Relationship between workplace spirituality with organization-based self-esteem and workplace deviant behaviors among Iranian nurses

BACKGROUND

Despite the numerous studies conducted on workplace spirituality, there is still lack of studies that have explored the relationship between workplace spirituality with organization-based self-esteem and workplace deviant behaviors. This study aims to examine the relationship between workplace spirituality with organization-based self-esteem and workplace deviant behaviors among Iranian nurses.

METHODS

236 nurses from 5 hospitals participated in this descriptive, analytical, and cross-sectional study from August to December 2022. Data was gathered by four questionnaires: demographic information, workplace spirituality, organization-based self-steam, and workplace deviant behaviors. The data were analyzed by SPSS 26 based on descriptive and inferential statistics (Independent Two-sample t Test, Pearson correlation coefficient and multiple regression).

RESULTS

Based on the findings, nurses had a moderate level of perception of workplace spirituality and organization-based self-esteem while having a low level of perception regarding the occurrence of workplace deviate behaviors. Results of Pearson correlation coefficient test showed a positive and statistically significant relationship between workplace spirituality and organization-based self-esteem. Additionally, there was an inverse and significant relationship between workplace spirituality and organization-based self-esteem with workplace deviant behaviors. Results of multiple regression analyses indicate that by controlling the demographic characteristics of nurses, the meaningful work and sense of community have a significant relationship with organization-based self-esteem. Furthermore, by controlling the demographic characteristics of nurses, permanent employment status, sense of community, alignment with the organization's values, and organization-based self-esteem have a significant relationship with workplace deviant behavior.

CONCLUSIONS

The study suggests that organizations must prioritize promoting workplace spirituality and organization-based self-esteem to ensure a healthy work environment and prevent workplace deviant behaviors.

Comparison of therapeutic effects of N-Acetylcysteine with pregabalin in improving the clinical symptoms of painful diabetic neuropathy: a randomized, double-blind clinical trial

OBJECTIVES

Painful diabetic neuropathy (PDN) is highly prevalent and annoyingly in patients with diabetes. The aim of this study was to investigate the effects of oral N-acetylcysteine (NAC) compared to pregabalin in PDN.

METHODS

One hundred two eligible patients with type 2 diabetes and PDN were randomly recievied pregabalin (150 mg/day) or N-Acetylcysteine (NAC) (600 mg/ twice a day) for 8 weeks. Mean pain score, Sleep interference score (SIS), Patient Global Impression of Change (PGIC), Clinical Global Impression of Change (CGIC), and also, serum levels of total antioxidant capacity (TAC), total thiol groups (TTG), catalase activity (CAT), nitric oxide (NO), and malondialdehyde (MDA) were assessed at baseline and at the end of the study.

RESULTS

NAC was well tolerated in all patients. The decrease in mean pain scores and increase in SIS was similar between two groups. More improvement in PGIC and CGIC from the baseline was reported in NAC group. NAC, significantly, decreased serum levels of MDA, and NO, but increased TAC, TTG, and CAT. Pregabalin, significantly, decreased serum levels of MDA, and NO and increased TAC.

DISCUSSION

NAC is efficacious in alleviate symptoms of PDN which is probably related to its antioxidant effects.

TRIAL REGISTRATION

The research protocol received approval from the Ethics Committee of Hamadan University of Medical Sciences (IR.UMSHA.REC.1397.137). The trial registry URL and number in Iranian Registry of Clinical Trials (IRCT): https://www.irct.ir/trial/33313 , IRCT20180814040795N2 (Registration date: 2019-01-21, Retrospectively registered).

Exploring the safe environment provided by nurses in inpatient psychiatric wards: A mixed-methods study

INTRODUCTION

Previous research has indicated that community-based mental health services in Iran are restricted, leading to overcrowding in psychiatric wards. This overcrowding has been linked to a range of problems, such as violence, suicide and medical errors. Despite the abundance of research on patient safety, there is still a lack of understanding regarding how mental health nurses (MHNs) create a secure environment within these wards.

AIM

This study focused on exploring a safe environment provided by MHNs in inpatient psychiatric wards at Farshchian (Sina) Hospital, Hamadan, Iran.

METHOD

An explanatory mixed-methods study was conducted. Initially, the Safe Environment Scale was distributed to all MHNs (n = 48) working in three wards at Farshchian (Sina) Hospital to evaluate the current status. The scale measured two dimensions, and descriptive statistics were used to analyse the collected data. Subsequently, 20 MHNs were selected for semi-structured interviews using purposeful sampling at the same hospital to interpret and fill gaps in the quantitative findings. The data collected from the interviews were analysed using conventional content analysis.

RESULTS

The perception and engagement of MHNs in creating a safe environment in the inpatient psychiatric wards were found to be at a medium level, according to the Safe Environment Scale (mean ± SD, 14.67 ± 4.18 and 85.27 ± 17.57, respectively). The qualitative study identified several categories in the results, including 'Hyper-vigilance to safety and security environment', 'Therapeutic communication gap', 'Nurse burnout', 'Staff safety and security need' and 'Environmental safety hazards'.

DISCUSSION

MHNs employ a hyper-vigilant strategy to guarantee a secure atmosphere within psychiatric wards. However, this approach may inadvertently impede the establishment of a safe environment and even diminish MHNs' perception and involvement in its maintenance.

IMPLICATIONS FOR MENTAL HEALTH NURSING

According to our research, it appears that MHNs need to improve their education and training in order to successfully implement the vigilance strategy for establishing a secure environment. Additionally, it is essential for them to prioritize therapeutic communication with patients, as this plays a vital role in promoting a safe environment within inpatient psychiatric wards.

Family-based association of HLA-DRB1 and DQB1 alleles and haplotypes in a group of Iranian Type 1 diabetes children

This family-based study was conducted in a group of Iranians with Type 1 diabetes (T1D) to investigate the transmission from parents of risk and non-risk HLA alleles and haplotypes, and to estimate the genetic risk score for this disease within this population. A total of 240 T1D subjects including 111 parent-child trios (111 children with T1D, 133 siblings, and 222 parents) and 330 ethnically matched healthy individuals were recruited. High-resolution HLA typing for DRB1/DQB1 loci was performed for all study subjects (n = 925) using polymerase chain reaction-sequence-specific oligonucleotide probe method. The highest predisposing effect on developing T1D was conferred by the following haplotypes both in all subjects and in probands compared to controls: DRB1*04:05-DQB1*03:02 (Pc = 2.97e-06 and Pc = 6.04e-10, respectively), DRB1*04:02-DQB1*03:02 (Pc = 5.94e-17 and Pc = 3.86e-09, respectively), and DRB1*03:01-DQB1*02:01 (Pc = 8.26e-29 and Pc = 6.56e-16, respectively). Conversely, the major protective haplotypes included DRB1*13:01-DQB1*06:03 (Pc = 6.99e-08), DRB1*15:01-DQB1*06:02 (Pc = 2.97e-06) in the cases versus controls. Also, DRB1*03:01-DQB1*02:01/DRB1*04:02|05-DQB1*03:02 and DRB1*03:01-DQB1*02:01/DRB1*03:01-DQB1*02:01 diplotypes conferred the highest predisposing effect in the cases (Pc = 8.65e-17 and Pc = 6.26e-08, respectively) and in probands (Pc = 5.4e-15 and Pc = 0.001, respectively) compared to controls. Transmission disequilibrium test showed that the highest risk was conferred by DRB1*04:02-DQB1*03:02 (Pc = 3.26e-05) and DRB1*03:01-DQB1*02:01 (Pc = 1.78e-12) haplotypes and the highest protection by DRB1*14:01-DQB1*05:03 (Pc = 8.66e-05), DRB1*15:01-DQB1*06:02 (Pc = 0.002), and DRB1*11:01-DQB1*03:01 (Pc = 0.0003) haplotypes. Based on logistic regression analysis, carriage of risk haplotypes increased the risk of T1D development 24.5 times in the Iranian population (p = 5.61e-13). Also, receiver operating characteristic curve analysis revealed a high predictive power of those risk haplotypes in discrimination of susceptible from healthy individuals (area under curve: 0.88, p = 5.5e-32). Our study highlights the potential utility of genetic risk assessment based on HLA diplotypes for predicting T1D risk in individuals, particularly among family members of affected children in our population.

The role of histamine H1 receptor in the anterior cingulate cortex on nociception level following acute restraint stress in male rats

Considering the importance of pain and stress, we decided to investigate the intra-anterior cingulate cortex (ACC) microinjection of histamine and mepyramine alone and concurrently on acute pain induced by hot plate following restraint stress in male rats. 24-gauge, 10 mm stainless steel guide cannula was implanted over the ACC in the incised scalp of 4 groups. Restraint stress in healthy rats produced a significant increase (p < .05) in the pain threshold. The simultaneous microinjection of 4 μg/side histamine and 8 μg/side mepyramine as a histaminergic system inverse agonist in healthy nonrestraint animals did not affect the pain threshold. Although Histamine decreased the threshold of pain meaningfully, mepyramine elevated it in a significant manner (p < .05). In the restrained animals, intra-ACC microinjection of histamine produced no significant impact on the pain threshold. However, intra-ACC microinjection of mepyramine before histamine, significantly (p < .01) altered the result and enhanced the threshold of pain. The results of our study demonstrated that histaminergic neurons have an important role in the processing of pain in the ACC following restraint stress.

