Spinal Reirradiation-Mediated Myelopathy: A Systematic Review and Meta-Analysis

Reirradiation of the spine is carried out in 42% of patients who do not respond to treatment or have recurrent pain. However, there are few studies and data on the effect of reirradiation of the spine and the occurrence of acute and chronic side-effects caused by reirradiation, such as myelopathy, in these patients. This meta-analysis aimed to determine the safe dose in terms of biological effective dose (BED), cumulative dose and dose interval between BED1 and BED2 to decrease or prevent myelopathy and pain control in patients undergoing radiation therapy in the spinal cord. A search was carried out using EMBASE, MEDLINE, PUBMED, Google Scholar, Cochrane Collaboration library electronic databases, Magiran, and SID from 2000 to 2022 to recognise qualified studies. In total, 17 primary studies were applied to estimate the pooled effect size. The random effects model showed that the pooled BED in the first stage, the BED in the second stage and the cumulative BED1 and BED2 were estimated at 77.63, 58.35 and 115.34 Gy, respectively. Studies reported on dose interval. The results of a random effects model showed that the pooled interval was estimated at 13.86 months. The meta-analysis revealed that using appropriate BED1 and/or BED2 in a safe interval between the first and second phases of treatment can have an influential role in preventing or reducing the effects of myelopathy and regional control pain in spinal reirradiation.

Impact of corn processing and weaning age on calf performance, blood metabolites, rumen fermentation, and behavior

This study examined the impact of two corn processing methods (steam-flaked (SFC) vs. ground) combined with two weaning ages (50 or 75 days) on calf performance, blood metabolites, rumen fermentation, nutrient digestion, and behavior. The study involved 48 three-day-old Holstein calves, with an average body weight of 41.4 ± 2.2 kg. The experimental design was a 2 × 2 factorial arrangement, resulting in four treatment groups: SFC50 (SFC and weaning at 50 days), SFC75 (SFC and weaning at 75 days), GC50 (ground corn and weaning at 50 days), and GC75 (ground corn and weaning at 75 days). Calves were given whole milk at 4 L/ day from day 3-15 and 7 L/ day from day 16 to either 43 or 68, depending on weaning age. Weaning occurred between days 44 and 50 for early-weaned calves and between days 69 and 75 for late-weaned calves. The study lasted until calves were 93 days old. The starter ration consisted of soybean meal, corn grain, 5% chopped wheat straw and premix. Results indicated that the SFC-based starter feed improved calf performance and nutrient digestion, as evidenced by increased weight gain, dry matter, crude protein, and neutral detergent fiber digestibility. Calves fed the SFC-based starter diet had lower blood albumin and urea N concentrations, while blood total protein and globulin concentrations were higher, especially in early-weaned calves. No significant changes in rumen pH and ammonia-N concentration were observed. In addition, the SFC starter feed resulted in higher volatile fatty acids concentration and longer feeding time in weaned calves compared to ground corn. Overall, these results suggest that an SFC-based starter feed may be beneficial for both early and late weaned calves.

An exploration into the challenges of managing the COVID-19 pandemic in mass education centers in Iran: A qualitative content analysis

Background: During the COVID-19 pandemic, Iran's mass education centers, which house a large number of trainees, encountered numerous difficulties in managing the disease. Understanding these challenges can help manage future pandemics. This study was conducted to explore the challenges of managing the COVID-19 pandemic in mass education centers in Iran. Methods: In this qualitative study, we used a qualitative content analysis of data collected from June to October 2022 in eight mass education centers in Iran. Semi-structured interviews (n=19) were used for data collection. Results: Four main themes and eleven subthemes were identified: The essence of dormitory life (Subthemes included: "The high population density in the dormitory", "Public toilets" and, Interprovincial travel), the inflexibility of the profession (Subthemes included: "Inapplicable health protocols" and, "Inflexible rules and regulations"), Negligence (Subthemes included: "Not adhering to health protocols", "Non acceptance of illness", and "High-risk taking"), and Weakness of health-care platform (Subthemes included: "shortage of healthcare facilities", "Lack of specialized personnel", and "The uni-dimensional aspect of healthcare services"). Conclusion: We identified several challenges that made the handling of COVID-19 difficult in Iran's centers for mass education. These findings can help future research in addressing the challenges and designing adaptable plans for pandemic management in mass education centers.

Cytosolic Calcium Measurement Utilizing a Single-Cell Biochip to Study the Effect of Curcumin and Resveratrol on a Single Glioma Cell

A microfluidic method has been developed for real-time measurement of the effects of curcumin on the intracellular calcium concentration in a single glioma cell (U87-MG). This method is based on quantitative fluorescence measurement of intracellular calcium in a cell selected in a single-cell biochip. This biochip consists of three reservoirs, three channels, and a V-shaped cell retention structure. Because of the adherent nature of glioma cells, a single cell can adhere within the aforementioned V-shaped structure. The single-cell calcium measurement will minimize cell damage caused by conventional cell calcium assay methods. Previous studies have shown that curcumin increased cytosolic calcium in glioma cells using the fluorescent dye: Fluo-4. So in this study, the effects of 5 μM and 10 μM solutions of curcumin on the increases of cytosolic calcium in a single glioma cell have been measured. Moreover, the effects of 100 μM and 200 μM of resveratrol are measured. At the final stage of the experiments, ionomycin was used to increase the intracellular calcium to the highest possible level due to dye saturation. It has been demonstrated that microfluidic cell calcium measurement is a real-time cytosolic assay that requires small quantities of reagent, which will have potential uses for drug discovery.

