Effect of a plant-based diet on oxidative stress biomarkers in male footballers

Proper nutrition plays a vital role in modulating oxidative status. There is an increasing popularity of plant-based dietary patterns among athletes. Therefore, the present study aimed to determine the plant-based diet index (PDI) score among male footballers and their non-athlete controls, as well as its relationship with oxidative biomarkers by evaluating the urinary excretion of F2alpha-isoprostane (F2a-IP) and 8-hydroxy-2'-deoxyguanosine (8-OHdG). A group of footballers (n = 45) and a healthy non-athlete group (n = 45) were selected. The two groups were matched based on body mass index (BMI) and age. The mean (standard deviation (SD)) age of the subjects was 22.88 (2.41) years, and their BMI was 22.08 (1.35) kg/m2. Anthropometric indices were evaluated, and fasting morning urine samples were analyzed to measure oxidative biomarkers. The PDI, unhealthy plant-based diet index (uPDI), and healthy plant-based diet index (hPDI) were calculated using valid food frequency questionnaire data. Generalized estimating equation models were used for all analyses. Compared to the non-athlete group, the PDI score was significantly greater in the footballer group (β = 9.8; P < 0.001), while the differences between the two groups in uPDI and hPDI scores were not significant. Overall, footballers consumed more plant-based foods. By examining the relationship between dietary indices and oxidative biomarkers, only a negative association was observed between PDI score and F2a-IP level (β = -1.25; P = 0.03). Based on the results, footballers were more adherent to a plant-based diet than non-athletes. In addition, it seems that following plant-based diets (the higher PDI) may exert beneficial effects on lowering F2a-IP levels due to improving the body's antioxidant status.

Usability Assessment of an Electronic Medical Record-Embedded Clinical Decision Support System for Arterial Blood Gas Interpretation

Since usability is considered a significant success factor for Clinical decision support systems (CDSSs), this study seeks to assess the usability of an electronic medical records-embedded CDSS for arterial blood gas (ABG) interpretation and ordering. The current study was conducted in the general ICU of a teaching hospital, using the System Usability Scale (SUS) and interviews with all anesthesiology residents and intensive care fellows in two rounds of CDSS usability testing. The feedback from the participants was discussed with the research team across a series of meetings, and the second version of CDSS was designed and tailored to participants' feedbacks. Subsequently, the CDSS usability score increased from 67.22±4.58 to 80.00±4.84 (P-value<0.001) through participatory, iterative design and the users' usability testing feedbacks.

Critical Criteria and Countermeasures for Mobile Health Developers to Ensure Mobile Health Privacy and Security: Mixed Methods Study

BACKGROUND

Despite the importance of the privacy and confidentiality of patients' information, mobile health (mHealth) apps can raise the risk of violating users' privacy and confidentiality. Research has shown that many apps provide an insecure infrastructure and that security is not a priority for developers.

OBJECTIVE

This study aims to develop and validate a comprehensive tool to be considered by developers for assessing the security and privacy of mHealth apps.

METHODS

A literature search was performed to identify papers on app development, and those papers reporting criteria for the security and privacy of mHealth were assessed. The criteria were extracted using content analysis and presented to experts. An expert panel was held for determining the categories and subcategories of the criteria according to meaning, repetition, and overlap; impact scores were also measured. Quantitative and qualitative methods were used for validating the criteria. The validity and reliability of the instrument were calculated to present an assessment instrument.

RESULTS

The search strategy identified 8190 papers, of which 33 (0.4%) were deemed eligible. A total of 218 criteria were extracted based on the literature search; of these, 119 (54.6%) criteria were removed as duplicates and 10 (4.6%) were deemed irrelevant to the security or privacy of mHealth apps. The remaining 89 (40.8%) criteria were presented to the expert panel. After calculating impact scores, the content validity ratio (CVR), and the content validity index (CVI), 63 (70.8%) criteria were confirmed. The mean CVR and CVI of the instrument were 0.72 and 0.86, respectively. The criteria were grouped into 8 categories: authentication and authorization, access management, security, data storage, integrity, encryption and decryption, privacy, and privacy policy content.

CONCLUSIONS

The proposed comprehensive criteria can be used as a guide for app designers, developers, and even researchers. The criteria and the countermeasures presented in this study can be considered to improve the privacy and security of mHealth apps before releasing the apps into the market. Regulators are recommended to consider an established standard using such criteria for the accreditation process, since the available self-certification of developers is not reliable enough.

Evaluating the success of Iran Electronic Health Record System (SEPAS) based on the DeLone and McLean model: a cross-sectional descriptive study

BACKGROUND

Quality dimensions are the most important criteria for predicting the success of an information system. The current study aims to evaluate the success of the Iran Electronic Health Record System (SEPAS) based on the DeLone and McLean model for information system success.

METHOD

This nationwide cross-sectional study was conducted in 2021. Participants were 468 health information management personnel who had working experience with SEPAS. Data were collected using a questionnaire based on the DeLone and McLean model. The validity and reliability of the questionnaire were confirmed. Data were analyzed using SPSS 22 through descriptive and analytic analysis including t-test and ANOVA.

RESULTS

Most participants were female (70.9%) and almost half of the participants mean age was between 30 and 40 years old (49.6%). The total mean of SEPAS success was 3.42 ± 0.53. According to the participants' perspectives "system quality" was the most influencing factor on SEPAS success. The least influencing factor was SEPAS "benefits". There was a significant relationship between the mean score of SEPAS success and age (p value = 0.001), Education level (p value = 0.01), and Work experience (p value < 0.001).

CONCLUSION

The total mean of system success was not acceptable. SEPAS has not been much successful in providing net benefits like provision of electronic services which locate patients in the center and improve the delivery of care to them. It sounds that SEPAS is not stable enough that means crashes sometimes. Hence, considering the required infrastructures for quick response and stability is more critical, especially when healthcare providers are supposed to use the SEPAS.

