surface (P < 0.05) as compared with birds fed a non-supplemented control diet. Results obtained here showed that supplementation of nano ZnO enhanced fertility considerably. Application of non-linear quadratic models showed that the maximum egg production percentage was achieved when 67 or 72 mg/kg of dietary zinc was supplied from nano and micro ZnO, respectively. This result indicated that nano ZnO could reduce the zinc requirement in laying Japanese quail.

COVID-19 Vaccine Triggered Rejection in Lung Transplant Recipients: A Case Series

Purpose

Methods

Results

Conclusion

The United States Experience of Lung Transplantation in Recipients with COVID-19 Fibrosis: A UNOS/OPTN Analysis

Purpose

Coronavirus Disease 19 (COVID-19) is a novel cause of end-stage fibrotic lung disease. Data has been limited to case series and single center reports with regards to outcomes in this unique cohort of patients. We sought to investigate the largest experience to date in patients with COVID-19 fibrosis (CVF) who underwent lung transplantation.

Methods

The United Network for Organ Sharing (UNOS) database was queried for all adult patients (≥18 years old) who underwent isolated lung transplantation between 2018 and July 2021. Recipients diagnosed with CVF were identified and compared to those with idiopathic pulmonary fibrosis (IPF). The IPF cohort included recipients from 2018, in the pre-COVID era. Baseline demographics, perioperative factors, and 30-day outcomes were examined.

Results

A total of 931 recipients were included in this study, 868 (93.2%) and 63 (6.8%) were IPF and CVF, respectively. IPF recipients were on average older (65 vs. 56 years, p<0.001), white race (83% vs. 51%, p<0.001), and less likely to be male (73% vs. 86%, p=0.04). BMI was similar between the IPF and CVF, 27.6 and 27.2 kg/m², as was the mean PAP 24 and 21 mmHg. The CVF cohort had lower predicted FVC (32% vs. 47%, p=0.01), and had less tobacco use (36% vs 61%, p<0.001). Mean creatinine level was clinically similar, though statistically higher in the IPF cohort, (0.83 vs 0.64, p<0.001). CVF recipients were on the waitlist for a shorter median duration (10 vs 32 days, p<0.001) with a higher LAS (85 vs 41, p<0.001). Notably, more CVF recipient were be on ECMO at time of listing (29% vs 2%, p<0.001) and require ventilatory support (27% vs. 2%, p<0.001). CVF recipients were more likely to receive a double lung transplantation compared to IPF (83% vs 64%, p=0.002), with similar ischemia times, 5.5 vs 5.1 hrs (p=0.17). Mortality at 30 days was comparable between CVF and IPF (7.0% vs. 2.3%, p=0.09), though 20 patients in the CVF cohort had missing data.

Conclusion

Patients with end-stage lung disease secondary to CVF are higher acuity, and more likely to require ECMO and ventilatory support as a bridge to lung transplantation. Early mortality, while comparable to non-COVID related fibrotic lung disease, remains almost 3 times higher with CVF. In the era of publicly reported survival outcomes, the transplant community may need to reconsider how we approach this new and devastating diagnosis of CVF.

Postprocedural Thrombosis following Endovascular Treatment of Intracranial Aneurysm with Flow Diverters or Coiling: A Histologic Study

Endovascular treatment of aneurysms with flow diverters or coiling is sometimes complicated by intraprocedural or postprocedural thrombosis along or within the devices. Thrombus composition and structure associated with such complications may provide insights into mechanisms of thrombus formation and clinical strategies to remove the thrombus. We present a retrospective histopathologic study of 4 patients who underwent mechanical thrombectomy due to acute occlusion of either implanted flow diverter devices or along coils during the treatment of intracranial aneurysm.

Arterial Collapse during Thrombectomy for Stroke: Clinical Evidence and Experimental Findings in Human Brains and In Vivo Models

BACKGROUND AND PURPOSE

Aspiration thrombectomy has become a preferred approach to recanalize large-vessel occlusion in stroke with a growing trend toward using larger-bore catheters and stronger vacuum pumps. However, the mechanical response of the delicate cerebral arteries to aspiration force has not been evaluated. Here, we provide preclinical and clinical evidence of intracranial arterial collapse in aspiration thrombectomy.