The occurrence of flexion-relaxation phenomenon in elite cyclists during trunk forward bending

Flexion-relaxation phenomenon (FRP) is a well-known phenomenon in spinal extensor muscles. According to the literature, prolonged flexed posture leads to creep phenomenon and affects the active and passive neuromuscular control of the spinal column. The purpose of this study was to investigate FRP occurrence in elite cyclists that prolonged flexion posture is an integral part of their professional life. Their muscles' contraction pattern during forward bending was also compared. Electromyography (EMG) was recorded during flexion and extension from standing position in thoracic erector spinae (TES), lumbar erector spinae (LES) and gluteus maximus (Gluteus max) in 15 healthy male elite cyclists. In addition, the kinematic data related to the trunk angles were simultaneously recorded by a motion analysis system. Two-way ANOVA was used to assess the effects of muscle group and direction of movement on maximum amplitude of EMG activity. Among 15 cyclists, FRP was detectable in 60%, 87% and 73% of the participants in TES, LES and Gluteus max, respectively, and happened between 74% and 82% of the trunk flexion. There was no statistically significant difference in onset and offset of muscles FRP. Despite prolong hyper kyphotic posture, FRP was identifiable in TES, LES and Gluteus max muscles of elite cyclists.

Distinguishing Characteristics of COVID-19-Associated Mucormycosis; a Case Series

INTRODUCTION

Since the emergence of COVID-19 pandemic, several articles have reported the co-existence of mucormycosis and COVID-19. This study aimed to distinguish the characteristics of COVID-19-associated rhinocerebral mucormycosis.

METHODS

In this case series, 18 patients with COVID-19-associated rhinocerebral mucormycosis and unique clinical manifestations and outcomes, who were referred to Amiralam Hospital, a tertiary otorhinolaryngology center, Tehran, Iran, during the COVID-19 era, were reported.

RESULTS

Eighteen patients with the mean age of 62.0 ± 11.6 (range: 42 - 83) years were studied (50% males). The mean time interval between diagnosis of COVID-19 and first manifestation of mucormycosis was 15.5 ± 9.7 days. The most common presenting symptom was facial paresthesia (72.2%). Fifty percent of patients developed frozen eye. Palatal necrosis was seen in 7 cases (38.8%). Remarkably, facial paralysis was observed in 5 (27.7%) patients. Another notable clinical picture was cavernous sinus thrombosis, seen in 7 patients. We also had two cases of carotid artery occlusion. Three patients, unfortunately, passed away.

CONCLUSION

Rhinocerebral mucormycosis is one of the most important complications of COVID-19 patients, especially those with underlying diseases. It seems that the key to proper management of mucormycosis is early diagnosis and timely intervention, which could give a patient a chance to live more.

The effects of a team-based planned care program on the quality of sleep in cardiac surgery patients hospitalized in the intensive care unit: A two-group controlled clinical trial

BACKGROUND

Sleep disturbances as a major health problem are common in patients hospitalized in critical care units. This study examined the effects of a team-based care plan on the quality of sleep in patients hospitalized in a cardiac surgery intensive care unit (CSICU) of a multidisciplinary hospital.

MATERIALS AND METHODS

In this clinical trial, 100 patients with cardiac surgery were selKMected through convenience sampling and then nonrandomly allocated to the intervention and or the control group. A plan of care with the recommendation of all intensive care unit care teams was designed and then applied. In this study, the Richards-Campbell Sleep Questionnaire was used to evaluate sleep quality. Patients in the intervention group received the care plan for two consecutive nights. The study's national approval code is IRCT2017091915512N2. Collected data were analyzed using SPSS software (v. 21), and by paired, independent t, Chi-square, and Fisher's exact tests.

RESULTS

Quality of sleep in patients admitted to the CSICU is significantly improved by noise reduction both in the first and second nights. Moreover, the team-based care plan requires good coordination between all team members taking care of cardiac surgery patients admitted to the CSICU (P < 0.001).

CONCLUSIONS

The team-based care plan significantly improves the quality of sleep. It may be due to the close coordination between all team members to avoid sleep disturbances.