Perceptions of professional challenges by emergency medical services providers: a qualitative content analysis study

INTRODUCTION

Emergency medical services (EMS) providers encounter a variety of challenges due to the unpredictable, uncontrollable, and dynamic conditions in the pre-hospital field. This study explored the perceived professional challenges among EMS providers.

MATERIALS AND METHODS

This study was conducted using a qualitative research approach and the method of content analysis. Eighteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. The collected data were then analyzed based on the Granheim and Lundman's method.

RESULTS

Based on data analysis, five categories and one theme were identified. The extracted theme was professional challenges. The five categories were as follows: Ineffective policies; multicultural and multidisciplinary factors; ambulance dispatch route problems; legal issues; and abuse against the emergency medical services CONCLUSION: In general, it has been found that EMS providers encounter numerous and complex professional challenges during their work. EMS managers can utilize the findings of the present study to develop strategies for reducing the professional challenges faced by EMS providers. By doing so, they can improve the quality of care in the prehospital field.

Understanding determinants related to farmers' protective measures towards pesticide exposure: A systematic review

OBJECTIVE

Pesticide poisoning is the main cause of adverse effects and mortality worldwide. Protective measures can reduce the intensity of the effects of pesticides on the health of farmers. Numerous cross-sectional studies have been conducted on the determinants of performing protective measures to reduce exposure to pesticides, but there is no systematic study that comprehensively examines the impact of these factors. Therefore, the aim of this study is to identify existing studies on the determinants of effective protective measures to reduce exposure to pesticides among farmers.

METHODS

In this systematic review, studies were obtained from PubMed, Web of Science and Scopus databases using a search strategy that covered articles from the first years of database design to April 20, 2023. The inclusion and exclusion criteria were based on the PICOs criteria. The study included cross-sectional studies that measured the implementation of protective measures using objective or valid subjective tools. The data were extracted and analyzed based on several criteria and ecological levels. The Ecological Model of Health Behavior was used to classify the determinants that affect the performance of protective behaviors. The National Heart, Lung and Blood Institute (NHLBI) has developed a quality assessment tool for studies.

RESULTS

A total of 39 studies were ultimately selected for inclusion in this analysis. Many of these studies were conducted in developing countries. The most important factors that have an impact on protective measures include a variety of socio-demographic characteristics (age, gender, level of education, income, farming experience, experience of using pesticides), individual level (knowledge, attitude, risk perception, intention), interpersonal level (subjective norms), organizational level (education), and public policy level (government attention, health costs, governmental extension services). The quality of most studies was fair.

CONCLUSIONS

Research indicates that several factors influence the use of personal protective equipment and safe behaviors when handling pesticides. These include farmers' education level, knowledge, and attitudes towards safety measures. Environmental factors such as access to information, extension services, training programs, and media coverage can also help minimize exposure to pesticides.

Modeling heart rate of individual and team manual handling with one hand using generalized additive mixed models

OBJECTIVES

Despite the fact that team manual handling is common in different working environments, the previous studies in this regard, particularly those with a physiological approach are quite limited. The present study is an attempt to model the heart rate (HR) of individual and team manual handling with one hand.

METHODS

Twenty-five young men (aged 21.24±1.42 year) volunteered for this study. The experiments included individual and two-person handling of the load with three different weights with and without height difference. The participants' HR was registered at the end of the route by a chest-strap pulse monitor and a polar watch according to the manufacturer's recommendation. A multivariate Generalized Additive Mixed Model (MGAMM) was used for modeling heart rate based on explanatory variables of workload, carry method, HRrest, body weight, height, knee height, shoulder height, elbow height, and hand height. The significance level of the tests was considered as <0.05.

RESULTS

Based on the MGAMM, the average HR (bpm) of participants increased as the workload increased (P<0.001). Handling the load with a taller person increased the HR compared to shorter partner (P<0.001). Moreover, the nonlinear associations of the resting HR (P<0.001), body weight (P<0.001), height (P<0.001), and the height of elbow, hand and knee (P<0.001) were statistically significant. The adjusted R2 of the model was 0.89 indicating that about 90 percent of the variations observed in HR could be explained by the variables in the model. This was greater than the model considering only linear effects (R2 =0.60).

CONCLUSION

The model obtained in this study can predict the heart rate of individual and team one-handed handling with high validity. The MGAMM can be used in modeling heart rate in manual handling.

MicroRNA -21 expression as an auxiliary diagnostic biomarker of acute brucellosis

BACKGROUND

This study aimed to measure the expression levels of peripheral blood miRNAs in brucellosis and their involvement in the different phases of the brucellosis.

METHODS

The expression levels of miRNAs including miR-210, miR-155, miR-150, miR-146a, miR-139-3p, miR-125a-5p, miR-29 and miR-21 were quantified in 57 brucellosis patients subgrouped into acute, under treatment & relapse phase and 30 healthy controls (HCs) using real-time polymerase chain reaction (RT-PCR). The receiver operating characteristic (ROC) analysis curve analysis was performed to find a biomarker for discrimination of different phases of brucellosis.

RESULTS

The expression of miR-155, miR-146a, miR-125a-5p, miR-29, and miR-21 was found to be elevated in the acute brucellosis patients compared to HCs. miR-29 changed in under-treatment patients, while miR-139-3p and miR-125a-5p showed alterations in relapse cases. The ROC curve analysis depicted the potential involvement of miR-21 in the pathogenesis of acute brucellosis.

CONCLUSION

The expression level of miR-21 is significantly augmented in acute brucellosis and has the potential to be a contributing diagnostic factor for acute infection.

Factors affecting subsequent dose of COVID-19 vaccine uptake based on BASNEF model among older adults

BACKGROUND

Vaccination is a primary prevention approach to preventing disease by disconnecting the transmission chain. The current study utilized a BASNEF model framework to identify factors influencing subsequent doses of COVID-19 vaccination among older adults.

METHODS

This cross-sectional study was performed in the west of Iran in May 2022. The participants were selected via multi-stage sampling. Finally, 1120 participants contributed to the present study. The questionnaire consisted of three sections: a) Socio-demographic characteristics, b) cognitive impairments tests, and c) Questionnaire about the subsequent dose of COVID-19 vaccine uptake based on the BASNEF model. Data were analyzed using the software IBM AMOS-20 and SPSS-23 via one-way analysis of variance (ANOVA) and independent sample T-tests were used, too. The significance level of statistical tests was regarded as less than 0.05.

RESULTS

The presented results of analyzing 50% of the variance of vaccination intention as the dependent variable (R square = 0.497) and 10% of the behavior variance as the dependent variable (R square = 0.104) can be explained based on the BASNEF model. The enabling factors (β = 0.636, p < 0.001) and the intention (β = 0.322, p < 0.001) were important factors for subsequent doses of COVID-19 vaccine uptake in older adults.

CONCLUSION

So, planning and implementing promotional intervention programs for older people (over 65; 80), females, illiterate, widows and divorced, good economic status, and urban areas is essential. It seems that enabling factors such as free vaccinations, vaccination inaccessible places such as public social security agencies, social supports such as involvement of the government and physicians, and improving information by the medium or knowledge-sharing experience, which can be further used to enhance the acceptance of subsequent doses of COVID-19 uptake in older adults.

The Effects of Coenzyme Q10 on Contrast-Induced Acute Kidney Injury in Type 2 Diabetes: A Randomized Clinical Trial

Contrast-induced acute kidney injury (CI-AKI) is a frequent challenge following the injection of contrast media and its subsequent oxidative stress. The aim of the present study was to evaluate the preventive effects of coenzyme Q10 (Q10), as a mitochondrial-targeted antioxidant in CI-AKI in diabetic patients, who account for a large proportion of angiographic cases. A total of 118 diabetic patients were randomly assigned to receive 120 mg of oral coenzyme Q10 (Q10 group) or placebo (Placebo group) for four days, starting 24 hours before contrast media injection. Blood urea nitrogen (BUN), serum and urinary creatinine, estimated glomerular filtration rate (eGFR), urinary malondialdehyde (UMDA), urinary total antioxidant capacity (UTAC), and urinary mitochondrial to nuclearDNA ratios (mtDNA/nDNA ratio) were evaluated before and after the treatment period. Urine sediments were also evaluated to report the urine microscopy score (UMS).The levels of BUN, serum and urine creatinine, and UMS were similar in the Q10 and placebo groups. EGFR was lower in the Q10 group before the treatment (p=0.013) but not after. The urinary mtDNA/nDNA ratio was 3.05±1.68 and 3.69±2.58 in placebo and Q10 groups, but UTAC was found to be lower in Q10 both before (p=0.006) and after the treatment (p<0.001). The incidence of CI-AKI was 14.40% and the mtDNA/nNDA ratio was similar between CI-AKI and non-CI-AKI patients. In conclusion, Q10 treatment shows no favorable effect on prevention of CI-AKI or a urinary mtDNA/nDNA ratio among diabetic patients.