Mobile Learning Among University Students: Adoption and Application of M-Learning

The successful implementation of mobile learning is mainly impacted by learners’ attitudes to accepting and applying mobile learning systems. In the current study, an m-learning application was developed and implemented for university students, and their perspective toward the adoption and application of m-learning was investigated. This cross-sectional study was carried out in 2020. The participants were 114 university students at Abadan University of Medical Sciences. Data were collected by means of a valid questionnaire containing 42 questions in 13 subscales in addition to an open-ended question about the positive and negative aspects of the m-learning application. There was a significant relationship between acceptance and major (P=0.001), mobile usage (P=0.035), and familiarity with m-learning (P<0.001). The total mean of m-learning application acceptance was 3.95±0.32, which shows a good level. Self-efficacy, perceived ease of use, and user interface were, respectively, the most influencing factors; mobile device limitation and governmental support were the least influencing factors. “Direct communication with the teacher/instructor” and “Internet disconnection during video teaching” were among the positive and negative aspects of applying the m-learning application, respectively. The m-learning application was well adopted among the students. Mobile device limitations are a reason for the student's concerns. “Usability features” can be a point for covering mobile device limitations.

Virulence factors of Mycoplasma synoviae: Three genes influencing colonization, immunogenicity, and transmissibility

Infections caused by Mycoplasma synoviae are major welfare and economic concerns in poultry industries worldwide. These infections cause chronic respiratory disease and/or synovitis in chickens and turkeys leading to reduced production and increased mortality rates. The live attenuated vaccine strain MS-H (Vaxsafe® MS), commonly used for protection against M. synoviae infection in many countries, contains 32 single nucleotide variations compared to its wildtype parent strain, 86079/7NS. Genomic analysis of vaccine strains reisolated from flocks following the administration of MS-H has identified reversions to the original 86079/7NS sequence in the obgE, oppF and gapdh genes. Here, three MS-H field reisolates containing the 86079/7NS genotype in obgE (AS2), obgE and oppF (AB1), and obgE, oppF and gapdh (TS4), as well as the vaccine MS-H and the parental strain 86079/7NS were experimentally inoculated to chickens. The strains were assessed for their ability to infect and elicit immune responses in the recipient chickens, as well as in naïve in-contact chickens. Despite the loss of temperature sensitivity phenotype and colonization of the reisolates in the lower respiratory tract, there was no significant differences detected in the microscopic mucosal thickness of the middle or lower trachea of the inoculated chickens. Concurrent reversions in ObgE, OppF and GAPDH proteins were associated with higher gross air sac lesion scores and increased microscopic upper-tracheal mucosal thickness in chickens directly inoculated with the reisolates following intratracheal administration of a virulent strain of infectious bronchitis virus. The gross air sac lesions of the chickens in-contact with those inoculated with reisolates were not significantly different to those of chickens in-contact with MS-H inoculated chickens, suggesting that horizontal transmission of the reisolates in the poultry flock will not lead to higher pathogenicity or clinical signs. These results suggest a significant role of GAPDH and/or cumulative effect of ObgE, OppF and GAPDH on M. synoviae pathogenicity. Future experiments will be required to investigate the effect of single mutations in gapdh or oppF gene on pathogenicity of M. synoviae.

Identification of faecal Escherichia coli isolates with similar patterns of virulence and antimicrobial resistance genes in dogs and their owners

BACKGROUND

The presence of antimicrobial resistance and virulence genes in Escherichia coli allows them to survive and cause infections. The close contact between humans and pets can reinforce the risk of transmitting resistant and virulent bacteria between them.

OBJECTIVES

This study aims to compare the patterns of the presence of tetracycline and streptomycin resistance genes, as well as important virulence genes in E. coli isolated from faeces of healthy dogs and their owners.

METHODS

Polymerase chain reactions were performed for detection of antimicrobial resistance (tetA, tetB, tetC, tetD, strA and strB) and virulence (fimH, iss, sitA and malX) genes in 144 faecal E. coli isolates from 28 dog-owner pairs and 16 humans who did not keep any pets as controls.

RESULTS

Among the investigated antimicrobial resistance and virulence genes, tetA (52.1%) and fimH (86.8%) genes had the highest prevalence. No statistically significant difference was found between the prevalence of antimicrobial resistance and virulence genes in isolates of dogs and their owners. In total, 46.4% of dog-owner pairs had the same patterns of presence or absence of six antimicrobial resistance genes, 50.0% had the same patterns of presence or absence of four virulence genes and 25.0% had the same patterns of presence or absence of all 10 tested genes.

CONCLUSION

The presence of antimicrobial-resistant virulent E. coli in humans and pets may predispose them to infections that are hard to cure with conventional antibiotics. Notable frequency of dogs' and their owners' E. coli isolates with similar patterns of antimicrobial resistance and virulence genes may indicate the possibility of sharing virulent antimicrobial resistant E. coli between them.

Development and Testing Requirements for an Integrated Maternal and Child Health Information System in Iran: A Design Thinking Case Study

BACKGROUND

 Management of child health care can be negatively affected by incomplete recording, low data quality, and lack of data integration of health management information systems to support decision making and public health program needs. Given the importance of identifying key determinants of child health via capturing and integrating accurate and high-quality information, we aim to address this gap through the development and testing requirements for an integrated child health information system.

SUBJECTS AND METHODS

 A five-phase design thinking approach including empathizing, defining, ideation, prototyping, and testing was applied. We employed observations and interviews with the health workers at the primary health care network to identify end-users' challenges and needs using tools in human-centered design and focus group discussion. Then, a potential solution to the identified problems was developed as an integrated maternal and child health information system (IMCHIS) prototype and tested using Software Quality Requirements and Evaluation Model (SQuaRE) ISO/IEC 25000.

RESULTS

 IMCHIS was developed as a web-based system with 74 data elements and seven maternal and child health care requirements. The requirements of "child disease" with weight (0.26), "child nutrition" with weight (0.20), and "prenatal care" with weight (0.16) acquired the maximum weight coefficient. In the testing phase, the highest score with the weight coefficient of 0.48 and 0.73 was attributed to efficiency and functionality characteristics, focusing on software capability to fulfill the tasks that meet users' needs.

CONCLUSION

 Implementing a successful child health care system integrates both maternal and child health care information systems to track the effect of maternal conditions on child health and support managing performance and optimizing service delivery. The highest quality score of IMCHIS in efficiency and functionality characteristics confirms that it owns the capability to identify key determinants of child health.