Effects of ground, steam-flaked, and super-conditioned corn grain on production performance and total-tract digestibility in dairy cows

This study aimed to evaluate the effects of feeding ground, steam-flaked, or super-conditioned corn on production performance, rumen fermentation, nutrient digestibility, and milk fatty acid (FA) profile of lactating dairy cows. Twenty-four lactating Holstein cows (130 ± 12 d in milk) in a completely randomized block design experiment were assigned to 1 of 3 treatments that contained 31% of one of the following corn types: (1) ground corn; (2) steam-flaked corn; and (3) super-conditioned corn. Actual milk yield was greater in the super-conditioned corn diet than in the steam-flaked and ground corn diets. Dry matter intake, 3.5% fat-corrected milk and energy-corrected milk remained unaffected by treatments; however, milk fat concentration decreased in the super-conditioned corn diet compared with the ground and steam-flaked corn diets. The molar proportion of ruminal acetate decreased in the super-conditioned corn diet compared with the ground and steam-flaked corn diets, whereas the molar proportion of propionate spiked in the super-conditioned corn diet. Ruminal pH dropped in cows fed super-conditioned corn compared with the other 2 diets. A similar pattern was observed for ruminal NH₃-N and acetate-to-propionate ratio. Total-tract starch digestibility increased the most in the super-conditioned corn diet followed by the steam-flaked and ground corn diets (96.8, 95.1, and 92.5%, respectively). The neutral detergent fiber digestibility declined in cows fed the super-conditioned corn diet as opposed to other diets (~3.9%). The concentrations of 16:0 and mixed-FA in milk fat dropped in the super-conditioned corn-based diet compared with the ground corn diet. Milk trans-10 18:1 FA increased, whereas trans-11 18:1 FA decreased in cows fed the super-conditioned diet. We concluded that super-conditioned corn has the potential to increase milk yield and starch digestibility in lactating dairy cows; however, reduced milk fat output caused by altering ruminal pH and ruminal FA biohydrogenation pathways may not be desirable in certain markets. Future research is warranted to investigate how super-conditioned corn affects feed efficiency.

Clinical display, diagnostics and genetic implication of novel Coronavirus (COVID-19) epidemic

COVID-19 pandemic can cause irreparable damage to the involved society. This study aimed to provide a summary of the up-to-dated clinical display, diagnostics, molecular and genetic implications for COVID-19 infected patients. In this review, 73 research articles published before 25 March 2020 were analyzed to better understand the clinical characteristics of patients and to introduce the available serological, hematology and molecular diagnostic methods. Apart from articles extracted from PubMed and Google Scholar, WHO (https://www.who.int/), NHC (National Health Commission of the People's Republic of China (http://www.nhc.gov.cn/), NICE (National Institute for Health and Clinical Excellence, https://www.nice.org.uk/), CDC (Centers for Disease Control and Prevention, https://www.cdc.gov/), and National Administration of Traditional Chinese Medicine (http://www.satcm.gov.cn/) were also accessed to search for eligible studies. Papers published between January 1, 2020, and 25 March 2020 were searched in English and the terms "2019-nCoV, Covid-19, Clinical Characteristics OR manifestation, method of detection, COVID-19 Genome and molecular test" were used. As the pandemic continues to evolve, there have been reports about the possibility of asymptomatic transmission of this newly emerged pneumonia virus. We highlighted the role of HLA haplotype in virus infection as HLA typing will provide susceptibility information for personalized prevention, diagnosis, and treatment in future studies. All the data in this article will assist researchers and clinicians to develop their clinical views regarding infected patients and to emphasize the origin of SARS-CoV-2 for diagnostics.

Medical Dominance in Nursing Education: Qualitative content analysis

Background: Training specialist manpower requires social justice in higher education and inequality leads to the emergence of hierarchies of power and types of dominant or dominated groups. Aim: The aim of the present study was to explain the perceptions and experiences of the heads of nursing departments of Iranian nursing schools regarding medical dominance in nursing education. Methods: The present study was a conventional content analysis. Data collection was carried out using purposeful sampling and in-depth semi-structured interviews with 24 participants. The data analysis process was performed according to Graneheim and Lundman’s qualitative content analysis (2004).  Findings: Data analysis led to the emergence of the theme of "Medical dominance in nursing education" and the three main categories of “physician-centered university education", "weakened educational status", and "belittling nursing education in medical system”. Conclusion: The findings of the present study indicated that physicians enjoy special and superior position in the structure of the Ministry of Health and Medical Education of Iran. Physicians manage the entire system including medical education due to their greater power in managing the system at all micro and macro levels. Thus, other disciplines including nursing education, which are closely related to medicine, are highly ignored.

The Effects of an Evidence-based Nursing Training Workshop on Critical Care Nurses’ Self-efficacy: A Two-group Pretest-posttest Quasi-experimental Study

Introduction: Evidence-based nursing and self-efficacy are significant factors behind quality care delivery in critical care units. Aim: This study aimed to assess the effects of an evidence-based nursing training workshop on critical care nurses’ self-efficacy. Methods: This two-group pretest-posttest quasi-experimental study was undertaken in 2016 in two large-scale hospitals in Tehran, Iran. The participating nurses from one hospital were purposefully allocated to the intervention group and the other hospital’s participants comprised the control group. A convenience sample of 45 nurses was selected from each hospital. For nurses in the intervention group, an evidence-based nursing training workshop was held in four two-hour sessions on two successive days, while the nurses in the control group received no specific evidence-based nursing training. Findings: After the intervention, these values increased to 51.1±2.49 and 61.6±2.05, respectively. The increase in the intervention group was statistically significant (P = 0.001), while the increase in the control group was insignificant (P = 0.06). Thus, the posttest mean score of self-efficacy in the intervention group was significantly greater than the control group. Conclusion: Evidence-based nursing training significantly improves the nurses’ self-efficacy. Therefore, healthcare policy-makers and authorities are recommended to provide nurses with in-service and evidence-based nursing training programs.  