A pan-cancer analysis indicates long noncoding RNA HAND2-AS1 as a potential prognostic, immunomodulatory and therapeutic biomarker in various cancers including colorectal adenocarcinoma

The HAND2-AS1 (HAND2 Antisense RNA 1) Long noncoding RNA (lncRNA) has emerged as a participant in the initiation of various cancer types, underscoring its pivotal involvement in both oncological processes and immune responses. To gain deeper insights into the functional nuances of HAND2-AS1 and identify novel avenues for cancer immunotherapy, a comprehensive evaluation of this gene was undertaken. Here, based on the co-expression network analysis and construction of interacting lncRNA-mRNA genes, we introduce the HAND2-AS1 lncRNA, emphasizing its key roles in tumorigenesis and immune regulation. Our study spans across 33 distinct cancer types, revealing the HAND2-AS1's aberrant expression patterns, methylation variations, mutational signatures, and immune engagement. Across a majority of tumors, HAND2-AS1 exhibited a propensity for down-regulation, remarkably an association with poor survival outcomes. The outcomes of functional enrichment analyses strongly suggest HAND2-AS1's engagement in tumor progression and its association with various immune pathways across diverse tumor classifications. Additionally, a positive correlation emerged between HAND2-AS1 expression and the infiltration levels of key immune cells, encompassing not only immunosuppressive entities such as tumor-associated macrophages, cancer-associated fibroblasts, and Tregs, but also immune effector cells like NK cells and CD8+ T cells, spanning a pan-cancer context. Furthermore, the differential expression of HAND2-AS1 appears to have downstream consequences on various pathways, thus implicating it as a potential regulator in diverse cancer types. Finally, we have employed CRC tumor and normal samples to carry out clinical validation of HAND2-AS1. Our study unveils HAND2-AS1's potential as a pan-cancer tumor suppressor, and its essential role in the tumorigenesis and immune surveillance. The increased HAND2-AS1 expression emerges as a promising candidate for prognostic evaluation, therapeutic strategy, and a focal point for immunotherapeutic interventions.

In vitro co-delivery of 5-fluorouracil and all-trans retinoic acid by PEGylated liposomes for colorectal cancer treatment

BACKGROUND

Single-target inhibitors have not been successful in cancer treatment due to the development of drug resistance. Nevertheless, therapeutic agents capable of simultaneously inhibiting multiple targets have revealed encouraging results in inducing apoptosis and overcoming drug resistance in cancerous cells. Here, we designed a composite liposomal nano-carrier co-loading 5-Fluorouracil (5-FU) with all-trans retinoic acid (ATRA) to assess anticancer efficacy of the combined drugs in colorectal cancer (CRC).

METHODS

A PEGylated liposomal nano-carrier with phospholipid/cholesterol/DSPE-PEG (2000) was synthesized by the thin film hydration technique for co-delivery of ATRA and 5-FU. After characterizing, the role of 5-FU and ATRA co-loaded liposomal nano-carrier in proliferation, epithelial-mesenchymal transition (EMT), apoptosis, and cancer stem cells (CSCs) were investigated by using colony forming and MTT assay, RT-qPCR and Annexin V/PI kit.

RESULTS

The average size of liposomes (LPs) was < 150 nm with uniform size distribution. Drug release analyses indicated that both ATRA and 5-FU could simultaneously release from LPs in a sustained release manner. The synergistic inhibitory effects of ATRA and 5-FU loaded in LPs were verified with a combination index of 0.43. Dual drug LPs showed the highest cytotoxicity, enhanced inhibition of cell proliferation, increased apoptotic potential, decreased CSCs, and attenuated EMT-associated biomarkers. Also, dual drug LPs decreased β-catenin gene expression more than other liposomal formulations.

CONCLUSION

These findings suggest that using LPs to achieve a synergistic effect of ATRA and 5-FU is an effectual approach to increase the therapeutic effect of 5-FU toward CRC cells.

A review on nonviral, nonbacterial infectious agents toxicity involved in neurodegenerative diseases

Neuronal death, decreased activity or dysfunction of neurotransmitters are some of the pathophysiological reasons for neurodegenerative diseases like Alzheimer's, Parkinson's and multiple sclerosis. Also, there is evidence for the role of infections and infectious agents in neurodegenerative diseases and the effect of some metabolites in microorganisms in the pathophysiology of these diseases. In this study, we intend to evaluate the existing studies on the role of infectious agents and their metabolites on the pathophysiology of neurodegenerative diseases. PubMed, Scopus, Google Scholar and Web of Science search engines were searched. Some infectious agents have been observed in neurodegenerative diseases. Also, isolations of some fungi and microalgae have an improving effect on Parkinson's and Alzheimer's.

Virtual reality for pain reduction during intravenous injection in pediatrics: a systematic review and meta-analysis of controlled clinical trials

BACKGROUND

Intravenous (IV) injections often cause pain, fear, and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide a distraction during or prepare patients for IV injections.

PURPOSE

To date, no meta-analysis has examined the evidence regarding the effectiveness of VR at reducing pain in pediatric IV injections.

METHODS

The PubMed, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases were searched for articles published through August 7, 2022. The methodological quality of the studies was measured using the Delphi checklist. The chi-square test and the I2 statistic were used to assess heterogeneity across studies. A summary measure of the mean difference in pain scores between the VR and control groups was obtained using a random effects model. All statistical analyses were set at a significance level of 0.05 using Stata 14.

RESULTS

Nine studies were included in this meta-analysis of VR interventions used during IV injections in pediatric patients. The difference in mean pain score between the intervention and control groups showed significant reductions in the VR group (mean difference, 0.47; 95% confidence interval, 0.3-0.65; I2=9.1%). No interstudy heterogeneity was observed.

CONCLUSION

Our results suggest that VR effectively reduces pain associated with IV injections in pediatric patients. No interstudy heterogeneity was noted among the analyzed studies. The Delphi checklist was used to assess methodological quality.

Ferulago bernardii as a New Source of α-Pinene Binds to ctDNA: In Silico and in Vitro Studies

Ferulago bernardii Tomk & M. Pimen belongs to Apiaceae family. Various species of the Ferulago genus have antioxidant, anticholinesterase, cytotoxic, and antiproliferative effects. In this study, the essential oil of F. bernardii was extracted using the Clevenger apparatus. The essential oil compounds were identified using GC-MS/FID. The interaction between the essential oil and DNA strands was evaluated through spectrophotometric titration. The molecular mechanism of the interaction between the main components of the essential oil and different DNA strands was assessed using molecular dynamics simulation. Based on the results, 92.03±1.20 % of the essential oil consisted of α-pinene. Therefore, the essential oil could serve as a suitable source of α-pinene. α-pinene is a monoterpene hydrocarbon that has various effects, including anti-inflammatory, antioxidant, antimicrobial, and antitumor properties. The binding constant of the essential oil to DNA strands (Ka ) was determined to be 5.40±0.47×10-3  M-1 . Molecular dynamics simulation demonstrated that α-pinene could interact with AT and CG rich DNA strands and indirectly stabilize G-Quadruplex. Given the different applications for α-pinene and its high percentage in the essential oil, it is suggested that researchers pay more attention to F. bernardii in the pharmaceutical, cosmetic, and food industries.

Using machine learning approach for screening metastatic biomarkers in colorectal cancer and predictive modeling with experimental validation

Colorectal cancer (CRC) liver metastasis accounts for the majority of fatalities associated with CRC. Early detection of metastasis is crucial for improving patient outcomes but can be delayed due to a lack of symptoms. In this research, we aimed to investigate CRC metastasis-related biomarkers by employing a machine learning (ML) approach and experimental validation. The gene expression profile of CRC patients with liver metastasis was obtained using the GSE41568 dataset, and the differentially expressed genes between primary and metastatic samples were screened. Subsequently, we carried out feature selection to identify the most relevant DEGs using LASSO and Penalized-SVM methods. DEGs commonly selected by these methods were selected for further analysis. Finally, the experimental validation was done through qRT-PCR. 11 genes were commonly selected by LASSO and P-SVM algorithms, among which seven had prognostic value in colorectal cancer. It was found that the expression of the MMP3 gene decreases in stage IV of colorectal cancer compared to other stages (P value < 0.01). Also, the expression level of the WNT11 gene was observed to increase significantly in this stage (P value < 0.001). It was also found that the expression of WNT5a, TNFSF11, and MMP3 is significantly lower, and the expression level of WNT11 is significantly higher in liver metastasis samples compared to primary tumors. In summary, this study has identified a set of potential biomarkers for CRC metastasis using ML algorithms. The findings of this research may provide new insights into identifying biomarkers for CRC metastasis and may potentially lay the groundwork for innovative therapeutic strategies for treatment of this disease.

Developing and validation of COVID-19 media literacy scale among students during the COVID-19 pandemic

OBJECTIVE

This cross-sectional validation work evaluated the psychometric features of the COVID-19 Media Literacy Scale (C-19MLs) in Students.

METHODS

The study was conducted on 530 students from a medical university in Hamadan, Iran, who were recruited through a stratified cluster random sampling process in June-July 2020. Intraclass Correlation Coefficient (ICC) and internal consistency were used to assess the reliability. Moreover, CFA (Confirmatory Factor Analyses) and EFA (Exploratory Factor Analyses) were carried out to examine construction validity. CVR (Content Validity Ratio) and CVI (Content Validity Index) were used to examine the content validity.

RESULTS

According to the factor analysis, it was indicated that the C-19MLs included 21 items measuring five dimensions (constructedness of credible Covid-19 media messages, contractedness of fake media coronavirus messages, fake media coronavirus messages, audience, with three questions in each factor; format, represented lifestyles in fake media coronavirus messages with six questions in each factor) for an explanation of 58.4% of the prevalent variance. The average scores for the CVI and CVR were respectively 0.94 and 0.77. According to confirmatory factor analysis, the studied model had an appropriate fitting to the data; the relative chi-square (x2/df) = 2.706 < 3, RMSEA = 0.093 ≤ 0.1; CFI = 0.893 ≥ 0.9; TLI = 0.874 ≥ 0.9; GFI = 0.816 ≥ 0.9; and SRMR = 0.06 ≤ 0.08. Further analyses represented acceptable findings for internal consistency reliability values with 0.86 of Cronbach's alpha.