MATERIALS AND METHODS

We presented a clinical case of arterial collapse with previously implanted flow diverters. We then evaluated the effect of vacuum with conventional aspiration catheters (with and without stent retrievers) in a rabbit model (n = 3) using fluoroscopy and intravascular optical coherence tomography. Then, in a validated human cadaveric brain model, we conducted 168 tests of direct aspiration thrombectomy following an experimental design modifying the catheter inner diameter (0.064 inch, 0.068 inch, and 0.070 inch), cerebral perfusion pressures (mean around 60 and 90 mm Hg), and anterior-versus-posterior circulation. Arterial wall response was recorded and graded via direct transluminal observation.

RESULTS

Arterial collapse was observed in both the patient and preclinical experimental models. In the human brain model, arterial collapse was observed in 98% of cases in the M2 and in all the cases with complete proximal flow arrest. A larger bore size of the aspiration catheter, a lower cerebral perfusion pressure, and the posterior circulation in comparison with the anterior circulation were associated with a higher probability of arterial collapse.

CONCLUSIONS

Arterial collapse does occur during aspiration thrombectomy and is more likely to happen with larger catheters, lower perfusion pressure, and smaller arteries.

C(sp2)–H bond sulfenylation of aminouracils and enaminones from aryl halides

Direct thioarylation of aminouracils and enaminones from aryl iodides and bromides using potassium cyanodithioformate as an odorless and stable source of sulfur.

An experimental approach to the influence of partial rebar corrosion and concrete degradation on behavior of FRP-strengthened RC beams

Human factors are one of the main reasons for structural damage as they decrease the bearing capacity and also lead to an inaccurate estimation of the structure. Previous studies show that the use of CFRP in the damaged structures can significantly increase their bending and shear capacity. This study examines the capacity and cracks distribution in eight RC (reinforced concrete) beams (210 × 250 × 250 cm), each of which was rehabilitated with seven CFRP (carbon fiber-reinforced polymer) strips using the strip method. Each beam, except for the control specimen, experiences different types of concrete and rebar damages, which are finally compared with those of the control specimen. The results indicated that rebar damage in all the beams was significant and the effects of concrete damage were minimized by CFRP strips. Moreover, the force–displacement diagrams indicate the greatest force for the control specimen. Other specimens reached up to 80% of the force experienced by the control specimen. Finally, the parametric study showed that the influence of the crack width on decreasing the bearing capacity was more significant compared with the other parameters.

Iatrogenic Foreign Materials Associated with Retrieved Clot Tissue via Mechanical Thrombectomy

BACKGROUND AND PURPOSE

Hydrophilic polymers and polytetrafluoroethylene liners, commonly used in the construction of endovascular devices, occasionally separate from devices with subsequent embolization. We determined the frequency of such materials in thrombus specimens retrieved by mechanical thrombectomy in patients with stroke.

MATERIALS AND METHODS

We retrospectively reviewed H&E-stained thrombus sections for presence and types of foreign materials. We identified 4 types of foreign materials-Type I: material was light green with refraction and had a homogeneous texture; type II: material was light gray and/or dark gray, thin, and loose or attenuated in texture; type III: material was light green with refraction, solitary in texture, irregular in shape, and was often associated with round or oval bubblelike particles and/or diffuse black particles; and type IV: material had homogeneous texture and was light pink or red. In addition, polymer materials from different layers of used mechanical thrombectomy catheters were compared with the foreign materials found in thrombus specimens.

RESULTS

A total of 101 thrombi were evaluated. Foreign materials were found in 53 (52.5%) thrombus samples. The most common type was type I (92%), followed by type II (30%). The histopathologic features of the polymer materials from mechanical thrombectomy catheters were similar to the foreign materials found in thrombus specimens. The inner polytetrafluoroethylene liner and coating layer of catheters resembled type I and type II of the foreign materials, respectively.

CONCLUSIONS

Foreign polymer materials are present in approximately half of retrieved thrombi, most commonly polytetrafluoroethylene from catheter liners and less from hydrophilic coatings.