Cosmetic Surgery in Iran: Sociodemographic Characteristics of Cosmetic Surgery Patients in a Large Clinical Sample in Tehran

Sociodemographic characteristics of cosmetic surgery patients are less studied in developing countries. Examining sociodemographic characteristics of cosmetic surgery patients in clinical settings can help surgeons identify their potential patients and highlights marketing opportunities for medical institutions. We conducted this study to determine the sociodemographic details of a large clinical sample from Tehran, Iran. The aim of this study was to present the demographic characteristics of Iranian patients undergoing cosmetic procedures. Tehran was selected from Iran as its most populated city and center of most medical facilities. The present study aimed to examine the sociodemographic characteristics of a large clinical sample (N = 744 patients; 900 cosmetic procedures) who underwent cosmetic surgery in Tehran, Iran. These surgeries were performed by 3 well-known plastic surgeons in Tehran. Sociodemographic details were gathered using patient’s cases and phone interview. A previously published questionnaire with modification was used. Findings suggest that most of the patients (90.7%) are women. Rhinoplasty (61.3%), facial fat injection (6.7%), blepharoplasty (6.3%), facelift (4.0%), and breast augmentation (3.8%) were the top 5 cosmetic procedures in the present sample. Approximately half of the sample (49.6%) was single, and most of married patients (80%) had children. A large number of patients (37.2%) were between 30 and 39 years old. In addition, a considerable proportion of the sample reported university education and being currently employed. This is the first study to document sociodemographic details in a large clinical sample from Iran as an understudied setting. We used insights from evolutionary psychology to explain the large sex differences in the number of cosmetic surgeries. In addition, we compared the findings with existing evidence from the United States and Saudi Arabia. Limitations and future directions are also discussed.

The Triple Classification of Dry Eye for Practical Clinical Use

PURPOSE

"Dry Eye is a condition produced by the inadequate interrelation between lacrimal film and ocular surface epithelium, and is caused by quantitative and qualitative deficits in one or both of them. It can be produced by one or combined etiologic causes, affecting one or several of the secretions of the glands serving the ocular surface, and producing secondary manifestations of different grades of severity". Clinicians need a practical classification to face diagnosis, prognosis and treatment. Dry eyes have many etiologies and pathogenesis, different affectation of the various dacryoglands and ocular surface epithelium, and diverse grades of severity. The specialists in xero-dacryology must know these three parameters to evaluate any case of dry eye, and to establish an adequate treatment.

METHODS

To facilitate this, an open session in the 8th congress of the International Society of Dacryology and Dry Eye (Madrid, April, 2005) proposed modifying the Triple Classification of dry eye approved in the XIV congress of the European Society of Ophthalmology (Madrid, June, 2003). There was consensus of all conclusions.

CONCLUSIONS

The following classification has been established: First, a classification of the etio-pathogenesis, distributed in ten groups: age-related, hormonal, pharmacologic, immunopathic, hyponutritional, dysgenic, infectious/inflammatory, traumatic, neurologic and tantalic. Second, a classification of the affected glands and tissues, which under the acronym of ALMEN includes the Aqueo-serousdeficient, Lipodeficient, Mucindeficient and Epitheliopatic dry eyes, and the Non dacryological affected exocrine glands (saliva, nasal secretion, tracheo-pharyngeal secretion, etc). And thirdly, a classification of severity, in three grades: Grade 1 or mild (symptoms without slitlamp signs), grade 2 or moderate (symptoms with reversible signs), and grade 3 or severe (symptoms with permanent signs).

The Effect of Social Support Skill-training Group Intervention on Perceived Social Support in Veterans with Posttraumatic Stress Disorder

Background:

Traumatic events related to war have long effects on psychiatric psychopathologies. From these disturbing conditions, posttraumatic stress disorder (PTSD) is considered to be the most characteristic feature of psychiatric traumatic experience. The current study was designed to assess the effect of two social support skill-training group interventions on perceived social support in veterans with PTSD.

Materials and Methods:

The study was conducted with the clinical trial method. According to the inclusion criteria, 60 of 367 veterans with PTSD were selected and randomly allocated into two intervention groups and a control group. The two training programs on social support skills consisting of three sessions, each being 1.5–2 h, were held weekly for 3 weeks. The Multidimensional Scale of Perceived Social Support was filled by samples before and 6 weeks after intervention. The data were analyzed by descriptive and analytical statistics using PASW Statistics 18.

Results:

The ANOVA results showed that after intervention, there were significant differences in perceived social support between intervention groups and control group (F = 1.06, p = 0.001), but there was no significant difference between intervention groups by t-test (t = 28.05, p < 0.10). The paired t-test showed a significant difference in all subscale scores of perceived social support between two intervention groups before and after intervention (p < 0.05).

