bluuebunny/crossref_metadata_2025 huggingface dataset:
Coronavirus Disease 2019 Occupational Considerations for Surgeons: A Review Article
Authors: Banihashemi Seyed Hesamaddin , Karimi Ahmadreza , Nikourazm Hasti , Bahmanyar Behnaz , Hooshyar Dariush
Published: July 2021

The severe acute respiratory syndrome coronavirus 2 virus and its associated disease, called coronavirus disease 2019 (COVID-19), first appeared in Wuhan, China in December 2019 and quickly spread around the world. Coronavirus was officially named COVID-19 by the World Health Organization and was recognized as a pandemic due to its rapid spread worldwide. Based on the published data, it is hoped to provide a source for later studies and to help prevent and control the contagious COVID-19 and its characteristics, and considerations that surgeons and medical staff must observe during the epidemic.
Prevalence of Surgical Site Infection in Patients With Femoral Shaft Fracture
Authors: Attarian Ali , Movahedi Sadra , Haghiri Dehbarez Ahmad , Hassani Azad Mehdi , Karimi Haji Khademi Atefeh
Published: July 2021

Background: The surgical site infections (SSIs) associated with orthopedic surgeries are prevalent since the commonly used implantation techniques increase the risk of infection. This study aimed to evaluate the prevalence of SSI in patients with femoral shaft fracture (FSF). Materials and Methods: This retrospective cross-sectional study was performed on patients with FSF referred to Shahid Mohammadi hospital of Bandar Abbas, Iran from 2012 to 2016 for open intramedullary nailing (IMN) of the femoral shaft. Data were entered into the SPSS software version 25.0 for statistical analysis. Results: Sixty-two individuals with the mean age of 26.95±1.19 years participated in the study, of whom 85.5% were male and 14.5% were female. Twelve patients (19.4%) had open fractures and 50 (80.6%) had closed FSFs. SSI was observed in eight cases, one of whom had deep SSI (osteomyelitis). Our results showed that SSI was not correlated with age or sex (P < 0.05), but it was significantly correlated with the frequency of hospitalizations, fractures in other areas, and the type of fracture (open and closed) (P < 0.05). Conclusion: The overall prevalence of SSI was 12.9%, which was higher compared to previous studies. Humidity and warm weather can be major contributing factors to the high prevalence of post-operative infection in this treatment center; however, the conditions of the orthopedic operating room and facilities should also be considered.
The Effect of Coronavirus Anxiety on Self-esteem, Life Satisfaction and Mood of Women with Moderate-to-Moderate Physical Activity During Covid-19 Quarantine
Authors: esteki samira
Published: July 2021

Background and Objectives: The widespread prevalence of Coronavirus disease and the resulting epidemic and implementation of quarantine has increased Coronavirus anxiety. On the other hand, collective tragedies, especially those involving infectious diseases, often increase waves of fear and anxiety that appear to cause widespread behavioral disturbances and threaten the mental health of many people in the population. Therefore, the present study aimed to investigate the effect of coronavirus anxiety on self-esteem, life satisfaction and mood of women with moderate to moderate physical activity during the Covid-19 quarantine period. Material and Methods: The present study is a descriptive survey study. The sample consisted of 165 women with regular moderate physical activity who participated in the study through available sampling through telegram and WhatsApp virtual networks by distributing online questionnaire link. Required data through standard questionnaires including coronary anxiety Brunel Mood Scale (BRUMS) Items, Life satisfaction of Diener. The Rosenberg Self-Esteem Scale (RSES) and IPAQ physical activity questionnaire was provided. Data in SPSS 26 software were analyzed using descriptive statistics and path analysis using SMARTPLS software. Results: The results showed that anxiety caused by coronavirus had a significant inverse effect on self-esteem (β = -0.238) and life satisfaction (β = -0.307) of women with moderate-to-moderate physical activity during coronavirus 19 quarantine, and has a positive and significant effect on mood (β = 0.573) of women with regular moderate physical activity and their model has a good fit (p <0.05). Conclusion: Coronary anxiety disorder plays an important role in the self-esteem, life satisfaction, and mood of women with moderate-to-moderate physical activity during the Covid-19 quarantine period. Reducing coronary anxiety through appropriate exercise programs can be effective in improving the self-esteem, life satisfaction, and mood of women with moderate to moderate physical activity during the Covid-19 quarantine period.
Safety Status of Imaging Ward in Public and Private Hospitals
Authors: Saadati Mohamad , Rezapour Ramin , Sajjadi Khasraghi Javad
Published: July 2021