Evaluating the Quality of a Clinical Mobile App for Physicians' CT Scan Ordering Using the MARS Rating Scale

Given the lack of literature on the contributing factors to adopt mobile applications (apps) among physicians and the crucial role of the quality of the apps in their widespread use, the aim of this study is using the Mobile App Rating Scale (MARS) to evaluate the quality of the head CT scan appropriateness criteria app(HAC app). It was developed to assist medical interns and residents in ordering head CT scans. MARS is internationally recognized as an app rating tool and consists of four objective and subjective quality subscales quality subscale. Although the overall quality score of the HAC app was favorable (82 out of 100), it had low quality scores in the "information" (73.37 out of 100) and the "engagement" (73.48 out of 100) subscales. The HAC app appears to be functional to the physicians; however, it needs to improve its quality in terms of interactivity and effectiveness.

Identification of data elements for blood gas analysis dataset: a base for developing registries and artificial intelligence-based systems

Background

One of the challenging decision-making tasks in healthcare centers is the interpretation of blood gas tests. One of the most effective assisting approaches for the interpretation of blood gas analysis (BGA) can be artificial intelligence (AI)-based decision support systems. A primary step to develop intelligent systems is to determine information requirements and automated data input for the secondary analyses. Datasets can help the automated data input from dispersed information systems. Therefore, the current study aimed to identify the data elements required for supporting BGA as a dataset.

Materials and methods

This cross-sectional descriptive study was conducted in Nemazee Hospital, Shiraz, Iran. A combination of literature review, experts’ consensus, and the Delphi technique was used to develop the dataset. A review of the literature was performed on electronic databases to find the dataset for BGA. An expert panel was formed to discuss on, add, or remove the data elements extracted through searching the literature. Delphi technique was used to reach consensus and validate the draft dataset.

Results

The data elements of the BGA dataset were categorized into ten categories, namely personal information, admission details, present illnesses, past medical history, social status, physical examination, paraclinical investigation, blood gas parameter, sequential organ failure assessment (SOFA) score, and sampling technique errors. Overall, 313 data elements, including 172 mandatory and 141 optional data elements were confirmed by the experts for being included in the dataset.

Conclusions

We proposed a dataset as a base for registries and AI-based systems to assist BGA. It helps the storage of accurate and comprehensive data, as well as integrating them with other information systems. As a result, high-quality care is provided and clinical decision-making is improved.

Exploring the Influence of Users' Characteristics in Continuance Intention to Use Electronic Medical Records (EMR): Extending the Expectation Confirmation Model (ECM)

Even though the "user characteristics" (UC) can influence "acceptance" and "the continuance intention to use" of information systems such as electronic medical records (EMR), the effect of UC has not been adequately evaluated in post-adoption models. This study seeks to examine the effect of UC on post-usage of EMR using the expectation confirmation model (ECM). A total of 450 questionnaires was collected by a survey to extend ECM by integrating UC using structural equation modeling (SEM). Data were analyzed using LISREL through confirmatory factor analysis. A path analysis test was also performed to fit and confirm the model fit. The UC affects the "confirmation of expectations" directly and the "continuance intention to use" indirectly. The findings of the present study can provide a new path for further research on the extending of the ECM model. Moreover, end users' characteristics should be considered in the preparation and training phases of EMR implementation.

The Effect of Short Messaging System-Based Feedback on Physicians' Head CT Scan Ordering Behavior in Neurology and Neurosurgery Departments

Short messaging system (SMS) works as one of the most popular strategies for physicians' behavior change via sending feedback and reminder messages. One of the areas in which SMS feedback can be effective on physicians' behavior is CT scan ordering. This study investigates the effect of mobile phone SMS feedback on residents' head CT scan ordering at a general teaching hospital in Iran. Through a three-month before-after experimental study, an intervention was conducted, and the CT scans ordered by an individual resident were evaluated every two weeks. Consequently, personal SMS-based feedback was provided to the residents, and the rate of CT per patient in the two phases of the study was analyzed. The mean CT scan ordered per patient decreased from 1.98 ± 1.09 to 1.74 ± 1.45, and this decrease was insignificant (P = 0.106). SMS-based feedback can reduce head CT scan ordering among residents; whereas this decline was not significant further studies are required to investigate its effectiveness.

Effectiveness of Clinical Decision Support Systems on the Appropriate Use of Imaging for Central Nervous System Injuries: A Systematic Review

BACKGROUND

One of the best practices for timely and efficient diagnoses of central nervous system (CNS) trauma and complex diseases is imaging. However, rates of imaging for CNS are high and impose a lot of costs to health care facilities in addition to exposing patients with negative impact of ionizing radiation.

OBJECTIVES

This study aimed to systematically review the effects and features of clinical decision support systems (CDSSs) for the appropriate use of imaging for CNS injuries.

METHOD

We searched MEDLINE, SCOPUS, Web of Science, and Cochrane without time period restriction. We included experimental and quasiexperimental studies that assessed the effectiveness of CDSSs designed for the appropriate use of imaging for CNS injuries in any clinical setting, including primary, emergency, and specialist care. The outcomes were categorized based on imaging-related, physician-related, and patient-related groups.

RESULT

A total of 3,223 records were identified through the online literature search. Of the 55 potential papers for the full-text review, 11 eligible studies were included. Reduction of CNS imaging proportion varied from 2.6 to 40% among the included studies. Physician-related outcomes, including guideline adherence, diagnostic yield, and knowledge, were reported in five studies, and all demonstrated positive impact of CDSSs. Four studies had addressed patient-related outcomes, including missed or delayed diagnosis, as well as length of stay. These studies reported a very low rate of missed diagnosis due to the cancellation of computed tomography (CT) examine according to the CDSS recommendations.

CONCLUSION

This systematic review reports that CDSSs decrease the utilization of CNS CT scan, while increasing physicians' adherence to the rules. However, the possible harm of CDSSs to patients was not well addressed by the included studies and needs additional investigation. The actual effect of CDSSs on appropriate imaging would be realized when the saved cost of examinations is compared with the cost of missed diagnosis.

Micro-computed tomographic evaluation of single-cone obturation with three sealers

Objectives

This study used micro-computed tomography (µCT) to compare voids and interfaces in single-cone obturation among AH Plus, EndoSequence BC, and prototype surface pre-reacted glass ionomer (S-PRG) sealers and to determine the percentage of sealer contact at the dentin and gutta-percha (GP) interfaces.