Conclusions:

The results of the current study agreed with the positive effects of social support skill training on perceived social support in veterans with PTSD. It is suggested that these training courses should be included in the community re-entry programs of veterans with PTSD.

Outcomes of organ donation in brain-dead patient's families: Ethical perspective

Background:

The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial.

Objective:

The aim of this study was to explore the outcomes of organ donation for the families of brain-dead patients.

Methods:

This was a qualitative descriptive study to which a purposeful sample of 19 donor family members were recruited. Data were collected through holding in-depth semi-structured interviews with the participants. Data analysis was performed by following the qualitative content analysis approach developed by Elo and Kyngäs.

Findings:

The main category of the data was “Decision to organ donation: a challenge from conflict to transcendence.” This main category consisted of 10 subcategories and 3 general categories. The general categories were “challenging outcomes,” “reassuring outcomes,” and “transcending outcomes.”

Ethical considerations:

The study was approved by the regional ethical review board. The ethical principles of informed consent, confidentiality, and non-identification were used.

Conclusion:

Donor families experience different challenges which range from conflict and doubtfulness to confidence, satisfaction, and transcendence. Healthcare providers and organ procurers should not discontinue care and support provision to donor families after obtaining their consent to donate because the post-decision phase is also associated with different complexities and difficulties with which donor families may not be able to cope effectively. In order to help donor families achieve positive outcomes from the tragedy of significant loss, healthcare professionals need to facilitate the process of achieving confidence and transcendence by them.

Management of Chronic Daily Headache and Psychiatric Co-Morbidities by Lifestyle Modification: Participatory Action Research Combining New Communication Media

Background

Lifestyle modification has a significant role in chronic daily headache (CDH) management. Participatory action research (PAR) can play an important role in managing chronic medical conditions. However, it has been scarcely used in CDH management.

Objectives

This study aimed to empower patients with CDH to modify their lifestyle in order to reduce both their headache and related psychiatric co-morbidities in a multidisciplinary headache clinic at Baqiyatallah hospital, Tehran, IR Iran.

Methods

In the PAR plan, 37 patients (27 females) diagnosed with CDH were selected using purposeful sampling. Along with face-to-face group sessions, all available communication means such as phone calls, emails, short message system (SMS), and social media (Telegram) were used to facilitate the process. Questionnaires of health promotion lifestyle profile (HPLPІІ), visual analog scale (VAS), and depression-anxiety-stress scale (DASS21) were used to collect data. The data were analyzed using SPSS software.

Results

Mean age of the patients was 38.33 (± 9.7) years. Both “general pain” and “the worst imaginable pain” reduced (mean of reduction: 2.56 ± 2.7 and 2.3 ± 2.9, respectively, P < 0.001). > 50% of pain reduction occurred in “the worst imaginable pain" category (-1.45 ± 2.02, P < 0.001) and mean VAS score reduced to 5.20 (± 2.3) compared to the start of the study (7.50 ± 1.9, P < 0.001). Mean DASS-21 score also reduced significantly for depression (P < 0.016), anxiety (P < 0.026), and stress (P < 0.008). HPLPІІ score significantly improved (118.17 ± 14.8 vs. 160.83 ± 16.4, P < 0.001) and the highest increase was seen in the subscale of "stress management" (17.73 ± 2.8 vs. 25.53 ± 3.9, P < 0.001).

Conclusions

The empowering PAR plan combined with new communication tools helped the CDH patients better handle their lifestyle, reduce their headache, and lower their symptoms. Further studies with better use of currently available communication tools and social media are recommended for action research to be more applicable.

The Effect of Wood Aerosols and Bioaerosols on the Respiratory Systems of Wood Manufacturing Industry Workers in Golestan Province

BACKGROUND

Occupational exposure to dust leads to acute and chronic respiratory diseases, occupational asthma, and depressed lung function. In the light of a lack of comprehensive studies on the exposure of Iranian workers to wood dusts, the objective of this study was to monitor the occupational exposure to wood dust and bioaerosol, and their correlation with the lung function parameters in chipboard manufacturing industry workers.

MATERIALS AND METHODS

A cross-sectional study was conducted on chipboard workers in Golestan Province; a total of 150 men (100 exposed cases and 50 controls) were assessed. Workers were monitored for inhalable wood dust and lung function parameters, i.e., FVC, FEV1, FEV1/FVC, and FEF25-75%. The workers' exposure to bioaerosols was measured using a bacterial sampler; a total of 68 area samples were collected. The analysis was performed using the Mann-Whitney, Kruskal-Wallis, and regression statistical tests.

RESULTS

The geometric mean value and geometric standard deviation of inhalable wood dust for the exposed and control groups were 19 ± 2.00 mg/m3 and 0.008 ± 0.001 mg/m3, respectively. A statistically significant correlation was observed between the lung parameters and cumulative exposure to inhalable wood dust, whereas a statistically significant correlation was not observed between the lung parameters and bioaerosol exposure. However, the exposure of Iranian workers to bioaerosols was higher, compared to their foreign coworkers.