CONCLUSIONS

The results proved that the C-19MLs is a reliable and valid tool, and it is suitable and acceptable now and can be utilized in forthcoming investigations. This highlights educators and stakeholders to realize the importance of participating individuals in the new media ecology and new 'Infomedia' ecosystems for enabling people in the current digital society.

The prognostic value of estimated glomerular filtration rate on admission for death within 30 days among COVID-19 inpatients using fractional polynomial and spline smoothing

BACKGROUND

The common regression models included estimated glomerular filtration rate (eGFR) in the continuous and categorical form for predicting the mortality in COVID-19 inpatients. However, the relationship may be non-linear, and categorizing implies a loss of information. This study aimed to assess the effect of eGFR on admission on death within 30 days among COVID-19 inpatients using flexible and smooth transformations of eGFR and compare the results against the common models.

METHODS

A retrospective study was conducted on hospitalized COVID-19 patients between April 2019 and July 2019 in Hamadan, Western Iran. The effect of eGFR on the death within 30 days was evaluated using different modeling: categorization, linear, unrestricted cubic spline (USC) with 4 knots, and fractional polynomial (FP). The results adjusted for older age and intensive care unit (ICU) admission. Discrimination power and model performance of the best-fitting model was evaluated using the area under the ROC (AUROC) and Brier score.

RESULTS

In total, 2945 patients (median age 61 years; interquartile range 48-73 years) were included, of whom the mortality rate was 9.23%. The relationship between the eGFR and death within 30 days is non-linear, so the degree-2 FP with powers (- 2, - 1) is the best-fitting model. Using the FP model, the risk increased exponentially in eGFR < 45 and then increased linearly and slowly. The AUROC of the FP model involving eGFR, older age, and ICU admission was 0.92 (95% CI 0.90-0.93) with a Brier score of 0.09.

CONCLUSION

There is a non-linear and asymmetric relationship between eGFR and death within 30 days among COVID-19 inpatients. Kidney function can be measured in COCID-19 patients on admission to know better understanding about prognosis of the patients.

Mitochondrial biogenesis and apoptosis as underlying mechanisms involved in the cardioprotective effects of Gallic acid against D-galactose-induced aging

BACKGROUND

Aging is a main risk factor for the development of cardiovascular diseases (CVDs). Gallic acid (GA) is a phenolic compound derived from a wide range of fruits. GA has a wide spectrum of pharmacological properties, including anti-oxidative, anti-inflammatory, and cardioprotective effects. This research was conducted to determine the cardioprotective effect of GA on cardiac hypertrophy in aged rats.

METHODS AND RESULTS

Following histological evaluation and through observing the heart, we found that GA improved the cardiac hypertrophy induced by D-galactose (D-GAL) in cardiac cells. To clarify the causes for this anti-aging effect, we evaluated the malonic dialdehyde levels and antioxidant enzyme activity in rat cardiac tissue. The levels of lactate dehydrogenase (LDH) and creatine kinase (CK-MB) in serum were measured. The levels of genes related to mitochondrial biogenesis, mitophagy, and apoptosis in cardiac tissue were surveyed. The findings represented that GA ameliorated antioxidant enzyme activity while significantly decreasing the malonic dialdehyde levels. Real-time PCR analysis proposed that GA effectively improved mitochondrial biogenesis in the heart via regulating the expression levels of Sirtuin 1 (SIRT1), PPARγ coactivator 1α (PGC1-α), nuclear factor erythroid 2-related factor 2 (Nrf2), and mitochondrial transcription factor A (TFAM). GA also mitigated apoptosis in the heart by modulating the expression levels of B-cell lymphoma protein 2 (Bcl-2) and Bcl-2-associated X (Bax). In addition, GA improved serum LDH and CK-MB levels.

CONCLUSIONS

GA may alleviate aging-induced cardiac hypertrophy via anti-oxidative, mitoprotective, and anti-apoptotic mechanisms.

Neonatal risk factors associated with attention-deficit/hyperactivity disorder: an umbrella review

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is being encountered more frequently.

PURPOSE

In this study, by compiling the evidence from available meta-analyses, an umbrella systematic review was performed of the neonatal risk factors associated with ADHD.

METHODS

The PubMed, Scopus, and Web of Science databases were searched for eligible studies. Only systematic reviews were included. Using a random-effects model, 95% prediction intervals were reported for each risk factor. Three studies were ultimately included in the review.

RESULTS

Congenital heart disease, short-duration or incomplete breastfeeding, low birth weight, and 5-minute Apgar scores <7 were significant risk factors for ADHD. However, the quality of the included systematic reviews was low to moderate and the evidence credibility level was suggestive to weak.

CONCLUSION

The results of this umbrella review proposed that congenital anomalies, short-duration or incomplete breastfeeding, low birth weight, and low Apgar scores were important factors for the manifestation of ADHD symptoms. However, the inclusion of more high-quality studies is needed to validate our results.

Exposure of the static magnetic fields on the microbial growth rate and the sludge properties in the complete-mix activated sludge process (a Lab-scale study)

BACKGROUND

In this study, the effect of static magnetic fields (SMFs) on improving the performance of activated sludge process to enhance the higher rate of microbial growth biomass and improve sludge settling characteristics in real operation conditions of wastewater treatment plants has been investigated. The effect of SMFs (15 mT), hydraulic retention time, SRT, aeration time on mixed liquor suspended solids (MLSS) concentrations, mixed liquor volatile suspended solids (MLVSS) concentrations, α-factor, and pH in the complete-mix activated sludge (CMAS) process during 30 days of the operation, were evaluated.

RESULTS

There were not any differences between the concentration of MLSS in the case (2148.8 ± 235.6 mg/L) and control (2260.1 ± 296.0 mg/L) samples, however, the mean concentration of MLVSS in the case (1463.4 ± 419.2 mg/L) was more than the control samples (1244.1 ± 295.5 mg/L). Changes of the concentration of MLVSS over time, follow the first and second-order reaction with and without exposure of SMFs respectively. Moreover, the slope of the line and, the mean of α-factor in the case samples were 6.255 and, - 0.001 higher than the control samples, respectively. Changes in pH in both groups of the reactors were not observed. The size of the sluge flocs (1.28 µm) and, the spectra of amid I' (1440 cm-1) and II' (1650 cm-1) areas related to hydrogenase bond in the case samples were higher than the control samples.

CONCLUSIONS

SMFs have a potential to being considered as an alternative method to stimulate the microbial growth rate in the aeration reactors and produce bioflocs with the higher density in the second clarifiers.

The effect of midwife-oriented breastfeeding counseling on self-efficacy and performance of adolescent mothers: a clinical trial study

BACKGROUND

Breastfeeding behaviors are strongly influenced by self-efficacy. This research aimed to determine the effect of breastfeeding counseling based on the Ready Set Baby (RSB) education program on self-efficacy and breastfeeding performance in adolescent mothers.

METHODS

In 2022, a parallel randomized clinical trial was carried out in Hamadan city's comprehensive health centers, involving 64 pregnant teenagers. The block randomization method was employed to divide the participants into two groups. The data collection instruments were a demographic characteristics questionnaire, a breastfeeding self-efficacy questionnaire, and the Bristol breastfeeding checklist. Three individual counseling sessions during pregnancy were conducted based on the "RSB" program. The ANCOVA was used for comparing groups. The statistical analyst was blinded to the group assignment.

RESULTS

The study included 64 participants with a mean age of 16.97(1.30) years, data from 60 participants were analyzed. The demographic and clinical characteristics of the two groups were relatively similar (P > 0.05). Following the intervention, self-efficacy and breastfeeding performance scores were measured and adjusted for confounding factors. The mean scores for self-efficacy were 116.03(20.64) and 100.02(20.64) (P < 0.005), with effect size 0.77 [MD = 16.01 (95% CI: 5.34,26.67)], and the mean scores for breastfeeding performance were 6.30(2.07) and 4.12(2.07) (P < 0.002), with effect size 1.05 [MD = 2.18 (95% CI: 1.11,3.24)] in the intervention and control groups, respectively.

CONCLUSIONS

The Ready Set Baby education program's breastfeeding counseling for primiparous adolescent pregnant women significantly boosted their self-efficacy and performance in breastfeeding. Given the crucial role of breastfeeding in ensuring the well-being of both mother and child, further research is imperative to identify suitable and impactful interventions that can encourage breastfeeding practices among adolescents.

TRIAL REGISTRATION

The trial protocol of this study has been registered in Iranian Registry of Clinical Trials at 08/09/2021. The registration reference is IRCT20200530047596N3.

Experiences of persons with multiple sclerosis of a collaborative care programme: A qualitative study

AIM

This study aimed to explain the experiences of individuals with multiple sclerosis (MS) about the collaborative care programme.

DESIGN

This qualitative study was conducted from July 2021 to March 2022.

METHODS

We conducted this study with individuals with MS who participated in the collaborative care programme in Hamadan, Iran. A purposive sampling with maximum variety was applied to recruit patients until data saturation. Eventually, 18 patients consented and were interviewed using a semi-structured interview guide. The transcriptions of audio-checked interviews were analysed using a conventional content analysis approach of Graneheim and Lundman by MAXQDA 10, 2010 edition.