Novel Human Acute Ischemic Stroke Blood Clot Analogs for In Vitro Thrombectomy Testing

BACKGROUND AND PURPOSE

Previous studies have successfully created blood clot analogs for in vitro endovascular device testing using animal blood of various species. Blood components vary greatly among species; therefore, creating clot analogs from human blood is likely a more accurate representation of thrombi formed in the human vasculature.

MATERIALS AND METHODS

Following approval from the Mayo Clinic institutional review board, human whole-blood and platelet donations were obtained from the blood transfusion service. Twelve clot analogs were created by combining different ratios of red blood cells + buffy coat, plasma, and platelets. Thrombin and calcium chloride were added to stimulate coagulation. Clot composition was assessed using histologic and immunohistochemical staining. To assess the similarities of mechanical properties to patient clots, 3 types of clot analogs (soft, elastic, and stiff) were selected for in vitro thrombectomy testing.

RESULTS

The range of histopathologic compositions produced is representative of clots removed during thrombectomy procedures. The red blood cell composition ranged from 8.9% to 91.4%, and fibrin composition ranged from 3.1% to 53.4%. Platelets (CD42b) and von Willebrand Factor ranged from 0.5% to 47.1% and 1.0% to 63.4%, respectively. The soft clots had the highest first-pass effect and successful revascularization rates followed by the elastic and stiff clots. Distal embolization events were observed when clot ingestion could not be achieved, requiring device pullback. The incidence rate of distal embolization was the highest for the stiff clots due to the weak clot/device integration.

CONCLUSIONS

Red blood cell-rich, fibrin-rich, and platelet-rich clot analogs that mimic clots retrieved from patients with acute ischemic stroke were created in vitro. Differing retrieval outcomes were confirmed using in vitro thrombectomy testing in a subset of clots.

Fractal signatures of the COVID-19 spread

Recent quantitative approaches for studying several aspects of urban life and infrastructure have shown that scale properties allow the understanding of many features of urban infrastructure and of human activity in cities. In this paper, we show that COVID-19 virus contamination follows a similar pattern in different regions of the world. The superlinear power-law behavior for the number of contamination cases as a function of the city population, with exponent β of the order of 1.15 is always obtained. Due to the strong indication that scaling is a determinant feature of covid-19 spread, we propose an epidemiological model that embodies a fractal structure, allowing a more detailed description of the observed data about the virus spread in different countries and regions. The hypothesis that fractal structures can be formed in cities as well as in larger networks is tested, indicating that indeed self-similarity may be found in networks connecting several cities.

Relationship Between Attitude Toward Spirituality and Attitude and Performance of Spiritual Care Among Nurse

Introduction

Although spiritual care is commonly regarded as a nursing task, in practice, it is often provided inadequately.

Objective

The purpose of this study was to examine relationship between attitude toward spirituality and the attitude and performance of spiritual care among nurses who working in hospitals of Iran university of medical sciences.

Methods

This was a correlative-descriptive study. Spiritual Perspective Scale (SPS) and Nursing Spiritual Care Perspective Scale (NSCPS) were used to gather the data. A number of 166 nurses participated in this study.

Results

Findings showed that of nurses’ spirituality attitude score was 4.98 ± 1.1 which indicated high attitude toward spirituality. The total average of nurses’ attitude about spiritual practices was 3.67 ± 0.51, which signified the positive attitude of nurses about spiritual practices. Findings revealed that positive spiritual attitude had a significant correlation with 6 out of 12 expressed spiritual interventions. In addition, spiritual attitude generally had a significant positive correlation with spiritual interventions. The positive spiritual attitude had a significant correlation with only 3 items out of 11 for the attitude toward spiritual practices. There was no correlation between spiritual attitude and the attitude toward spiritual practices.

Conclusion

In spite of the positive attitude, nurses did not perform half of the spiritual interventions which most of them were in line with fulfilling the patients’ religious needs. Establishment of in-service education program regarding spiritual care practice by role play and modeling methods are recommended.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Socioeconomic inequalities in metastasis, recurrence, stage and grade of breast cancer: a hospital-based retrospective cohort study

Introduction

This study aims to estimate the Socio-Economic Status (SES) inequality on the metastasis, recurrence, stage and grade in Breast Cancer (BC).