CONCLUSION

Considering the high level of exposure among workers in this study along with their lung function results, long-term exposure to wood dust may be detrimental to the workers' health and steps to limit their exposure should be considered seriously.

Genetic diversity of the Dwarf honeybee (Apis florea Fabricius, 1787) populations based on microsatellite markers

Apis florea is one of two species of small, wild honeybee. The present study was conducted to evaluate the genetic diversity of Apis florea honeybee from 48 nests (colonies) using microsatellite markers in the South of Iran. All honeybee samples were analyzed for six microsatellite loci (A88, A107, A7, B124, A113 and A35). The six loci had different numbers of alleles in the sampled colonies ranging from 7 (loci A107) to 3 (loci A7, A35). Gene diversity in Apis florea ranged from 0.491 to 0.595. This range probably reflects the spreading of nests in a large region with a varied climate. Phylogenetic tree showed two distinct clusters including a) Minab region samples and b) Bandar Abbas, Bandar Khamir and Qeshm Island regions. All of these regions are geographically rich, having varied vegetation and climate conditions. Our findings are an important contribution to the methods of studying distribution and conservation of Apis florea.

Effect of Vitamin B12 supplementation on serum homocysteine in patients undergoing hemodialysis: A randomized controlled trial

Clinical studies have shown that hyper-homocysteinemia is a potent independent risk factor for cardiovascular diseases, and many different methods have been investigated for lowering it in hemodialysis (HD) patients. Our study investigated the effect of Vitamin B 12 supplementation on serum homocysteine levels in these patients. This randomized trial was conducted on 140 HD patients. They were randomly distributed by lottery method into two groups: intervention and control. In the intervention group, 100 μg/mL of Vitamin B 12 was intravenously injected two times a week, for eight weeks. No intervention was performed in the control group. Serum levels of homocysteine, hemoglobin (Hb), and hematocrit (Hct) were measured at the beginning and again after eight weeks (2 months) of treatment. About 91% of the patients had hyperhomocysteinemia (serum homocysteine >15 μmol/L). The median baseline levels of serum homocysteine in the intervention and control groups were 31.9 and 26.9 μmol/L, respectively (P = 0.1). After eight weeks, the median homocysteine level reduced significantly in the Vitamin B 12 group to 22.2 versus 28.4 μmol/L in control group (P = 0.006). The mean Hb and Hct also changed significantly during our study (12.3 vs. 11.4 g/dL; P = 0.003 and 37.9 vs. 35.3%; P = 0.02, respectively). Our results demonstrated the existence of a statistical negative relationship between Vitamin B 12 and serum levels of homocysteine. Detailed investigations with larger sample sizes and longer-term use of Vitamin B 12 are recommended.

Genetic diversity of Iranian honey bee (Apis mellifera meda Skorikow, 1829) populations based on ISSR markers

Honey bee is one of the most important insects considering its role in agriculture,ecology and economy as a whole. In this study, the genetic diversity of different Iranian honey bee populations was evaluated using inter simple sequence repeat (ISSR) markers. During May to September 2014, 108 young worker honey bees were collected from six different populations in 30 different geoclimatic locations from Golestan, Mazendaran, Guilan, West Azerbaijan, East Azerbaijan, Ardebil provinces of Iran. DNA was extracted from the worker honey bees. The quality and quantity of extracted DNA were measured. A set of ten primers were screened with the laboratory populations of honey bees. The number of fragments produced in the different honey bee populations varied from 3 to 10, varying within 150 to 1500 bp. The used ten ISSR primers generated 40 polymorphic fragments, and the average heterozygosity for each primer was 0.266. Maximum numbers of bands were recorded for primer A1. A dendrogram based on the Unweighted Pair Group Method with Arithmetic mean (UPGMA) method generated two sub-clusters. Honey bee populations of Golestan, Mazendaran, Guilan provinces were located in the first group. The second group included honey bee populations of Ardebil, West Azerbaijan, East Azerbaijan provinces, but this group showed a close relationship with other populations. The results showed obviously the ability of the ISSR marker technique to detect the genetic diversity among the honey bee populations.

Occupational Exposure and Health Impairments of Formaldehyde on Employees of a Wood Industry

Background: Occupational exposure to formaldehyde may decrease white blood cell counts and change blood concentration. In this study, the influences of occupational exposure to formaldehyde on the number of white blood cells and blood concentrations were studied.

Methods: This case-control study was conducted in June of 2012 at North Wood Factory, Golestan Province, Iran. The US-NIOSH method No. 2541 was used to determine the occupational exposure of 30 workers of the production line (case group) and 30 administrative staffs (control group) to formalde­hyde. The number of white blood cells and blood concentration were determined using the normal blood count method and related indices. Demographic features as well as the symptoms of being exposed to formaldehyde were collected using a standard questionnaire.

Results: The occupational exposure of case group ranged from 0.50 ppm to 1.52 ppm. The prevalence of all studied symptoms from formaldehyde exposure in workers (2<median<5; range 1 to 5) was signifi­cantly different (P<0.001) towards the administrative staffs (median 1; range 1 to 4). The number of white blood cells in production line workers was not significantly different from those in administra­tive staff. The average blood concentration in the case group was significantly different from the con­trol group (mean difference= 0.9 [95% CI: 0.40-1.39];P=0.007).