RESULTS

The study identified three main categories. that emerged from the participants' experiences of collaborative care: the 'Beginning of Communication', which included two subcategories, 'Introduction and Acquaintance with Each Other' and 'Formation of Trust'; 'Mutual Interaction', which included three subcategories, 'Dialogue', 'Mutual Goal Setting' and 'Mutual Agreement of Care Solutions'; and 'Exchange of Targeted Behaviors', which included six categories, Implementation of Strategies for 'Nutritional Behaviors', 'Sleep and Rest', 'Constipation Relief', 'Promotion of Physical Activity and Exercise', 'Fatigue Reduction' and 'Stress Management'.

CONCLUSIONS

The findings highlight the statistically significant role of collaborative care in MS management. Utilizing these research findings can update the development of interventions based on collaborative care, which can provide appropriate support to individuals with MS.

PATIENT OR PUBLIC CONTRIBUTION

Individuals with multiple sclerosis.

The Boosting Effects of Melatonin on the In Vitro Fertilization (IVF) of Women with Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is one of the most critical disorders, which affects approximately 20% of women of childbearing age and melatonin supplementation in these women can be effective. However, human studies in this area are particularly limited to IVF candidates. The aim of this clinical trial study was to evaluate the effect of melatonin on the in vitro fertilization (IVF) in PCOS involved women. In this clinical trial study, a total of 320 women with PCOS were randomly assigned to the intervention and control groups. Patients in the intervention group (n=160) received a combination of melatonin and metformin (3 mg and 500 mg, respectively) three times a day. The control group (n=160) received metformin 500 mg from the luteal phase of the cycle before the start of gonadotropin. Oocyte and embryo quality, number of oocytes, and pregnancy outcomes were compared in both groups. Our study revealed that the frequency of Metaphase II oocytes (69.9% vs. 57.9%, p<0.001) and the number of embryos of the top-quality (grade A) were higher in the group treated with melatonin (40.3% vs. 29.9%, p=0.001). The rate of clinical pregnancy and implantation were also higher in the intervention group. The odds of clinical pregnancy in the intervention group was 1.8 times (p=0.039). Moreover, oral melatonin supplementation was effective in patients with PCOS, who were candidates for IVF because of the increased quality of mature oocytes, top-quality embryos, and increased odds of clinical pregnancy.

Aging and Speech-in-Noise Perception

The objective was investigating the effect of age on speech-in-noise perception (SINP) using word perception score in white noise (WPS in WN). This cross-sectional study was conducted on 76 participants, including 30 elderly (older than 61 years) and 46 young adults (between 14 and 35 years) with normal levels of stress, night sleep and mini-mental states. Audiological evaluations included acoustic immittance testing, pure tone audiometry, determination of speech reception threshold and WPS in WN. Data analysis were performed using Mann-Whitney and Tukey HSD tests. Based on the results of the tests, the participants were divided into three groups: (1) young adults with normal hearing (n = 30), (2) elderly adults with normal hearing (n = 16), (3) elderly adults with mild to moderate high frequency hearing loss (n = 14). In both groups of old adults, the means WPS in WN differences were significant only in the left ears (Pv = 0.008, 0.033, 0.025 for SNR = 0, +5, +10 dB). In the three groups and in the right ears, there were the significant differences between the means of WPS in WN (Pv = 0.002, 0.000, 0.001 for SNR = 0, +5, +10 dB), and also the left ears (Pv = 0.000, 0.002, 0.002 for SNR = 0,+5, +10 dB).There is a relationship between increasing age and decreasing WPS in WN. The deleterious effects of aging on SINP decline are greater than that of hearing loss.

Co-delivery of streptomycin and hydroxychloroquine by labeled solid lipid nanoparticles to treat brucellosis: an animal study

Can brucellosis-related biochemical and immunological parameters be used as diagnostic and treatment indicators? The goal of this project was to look at biochemical parameters, trace elements, and inflammatory factors in the acute and chronic stages of brucellosis after treatment with streptomycin and hydroxychloroquine-loaded solid lipid nanoparticles (STR-HCQ-SLN). The double emulsion method was used for the synthesis of nanoparticles. Serum levels of trace elements, vitamin D, CRP, and biochemical parameters were measured in rats involved in brucellosis. The therapeutic effect of STR-HCQ-SLN was compared with that of free drugs. In both healthy and infected rats, serum concentrations of copper, zinc, iron, magnesium, potassium, and biochemical parameters of the liver were significantly different. By altering the serum levels of the aforementioned factors, treatment with STR-HCQ-SLN had a positive therapeutic effect on chronic brucellosis. Vitamin D levels declined (46.4%) and CRP levels rose (from 7.5 mg to less than 1 mg) throughout the acute and chronic stages of brucellosis. This study showed that by comparing the biochemical parameters and the levels of trace elements in the serum of healthy and diseased mice in the acute and chronic stages of brucellosis, it is possible to get help from other routine methods for diagnosis.

The psychological symptoms and behavioral problems of children with mothers working as medical staff in the crisis of Covid-19 outbreak in Hamadan, Iran

Background and objectives

The purpose of this study was to investigate the psychological symptoms and behavioral problems of children with mothers working as medical staff in the crisis of Covid-19 disease in Hamadan.

Methods

This descriptive causal-comparative study was conducted on all mothers with children aged 6 to 12  years in Hamadan from September 2 to November 29, 2020. In this study, eligible individuals were selected using random sampling and were assigned to two groups of mothers working as the medical staff and the control group. The research instruments included the Child Behavior Checklist (Achenbach) and the Child Symptom Inventory-4 (CSI-4).

Results

The results showed that the mean scores of psychological and behavioral symptoms of children in terms of group membership (group of mothers working in the medical staff and control group) had a significant difference. There was a significant difference between the mean scores of depression and aggression in children of the staff group and the control group meaning that for depression and aggression scores of children of the staff group are higher than children of the control group (p < 0.05). There was no significant difference between the mean anxiety scores and there was almost a significant difference between the attention scores of the staff group and the control group (p < 0.05).

Conclusion

Children whose mothers worked as medical staff during Covid-19 show more depression, attention, and aggression problems than children whose mothers do not work as medical staff.

Novel Pyrano[3,2-c]quinoline-1,2,3-triazole Hybrids as Potential Anti-Diabetic Agents: In Vitro α-Glucosidase Inhibition, Kinetic, and Molecular Dynamics Simulation

In this study, a novel series of pyrano[3,2-c]quinoline-1,2,3-triazole hybrids 8a-o were synthesized and evaluated against the α-glucosidase enzyme. All compounds showed significant in vitro inhibitory activity (IC₅₀ values of 1.19 ± 0.05 to 20.01 ± 0.02 μM) compared to the standard drug acarbose (IC₅₀ = 750.0 μM). Among them, 2-amino-4-(3-((1-benzyl-1H-1,2,3-triazol-4-yl)methoxy)phenyl)-5-oxo-5,6-dihydro-4H-pyrano[3,2-c]quinoline-3-carbonitrile (compound 8k) demonstrated the best inhibitory effect toward α-glucosidase (IC₅₀ = 1.19 ± 0.05 μM) with a competitive pattern of inhibition. Since compound 8k was synthesized as a racemic mixture, molecular docking and dynamics simulations were performed on R- and S-enantiomers of compound 8k. Based on the molecular docking results, both R- and S-enantiomers of compound 8k displayed significant interactions with key residues including catalytic triad (Asp214, Glu276, and Asp349) in the enzyme active site. However, an in silico study indicated that S- and R-enantiomers were inversely located in the enzyme active site. The R-enantiomer formed a more stable complex with a higher binding affinity to the active site of α-glucosidase than that of the S- enantiomer. The benzyl ring in the most stable complex ((R)-compound 8k) was located in the bottom of the binding site and interacted with the enzyme active site, while the pyrano[3,2-c]quinoline moiety occupied the high solvent accessible entrance of the active site. Thus, the synthesized pyrano[3,2-c]quinoline-1,2,3-triazole hybrids seem to be promising scaffolds for the development of novel α-glucosidase inhibitors.

Correlation of Wilms' Tumor 1 (WT1) with Oxidative Stress Markers and Expression of miR-361-5p; New Aspect of WT1 in Breast Cancer

Breast carcinoma is a heterogeneous disease that affects millions of women worldwide. Wilms' tumor 1 (WT1) is an oncogene that promotes proliferation, metastasis and reduces apoptosis. MicroRNAs (miR) are short noncoding RNAs with a major role in cancer metastasis. In present study, we investigated the association of serum level of WT1 with oxidative stress and expression of miR-361-5p in breast cancer. Serum samples of 45 patients and of 45 healthy women analyzed for protein level of WT1, malondialdehyde (MDA), total oxidant status (TOS), and total antioxidant capacity (TAC). Serum and tissue expression of miR-361-5p in 45 tumor tissues and 45 paired non-tumor adjacent tissues and 45 serum samples of patients and healthy women analyzed by qRT-PCR. Protein levels of WT1 not significantly difference in serum of patients compared to healthy controls. Serum levels of MDA and TOS in patients were higher, but TAC level was lower than healthy controls (p < 0.001). There was a positive correlation between WT1 with MDA and TOS, and a negative correlation between WT1 with TAC in patients. miR-361-5p expression in tumor tissues and serum of patients was lower than non-tumor adjacent tissues and serum of healthy controls, respectively (p < 0.001). Moreover, there was a negative correlation between miR-361-5p and WT1 in patients. The positive correlation between WT1 with MDA and TOS and negative correlation between TAC and miR-361-5p suggests that this gene can play an important role in worse prognoses in breast cancer. Additionally, miR-361-5p may serve as an invasive biomarker for early detection of breast cancer.