Materials and Methods

Fifteen single-rooted human teeth were shaped using ProTaper NEXT size X5 rotary files using 2.5% NaOCl irrigation. Roots were obturated with a single-cone ProTaper NEXT GP point X5 with AH Plus, EndoSequence BC, or prototype S-PRG sealer (n = 5/group).

Results

The volumes of GP, sealer, and voids were measured in the region of 0–2, 2–4, 4–6, and 6–8 mm from the apex, using image analysis of sagittal µCT scans. GP volume percentages were: AH Plus (75.5%), EndoSequence BC (87.3%), and prototype S-PRG (94.4%). Sealer volume percentages were less: AH Plus (14.3%), EndoSequence BC (6.8%), and prototype S-PRG (4.6%). Void percentages were AH Plus (10.1%), EndoSequence BC (5.9%), and prototype S-PRG (1.0%). Dentin-sealer contact ratios of AH Plus, EndoSequence BC, and prototype S-PRG groups were 82.4% ± 6.8%, 71.6% ± 25.3%, and 70.2% ± 9.4%, respectively. GP-sealer contact ratios of AH Plus, EndoSequence BC, and prototype S-PRG groups were 65.6% ± 29.1%, 80.7% ± 25.8%, and 87.0% ± 8.6%, respectively.

Conclusions

Prototype S-PRG sealer created a low-void obturation, similar to EndoSequence BC sealer with similar dentin-sealer contact (> 70%) and GP-sealer contact (> 80%). Prototype S-PRG sealer presented comparable filling quality to EndoSequence BC sealer.

Calculation of the Cost of Student Education: A Case Study of Shiraz Medical School

INTRODUCTION

Given the importance of the education system in the health sector and the necessity to calculate the cost in this sector, this study aimed to calculate the cost of education for health students in Shiraz Medical School, using activity-based costing (ABC).

METHODS

This study was conducted in Shiraz University of Medical Sciences in 2015-2016, considering the cost structure of the education department. The data required for the present research study was gathered from accrual accounting system, payroll system, educational deputy system called SAMA, list of paid salaries, information received from medical school such as exact position of individuals and course credits assigned to teachers, interviews conducted at the university headquarter in order to determine the appropriate indicators for allocating the costs, and interviewing clinical and non-clinical teachers to calculate the cost of training in these fields.

RESULTS

The findings indicated that the cost of training in general accounted for 70% of the total cost of student education. PhD in Medical Ethics, Assistant of Radiotherapy and Ph.D. in Pharmacology turned out to posit the highest cost for each student respectively, while MPH, Master of Medical Engineering, and Master of Electronic Medicine Education had the lowest cost for each student, respectively. The cost in all fields is more than the per capita cost of student education paid to the university.

CONCLUSION

Authorities should focus on controlling and reducing the cost of training, which is the main component of the costs. Factors such as the number of students in each field, degree, and type of field are effective in the costs of education. Hence, in order to allocate the budget more equitably, costs of education for each field calculated by ABC should be based on allocating the funds to the university.

Melatonin attenuates chemical-induced cardiotoxicity

Environmental chemicals and drugs can induce cardiotoxicity, mainly by generating free radicals. Reactive oxygen species play a critical role in the pathogenesis of cardiac tissue injury. This highlights a need for prevention of cardiotoxicity by scavenging free radicals. Melatonin has been shown to act as a protector against various conditions in which free radicals cause molecular and tissue injury. Some of the mechanisms by which melatonin operates as a free radical scavenger and antioxidant have been identified. The importance of endogenous melatonin in cardiovascular health and the benefits of melatonin supplementation in different cardiac pathophysiological disorders have been shown in a variety of model systems. Melatonin continues to attract attention for its potential therapeutic value for cardiovascular toxicity. The therapeutic potential of melatonin in treatment of cardiotoxicities caused by various chemicals along with suggested molecular mechanisms of action for melatonin is reviewed.

Evaluating and managing the probability of medical errors in nursing personnel using the HEART method

Introduction: Medical errors cause serious and often preventable injuries to patients. Studying human errors and their use as an opportunity for learning is a key factor in the effort to improve patient safety and quality of care in the hospitals. The purpose of this study was to identify and evaluate human errors to reduce their risks in nursing personnel using the Human Error Evaluation and Reduction (HEART) method.Materials and Methods: This cross-sectional descriptive study was performed in one of the hospitals of Rafsanjan in 1977. Initially, hierarchical task analysis was performed using HTA method and nurses' tasks were identified. In the next step, the probability of their human errors during work for all tasks was determined using the HEART method and the factors and conditions that were effective in causing the error were determined. Finally, in light of these conditions, suggestions were made to reduce the likelihood of these errors occurring.Results: The mean (standard deviation) human error score for the different tasks of nursing job was 1.79 (3.44). The maximum likelihood of error occurring in relation to the task of regulating and applying DC shock in emergencies was determined as 14.48. The least probability of error occurring for skin care task was 0.0014. The results of this study regarding the conditions that can lead to human error in nurses showed that the most important error generating conditions in nurses were novice and inexperienced, high stress, unreliable work tool, lack of control system transparency, lack of clarity and timely and direct confirmation of action. The highest mean human error probability score for Type C tasks was 4.34. Also the mean human error probability score for D, E and G tasks were 0.225, 0.198, and 0.00206 from right to left, respectively. The results of Kruskal-Wallis nonparametric test showed that there was a statistically significant difference among the mean scores of human error probability scores of different groups (P-value <0.001).Conclusion: Considering the critical consequences of human errors in nurses' work activities, developing specialized guidelines for their various activities, providing specialized training, as well as retraining of scientific and practical skills, increasing the workforce, reducing overtime, regular work shifts to improve the reliability of medical staff performance and familiarize staff with the risks that may result from errors in patients are necessary to reduce the likelihood of errors occurring in nurses.