Background and Objectives: Safety is one of the main dimensions of quality of health services. Considering the expansion of imaging equipment in diagnosis of diseases and the importance of maintaining and improving the safety of patients and staff in these wards, this study aimed to investigate the safety status of imaging wards in hospitals. Material and Methods: This study is a cross-sectional descriptive-analytical study. The sampling method was the census so that all public and private hospitals in Tabriz city of Iran (7 public hospitals affiliated to Tabriz University of Medical Sciences and 6 private hospitals) were enrolled in the study. The instrument used was a researcher-made checklist whose content validity ratio was 0.82 and the Content Validity Index was 0.86. The safety status of the wards was evaluated in 9 domains. Data were analyzed by SPSS software version 24 using descriptive statistics and Mann-Whitney test. Results: The mean safety score of imaging wards was 79.78 ± 6.2 The average safety scores in public hospitals were 79.7±5.91 and private hospitals were 79.8 ±7.29. Radiation safety was the highest score in public and private hospitals (92.85 ± 8.09) and private (95.8 ± 9.17). The lowest standards compliance in public hospitals was related to electrical safety (69.28 ± 10.96). In private hospitals, employee safety had the lowest score (62.96 ± 9.07). There was a significant difference between the mean score of employee safety and the type of hospital ownership (public and private) (p value=0.019). Conclusion: Safety improvement in imaging should be studied as one of the priority issues in all hospitals. Employee safety had the lowest score thus it is necessary to implement strategies to improve employee safety including providing appropriate protective clothing, daily distribution of milk and proportionate compensation such as paying to work with radiation, reducing working hours and increasing annual leave according to existing laws.
Developing a Causal Model to Improve Knowledge Management in Knowledge-Based Companies in the Field of Health by Mixed Methods
Authors: Sojoudi Hossein , Bagherzadeh khajeh Majid , Bafandeh Zendeh Alireza , Iranzadeh Soleyman
Published: July 2021

Background and Objectives: Among the many factors, researchers have pointed to the existence of a wide range of models and tools for knowledge management success, which makes it difficult for companies to choose the right model according to the internal conditions of the company. Given the knowledge of many health businesses, increasing managerial skills will not be possible without considering the success of knowledge management. Accordingly, the purpose of this study was to develop a causal model to improve knowledge management in knowledge-based companies in the field of health by combining themes of analysis methods and structural-interpretive modeling. Material and Methods: The research method is mixed using the qualitative research method of theme analysis, the success factors of knowledge management in knowledge-based companies in the field of health are identified and in the next step, based on confirmatory factor analysis, the results of the qualitative section in the statistical community of knowledge companies The foundations of the field of health have been examined and in the next step, using the interpretive structural modeling method, the causal model of success factors has been developed. Results: The results of the research in the qualitative section show nine main themes including knowledge management strategy, industrial environmental factors, cultural factors, IT infrastructure development, individual factors, organizational factors, Knowledge management incentives, subjective norms and central category (knowledge management). It came with forty-two sub-themes. Also, the results of confirmatory factor analysis indicate the appropriateness of the main themes extracted from the qualitative part. The results of structural-interpretive modeling also showed that knowledge management strategy and environmental and industrial factors are considered as the main factors in the success of knowledge management. Conclusion: The results of this study created a model of knowledge management success and also showed the results of a quantitative part of the exact model's quality.
Exploring the Family Expectation of Patients Undergoing Surgery: A Qualitative Study
Authors: Nasiri Ebrahim , Shabanzad Sara
Published: July 2021