Methods

This retrospective cohort study conducted on 411 BC patients in Arak, Iran. Asset-based questionnaire used to estimate the household SES. For calculate of SES inequality was used from Concentration Index (C). Moreover for investigate the association between recurrence and metastasis with other variables were used from multilevel logistic regression and analysis of variance were used to investigate the relationship between SES and other variables. The data were analyzed with Stata (v.13) software.

Results

Results of analysis of variance showed statistical significant relationship between SES with, insurance, surgery, grade, stage, recurrence and metastasis (p-value < 0.05). Moreover the Odds Ratio (OR) were significant of recurrence with age, academic level of education, supplementary insurance history of BC in first-degree relatives, stage and grade, also, metastasis with age of > 80 years, insurance, supplementary insurance, history of BC in first-degree relatives, chemotherapy, radiotherapy, stage and grade four. The total C index obtained 0.015 (0.002, 0.026), 0.011 (0.003, 0.031), – 0.014 (– 0.034, – 0.001) and – 0.042 (– 0.061, – 0.002) for metastasis, recurrence, stage and grade of BC respectively.

Conclusions

Our results showed evidence of inequality in the metastasis, recurrence, stage and grade in BC patients.

Improved diagnostic accuracy for myocardial perfusion imaging using artificial neural networks on different input variables including clinical and quantification data

OBJECTIVE

Diagnostic accuracy of myocardial perfusion imaging (MPI) is not optimal to predict the result of angiography. The current study aimed at investigating the application of artificial neural network (ANN) to integrate the clinical data with the result and quantification of MPI.

METHODS

Out of 923 patients with MPI, 93 who underwent angiography were recruited. The clinical data including the cardiac risk factors were collected and the results of MPI and coronary angiography were recorded. The quantification of MPI polar plots (i.e. the counts of 20 segments of each stress and rest polar plots) and the Gensini score of angiographies were calculated. Feed-forward ANN was designed integrating clinical and quantification data to predict the result of angiography (normal vs. abnormal), non-obstructive or obstructive coronary artery disease (CAD), and Gensini score (≥10 and <10). The ANNs were designed to predict the results of angiography using different combinations of data as follows: reports of MPI, the counts of 40 segments of stress and rest polar plots, and the count of these 40 segments in addition to age, gender, and the number of risk factors. The diagnostic performance of MPI with different ANNs was compared.

RESULTS

The accuracy of MPI to predict the result of angiography, obstructive CAD, and Gensini score increased from 81.7% to 92.9%, 65.0% to 85.7%, and 50.5% to 92.9%, respectively by ANN using counts and clinical risk factors.

CONCLUSION

The diagnostic accuracy of MPI could be improved by ANN, using clinical and quantification data.

Low Temperature Oxidation of Cyclohexane: Uncertainty of Important Thermo-Chemical Properties

The study of the standard formation enthalpy, entropy, and heat capacity for key species relevant to the low-temperature combustion of cyclohexane has been performed by applying the group additivity method of Benson. The properties of 18 Benson groups (8 of them for the first time), and 10 ring correction factors for cyclic species were estimated through different empirical and semi-empirical methods. The method validation proceeded through comparison of predicted values for certain number of newly estimated groups and available literature data derived from quantum chemistry estimations. Further validations of the estimated properties of groups have been provided by comparing estimated properties of test species with data in literature and kinetic databases. Also the standard deviation between prediction and reported values has been evaluated for each validation case. A similar approach has been applied for validation of the estimated ring correction groups. For selected well-studied cyclic molecules the predicted values and the literature data have been compared with each other, and the standard deviations have been also reported. The evaluated properties of the cyclohexane relevant species were also compared with similar ones available in other kinetic models and in databases. At the end the estimated properties have been presented in a tabulated form of NASA polynomial coefficients with extrapolation up to 3500 K.