Regenerative Effect of Bone Marrow-derived Mesenchymal Stem Cells in Thioacetamide-induced Liver Fibrosis of Rats

The present study determined the regenerative effect of bone marrow-derived stem cells (BMSCs) on thioacetamide (TA)-induced liver fibrosis in rats. A total of 30 male Wistar rats were randomly divided into sham control and treatment groups. The rats of the sham control group were subdivided into three groups and sampled on the 14th, 18th, and 20th weeks after fibrosis induction. The rats of the treatment group were subdivided into two groups and sampled on the 4th and 6th weeks after BMSCs treatment. Fibrosis was induced by the intraperitoneal administration of 200 mg/kg of TA twice a week for a period of 14 weeks. All the animals underwent liver function tests and histopathologic evaluation 4 and 6 weeks after BMSCs transplantation. The BMSCs were characterized using osteogenic induction and reverse transcription-polymerase chain reaction. The BMSCs were plastic adherent, spindle-shaped, and positive for osteogenic differentiation. They expressed CD73 and were negative for CD45. The infiltration of inflammatory cells and deposition of collagen fibers were noticed after TA administration. A significant decline in inflammatory cells and a healing process were detected 4 weeks after cell transplantation. The amelioration in hepatic tissue was significant 6 weeks after cell therapy. Following the injection of BMSCs, a nonsignificant decrease was visible in aspartate transaminase level; however, this decline was significant for alanine aminotransferase level. The alkaline phosphatase and albumin levels showed an increasing trend after cell administration. The transplantation of BMSCs resulted in a significant regenerative effect after hepatic injuries. Therefore, it was shown that BMSCs transplantation can open a new window and be a therapy of choice in the amelioration of liver fibrosis.

Molecular typing of Staphylococcus aureus from different sources by RAPD-PCR analysis

Staphylococcus aureus is an opportunistic bacterium which is carried as a normal flora organism but has a major role in the epidemiology and pathogenesis of different staphylococcal infections in humans and animals. Fifty S. aureus isolated from banknotes, foods, human infections and bovine mastitis were subjected to DNA fingerprinting by randomly amplified polymorphic DNA (RAPD) analysis to examine their genotypic polymorphism and investigate the amount of genetic relatedness among these various isolates. At 100% RAPD profile similarity level, isolates were classified into four, five and seven groups of the same clone, according to the RAPDPCR with OLP6, OLP11 and OLP13 primers, respectively. Amplification of the isolates resulted in several polymorphic bands ranged from >50 to >1500 bp in size. Maximum number of bands was obtained by primer OLP13 which produced seven bands in bovine mastitis isolates. Most polymorphisms were observed in isolates of bovine mastitis and the lowest were associated with human infections isolates. There was no relationship between the RAPD patterns and the sources of isolates, except the three clusters which showed host specificity and only included the strains from the same sources. The results confirm the wide genotypic diversity of the studied S. aureus strains. RAPD-PCR technique can be a valuable tool for assessing the genetic relationship, detection of polymorphism in S. aureus and tracing the sources and management of S. aureus infections.

Presenting a Model to Evaluate Factors Affecting Outsourcing of Health Information Technology Services

Introduction:

Outsourcing of health information technology services (OHITS) is an important process for healthcare organizations due to the lack of expert staff to respond rapid advance in IT and the security of patient’s information. This study aimed at presenting a model to evaluate factors affecting OHITS.

Method:

This is a descriptive-analytic study, conducted in 2017. Participants were experts of IT and accounting field. This research was performed in four general steps: identifying the factors affecting OHITS through literature review; determining suitable indicators by Delphi technique; prioritizing the factors using Analytical Hierarchical Process (AHP), measuring the accuracy of research hypotheses by Partial Least Square (PLS) and calculating the Goodness Of Fit (GOF) criteria for the model.

Findings:

the most and the least important factors affecting OHITS were “motivation” and “selection of a provider” respectively. GOF criteria was 0.697, suggesting powerful model fitting.

Conclusion:

Using the model presented in this research, the healthcare managers and chief officers of IT will be able to decide consciously about outsourcing projects, and also manage the project better.

Serum CXCL12, but not CXCR4, Is Associated with Head and Neck Squamous Cell Carcinomas

Background: Squamous cell carcinoma (SCC) is the most frequent malignancy of the head and neck (HN) region. We here evaluated associations of stromal cell derived factor-1 (SDF-1or CXCL12) and its receptor, CXCR4, with HNSCCs. Materials and Methods: Sixty newly diagnosed HNSCC patients were enrolled in the patient group, and 28 healthy individuals in the control group. Plasma levels of CXCL12 and CXCR4 were measured using ELISA kits. Results: There was a significant difference in mean CXCL12, but not CXCR4, plasma levels between the patient and control groups (P=0.0001). No significant associations were found between mean plasma levels of either CXCL12 or CXCR4 with age, gender, tumor site, tumor size, lymph-node involvement or tumor stage. Conclusion: For the first time, our findings demonstrate a significant association between serum CXCL12 but not CXCR4 levels and HNSCCs.

Virulence factors, antibiotic resistance genes and genetic relatedness of commensal Escherichia coli isolates from dogs and their owners

Escherichia coli (E. coli) is a normal flora of gastrointestinal tracts of humans and warm-blooded animals including dogs that has close vicinity with humans. Because the inter-species transmission of E. coli between pets and human beings, within a household, obtaining more information about the epidemiology, genetics, virulence factors, and antibiotic resistance of E. coli from dogs and their owners will help to control the inter-species transmission and treatment of E. coli infections. In this study we characterize and compare the antibiotic resistance and virulence profiles of fecal E. coli isolates from dogs and their owners. A total of 149 commensal E. coli isolates comprised 62 isolates from dogs, 56 isolates from their owners and 31 isolates from humans with no pet as control were collected. Extracted DNA was assessed for the presence of antibiotic resistance genes cmlA (chloramphenicol), sulI (sulfamethoxazole), floR (florfenicol) and blaCTX-M1 (cefotaxime) and virulence genes (papA, ompT, hlyD, traT, tsh and cnf1). To determine the extent of genetic relatedness of isolates, RAPD-PCR was performed. sulI and traT genes were the most dominant resistance profile and the most prevalent virulence gene in all groups, respectively, while hlyD had the lowest frequency among investigated virulence genes. Based on RAPD-PCR analysis clonal sharing between dogs and their owners were observed in 2/28 (7.1%) potential within-household clone-sharing pairs. Allowing dog to lick on owner's face, dog sex (female dogs), dog's sexual status (intact dogs) and times of disposing the feces (≥twice a day) were associated with a higher percentage of RAPD profile similarity (P < 0.05). The current study did not show an obvious evidence to prove considerable transmission of fecal E. coli from dogs to their owners. But in two households, there were relationship between isolates from dogs and their owners.