Background and Objectives: Accompanying the patients' family members in hospital creates feeling of empathy, safety of and help with fulfilling their expectations. Because both the patients and careers suffer from high stress due to lack of awareness about medical condition and treatment process. It is important for health system to understsand the expectations of patients and family members to be responsive and fullfill it correctly. This study was conducted to discover the patients carers (family members) experiences and expectation of patients undergoing surgery. Material and Methods: This qualitative phenomenological study was performed on 15 family members of patients undergoing surgery by purposive sampling until complete saturation of information. Data were collected through semi-structured interviews and recorded using word software. Items were extracted and qualitative content analysis method was used to analyze the data. Results: By analyzing the data, the main theme is "anxious minutes" and 5 main categories including "associated internal conflicts, behavioral changes while waiting, concerns about the prognosis of surgery, concerns about the outcome of the treatment process, and doubts about Hospital components" were extracted. Conclusion: While waiting for the end of the surgery, families experience many anxieties and worries about the patient's health and the treatment process. Considering the concerns of the patient's companions with principled planning, appropriate and practical interventions can improve the mental health of families and improve the quality of patient care.
Effectiveness of Acceptance and Commitment Therapy on Safety Performance, Quality of Life and Somatic Symptoms in Patients with Irritable Bowel Syndrome
Authors: shakernezhad sepideh , khalatbari javad , Mahmoud Aliloo Majid
Published: July 2021

Background and Objectives: The aim of this research was to evaluate the effectiveness of acceptance and commitment based therapy on immune function, quality of life and physical symptoms in patients with irritable bowel syndrome. Material and Methods: This research was an experimental with pre-test, post-test and 90 days later follow-up with the control group. The research sample were selected as available and included 30 patients with irritable bowel syndrome. Using available sampling method with the consent of the patients, They randomly sampled into two groups of 15 experimental and control, using availa be sampling method with the consent of the patients. The experimental group received acceptance and commitment group therapy for 8 sessions, while the control group did not receive any intervention. Both groups were assessed before and after the intervention and in the follow-up stage using quality of life questionnaires, irritable bowel syndrome evaluation questionnaire (Rome IV) and fecal calprotectin test for immune function. Data analysis was performed first by repeated measures analysis of variance and then by repeated measures analysis of variance by considering the protein variable in the pre-test stage as a covariate variable. Results: In the repeated measures method, the results showed that the effect of time on all three variables of safety function (F = 8.597, P = 0.001), physical condition (F = 63.95, P = 0.0001) and quality of life (F = 65.93, P = 0.0001) is significant. In the method of repeated measures with covariate, the effect of time on the safety performance variable is not significant (F = 0.217, P = 0.645) and it is significant in the variables of physical condition (F = 11.302, P = 0.0001) and quality of life (F = 13.154, P = 0.0001). The results of intergroup test also indicated the significance of the effect of treatment (control and experiment) in all three variables studied in both methods. Conclusion: The findings of the research showed that acceptance and commitment therapy can play an effective role in reducing physical symptoms and improving patients' immune function and improving their quality of life. Therefore, this treatment is recommended as an adjunctive therapy in patients with irritable bowel syndrome.
Prevalence and Screening of Determinants of Depression Disorder during Pregnancy and after Childbirth; Case-Control Study
Authors: Heidari Fariba , Helali Haleh , Baradaran Binazir Maryam
Published: July 2021

Background and Objectives: Depression disorder during pregnancy and after childbirth is one of the mental illnesses that has adverse effects on maternal and neonatal health, especially infant growth and development. The aim of this study was to determine the prevalence and factors affecting depression disorder during pregnancy and after childbirth in Azarshahr in 2017-2018. Material and Methods: In this case-control study, all pregnant women with depression and the total number of women with postpartum depression in Azarshahr were considered as the case group. For the control group, 150 pregnant and delivered mothers were selected by systematic random sampling from Apple system. Statistical calculations were performed by using SPSS software version 16. Logistic regression test was used to compare the data in the case and control groups. Results: The prevalence of depression during pregnancy was 4.15% and the prevalence of postpartum depression disorder was 2.14%. There was a significant relationship between postpartum depression disorder and postpartum depression disorder with age, body mass index, spouse's job, number of previous children, number of previous daughters, household income, having a smoker husband, mother's daily physical activity and history of abortion. Conclusion: The prevalence of depression disorder during pregnancy in Azarshahr is higher than the provincial average. So, providing screening, diagnosis, treatment and support services for depression disorder in pregnant women in this city is essential. Considering the factors, high-risk mothers can be identified, and these services can be tailored for the high-risk group.
Subjective Commentary of Health Literacy through Social Networks for Civil Servants’ Pension Fund Beneficiaries: A Qualitative Study
Authors: Noorizadeh Ghasri Atefeh , Famil Rouhany Seyyed Aliakbar , Erfani Nasrolah
Published: July 2021