An ethical framework for evaluation of public health plans: a systematic process for legitimate and fair decision-making

OBJECTIVES

Given the increasing threats of communicable and non-communicable diseases, it is necessary for policy-makers and public health (PH) professionals to address ethical issues in health policies and plans. This study aimed to develop a practical framework for the ethical evaluation of PH programs.

STUDY DESIGN

A multidisciplinary team developed an ethical framework to evaluate PH plans from 2015 to 2017.

METHODS

In this study, the multi-method approach was used. First, a list of moral norms in PH policy and practice was drafted and completed in two interactive sessions. Then, the Delphi method was used for consensus about the structural components to be adopted in the framework. After developing the framework, its efficiency was assessed by evaluating Iran's Fourth Strategic Plan for HIV/AIDS Prevention and Control.

RESULTS

The framework was developed in the following three sections: (i) determination of the general moral norms in PH practice and policy; (ii) five steps of evaluation; and (iii) a procedural evaluation step to ensure fair decision-making. The ratio of the ethical points of the PH plan increased by 46% after implementation of the framework, and the frequency of ethical points increased significantly after applying the framework (P = 0.001).

CONCLUSION

The application of the framework for the ethical evaluation of various PH programs ensures a comprehensive and scientific-deliberative decision-making process, while also contributing to the development of the framework.

Uncertainty Quantification in Chemical Modeling

A module of PrIMe automated data-centric infrastructure, Bound-to-Bound Data Collaboration (B2BDC), was used for the analysis of systematic uncertainty and data consistency of the H2/CO reaction model (73/17). In order to achieve this purpose, a dataset of 167 experimental targets (ignition delay time and laminar flame speed) and 55 active model parameters (pre-exponent factors in the Arrhenius form of the reaction rate coefficients) was constructed. Consistency analysis of experimental data from the composed dataset revealed disagreement between models and data. Two consistency measures were applied to identify the quality of experimental targets (Quantities of Interest, QoI): scalar consistency measure, which quantifies the tightening index of the constraints while still ensuring the existence of a set of the model parameter values whose associated modeling output predicts the experimental QoIs within the uncertainty bounds; and a newly-developed method of computing the vector consistency measure (VCM), which determines the minimal bound changes for QoIs initially identified as inconsistent, each bound by its own extent, while still ensuring the existence of a set of the model parameter values whose associated modeling output predicts the experimental QoIs within the uncertainty bounds. The consistency analysis suggested that elimination of 45 experimental targets, 8 of which were self- inconsistent, would lead to a consistent dataset. After that the feasible parameter set was constructed through decrease uncertainty parameters for several reaction rate coefficients. This dataset was subjected for the B2BDC framework model optimization and analysis on. Forth methods of parameter optimization were applied, including those unique in the B2BDC framework. The optimized models showed improved agreement with experimental values, as compared to the initially-assembled model. Moreover, predictions for experiments not included in the initial dataset were investigated. The results demonstrate benefits of applying the B2BDC methodology for development of predictive kinetic models.

Medical radiation workers' knowledge, attitude, and practice to protect themselves against ionizing radiation in Tehran Province, Iran

BACKGROUND

Medical radiation workers are potentially at a risk of unwanted ionizing radiation exposures. This study assessed the radiation protection knowledge, attitude, and practice (RP-KAP) of health-care workers who are occupationally exposed to radiation regarding protecting themselves from radiation.

MATERIALS AND METHODS

This study was cross-sectional in design and was carried out in 16 hospitals affiliated to the Tehran University of Medical Sciences between May and September 2014. Total health-care workers who were occupationally exposed to radiation comprising 670 individuals were included in the study based on census sampling method. In total, 413 individuals consented to complete an anonymous 32-item questionnaire comprising single best choice questions with a numerical value assigned to each correct answer. Each set of RP-KAP questions was scored and categorized as poor, medium, and good. The effect of independent variables for prediction of RP-KAP was explored using linear regression analyses.

