A Salivary Gland Resident Macrophage Subset Regulating Radiation Responses

Radiotherapy of head and neck cancers frequently leads to irreversible hypofunction of salivary glands, which severely compromises the quality of life and is extremely difficult to treat. We found recently that salivary gland resident macrophages are sensitive to radiation and interact with epithelial progenitors and endothelial cells through homeostatic paracrine factors. Heterogeneous subpopulations of resident macrophages are present in other organs with distinct functions, whereas subpopulations of salivary gland resident macrophages with distinct functions or transcriptional profiles have not been reported yet. Using single-cell RNA sequencing, we found that mouse submandibular glands (SMGs) contain 2 distinct self-renewing resident macrophage subsets, an MHC-IIhi subset present in many other organs and an uncommon Csf2r+ subset. The main source of Csf2 in SMGs are innate lymphoid cells (ILCs) that rely on IL15 for maintenance, while the main source of IL15 protein is Csf2r+ resident macrophages, indicating a homeostatic paracrine interaction between these cells. Csf2r+ resident macrophages are the major source of hepatocyte growth factor (Hgf) that regulates homeostasis of SMG epithelial progenitors. Meanwhile, Csf2r+ resident macrophages are responsive to Hedgehog signaling that can rescue salivary function impaired by radiation. Consistently, irradiation persistently decreased numbers of ILCs and levels of IL15 and Csf2 in SMGs, which were all recovered by transient activation of Hedgehog signaling after radiation. Csf2r+ resident macrophages and MHC-IIhi resident macrophages share transcriptome profiles of perivascular macrophages and macrophages associated with nerves and/or epithelial cells in other organs, respectively, and such niche preferences were supported by lineage tracing and immunofluorescent staining. These findings reveal an uncommon resident macrophage subset that regulates the homeostasis of the salivary gland and is promising as the target to restore salivary gland function impaired by radiation.

Challenges in Access to Support Resources for Diabetic Patients: A Qualitative Study in Deprived Areas of Iran

OBJECTIVES

This study aimed to identify the perceptions of challenges in access to diabetes-related support resources among patients with type 2 diabetes and their family caregivers.

METHODS

This qualitative study was conducted with 18 patients with type 2 diabetes and nine of their family caregivers, using the conventional content analysis method, in 2020 in Lorestan Province, Iran. The participants were selected through purposive sampling and the process continued until the data was saturated. Thirty semi-structured interviews, carried out from February to April 2020, were used to collect the data; they were analyzed using Graneheim and Lundman's content analysis (2004).

RESULTS

The study showed two main categories of structural challenges (subcategories: shortage of skilled professionals and defects in executive processes) and destructive inefficiencies (subcategories: service bottlenecks, uncertain support, and irresponsibility of medical team), indicating the dimensions of the participants' perceptions of barriers to support.

DISCUSSION

The findings of the study showed that barriers relating to the structure and function of healthcare organizations were among the most important challenges perceived by patients with diabetes when pursuing their care. However, there may be other barriers that have not been addressed due to the lack of support resources in deprived areas and the lack of awareness of patients.

Effect of Peer Support on Health Literacy in Diabetic Patients With Limited Access to Support Resources in Iran: A Randomized Clinical Trial

Background: Health literacy (HL) is one of the factors influencing the use of health-related information by patients with diabetes. As a social support resource, peers can help improve diabetes knowledge in these patients. The aim of this study was to determine the effect of peer support on HL in patients with type 2 diabetes (T2D) with low support resources. Methods: This randomized controlled trial was conducted on 80 patients with T2D referring to a diabetes clinic in Aligoudarz. Patients meeting the inclusion criteria were selected by the random sampling method and randomly assigned to two groups of intervention and control each containing 40 cases. The data were collected using the Test of Functional Health literacy in Adults (TOFHLA) at the beginning of the study and after 3 months of educational peer support intervention. Eventually, data were analyzed by the statistical tests of chi-square, Fisher’s exact test, t test, and paired t test. Results: The results showed that there was no significant difference in the mean (±SD) HL between the two groups before the intervention (53.12±13.86 vs. 56.62±10.34, P=0.204). However, the mean HL in the intervention group represented a significant improvement after 3 months of peer intervention compared to the control group (70.27±9.78 vs. 56.87±10.07, P<0.001). Conclusion: Overall, peer support was found to be effective in improving the HL of diabetic patients with limited access to support resources. Therefore, it is recommended to use the capacity of peers as a social support resource in diabetes care programs.