Background and Objectives: Elderly people need to pay more attention to promoting health promotion and improving quality of life in comparison with other people. On the other hand, the interest and desire to work with the Internet and social networks of internet plays an indelible role in improving the health literacy of the community. This study was carried out with the aim of evaluation the subjective explanation of health literacy through social networks for retired of fund beneficiaries. Material and Methods: The present study is a phenomenological study with emphasis on Van Mennen's perspective to discover the experiences of retirees from the phenomenon of health literacy through social networks. The data were collected through a deep interview. Semi-structured interviews were conducted with 15 retirees of the State Pension Fund in Tehran in 2020 using purposive sampling. All interviews were recorded and implemented and the theme analysis method was used to analyze the interviews. Results: Data analysis resulted in the extraction of 71 primary codes and 33 sub-themes, which was classified in four main themes of experience in the field of "access to health information", experience in the field of "understanding health information" "Experience in the field of" health information evaluation ", experience in the field of" application of health information ". Conclusion: Retirees, who make a large part of the country's elderly population, are embedded in social networks, and all organizations that play a role in the health and education of retirees can create rich educational content and using Simple, understandable multimedia content by social networks as well as the introduction of networks with reliable information for retirees, to improve the level of health literacy and increase useful health information for them, which is an effective factor in maintaining health and increasing the quality of life.
Design and Psychometric Evaluation of User Satisfaction Questionnaire in Integrated Health System for Reliability and Validity
Authors: Abolghasemi Jamileh , Mohammadzadeh Zeinab , Maserat Elham , Kariminezhad Reza
Published: July 2021

Background and Objectives: Evaluating the effectiveness of health information systems and users' satisfaction with system performance is important. The success of an information system is directly dependent on the system responding to user needs. Due to the importance of this issue, a tool has been designed to evaluate users' satisfaction with Integrated Health System. Material and Methods: This cross-sectional study was conducted in 2018 to design a questionnaire to assess the users' satisfaction with Integrated Health System. In the first step, the areas of user satisfaction were identified by reviewing literature and reliable scientific sources. Then a bank of questions was created and after classifying the indicators and identifying related questions the primary tool was developed in several areas. Face validity and content validity of the questionnaire were determined using CVI and CVR indices. Reliability over time was assessed by 20 users of in an Integrated Health System with two-week intervals. Results: The final questionnaire included demographic information and 55 questions about the components of a System Satisfaction Questionnaire. Questions related to each component included system interface, system functions, system performance, system information and statistics, system supportive services, System services, and and total satisfaction from the system. The average CVI and CVR for total questions were 0.84 and 0.73, respectively. For reliability over time, the coefficient (ICC) for the whole structure was 0.98. The reliability of the questionnaire evaluated by Cronbach's alpha and internal consistency method, that this value was obtained 0.914 for total questionnaire. Also, separately for each structure was obtained in the "good" range. Conclusion: In this study, we tried to provide a brief and expressive user satisfaction assessment tool that required the least amount of time to respond. The high response rate of all questions indicates that designed tool achieved the objectives of the study. The most emphasized component by users is the system support component. Ease of use of the system, usefulness and support of the system from performing daily activities are other things that are more important for users.
The Relationship between Workaholism and Workplace Incompatibility: The Role of Family-Work Enrichment and Gender
Authors: طاهری فاطمه
Published: July 2021

Background and objectives: Incompatibility in the workplace causes destructive behaviors and the desire to withdraw employees from the organization. Therefore, identifying the factors affecting its occurrence is inevitable. The present study investigated the relationship between work-related addiction and workplace incompatibility: the role of family-work enrichment and gender. Materials and Methods: This research is applied in terms of purpose and descriptive correlational study in terms of method. The statistical population is 590 employees of Qom Health Center. A total of 233 samples were selected randomly according to Krejcie & Morgan sample size determining table. Data analysis was performed by Structure Equation Modeling using SPSS 25 and AMOS 18 software. Results: Work addiction has a positive effect on incompatibility and work-family enrichment has a negative effect on it. Work addiction has a positive effect on work-family incompatibility and enrichment. Also, family-work enrichment plays a median role between work-to-work addiction and incompatibility. In addition, gender only moderates the relationship between work-related addiction and incompatibility. Conclusion: The results of this study showed that reducing workplace incompatibility can be done by considering the status of work addiction and enriching the employees' work-life and implementing methods to improve them.
Therapeutic Potential of Traditional Indian Herbal Medicine in COVID-19: A Narrative Review
Authors: Singh Snigdha , Javed Danish , Mukherjee Sukhes , Mittal Rishabh , Chourasia Nidhi , Agrawal Amit , Kotnis Ashwin
Published: July 2021