Conclusion: Occupational exposure to formaldehyde changed the blood concentration of the studied workers but did not change the number of their white blood cells.

Experiences of Iranian Nursing Faculty Members on Working in Conflict Climate

BACKGROUND

Few studies have been conducted on role conflict in nursing faculty in the world. This research reports the first study about this subject in Iran.

OBJECTIVES

The purpose of this research was to explore the experiences of role conflict in Iranian nursing faculty members.

MATERIALS AND METHODS

We conducted a qualitative study using a conventional content analysis approach. We used semi-structured and in-depth interviews by purposive sampling of 19 (15 instructors, three group managers and one educational assistant) participants to identify the influential factors of role conflict among nurse faculty members, working in seven nursing colleges in Iran.

RESULTS

The three following categories emerged from data analysis: "roles Interference"; "role ambiguity", and "conflicting expectations". The main theme was "working in conflict climate".

CONCLUSIONS

This study highlighted the influential factors that could produce role conflict for nursing faculty members. The results can help university leaders to improve nursing faculty working conditions.

Kinetic Study for Platinum Extraction from Spent Catalyst in Cyanide Solution at High Temperatures

In this research, the kinetics of platinum extraction from a selective linear paraffin dehydrogenation spent catalyst in cyanide solutions at high pressure and temperature was experimentally studied. Three variables, including reaction temperature, initial sodium cyanide concentration in solution and liquid to solid weight ratio were investigated. Based on the design of experiments via response surface methodology (RSM) by computer simulating software “Minitab 16”, experiments were carried out at operating conditions including five solution temperatures, five initial concentrations of cyanide solution and five liquid/solid weight ratios. The effects of these operating conditions on the reaction kinetics and extraction time were determined. The obtained kinetics data were fitted into an empirical power–law rate equation. The kinetics model parameters were evaluated by using experimental data via non-linear regression analysis. It was found that the platinum extraction from a selective linear paraffin dehydrogenation spent catalyst in cyanide solution at high pressure and temperature can be appropriately modeled by the proposed correlation in the selected range of operating conditions.

Evaluation of FGFR2 gene polymorphism in women with breast cancer

Breast cancer (BC) is one of the most frequent cancers among women worldwide. It is a complex polygenic disorder that genetic factors play an important role in disease etiology. The highly significant association of the Fibroblast growth factor receptor 2 (FGFR2) locus with breast cancer risk has been replicated in multiple genome association study; however, it's mechanism of action remains unclear. The aim of this study was to investigate whether the single nucleotide polymorphism (SNP) C—906T within intron 2 of FGFR2 is responsible for susceptibility to breast cancer. This case-control study included 108 breast cancer cases and 108 cancer-free controls. The prevalence of genotype frequencies of the FGFR2 CC/CT/TT was 5.5%, 90.7% and 3.7%, respectively, in cancer cases. Among controls, the distribution of CC, CT and TT genotype was 48.14%, 47.66% and 10.18% respectively. Significant differences in allele and genotype distribution among controls and patients were found (OR, 18.87 95% CI, 7.55—47.16; p = 0.0001). The results from this study suggest that the FGFR2 C—906T polymorphism may be associated to breast cancer in population studied. Well—designed studies with larger sample sizes are needed to confirm the role of FGFR2 SNP in breast cancer risk.

Relationship Between Low Back Pain With Quality of Life, Depression, Anxiety and Stress Among Emergency Medical Technicians

Background:

Musculoskeletal disorders have become increasingly common among healthcare providers. They have become the most common cause of work-related disabilities among nurses.

Objectives:

The current cross-sectional study aimed to measure the prevalence of back pains among emergency medical technicians (EMTs), and association of back pain with quality of life, depression, anxiety and stress.

Materials and Methods:

One hundred and eighty registered nurses working as EMTs at the Hamadan Emergency Medical Center were selected by consensus. Data collection tools were Demographic, Perceived Quality-of-Life, Short Form Health Survey (SF-36), and Depression Anxiety Stress Scales (DAS21) and pain scale measurements.

Results:

Data showed that while 50.7% of the participants had an average awareness of the basic principles of back care, the majority (71.8%) had at least one type of back pain. There were associations between the prevalence of pain and depression (P = 0.049), pain and awareness (P = 0.035), and stress and job satisfaction (P = 0.024).

Conclusions:

A large number (about two-thirds) of EMTs had some sort of back pain; it is highly recommended to promote the attitude and motivation of the individuals to take care to prevent back injury and inform them of the principles of back care. Implications for primary prevention and care practice include encouraging EMTs to apply accurate principles of back care.