RESULTS

A significant number of participants had poor RP-knowledge (78.9%), RP-attitude (70.7%), and RP-practice (32.4%). Based on linear regression analyses, it was found that field of study (β = 0.1, P = 0.001), marital status (β = -0.14, P = 0.01), and level of education (β = 0.2, P < 0.001) were the predictors of higher RP-knowledge. In-service RP-training (β = 0.1, P = 0.04) was associated with an increased RP-attitude. Being a woman (β = 0.2, P < 0.001) and longer years of experience with radiation (β = 0.2, P < 0.001) were significantly related to better practice.

CONCLUSION

In-service training with appropriate qualified and up-to-date materials based on radiation workers' educational needs and approved protocols and guidelines is recommended.

Cu-Catalyzed first direct access towards 3-sulfenylindoles from aryl halides

The copper-catalyzed cross-coupling of indole derivatives with aryl halides in the presence of thiourea proceeds to give 3-sulfenylindoles in DMSO at 120 °C.

Association between upper extremity musculoskeletal disorders and mental health status in office workers

BACKGROUND

Musculoskeletal Disorders (MSDs) can lead to potential adverse consequences for individuals and their organizations, and in various research, its relationship to physical and mental health of workforce has been studied.

OBJECTIVE

The purpose of this study was to determine the prevalence of MSDs of upper extremities among office workers and its association with mental health status.

METHODS

In this cross sectional study, 1488 out of 1630 office workers completed the Standardized Nordic Musculoskeletal Disorders Ques-tionnaire and General Health Questionnaire (GHQ-28) (response rate = 91.3%).

RESULTS

Upper extremity MSDs were reported in 410 (27.5%) office workers, including 269 (18.1%) shoulder, 79 (5.3%) elbow and 207 (13.9%) hand/wrist symptoms. Based on GHQ-28, 254 (17.1%) participants were found to be at risk of developing a psychiatric disorder that were observed in 26.7% of workers with MSDs symptoms. Shoulder (p < 0.001), elbow (p < 0.001) and hand/wrist (p < 0.001) MSDs were associated with poor mental health. Among the four GHQ-28 subscales (somatic symptoms, anxiety/insomnia, social dysfunction, and depression), anxiety/insomnia was strongly correlated with shoulders (P < 0.001), elbows (P = 0.002), and hands/wrists (P < 0.001) symptoms.

CONCLUSION

Office workers with upper extremity MSDs were more likely to be experiencing mental distress. This indicates a need for greater emphasis on preventive programs at workplace to support their psychological well-being.

Epidemiological trends of dermatophytosis in Tehran, Iran: A five-year retrospective study

OBJECTIVE

Dermatophytosis is the most frequent fungal infection all over the world and its frequency is constantly increasing. The aim of this study was to evaluate clinical features and epidemiological trends of dermatophytosis over the years 2010 to 2014 in Tehran, Iran.

PATIENTS AND METHODS

A total of 13,312 patients clinically suspected of cutaneous fungal infections were examined. Skin scales, plucked hairs, nail clippings and sub-ungual debris were examined by direct microscopy and culture. Dermatophyte species were identified at the species level by a combination of morphological and physiological criteria.

RESULTS

Direct microscopy confirmed a contamination rate of 19.7% (2622/13,312 cases) of which 1535 cases (58.5%) were culture positive distributed in male (1022 cases) and female (513 cases). The most commonly infected age group was the 30-39 years old. Tinea pedis (30.4%) was the most prevalent type of dermatophytosis followed by tinea cruris (29.8%) and tinea corporis (15.8%). Epidermophyton floccosum (31%) was the most prevalent causative agent, followed by Trichophyton rubrum (26.2%) and Trichophyton mentagrophytes (20.3%).

CONCLUSION

Our results showed considerable distribution of dermatophytosis from zoophilic, anthropophilic and geophilic species among population with diverse age groups. Although anthropophilic fungi such as T. mentagrophytes, E. floccosum, and T. rubrum were the main etiologic agents of dermatophytosis, the prevalence of T. verrucosum showed a meaningful increase over the years, which highlights the importance of rural dermatophytosis mainly transmitted from large animals. This noticeable information improves our current knowledge about dermatophytosis and assists to establish effective prevention and therapeutic strategies to overcome the disease.