Background: Coronavirus disease 2019 (COVID-19) has become a global challenge to the health care system. A novel agent to combat this deadly virus is still a matter of research. Herbal molecules have served humanity since the beginning. Objectives: This narrative review aims to study the antiviral properties of medicinal plants, which are already effectively used in the past against various viruses. It derives the importance of exploration of such phytochemicals, which can be complementarily used to treat COVID-19. Methods: Studies related to traditional medicine and treatment for viruses were retrieved from databases including PubMed, Google scholar until December 2020 using the keywords SARS-CoV-2, COVID-19, Immunological, Phyto-chemicals, Traditional Medicine. The resulting publications were analyzed to develop a narrative review on the traditional Indian phytochemicals that have been shown to effectively treat various viral infections and potentially treat or prevent COVID-19. Results: Many of the researches are showing that Indian herbal compounds have a significant potential against viral diseases. Plants like Azadirachta indica, Withania somnifera, Tinospora cordifolia, Ocimum basilicum, and many more have been shown tremendous antiviral, anti-inflammatory, and immune-modulatory activities. Conclusion: Phytochemicals obtained from the herbs can be helpful in the treatment and prevention of SARS-CoV-2via various modes such as inhibition of attachment, penetration, uncoating, replication, assembly, and release of respiratory viruses. Further analysis of the potential phytochemicals in treating SARS-CoV-2 in clinical trials is warranted.
Relationship Between Educational Justice and Academic Burnout in Medical Interns
Authors: Malakian Arash , Sayyah Mehdi , Motamed Kowsar
Published: July 2021

Background: Poor teaching and lack of proper relations between teacher and student and various other causes affect students’ academic burnout. Objectives: Present study was conducted to determine the relationship between educational justice and academic burnout in medical interns of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Methods: This study was descriptive and analytical. The number of samples was equal to 300 medical interns identified and entered by the census sampling method. Data were completed by two questionnaires (researcher-made educational justice and burnout standard) whose reliability and validity were confirmed. Data were analyzed by SPSS Version 22. Results: There was no significant relationship between educational justice and academic burnout (P>0.05). Also, educational justice was below average and academic burnout was above average. There was a significant relationship between educational justice score and gender (P<0.05), and there was no critical relationship with other demographic variables (P>0.05). There was no significant relationship between academic burnout score and all demographic variables (P>0.05). Conclusion: This study concluded that causes other than educational justice have been influential on students’ academic burnout. Hence, it suggested that studies be conducted on high academic burnout and identify influential variables. On the other hand, although the relationship between the two variables was not significant, due to the low level of educational justice, the university’s need for fair educational opportunities, especially professors, should be considered.
The Predictive Value of Mean Platelet Volume for Liver Fibrosis in Children With Chronic Liver Diseases
Authors: Dehghani Seyed Mohsen , Bordbar Mohammad Reza , Salimi Rezvan , Shahramian Iraj , Mirzae Hadi , Gholami Siavash , Sharafi Fatemeh , Bazi Ali , Ataollahi Maryam , Fazeli Fatemeh , Hamzeloo Samaneh
Published: July 2021

Introduction: Almost all causes of chronic liver damage can culminate in liver fibrosis and ultimately cirrhosis. Studies have suggested a relationship between mean platelet volume (MPV) and liver fibrosis; however, this needs confirmation by further studies. We here assessed the predictive value of MPV for liver fibrosis in children with chronic liver diseases. Methods: In this study, children <18 years old with chronic liver diseases referred to the Nemazee Hospital of Shiraz during 2013-2016 were studied. The patients underwent liver biopsy for assessing liver fibrosis. Statistical analyses were conducted in SPSS 23. Results: From 368 studied children, 52.2% were boys. The patients’ mean age was 4.5±3.9 years old. Most patients had grade 6 fibrosis (36.7%). Cryptogenic (42.7%) was the most common cause of chronic liver disease, and jaundice was the most prevalent clinical presentation (53%). There was a significant association between the liver fibrosis and MPV (P=0.025). Conclusion: MPV was significantly different between patients with different severities of liver fibrosis. However, assigning an appropriate cut off value to distinguish different degrees of fibrosis requires more studies.
Evaluation of Blood Transfusion Complications in Patients Undergoing Surgery
Authors: Azizi Farsani Hamidreza , Mokhtari Amin , Ebrahimi Dehkordi Masih , Mokhtari Ali , Mardanshahi Maryam , Sheibani Tehrani Donya
Published: July 2021