The association of CNTNAP2 rs7794745 gene polymorphism and autism in Iranian population

Autism is a heterogeneous and multifactorial disease that results from the interaction between genetic vulnerability and environmental factors. Several studies showed that many of genes that play role in autism are component of signaling networks that regulate growth and synaptic plasticity, play an important role in the etiology of autism. Contactin associated-like 2 (CNTNAP2) gene is a member of the superfamily of synaptic adhesion proteins and encodes a scaffold protein called CASPR2 that is involved in the interaction of neuron-glia and clusters K⁺ channels in myelinated axons. CNTNAP2 is highly expressed during the nervous system development. In this study the association of rs7794745 CNTNAP2 gene polymorphism and autism was investigated. Two hundred patients with autism and 260 healthy individuals were included in this study. Genomic DNA was extracted from peripheral blood cells. Genotypes were analyzed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). Statistical analysis was performed using the software MedCalc (12.1). The genotype frequencies of AA, AT, TT were 35.3%, 50.7% and 13.8% in controls and these values were 32% and 68% and 0% in patients with autism, respectively (P=0.0001) (OR=0.01, 95% CI 0.001-0.32). The frequency of A and T alleles were 66%, 34% in patients and 60%, 40% in controls, respectively (P=0.11). The results of this study showed that there is a significant association between rs7794745 CNTNAP2 gene polymorphism and autism in the studied population. However, to obtain a definitive conclusion larger studies with more patients and controls are needed to confirm the results.

Comparison of Renal Growth, Proteinuria and Graft Survival between Recipients of Pediatric and Adult Cadaveric Kidney Transplants

BACKGROUND

The shortage of cadaveric kidney donors has prompted transplant teams to expanding the donor selection criteria. The usage of pediatric cadaveric kidneys is one of those expanded criteria. But the main concern is the probability of hyperfiltration syndrome due to small renal mass of pediatric donors.

OBJECTIVE

To compare the graft and patient survivals, post-transplantation complications, rate and severity of proteinuria secondary to hyperfiltration injury and the kidney growth of recipients who underwent transplantation from adult (group 1) and pediatric deceased donors (group 2).

METHODS

In this historical cohort study, each group contains 36 patients. Outcome measures included patient and graft survivals, quality of graft function as assessed by serum creatinine (SCr) and estimated GFR (eGFR), surgical complications, proteinuria that was detected by routine urinalysis and then confirmed by a 24-h urine protein >150 mg, blood pressure, and kidney length and volume measured by early and follow-up ultrasonography.

RESULTS

The mean donor age in groups 1 and 2 was 36 and 6.5 years, respectively. 9 (25%) kidneys taken from pediatric donors (group 2) were offered en-bloc. The mean follow-up was 28 month. The two groups were not significantly different in terms of the incidence of DGF, rate of acute rejection, 1-year graft survival, SCr and eGFR levels, rates of surgical complications requiring surgical interventions, development of proteinuria, and rate of post-transplantation rise in blood pressure. The mean±SD kidney length within 24 hours of transplantation was significantly higher in group 1 compared to group 2 recipients (112±14 vs. 75±12 mm; p=0.001), but the rate of increase in kidney length in group 2 was significantly higher than that in group 1 recipients (43±4 vs. 10±2 mm; p=0.002) during the follow-up period. 80% of the increase in the kidney size was observed during the first 12 months of surgery; another 20% happened between 12 and 18 months.

CONCLUSION

We found that obligatory and compensatory growth of pediatric kidney donors can overcome the concern of hyperfiltration syndrome and that the outcome is the same as adult donors.

The Healing Effect of Adipose-Derived Mesenchymal Stem Cells in Full-thickness Femoral Articular Cartilage Defects of Rabbit

BACKGROUND

Articular cartilage defect can lead to degradation of subchondral bone and osteoarthritis (OA).

OBJECTIVE

To determine the healing effect of transplantation of adipose-derived mesenchymal stem cells (Ad-MSCs) in full-thickness femoral articular cartilage defects in rabbit.

METHODS

12 rabbits were equally divided into cell-treated and control groups. In cell-treated group, 2×10(6) cells of third passage suspended in 1 mL of DMEM was injected into articular defect. The control group just received 1 mL of DMEM. Dulbecco's modified Eagles medium (DMEM) supplemented with 10% fetal bovine serum (FBS), 1% penicillin and streptomycin and 2 mM L-glutamine were used for cell culture. To induce cartilage defect, 4 mm articular cartilage full-thickness defect was created in the knee. For histological evaluation in each group (H&E, safranin-O and toluidine blue), 3 rabbits were sacrificed 4 weeks and 3 animals, 8 weeks after cell transplantation.

RESULTS

In cell therapy group post-transplantation, no abnormal gross findings were noticed. Neo-formed tissues in cell-treated groups were translucent with a smooth and intact surface and less irregularity. In cell-treated group after 8 weeks post-transplantation, the overall healing score of experimental knees were superior when compared to other groups.

CONCLUSION

We showed that Ad-MSCs, as an available and non-invasive produced source of cells, could be safely administered in knee osteochondral defects.

Protective effects of Cornus mas fruit extract on carbon tetrachloride induced nephrotoxicity in rats

Oxidative damage is implicated in the pathogenesis of kidney injury. Cornus mas is used for in renal aliments traditionally in Iran. The present study was aimed to investigate the antioxidant activity of C. mas fruit extract (CMFE) on carbon tetrachloride (CCl₄) treated oxidative stress in Wistar albino rats. Forty two male albino rats were divided into seven groups. Group I served as a sham; Group II served as a normal control; Group III served as a toxic control, with CCl₄ (1 ml/kg body weight; 80% in olive oil); Groups IV and V received CMFE at doses of 300 and 700 mg/kg before CCl₄ injection; Groups VI and VII received extract at same doses orally at 2, 6, 12, 24 and 48 h after CCl₄ intoxication. CCl₄ injection produced a significant rise in serum markers of oxidative stress and lipid peroxidation product malondialdehyde along with the reduction of antioxidant enzymes such as superoxide dismuta, catalase and glutathion peroxidase. Serum creatinine, urea and uric acid concentrations were increased whereas level of protein and albumin were reduced. Treatment of rats with different doses of fruit extract (300 and 700 mg/kg) significantly (P < 0.05) ameliorated the alterations induced with CCl₄ in lipid peroxidation, antioxidant defenses, biochemical and renal lesions. Based on these results, we conclude that CMFE protects kidney from oxidative stress induced by CCl₄.