The effect of the combined system of hydrodynamic cavitation, ozone, and hydrogen peroxide on chlorophyll a and organic substances removal in the raw water

Increased levels of nutrients and algae can cause drinking water problems in communities. Harmful algal blooms affect humans, fish, marine mammals, birds, and other animals. In the present study, we investigated the use of a combined system [Hydrodynamic Cavitation, Ozone (O₃), and Hydrogen Peroxide (H₂O₂)] on the removal of Chlorophyll a and Organic substances in the raw water was investigated. The Effect of different operating conditions such as pH, cavitation time, pressure, distance, flow rate, ozone dose, and hydrogen peroxide concentration was studied. Utilizing the Taguchi design method, experiments were planned and optimized. The combined system treatment yielded a maximum reduction in Chlorophyll a and Total Organic Carbon (TOC) at an optimum condition of pH 5, cavitation pressure 5 bar, flow rate of 1 m³/h, a distance of 25 cm from the orifice plate, O₃ 3 g/h and 2 g/l of H₂O₂ concentrations. The most efficient factor in the degradation of TOC and Chlorophyll a, was cavitation pressure based on the percentage contributions of each parameter (38.64 percent and 35.05 percent, respectively). H₂O₂ was found to have the most negligible impact on degradation efficiency (4.24 percent and 4.11 percent, respectively).

Treatment adherence and associated factors in older people with type 2 diabetes: A qualitative study

PATIENT CONTRIBUTION

Older people with T2D participated in this study to achieve the objective of the study.

AIM

Treatment adherence is an important indicator for evaluating successful diabetes control and overall disease management. It is necessary to identify the hidden themes of the concept of treatment adherence and related factors based on the experiences of older people with T2D. Therefore, the present study was conducted to identify the concept of treatment adherence and its associated factors in older people with type 2 diabetes (T2D).

DESIGN

The study was conducted as a qualitative study using a content analysis approach.

METHODS

Semi-structured interviews were conducted with 20 older people with T2D, between May and September 2021. Data were organized using MAXQDA-10 software and analysed using the Elo and Kyngas qualitative content analysis method. We followed the COREQ Checklist to ensure rigour in our study.

RESULTS

Three themes emerged from the analysis of the data, including: 'Health literacy', 'Support umbrella' and 'responsibility'.

Relationship between moral sensitivity of nurses and quality of nursing care for patients with COVID-19

AIM

This study aimed to: (1) assess the level of moral sensitivity of nurses and the quality of nursing care for patients with COVID-19 in Iran; and (2) identify the relationship between the moral sensitivity of nurses and the quality of nursing care for patients with COVID-19 in Iran.

DESIGN

This study was designed as a descriptive, cross-sectional, and correlational research.

METHOD

A total of 211 nurses working in four hospitals affiliated with the Hamadan University of Medical Sciences in Iran from December 2021 to April 2022 were selected via the stratified proportional random sampling method. Demographic information, a moral sensitivity questionnaire, and the Good Nursing Care Scale were used for data collection. The data were analysed by SPSS 24 based on descriptive and inferential statistics (Pearson correlation coefficient and multiple regression).

RESULTS

Results revealed that 188 of the nurses (89.1%) had a moderate level of moral sensitivity. Furthermore, 160 of the participants (75.8%) reported a relatively low level of the quality of nursing care. The results of the Pearson correlation coefficient test indicated that there was an inverse and significant relationship between the moral sensitivity of nurses and the quality of nursing care (r = -0.528, p < 0.001). The results of multiple regression indicated that the model of moral sensitivity components explained 27.9% of the variance in the quality of nursing care. The components of moral sensitivity, including relation (β = -0.246, p < 0.001), meaning (β = -0.188, p = 0.003), conflict (β = -0.170, p = 0.008), benevolence (β = -0.153, p = 0.012), and rules (β = -0.144, p = 0.019) had inverse and significant effects on the quality of nursing care.

CONCLUSION

Since higher mean scores of moral sensitivity reflect lower moral sensitivity, it can be stated that with the increase in moral sensitivity of nurses, the quality of nursing care for patients with COVID-19 grows.

Chlorogenic acid protective effects on paraquat-induced pulmonary oxidative damage and fibrosis in rats

Paraquat (PQ) is a widely used herbicide that can cause severe oxidative and fibrotic injuries in lung tissue. Due to the antioxidant and anti-inflammatory properties of chlorogenic acid (CGA), the present study investigated its effects on PQ-induced pulmonary toxicity. To this end, 30 male rats were randomly categorized into five groups of six. Initially, the first and third groups were treated intraperitoneally (IP) with normal saline and CGA (80 mg/kg) for 28 consecutive days, respectively. The second, fourth, and fifth groups were treated with normal saline and 20 and 80 mg/kg of CGA for 28 consecutive days, respectively, and received a single dose of PQ (IP, 20 mg/kg) on Day 7. Then, the animals were anesthetized with ketamine and xylazine, and lung tissue samples were collected for biochemical and histological examinations. The results showed that PQ significantly increased hydroxyproline (HP) and lipid peroxidation (LPO) and decreased the lung tissue antioxidant capacity. In addition, myeloperoxidase (MPO) activity increased significantly, while glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD) activity declined substantially. The administration of therapeutic doses of CGA could prevent the oxidative, fibrotic, and inflammatory effects of PQ-induced lung toxicity, and these changes were consistent with histological observations. In conclusion, CGA may improve the antioxidant defense of lung tissue and prevent the spread of inflammation and the development of PQ-induced fibrotic injuries by enhancing antioxidant enzymes and preventing inflammatory cell infiltration.

Studying of Distortion Product of Otoacoustic Emissions in Menopausal Women

Introduction

The sex hormones; estrogen and progesterone have a direct effect on the mechanisms of the inner cochlea and they control the functions of the ascending auditory pathway from the auditory nerve to the cerebral cortex. Therefore, the aim of this study was to determine the amplitude of distortion product of otoacoustic emissions (DPOAE) in postmenopausal women.

Materials and Methods

This cross-sectional case-control study included 60 women who were naturally menopausal and were in the age range of 55 - 45 years (case group). The other 60 included women of the same age and non-menopause (control group). Both groups were selected from individuals who had normal auditory function based on pure tone audiometry, immitance audiometry (tympanometry + ipsilateral and contralateral reflex), speech tests and auditory brainstem responses. Then both groups were evaluated by DPOAE and its findings were analyzed in two groups based on independent t-test and the significance level of the test was determined to be less than 0.05.

Results

The difference between the mean DPOAE domains in the two groups was not significant (P-value = 0.484).

Conclusion

Menopause is not an etiological factor to be created of abnormalities in the cochlea of ​​the inner ear.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-022-03210-1.

Effect of Fennel-Valerian Extract on Hot Flashes and Sleep Disorders in Postmenopausal Women: A Randomized Trial

OBJECTIVES

This study aims to evaluate the effect of a mixture of fennel and valerian extracts on hot flashes and sleep disorders of postmenopausal women in Iran. A randomized trial was conducted.

METHODS

A total of 76 postmenopausal women were randomly assigned to either of the two groups: fennel-valerian extract or control. One 500 mg fennel-valerian extract capsule was given twice, daily for 8 weeks. The 500 mg oral placebo capsule (starch) was given the same way.

RESULTS

The mean duration of hot flashes increased in both the groups over time (P < 0.001). The mean frequency and severity of hot flashes in the intervention group were significantly lower than in the control group, in the first and second months after intervention (P < 0.050). Women in the fennel-valerian extract group had a significantly lower Pittsburgh Sleep Quality Index score than the control group 2 months after intervention (P = 0.030).

CONCLUSIONS

This study found that fennel-valerian extract was effective for relieving sleep disorders as well as the severity and frequency of hot flashes compared with a placebo.

The best location for the application of static magnetic fields based on biokinetic coefficients in complete-mix activated sludge process

The use of the kinetic coefficients for the mathematical expression of the biochemical processes and the relationship between the effective parameters is importance. Change of the biokinetic coefficients in the complete-mix activated sludge processes were calculated for 1 month operation of the activated sludge model (ASM) in a Lab-scale in three series. 15 mT intensity of static magnetic fields (SMFs) applied on the aeration reactor (ASM 1), clarifier reactor (ASM 2) and, sludge returning systems (ASM 3) for 1 h, daily. During the operation of the systems, five basic biokinetic coefficients such as maximum specific substrate utilization rate (k), heterotrophic half-saturation substrate concentration (K_s), decay coefficient (k_d), yield coefficient (Y) and, maximum specific microbial growth rate (μ_max) were determined. The rate of k (g COD/g Cells.d) in ASM 1 was 2.69% and, 22.79% higher than ASM 2 and, ASM 3. The value of K_s (mg COD/L) was 54.44 and, 71.13 (mg/L) lower than the ASM 2 and, ASM 3. The rate of k_d ASM 1, ASM 2 and, ASM 3 was 0.070, 0.054 and, 0.516 (d^-1). The value of Y (kg VSS/kg COD) in ASM 1 was 0.58% and, 0.48% lower than ASM 2 and, ASM 3. The rate of μ_max (d^-1) in ASM 1 was 0.197, this value for ASM 2 and ASM 3 were 0.324 and 0.309 (d^-1). Related to the biokinetic coefficients analyses the best location for the application of 15 mT SMFs was the aeration reactor, where the present of oxygen, substrate and, SMFs have the greatest impact on the positive changes of these coefficients.