Introduction: Patients undergoing surgery may need transfusion of blood products for a variety of reasons. Therefore, this study aimed to determine the incidence of blood transfusion complications in patients undergoing surgery. Methods: The present study was performed as a cross-sectional study in 2020 at Shohadaye Tajrish Hospital in Tehran, Iran. A total of 1132 patients who had complications during surgery upon transfusion of blood and blood products from 2015 to 2020 were included in the census. To collect information, a checklist, including patients’ information, the type of product, and types of complications was used. SPSS software version 21 was used for data analysis. Results: In this study, 99.7% of the complications were acute, and in 91.1% of the cases, the severity of complications was mild. Of the confirmed complications, 46.4% were allergic reactions, and 43.8% were reported as non-hemolytic febrile reactions. A total of 91.1% of patients completely recovered after the onset of the complication, 6.2% had a partial disability, 0.4% had severe disability, and 0.3% died. Conclusion: The results showed that most patients had acute complications in terms of the type of complication and mild in terms of the severity, thus a completely regular program is recommended to control side effects related to blood and blood products transfusion.
Effects of Supplementary Vitamin D on Vitamin D3 Serum Level in Nephrotic Syndrome Patients Receiving Steroid Therapy
Authors: Mahmoodzadeh Hashem , Valizadeh Mohammad , Nikibakhsh Ahmadali , Abbasi Ezatollah
Published: July 2021

Introduction: Nephrotic syndrome is one of the most common glomerular diseases in children who are also at risk of metabolic bone diseases. In this study the effect of supplementary use of vitamin D3 was assessed on serum levels of vitamin D3 in patients with nephrotic syndrome receiving steroid therapy. Methods: Thirty children with nephrotic syndrome were included in this study. After obtaining blood samples to measure 25(OH) D levels, all patients were supplemented with daily doses of Vitamin D for one month. Serum 25(OH) D level was checked again, and these patients were supplemented for another month if they had been recognized with deficiency at the last check. Results: Out of 30 children, 60% were male and 40% were female with a mean age of 6.91 ± 3.34 years. Before intervention, 70% of patients had severe vitamin D deficiency, and 26.7% had mild to moderate deficiency, and none of the patients had normal serum levels of 25-(OH)-D. After one month, only one patient gained normal levels which was not statistically significant (P=0.500). After two months of intervention, 12 patients escaped deficiency but still exhibited insufficient levels followed by 8 people with deficiency, and 10 patients reached normal values which was statistically significant (P=0.002). The mean level of 25(OH) D was 8.277±0.84 ng/ mL rising to 14.364±1.14 ng/mL after two months (P=0.001). Conclusion: This study showed a high incidence of vitamin D deficiency in the children with nephrotic syndrome warranting routine surveillance of vitamin D serum levels in these patients. Daily doses of vitamin D in the first month of onset of the disease was insufficient. We suggest that children may benefit from routine measurement of their serum vitamin D from diagnosis and later in follow-up visits so an individual strategy for vitamin D supplementation could be given.
The Effect of Combined Training Courses on the Expression of ABCG4 Gene and Interleukin-4 Plasma Level in Middle-Aged Men Undergoing Coronary Artery Bypass Grafting
Authors: Yonesi Fahimeh , Rashidlamir Amir , Khajei Rambod , Barjaste Yazdi Ameneh
Published: July 2021