The predictors of nursing students' clinical competency in pre-internship objective structured clinical examination: The roles of exam anxiety and academic success

BACKGROUND

Identifying the predictors of nursing students' clinical competency in objective structured clinical examination (OSCE) is of utmost importance. Therefore, the present study was to investigate the predictive roles of exam anxiety and academic success in nursing students' clinical competency in the pre-internship OSCE.

METHODS

In this descriptive-analytical study, a total number of 102 nursing students, meeting the inclusion criteria and enrolled in the sixth semester (third year) of the graduate nursing program in Iran, were firstly selected by the census method. The pre-internship OSCE was then implemented at eight stations based on a pre-designed schedule template. The required data were also collected through a demographic-academic characteristics questionnaire and the State-Trait Anxiety Inventory to determine the exam anxiety score, the nursing program grade point average (GPA) to reflect on the levels of academic success, and the OSCE score to control clinical competency. The data analysis was also performed at the significance level of 0.05.

RESULTS

The linear regression model, in which the exam anxiety, the nursing program GPA, and the demographic-academic characteristics variables had been imported, could explain 33.52% of the variance of the nursing students' clinical competency in the pre-internship OSCE (R² = 0.616). Of the variables concerned, only the nursing program GPA could be a significant predictor of the nursing students' clinical competency scores in the OSCE, so that 0.8 points were added to the clinical competency scores in the OSCE as the nursing program GPA increased by one unit (p = 0.000, β = 0.717), but no significant relationship was observed between exam anxiety and clinical competency in the pre-internship OSCE among the nursing students.

CONCLUSIONS

The results of this study endorsed the use of the OSCE in assessing the nursing students' clinical competency and implementing learning strategies to strengthen the levels of academic success in such individuals.

The effect of peer support on quality of life among type 2 diabetic patients in deprived areas in Iran: A randomized clinical trial

BACKGROUND

Quality of life (QOL) is one of the effective factors in promoting the health of diabetic patients. In recent years, the role of peer support in the optimal management of diabetes has gained increasing attention. However, contradictory results have been reported from the effectiveness of this method. This study aimed to investigate the effect of peer support on the QOL among type 2 diabetic patients in deprived areas.

MATERIALS AND METHODS

This study was a randomized clinical trial conducted on 80 patients with T2D referring to the diabetes Clinic in Aligoudarz in Iran. Participants were randomly assigned into two groups of 40 patients. Intervention group received a peer Supportive-educational program for 3 months and the control group received routine clinic care. Diabetes QOL brief clinical inventory was used to collect the data. This questionnaire was completed three times at the beginning of the study, immediately after the 3-day training, and after 3 months of peer supportive intervention. The SPSS software (v. 18.0) was used to analyze the data through the Generalized Estimating Equations.

RESULTS

There was no significant difference in mean QOL between the two groups before the intervention (P = 0.891) and immediately after the education (P = 0.076). However, after 3 months of intervention, the intervention group showed a significant improvement in mean QOL compared to those in the control group (P < 0.001).

CONCLUSION

Peer support program can improve the QOL in type 2 diabetic patients in deprived areas. Therefore, this method can be recommended to improve care and educational programs in these patients.

Is Telenursing an Effective Method to Control BMI and HbA1c in Illiterate Patients Aged 50 Years and Older With Type 2 Diabetes? A Randomized Controlled Clinical Trial

Introduction: Telenursing is a simple method to provide and maintain nursing care for patients with chronic illness such as diabetes. This study aimed to determine the effectiveness of telenursing on body mass index (BMI) and glycosylated hemoglobin (HbA1c) in illiterate patients aged 50 years and older with type 2 diabetes.

Methods: A randomized controlled clinical trial was performed. Sixty patients with type 2 diabetes who referred to Aligoodarz diabetes clinic (Lorestan, Iran) were randomly assigned to the intervention and control group. Each patient was assessed before and after intervention for the following clinical parameters: HbA1c by Drew-DS5 analyzer and weight by scale (Sahand BMI electronic scale /Iran). All patients received diabetes self-care training for 3 days before the study. Telephone follow ups were applied in intervention group for 12 weeks. The data were analyzed using chi-square, paired t test and independent t test by SPSS11.