Neuroprotective effects of vinpocetine, as a phosphodiesterase 1 inhibitor, on long-term potentiation in a rat model of Alzheimer's disease

BACKGROUND

Vinpocetine (Vin) is known as a phosphodiesterase 1 inhibitor (PDE1-I) drug with multilateral effects, including antioxidant and anti-inflammatory activity. In this research, we investigated the neuroprotective and therapeutic effects of Vin through hippocampal synaptic plasticity on a rat's model of Alzheimer's disease (AD) induced by an intracerebroventricular (ICV) injection of beta-amyloid (Aβ).

METHODS

Sixty adult male Wistar rats were randomly divided into six groups: 1. control, 2. sham, 3. Aβ, 4. pretreatment (Vin + Aβ): Vin (4 mg/kg, gavage) for 30 days and then, inducing an AD model by an ICV injection of Aβ(1-42), 5. treatment (Aβ + Vin): inducing an AD model and then receiving Vin for 30 days by gavage, and 7. pretreatment + treatment (Vin + Aβ + Vin): receiving Vin by gavage for 30 days before and 30 days after the induction of an AD model. After these procedures, via stereotaxic surgery, the stimulating electrodes were placed at the perforant pathway (PP) and the recording electrodes were implanted in the dentate gyrus.

RESULTS

Excitatory postsynaptic potential (EPSP) slope and population spike (PS) amplitude in the Aβ group meaningfully diminished compared to the control group after the induction of long-term potentiation (LTP).

CONCLUSIONS

Vin could significantly prevent the Aβ effects on LTP. It can be concluded that pretreatment and treatment with Vin can be neuroprotective against harmful consequences of Aβ on hippocampal synaptic plasticity.

Development and Psychometric Properties of an Extended Theory of Planned Behavior Questionnaire for Childbearing Intentions and Behaviors in Iran

BACKGROUND

Childbearing is the most important determinant of population fluctuations, and its study is more important than other population phenomena. Owing to the lack of a valid questionnaire based on the extended theory of planned behavior, this mixed-method study was conducted to determine the validity and reliability of a questionnaire designed to examine related belief-based factors on the intention to bear children in Iranian society.

METHODS

This study was conducted in two phases in Hamadan city, western Iran, in 2021. Phase 1 consisted of an extensive literature review and a qualitative study using a directed content analysis approach to generate an item pool. Psychometrics were measured in phase 2, including content, face, and construct validity. Reliability was assessed based on internal consistency and stability. The collected data were analyzed using IBM SPSS and AMOS ver. 24.0.

RESULTS

Mean content validity ratio and content validity index were 0.7 and 0.85, respectively. Exploratory factor analysis of the 32 items identified an eight-factor solution. These factors jointly accounted for 79.1% of the observed variance in the outcome variables. Confirmatory factor analysis indicated a good fit for the data. The internal consistency based on Cronbach's α was 0.85 (0.71-0.93). In addition, stability was confirmed using the test-retest method and intraclass correlation coefficient (0.74-0.94).

CONCLUSION

The designed questionnaire is a valid and reliable instrument for evaluating related belief-based factors on the intention and behavior of childbearing among married men and women in Iran.

Risk assessment of methanol storage tank fire accident using hybrid FTA-SPA

Fire accidents in storage tanks are of great importance due to the difficulty in extinguishing and ease of spread to nearby products. This study aimed to introduce a framework based on FTA-based Set Pair Analysis (SPA) established via experts' elicitation to identify and assess the risk of storage tank fire. In the quantitative FTA of a system, sufficient data are only sometimes available to calculate the failure probability of the system appertains to study. Thus, the obtained result of the SPA added new value to the Basic Events (BEs) and estimated top event. To illustrate the applicability of the proposed approach, a fault tree of the methanol storage tank fire is performed and analyzed BEs. According to the obtained results, the fire accident was computed by 48 BEs, and the occurrence probability value of the top event was estimated 2.58E-1/year. In addition, the most crucial paths that led to the fire accident are listed in this study. The proposed approach established in the present study can assist decision-makers in determining where to take preventative or appropriate action on the storage tank system. Moreover, it can be adjusted for various systems with limited manipulation.

N-Acetyl Cysteine as an Add-on Therapy is Useful in Treating Acute Lumbar Radiculopathy Caused by Disc Herniation: Results of a Randomized, Controlled Clinical Trial

BACKGROUND

Available experimental and clinical evidence indicates that N-Acetyl cysteine (NAC) may have an analgesic role in specific pain conditions, particularly neuropathic pain. Thus, we hypothesized that NAC supplementation might be also helpful in decreasing pain and improving pain-related disability in patients with acute radiculopathy. We designed this study to investigate the potential use of NAC-adjunctive treatment to Nonsteroidal Anti- Inflammatory Drugs (NSAIDs) in patients with acute radiculopathy secondary to lumbar intervertebral disc herniation.

METHODS

Sixty-two patients diagnosed with acute lumbar radiculopathy associated with disc herniation were randomly allocated to the NAC or the placebo groups. Besides naproxen at a dose of 500 mg twice a day, participants based on their allocation group started with NAC or matched placebo at a dose of 600 mg twice a day for eight weeks. The pain severity, measured by the Visual Analog Scale (VAS), and pain-related disability measured by the Oswestry Disability Index (ODI) were measured at baseline and weeks 2, 4, and 8 of treatment. Global improvement of symptoms rated by Patient and Clinical Global Impressions of Change (PGIC and CGIC) was also recorded at the end of week 8. All analyses were conducted on an Intentionto- Treat (ITT) analysis data set.

RESULTS

A comparison of the VAS and ODI scores at weeks 2 and 4 of the treatment between the two groups did not show a significant difference. In contrast, from week 4 to week 8, we noticed a significantly greater reduction in the mean VAS and ODI scores in the NAC group compared to the placebo group (p-value <0.001 for both variables). In parallel with these results, also, more NAC-treated than placebo-treated patients achieved treatment success defined as ''very much'' or ''much improved'' on CGIC and PGIC scales, and these differences reached a significant level (p-value = .011 and p-value = .043).

CONCLUSIONS

This study suggested that NAC might be a relevant candidate for adjunct therapy in managing acute lumbar radiculopathy. Additional clinical trials are needed to validate these findings.

Evaluation of Lactocare® Synbiotic Administration on the Serum Electrolytes and Trace Elements Levels in Psoriasis Patients: a Randomized, Double-Blind, Placebo-Controlled Clinical Trial Study

BACKGROUND

Despite the exact etiopathogenesis of psoriasis remains unknown, the increasing or decreasing of some trace elements and oxidative stress status are considered to play a role. In this study, the effect of Lactocare® synbiotic on the serum levels of trace elements including Zn, Cu, Mg, Na, Fe, P, Ca, and K in the patients with mild to moderate psoriasis was investigated.

METHODS

Sixty-four patients with mild to moderate psoriasis were included. Patients were randomly divided into treatment (n═32) and control (n═32) groups. The treatment group received Lactocare® and the control group received a placebo (two times daily for 12 weeks). Eight patients from the intervention group and 18 patients from the control group discontinued the study because of the recent COVID-19 condition. For routine trace element analysis, the blood samples were collected from all patients at the baseline as well as week 12 post-treatment. The serum was then isolated and the serum levels of trace elements including Fe, K, Ca, Mg, P, Zn, Na, and Cu were measured using an automatic electrolyte analyzer. For confirmation of the effect of Lactocare® on the alteration of serum levels of trace elements, intra-group analysis was performed at two interval times: baseline and week 12 post-treatment.

RESULTS

The serum levels of K, P, and Ca in the placebo group were significantly higher than that of the treatment group at baseline. Serum levels of Zn and Ca were significantly higher in the treatment group compared to the placebo group at week 12 post-treatment. Moreover, a significantly lower serum level of K, P, and Ca in the treatment group at the baseline compared to the placebo group was compensated on week 12 post-treatment. Intra-group analysis in the treatment group showed that the serum levels of Fe, Ca, Mg, P, Zn, and Na was significantly increased at week 12 post-treatment compared to baseline levels. Whereas, intra-group analysis in the control group showed only Ca has a significant difference between baseline and week 12 post-treatment.

CONCLUSION

The serum levels of Fe, Zn, P, Mg, Ca, and Na are increased significantly 12 weeks after oral administration of Lactocare® in psoriatic patients. The serum level of Fe and Cu is affected by sex at pre- and post-treatment. This study supports the concept that Lactocare® exerts beneficial effects in the gastrointestinal tract to improve mineral absorption in psoriatic patients.