First identification of Sarcocystis hominis in Iranian traditional hamburger

Zoonotic concerns of cattle sarcocystosis are of importance, because humans are the final host for Sarcocystis hominis. Therefore the meat products containing beef may encompass sarcocysts which endanger food safety. In this study, we described the first report of molecular identification of S. hominis in Iranian traditional hamburgers using PCR-RFLP. Throughout a pilot research that was carried out to setup a molecular approach to identify the Sarcocystis spp., using PCR-RFLP, a sample of raw Iranian traditional hamburger was purchased from a street food seller located in Yazd, central Iran in May 2013. DNA extraction was done, by salting out method; briefly, the sample was lysed with NET buffer. The DNA purification and precipitation was then performed. Amplicon and digestion results were analyzed, using gel agarose electrophoresis. The results showed a PCR product with 926 bp in length after amplification and 376 and 550 bp in length after digestion. This product was identified as S. hominis. To the best of our knowledge, this is the first report of S. hominis infection in Iranian hamburger.

SNP detection in Na/K ATP-ase gene α1 subunit of bisexual and parthenogenetic Artemia strains by RFLP screening

In order to find a marker for differentiating between a bisexual and a parthenogenetic Artemia strain, Exon-7 of the Na/K ATPase α(1) subunit gene was screened by RFLP technique. The results revealed a constant synonymous SNP (single nucleotide polymorphism) in digestion by the Tru1I enzyme that was consistent with these two types of Artemia. This SNP was identified as an accurate molecular marker for discrimination between bisexual and parthenogenetic Artemia. According to the Nei's genetic distance (1973), the lowest genetic distance was found between individuals from Artemia urmiana Günther 1890 and parthenogenetic populations, making the described marker the first marker to easily distinguish between these two cooccurring species.

A comparison of effects of ABVD and ChlVPP chemotherapeutic protocols for Hodgkin's disease on rats' epididiymal and testicular tissues

The goal of this study was to determine the effects of ABVD and ChlVPP chemotherapeutic protocols for Hodgkin's disease on the structure of testis and epididymis of male rat. After determining tolerance dose of drugs in pilot study, 24 male rats were divided to four groups: ABVD (doxorubicin, bleomycine, vinblastin, dacarbazine) group, ChlVPP (chlorambucil, vinblastin, procarbazine, prednisolone) group and two control groups one for each treatment group. One half of the lethal dose for 50% of population (LD50) was used for treatment of animals in each protocol. Testes and epididymis tissues were examined for structural changes and serum testosterone level was measured by Lission (chemiluminescence method). Body weight, testis and epididymis weights, in treated rats were significantly less than their control groups specifically in ABVD group was less than ChlVPP group. Decreasing of mean diameter of seminiferous tubules, height of spermatogenic cells and diameter of epididymis in caput, corpus and cauda in ABVD group were significantly more than ChlVPP and control group. The serum testosterone level in ABVD group was significantly less than ChlVPP and control group. According to this study results, the ChlVPP had fewer impairment effects than ABVD on testis and epididymis tissue in tolerance doses on male rats' reproductive system. More clinical trial studies are suggested on Hodgkin's patients. With equal treatment effectiveness, it will be better to use the most reliable and safe treatment especially in young patients.

Comparison of lidocaine 1% and normal saline in paracervical anesthesia for decreasing of pain in curettage

The objective of this study was to compare the efficiency oflidocaine with that of plain saline for paracervical pain relief during fractional curettage. The double-blind randomized clinical trial was performed on 150 patients presenting from 2004 to 2005 for curettage. The patients were assigned randomly in two groups to receive lidocaine 1% or normal saline. Number of patients at each group was 75 women. The pain intensity was assessed in four stages: (1) after speculum insertion, (2) during cervical dilatation, (3) during curettage and (4) 30 min after curettage completion. The pain intensity was graded as 0 to 100 according to the Likert Scale. The Mean +/- SD of pain intensity after speculum insertion, during dilatation, during curettage and 30 min after curettage in lidocaine group were 11.33 +/- 9.70, 24.93 +/- 15.36, 37.00 +/- 17.35, 6.47 +/- 6.42 and in normal saline group were 11.73 +/- 9.81, 28.20 +/- 13.19, 49.47 +/- 21.55 and 7.33 +/- 6.22, respectively. There was no significant difference between pain intensity after speculum insertion, during dilatation and during 30 min after curettage but there was a significant difference in pain intensity during curettage between lidocaine 1% group and normal saline group (p < 0.05). Normal saline is as effective as lidocaine 1% in low pain in curettage (distention of nerve capsule) but when increase pain in curettage (third time point), lidocaine 1% is more effective than normal saline. Nerve capsule distention is not the only factor for pain control in paracervical block and analgesic agent is still an important factor.

Concentration of heavy metals in different tissues of Astacus leptodactylus from Aras dam of Iran

Due to different human activities in the vicinities of Aras dam, various pollutants such as heavy metals are entered into the reservoir and thus polluting the aquatic ecosystem. As a result, this heavy metal is accumulated in the tissues of Astacus leptodoctylus, which is considered as one the abundant species of crayfish that has got important food values and is of economic importance due to its export to other countries. In this research, the bioaccumulation of heavy metals in different tissues of this animal is taken into consideration. The concentration of Fe, Cu, Zn, Mn, Pb, Ni, Co and Cr among the tissues of female and male Astacus leptodactylus has been determined. The highest concentration of Cu and Fe was found in the gills and the highest level of Zn was found in hepatopancreas. Besides, the highest Mn concentration was recognized in exoskeleton. Furthermore, no significant difference was found between the male and female crayfish in the concentration of the heavy metals in their tissues, except for the concentration of some of the metals such as Fe in some of the tissues such as hepatopancreas.