Results: Results showed statistically significant decrease in BMI at the end of the training from 29.28 (3.29) to 28.35 (3.37) kg/m 2 and statistically significant decrease in HbA1c from 8.96 (1.24) to 7.56 (0.71) in the intervention group. The effect size base on Cohen’s formula for BMI and HbA1c was Cohen’s d = 2.85, effect size r = 0.81 and Cohen’s d = 2.04, effect size r = 0.71, respectively.

Conclusion: The findings indicate that nurse-led telephone follow up can increase adherence from treatment program and has beneficial effects on HbA1c and BMI in illiterate patients aged 50 years and older with type 2 diabetes.

Model selection for athermal cross-linked fiber networks

Athermal random fiber networks are usually modeled by representing each fiber as a truss, a Euler-Bernoulli or a Timoshenko beam, and, in the case of cross-linked networks, each cross-link as a pinned, rotating, or welded joint. In this work we study the effect of these various modeling options on the dependence of the overall network stiffness on system parameters. We conclude that Timoshenko beams can be used for the entire range of density and beam stiffness parameters, while the Euler-Bernoulli model can be used only at relatively low network densities. In the high density-high bending stiffness range, strain energy is stored predominantly in the axial and shear deformation modes, while in the other extreme range of parameters, the energy is stored in the bending mode. The effect of the model size on the network stiffness is also discussed.

Blood pressure of primary-school children of Eghbalieh city, Islamic Republic of Iran

This study determined the percentiles of systolic and diastolic blood pressure and theABSTRACT This study determined the percentiles of systolic and diastolic blood pressure and the prevalence of hypertension among 789 primary-school children aged 7-12 years in the city of Eghbalieh, Islamic Republic of Iran. Mean systolic and diastolic blood pressure increased with increasing age in both sexes. There was no significant difference between mean systolic pressure in boys and girls overall, but a significant difference was found between boys and girls in 3 age groups. The prevalence of systolic and diastolic hypertension overall was 6.5% and 12.8% respectively. The mean systolic and diastolic blood pressure of boys and girls in all age groups were significantly lower than the Second Task Force on Blood Pressure Control in Children scale.

Effect of mycorrhizae, Thiobacillus and sulfur nutrition on the chemical composition of soybean [Glycine max (L.)] Merr. seed

A field experiment carried out in a calcareous soil with a low available phosphorus to evaluate effectiveness of biofertilizers, mycorrhizae (Glomus intraradices) and Thiobacillus sp. inoculation individually or in combination on seed yield, oil, protein and some elements (P, Fe, Mn, Zn) concentration in two soybean [Glycine max (L.) Merr.] cultivars. The applied treatments were different fertilizers with 6 levels (including: NP (control, 12 kg N ha(-1) as urea, 46 kg P2O5 ha(-1) as triple super phosphate); NPK (NP + 75 kg K2O ha(-1) as potassium sulphate); NPKS [NPK+ S (100 kg S ha(-1))]; NPKST (NPKS + seed inoculation with Thiobacillus bacteria); NPKM (NPK + Seed inoculation with mycorrhizae fungi) and NPKSTM (NPKS + seed inoculation with Thiobacillus and mycorrhizae) and two cultivars (JK and 032). Before planting, soybean seeds were inoculated by Bradyrhizobium japonicum in all treatments. Results showed that combined inoculation of biofertilizers increased yield, however the highest yield was observed in treatment NPKST. Increasing oil content (percentage) was more pronounced in treatments NPKM, while most protein content (percentage) increasing was observed in NPKS and NPKM. Fe and Zn concentrations were unaffected significantly by fertilizer treatments, but NPKSTM showed significantly higher value of seed's Mn concentration compared to treatments NP and NPK. Although no significant difference was observed in terms ofP concentration of 032 line among fertilizer treatments, JK cultivar and NPKSTM caused a significant increasing in P concentration compared to NP, NPKS and NPKM. Present results suggested that applying biofertilizers i.e., mycorrhizae and Thiobacillus increased soybean yield compared to control (NP). Overall, this study demonstrated that soybean seed yield and its chemical composition could be affected by biofertilizer inoculation.