Exploring the Role of Heavy Metals and Their Derivatives on the Pathophysiology of COVID-19

Many aspects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its disease, COVID-19, have been studied to determine its properties, transmission mechanisms, and pathology. These efforts are aimed at identifying potential approaches to control or treat the disease. Early treatment of novel SARS-CoV-2 infection to minimize symptom progression has minimal evidence; however, many researchers and firms are working on vaccines, and only a few vaccines exist. COVID-19 is affected by several heavy metals and their nanoparticles. We investigated the effects of heavy metals and heavy metal nanoparticles on SARS-CoV-2 and their roles in COVID-19 pathogenesis. AgNPs, AuNPs, gold-silver hybrid NPs, copper nanoparticles, zinc oxide, vanadium, gallium, bismuth, titanium, palladium, silver grafted graphene oxide, and some quantum dots were tested to see if they could minimize the severity or duration of symptoms in patients with SARS-CoV-2 infection when compared to standard therapy.

Evaluation of SARS-CoV-2 in Indoor Air of Sina and Shahid Beheshti Hospitals and Patients' Houses

Side by side air sampling was conducted using a PTFE filter membrane as dry sampler and an impinger containing a suitable culture medium as a wet sampler. Most of the samples were collected from two hospitals and few air samples were collected from private houses of non-hospitalized confirmed COVID-19 patients. The collected air samples were analyzed using RT-PCR. The results indicated that all air samples collected from the hospitals were PCR negative for SARS-CoV-2. While two of four air samples collected from the house of non-hospitalized patients were PCR positive. In this study, most of the hospitalized patients had oxygen mask and face mask, and hence this may be a reason for our negative results regarding the presence of SARS-CoV-2 in indoor air of the hospitals, while non-hospitalized patients did not wear oxygen and protective face masks in their houses. Moreover, a very high concentration of particles in the size range of droplet nuclei (< 5 µm) was identified compared to particles in the size range of respiratory droplets (> 5-10 µm) in the areas where patients were hospitalized. It can be concluded that using face mask by patients can prevent the release of viruses into the indoor air, even in hospitals with a high density of patients.

The contribution of avoidable factors in doubling or halving the odds of hypertension

Background

Despite the well-known impact of fruit/vegetable consumption, physical activity, body mass index, waist-hip ratio, fasting blood glucose, and total cholesterol on blood pressure, the amount of exposure to these factors is required to halve or double the odds of hypertension is unknown, but it was investigated in this research.

Methods

The data used in this study are derived from results of the seventh Iranian national STEPS survey involving 30,542 adults aged 18 years or older. The questionnaire measured non-communicable disease risk factors covered three different levels including behavioral characteristics, physical and biochemical measurements. The level of exposure to factors necessary to reach the odds ratio of 0.5 or odds ratio of 2.0 was obtained from the coefficients of the multiple logistic regression model.

Results

An OR of 0.5 corresponds to 7 servings of fruit and vegetable consumption daily and burning of 7175 kcal through physical activity at work or recreation daily. An OR of 2.0 corresponds to an increase in body mass index of about 11 kg/m², an increase in the waist-hip ratio of about 18%, an increase in fasting blood glucose of about 77 mg/dl, and an increase in total cholesterol of about 134 mg/dl.

Conclusion

The results of this study indicate how much fruit and vegetable and physical activity halve the odds of hypertension and how much increase in body mass index, the waist-hip ratio, fasting blood glucose, and total cholesterol can double the odds of hypertension. Such information may be useful for developing guidelines by policymakers.

A comprehensive method for the quantification of medication error probability based on fuzzy SLIM

Medication errors can endanger the health and safety of patients and need to be managed appropriately. This study aimed at developing a new and comprehensive method for estimating the probability of medication errors in hospitals. An extensive literature review was conducted to identify factors affecting medication errors. Success Likelihood Index Methodology was employed for calculating the probability of medication errors. For weighting and rating of factors, the Fuzzy multiple attributive group decision making methodology and Fuzzy analytical hierarchical process were used, respectively. A case study in an emergency department was conducted using the framework. A total number of 17 factors affecting medication error were identified. Workload, patient safety climate, and fatigue were the most important ones. The case study showed that subtasks requiring nurses to read the handwritten of other nurses and physicians are more prone to human error. As there is no specific method for assessing the risk of medication errors, the framework developed in this study can be very useful in this regard. The developed technique was very easy to administer.

The Influence of Face Masks on Verbal Communication in Persian in the Presence of Background Noise in Healthcare Staff

Wearing face masks has resulted in verbal communication being more challenging during the COVID-19 pandemic. This study aimed to investigate the effect of face masks on the speech comprehensibility of Persian nurses in healthcare settings. Twenty female nurses from the governmental hospitals randomly participated in an experiment on seven typical commercial face masks at two background noise levels. Nurses' speech intelligibility from a human talker when wearing each face mask was determined based on the speech discrimination score. The vocal effort of nurses wearing each face mask was determined based on the Borg CR10 scale. Based on the linear mixed model, the speech intelligibility of nurses from a human speaker wearing surgical masks, N95 masks, and a shield with face masks were approximately 10%, 20%, and 40-50% lower, respectively, than no-mask conditions (p < 0.01). The background noise decreased the speech intelligibility of nurses by approximately 22% (p < 0.01). The use of a face shield further decreased speech intelligibility up to 30% compared to using a face mask alone (p < 0.01). The vocal efforts of nurses when wearing surgical masks were not significant compared with the baseline vocal efforts (p > 0.05); however, vocal efforts of nurses when wearing N95 and N99 respirators were at an unacceptable level. The face masks had no considerable effect on the speech spectrum below 2.5 kHz; however, they reduced high frequencies by different values. Wearing face masks has a considerable impact on the verbal communication of nurses in Persian. The level of background noise in the healthcare setting can aggravate the effect sizes of face masks on speech comprehensibility.

Effect of ramosetron, a 5-HT3 receptor antagonist on the severity of seizures and memory impairment in electrical amygdala kindled rats

The entorhinal cortex (EC) plays a pivotal role in epileptogenesis and seizures. EC expresses high density of serotonergic receptors, especially 5-HT3 receptors. Cognitive impairment is common among people with epilepsy. The present study investigated the role of 5-HT3 receptor on the severity of seizures and learning and memory impairment by electrical kindling of amygdala in rats. The amygdala kindling was conducted in a chronic kindling manner in male Wistar rats. In fully kindled animals, ramosetron (as a potent and selective 5-HT3 receptor antagonist) was microinjected unilaterally (ad doses of 1, 10 or 100 µg/0.5 µl) into the EC 5 min before the novel object recognition (NOR) and Y-maze tests or kindling stimulations. Applying ramosetron at the concentration of 100 μg/0.5 µl (but not at 1 and 10 µg/0.5 µl) reduced afterdischarge (AD) duration and increased stage 4 latency in the kindled rats. Moreover, the obtained data from the NOR test showed that treatment by ramosetron (10 and 100 µg/0.5 µl) increased the discrimination index in the fully kindled animals. Microinjection of ramosetron (10 and 100 µg/0.5 µl) in fully kindled animals reversed the kindling induced changes in the percentage of spontaneous alternation in Y-maze task. The findings demonstrated an anticonvulsant role for a selective 5-HT3 receptor antagonist microinjected into the EC, therefore, suggesting an excitatory role for the EC 5-HT3 receptors in the amygdala kindling model of epilepsy. This anticonvulsive effect was accompanied with a restoring effect on cognitive behavior in NOR and Y-maze tests.

Prediction of the optimal dosage of coagulants in water treatment plants through developing models based on artificial neural network fuzzy inference system (ANFIS)

PURPOSE

Coagulation and flocculation are the prominent processes and unit-operations in water treatment plants. One of the most challenging operations in water treatment process is determining of the coagulant dose.

METHOD

The Jar-test method is usually used to determine the coagulant dose. Considering that this traditional method is time consuming, associated with human error and highly affected by raw water quality fluctuations. In this study, artificial fuzzy neural network (ANFIS) according to subtractive clustering (SUB) method was applied in order to determine the optimal dose of coagulant in the water treatment plants.

RESULTS

Adopting SUB method tend to moderate the number of rules and the interconnections besides enhancing the model responsibility and smart model recognition. The amount of pH, turbidity of raw water influent, alkalinity, temperature, and electrical conductivity were collected as input data.

CONCLUSIONS

The results of modeling by ANFIS with correlation coefficients of 0.85 and 0.84 and RMSE 1.32 and 1.83, respectively, for alum and polyaluminum chloride (PAC) coagulant dose, indicated that ANFIS is an effective method for determination of the optimal coagulation dose in the water treatment plant.

Sex differences in spatial learning and memory and hippocampal long-term potentiation at perforant pathway-dentate gyrus (PP-DG) synapses in Wistar rats

BACKGROUND

Recent studies show that gender may have a significant impact on brain functions. However, the reports of sex effects on spatial ability and synaptic plasticity in rodents are divergent and controversial. Here spatial learning and memory was measured in male and female rats by using Morris water maze (MWM) task. Moreover, to assess sex difference in hippocampal synaptic plasticity we examined hippocampal long-term potentiation (LTP) at perforant pathway-dentate gyrus (PP-DG) synapses.

RESULTS

In MWM task, male rats outperformed female rats, as they had significantly shorter swim distance and escape latency to find the hidden platform during training days. During spatial reference memory test, female rats spent less time and traveled less distance in the target zone. Male rats also had larger LTP at PP-DG synapses, which was evident in the high magnitude of population spike (PS) potentiation and the field excitatory post synaptic potentials (fEPSP) slope.

CONCLUSIONS

Taken together, our results suggest that sex differences in the LTP at PP-DG synapses, possibly contribute to the observed sex difference in spatial learning and memory.