Stiffening effects of riboflavin/UVA corneal collagen cross-linking is hydration dependent

The collagen cross-linking is a relatively new treatment option for strengthening the cornea, delaying, and in some cases stopping the progression of keratoconus. The uniaxial tensile experiments are among the most commonly used techniques to assess the effectiveness of this therapeutic option in enhancing tensile properties. In the present study, we investigated the possible effects of hydration on stiffening effects of corneal collagen cross-linking procedure, as measured by the uniaxial tensile testing method. For this purpose, after cross-linking bovine corneas, we let the strips to dehydrate in air or swell in a solution until their thickness reached an average thickness of 0.5, 0.7, 0.9, 1.1, and 1.5 mm. Using thickness as a representative of hydration, we divided corneal strips into five different groups and measured their stress-strain behavior by conducting uniaxial tensile experiments in mineral oil. It was observed that the collagen cross-linking treatment and hydration together affect the tensile behavior of the bovine cornea. While corneal collagen cross-linking resulted in a significant increase in the tensile stress-strain response of each thickness group (P<0.01), less hydrated collagen cross-linked samples showed a significantly stiffer response (P<0.01). A master curve was found for representing the tensile behavior of the collagen cross-linked bovine cornea at different levels of hydration. The results of the present research confirmed that the amount of mechanical stiffening of the corneal collagen cross-linking, as measured by uniaxial tensile testing, strongly depends on the hydration. Therefore, it is concluded that uniaxial tensile experiments could only be used to assess stiffening effects of the collagen cross-linking treatment if the hydration of specimens is fully controlled.

Interaction between the protective effects of cannabidiol and palmitoylethanolamide in experimental model of multiple sclerosis in C57BL/6 mice

Cannabinoids (CBs) have recently been approved to exert broad anti-inflammatory activities in experimental models of multiple sclerosis (MS). It has been demonstrated that these compounds could also have effects on neurodegeneration, demyelination, and autoimmune processes occurring in the pathology of MS. However, the clinical use of CBs is limited by their psychoactive effects. Among cannabinoid compounds, cannabidiol (CBD) and palmitoylethanolamide (PEA) have no psychotropic activities. We induced experimental autoimmune encephalomyelitis (EAE), a model of MS, by injecting myelin oligodendrocyte glycoprotein (MOG) to C57BL/6 mice. We assessed the effects of CBD, PEA, and co-administration of CBD and PEA on neurobehavioral scores, immune cell infiltration, demyelination, axonal injury, and the expression of inflammatory cytokines by using histochemistry methods and real-time RT-PCR. Treatment with either CBD (5mg/kg) or PEA (5mg/kg) during disease onset reduced the severity of the neurobehavioral scores of EAE. This effect of CBD and PEA was accompanied by diminished inflammation, demyelination, axonal damage and inflammatory cytokine expression while concurrent administration of CBD (5mg/kg) and PEA (5mg/kg) was not as effective as treatment with either drug per se. These results suggest that, CBD and PEA, non-psychoactive CBs, attenuate neurobehavioral deficits, histological damage, and inflammatory cytokine expression in MOG-immunized animals. However, there is an antagonistic interaction between CBD and PEA in protection against MOG-induced disease.

Upwind responses of Anopheles stephensi to carbon dioxide and L-lactic acid: an olfactometer study

Excretion of carbon dioxide and L-lactic acid through exhalation and perspiration provides olfactory signals to mosquitoes which allow them to find and bite humans; however, mosquito species differ in this regard. This study investigated upwind responses of Anopheles stephensi, mysorensis form, an important malaria vector in Asia, to carbon dioxide and L-lactic acid under laboratory conditions. While a minimal dose of carbon dioxide (90 ppm) activated the mosquitoes, 10 times this amount suppressed them. L-lactic acid alone did not produce a significant effect by itself, but addition of 6 microg/min of L-lactic acid to a range of 90 to 410 ppm carbon dioxide resulted in attraction. The results provide further support for the hypothesis that CO2 plays an important role in the host-seeking behaviour of zoophilic mosquitoes, and suggests that L-lactic acid might play a more critical role than CO2 in the attraction of An. stephensi.

Exploring spirituality in Iranian healthy elderly people: A qualitative content analysis

BACKGROUND

Spirituality is recognized as a personally important matter to the elderly, and there are evidences of its impact on their health. The aim of this study was to explore the concept of spirituality from the perspectives of Iranian healthy elderly individuals.

MATERIALS AND METHODS

A conventional qualitative content analysis of carried out with 21 healthy elderly people from both male and female genders were chosen using a purposive sampling method in Tehran in 2010-2011. Data collection was done through semi structured interviews. A qualitative content analysis was used to analyze the participants' experiences and perceptions on spirituality, using a central question 'what characterizes the spirituality in the Iranian healthy elderly people?'

RESULTS

THE FOLLOWING CATEGORIES EMERGED FROM THE DATA ANALYSIS: (1) Spiritual health, with four sub categories including saying prayer as a calming factor; beneficence as a way to God; loss of psychological and spiritual support; faith as a way to happiness; (2) spiritual beliefs, with three sub categories including seeking help from God in difficulties; God's power over life and death; doing good deeds is the God's will; and (3) religious practice with three sub categories including saying prayer; reading Quran; and going to mosque, religious ceremonies and pilgrimage.

CONCLUSIONS

In this study was found that spirituality was a fundamental element in elderly individuals' lives that help them to adapt with daily living conditions.