Introduction: Atherosclerosis (AS), as a significant cardiovascular disease, is the main factor of death in the world. There has been an association between plasma lipoproteins and AS. Reverse cholesterol transfer (RCT), in which ATP binding cassette (ABC) adenosine triphosphate transporters are major contributors, prevents AS incidence by reducing the accumulation of cholesterol on the walls of blood vessels. Our purpose was to investigate the effect of a combination training session on the gene expression of ABCG4 and plasma level of interleukin-4 (IL-4) in nucleated blood cells of middle-aged men after coronary artery bypass grafting (CABG). Methods: The statistical population consisted of 20 middle-aged men who had previously undergone CABG. After selection, these individuals were randomly divided into two groups of n=10; control and combined exercise. At the beginning and end of training sessions, blood samples were obtained to isolate mononuclear cells and extract mRNA. Real-time polymerase chain reaction (PCR) was used for gene expression analysis, and IL-4 was determined by ELISA. SPSS software version 16 was used for data analysis. Results: The training period remarkably increased ABCG4 expression and IL-4 plasma level compared to the control group. Conclusion: Combined training, as a part of cardiac rehabilitation in those undergoing CABG may improve the RCT process by affecting the gene expression of ABCG4 and IL-4 production, which are involved in fat burning and metabolism.
The Effect of Eight Weeks of Testosterone Enanthate Consumption on Oxidative Indicators of Kidney Tissue in Resistance Trained Rats
Authors: Mehrabi Masoumeh , Kazemzadeh Yaser , Gorzi Ali , Hosseini Seyed Ali , Sedaghati Saeid
Published: July 2021

Introduction: Taking anabolic steroids can affect the state of oxidative stress in different tissues of the body such as kidneys. This study aimed to examine the effect of 8 weeks of resistance training with testosterone enanthate consumption on tissue oxidation indicators in male rats. Methods: In the current experimental study, 18 rats with an average weight of 250 ± 50 g were divided into 3 groups of 6 animals including: (1) control, (2) training, and (3) training + testosterone. Rats in the training and training + testosterone groups underwent resistance training for 8 weeks and 5 sessions per week. Also, rats in the training + testosterone group received 20 mg/kg of testosterone enanthate by intramuscular injection 3 days a week. The resistance training protocol consisted of climbing a 1-meter ladder 5 days a week (4 sets of 6 with a rest interval of 60 to 90 seconds) in which the weights were 60% of the rats’ body weights in the first week, and 20% of the body weight was added to the weights every week. One-way analysis of variance was used to analyze the research findings (P≤0.05). Results: Glutathione peroxidase (GPx) level in the training + testosterone group was significantly lower than the control group (P=0.007); however, there were no significant differences in malonaldehyde (MDA) (P=0.64) and superoxide dismutase (SOD) (P=0.29) levels between the research groups. Conclusion: It seems that testosterone consumption can be effective in increasing oxidative stress factors in the kidney tissue of resistance-trained rats.
Evacuation the Effect of Single- and Multi-dose Administration of Ethanolic Extract of Pinus eldarica Pollen Against Acetaminophen-induced Rat Liver Injury
Authors: Asadian Salileh , Moallem Seyed Adel , Moshiri Mohammad , Mansouri Mustafa , Ariaee-Nasab Nazila , Ghadiri Ameneh , Shahbazi Niosha , Etemad Leila
Published: July 2021

Introduction: Acetaminophen (APAP)-induced liver injury is one of the main causes of acute liver failure in the world. Pinus eldarica is specially distributed in the north of Iran and has been used for decades to treat wounds, pain, infection, fever, bronchitis and inflammation in many countries. This study was undertaken to evaluate the role of pine pollen extract (PE) on APAP-induced hepatotoxicity. Methods: This study was conducted in two separate parts: single- and multi- dose administration of PE. In a multiple dosing regimen, different doses of extract (10, 20, 30, 40 and 50 mg/kg) were orally administrated for 2 weeks and then on the 15th day, the animals received a single dose of APAP (600 mg/kg). In the second part, the highest dose of PE (50 mg/kg) was orally administrated half an hour after receiving the APAP at dose of 600 mg/kg. The negative and positive control groups were treated with normal saline and N-acetylcysteine (NAC), respectively. At the end of procedure, the biochemical parameters including alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP) as well as pathological findings were evaluated. Results: A single and multiple oral dose of APAP increased the serum level of ALT, AST and ALP that were significantly attenuated by PE administration in both model. Indeed, exposure to APAP caused extensive necrosis and lymphocytic inflammation that were completely prevented by single- and multi-dose administration of PE, specially at a high dose. Conclusion: Finally, the present results indicate that PE could reverse the reduction of aminotransferases and improve histological changes of APAP-induced liver toxicity. Further research is needed to confirm this finding and reveal the exact mechanisms.
The Assessment of Vitamin D Serum Level in Patients With Pulmonary and Extra-Pulmonary Tuberculosis in Karaj, Iran, During 2017-2018.
Authors: Soleimani Alireza , Dehghan Tarzejani Mohammad Hossein , Hakimi Shirin Shams , Alishiri Niloofar , Torabizadeh Roya
Published: July 2021