Effects of lead nitrate (PbNO3) on the glucose and cortisol hormone levels in common carp, Cyprinus carpio

The objective of this study was to evaluate the possible effects of PbNO3 exposure on variations of glucose and cortisol levels in Cyprinus carpio. Fish were subjected to two sub-lethal concentrations of PbNO3 for 14 days. Blood samples were isolated from the fish following the exposure, to measure the levels of cortisol and glucose compared to the control group. We found significant increases (p<0.05) in the levels of blood cortisol in two groups of fish after 14 days of exposure to two concentrations of PbNO3 (1.3 and 2.6 mg L (-1)) The results showed significant increases in the glucose levels of both fish groups exposed for 14 days In the later treatment, the rate of increase in group II (exposed to 2.6 mg L(-1) PbNO3) was higher than that of group I (exposed to 1.3 mg L(-1) PbNO3) (P = 0 compare to P = 0.007). Present findings attest that exposing to waterborne lead would affect the levels of both glucose and cortisol in Cyprinus carpio.

Effects of copper sulfate (CuSO4) on the levels of glucose and cortisol in common carp, Cyprinus carpio

The objective of this study was to evaluate the possible effects of CuSO4 exposure on variations of glucose and cortisol levels in Cyprinus carpio. Three replicates of 6 fish were subjected to two sub-lethal concentrations of CuSO4 (0.16 and 0.53 mg L(-1)) for 14 and 21 days. Blood samples were isolated from the fish following the exposure, to measure the levels of cortisol and glucose compared to the control group. The results showed significant increases (p < 0.05) in cortisol levels for both fish groups after 14 days of exposure, whereas, the levels of blood cortisol in both groups did not differ from that of control when the fish subjected to copper sulfate for 21 days. We found significant increases (p < 0.05) in the levels of blood glucose of two groups of fish after 14 days of exposure to two doses of CuSO4, as well as significant decrease in the blood glucose of both groups exposed for 21 days. In the later treatment, the rate of decrease in group II (exposed to 0.53 mg L(-1) CuSO4) was higher than that of group I (exposed to 0.16 mg L(-1) CuSO4) (p = 0.001 compared to p = 0.032). Our findings attest that exposing to waterborne copper would affect the levels of both cortisol and glucose, as indicators of stress response in Cyprinus carpio.

Breast cancer risk factors in south of Islamic Republic of Iran: a case-control study

A case-control study was carried out from April 2000 to March 2002 to investigate risk factors for breast cancer in Bandar Abbas, south Islamic Republic of Iran. Using logistic regression analysis, 168 women with pathologically confirmed primary breast cancer were compared with 504 age-matched controls. Significant risk factors were: family history of breast cancer in a first-degree relative, younger age at menarche, never married, first full-term pregnancy age 30+ years and >5 full-term pregnancies. In multivariate analysis, negative history of breastfeeding was also significant. Cases and controls did not differ with regard to parity, history of abortion, oral contraceptive use, menopausal status, age at menopause, ever-use of hormone replacement therapy, history of benign breast disease or history of cigarette smoking.

Bioaccumulation of lead nitrate in freshwater crayfish (Astacus leptodactylus) tissues under aquaculture conditions

The aim of this research was to evaluate the amount of lead in the tissue of Astacus leptodactylus especially in their muscle which the consumed part of their body. In this study the crayfish was exposed to intermediate concentration of lead nitrate (500 microg L(-1)) for periods up to 3 weeks. In the first, second and third weeks bioaccumulation in various tissues was under investigation. The data of toxicological analysis obtained by the method of atomic absorption revealed that the levels of bioaccumulation of metal are different in various tissues of this crayfish. The accumulation of the lead in gills was the highest and in muscles was lowest degree. The amount of heavy metals in the tissues of crayfish was as follow. Gills>exoskeleton>hepatopancreas (digestive glands)>digestive tract>green gland>testis and ovary>muscles.

Therapeutic efficacy of artesunate in Plasmodium vivax malaria in Thailand

Our previous study showed that in vitro susceptibility of Plasmodium vivax to chloroquine has significantly decreased in Thailand within the past two decades. Thus, the evaluation of alternative antimalarials for treatment of vivax malaria is needed. The aim of this study was to examine parasitological and clinical efficacy of an artemisinin derivative (artesunate) for the treatment of vivax malaria in patients who were admitted to the Bangkok Hospital for Tropical Diseases. We randomly allocated patients aged 12-56 years to receive 3.3mg/kg (adult dose 200 mg) on the first day, and for the next four days each patient was given 1.65 mg/kg orally (adult dose 100 mg), total dose = 600 mg. After the five-day course of artesunate, primaquine was given: a single oral dose of 15mg for 14 days. A total number of 42 patients received treatment. All participants were followed up for 28 days. In all the cases, both parasitemia and fever were resolved rapidly; the mean fever clearance time and parasite clearance time, 14.6 and 36.7 hours, respectively, showed that therapeutic response to artesunate was better than that of chloroquine. The 14-day cure rate was 100%, but reappearance of parasitemia was seen in two patients on days 21 and 25 following treatment, respectively. These two cases of failure rate should be considered as true relapse rather than recrudescence, since the relapse interval in Southeast Asian vivax malaria according to recent findings seems to be 3 weeks after start of treatment, if primaquine is not given or an inadequate amount is given. In conclusion, artesunate might be useful in treatment of vivax malaria, causing a good blood schizontocidal effect. However, to prevent emerging resistance it should never be used alone.

Cutaneous leishmaniasis in Hormozgan, Iran

BACKGROUND

Epidemiology of Cutaneous Leishmaniasis in Hormozgan province during April 1994 to March 1998 was studied.

METHODS

Data were collected from the Health service Centres throughout the province as well as from dermatologists. The patients were diagnosed clinically or paraclinically and all important details were recorded on specially designed forms.

RESULTS

A total of 4094 patients with 7255 lesions were diagnosed. 42.24% of the sufferers were under 20 years and 6.47% were over 40 years old. 52.10% of the patients had one lesion and 33.98% had two lesions. Most of the cases were seen during January to March. The incidence rate per 10000 ranged from 5.90 in 1998 to 16.98 in 1996.

CONCLUSIONS

A decreasing trend in the number of cases after 1996 may be due to the awareness of local health authorities, preventative activities and education.