Background: It is important to determine the type of tuberculosis and its related factors in order for effectively treating a disease and reducing its side effects in the society. Objective: This study aimed to determine vitamin D level in patients with pulmonary and extra-pulmonary tuberculosis in Karaj, Iran in 2017-2018. Materials and Methods: In this observational study, 102 patients suffering from pulmonary and extra-pulmonary tuberculosis disease were availably selected in Karaj, Iran in 2017-2018. They were examined and, then, their vitamin D level were assessed and compared according to the type of tuberculosis. Results: The study results showed that vitamin D level was normal in 39.2% of the case study population, but it was abnormal in 60.8% of it (18.6% deficiency and 42.2% insufficiency). Vitamin D deficiency was 15.8% in pulmonary tuberculosis patients and it was 22.2% in extra-pulmonary tuberculosis ones, showing no significant difference (P>0.05) statistically. Conclusion: According to the obtained results, hypovitaminosis-D was detected in more than half of the patients with pulmonary and extra pulmonary tuberculosis, which was not associated with the type of tuberculosis. Seemingly, the patients needed the same amount of – or even more – food, medical supplements, sports, and sunlight compared to healthy people.
Key Factors that Promote Low-Value Care: Views of Experts From the United States, Canada, and the Netherlands
Authors: Verkerk Eva W. , Van Dulmen Simone A. , Born Karen , Gupta Reshma , Westert Gert P. , Kool Rudolf B.
Published: July 2021

Background: Around the world, policies and interventions are used to encourage clinicians to reduce low-value care. In order to facilitate this, we need a better understanding of the factors that lead to low-value care. We aimed to identify the key factors affecting low-value care on a national level. In addition, we highlight differences and similarities in three countries. Methods: We performed 18 semi-structured interviews with experts on low-value care from three countries that are actively reducing low-value care: the United States, Canada, and the Netherlands. We interviewed 5 experts from Canada, 6 from the United States, and 7 from the Netherlands. Eight were organizational leaders or policy-makers, 6 as low-value care researchers or project leaders, and 4 were both. The transcribed interviews were analyzed using inductive thematic analysis. Results: The key factors that promote low-value care are the payment system, the pharmaceutical and medical device industry, fear of malpractice litigation, biased evidence and knowledge, medical education, and a ‘more is better’ culture. These factors are seen as the most important in the United States, Canada and the Netherlands, although there are several differences between these countries in their payment structure, and industry and malpractice policy. Conclusion: Policy-makers and researchers that aim to reduce low-value care have experienced that clinicians face a mix of interdependent factors regarding the healthcare system and culture that lead them to provide low-value care. Better awareness and understanding of these factors can help policy-makers to facilitate clinicians and medical centers to deliver high-value care.
Developing a National Set of Health Equity Indicators Using a Consensus Building Process
Authors: Wilf-Miron Rachel , Avni Shlomit , Valinsky Liora , Myers Vicki , Ziv Arnona , Peretz Gidi , Luxenburg Osnat , Saban Mor , Feder-Bubis Paula
Published: July 2021

Background: Considerable health inequities documented in Israel between communities, populations and regions, undermine the rights of all citizens to optimal health. The first step towards health equity is agreement on a set of national indicators, reflecting equity in healthcare provision and health outcomes, and allowing monitoring of the impact of interventions on the reduction of disparities. We describe the process of reaching a consensus on a defined set of national equity indicators. Methods: The study was conducted between January 2019 and June 2020, in a multistage design: (A) Identifying appropriate and available inequity measures via interviews with stakeholders. (B) Agreement on the screening criteria (public health importance; gap characteristics; potential for change; public interest) and relative weighting. (C) Constructing the consultation framework as an online, 3-round Delphi technique, with a range of experts recruited from the health, welfare and education sectors. Results: Participants were of diverse age, gender, geographic location, religion and ethnicity, and came from academia, healthcare provision, government ministries and patient representative groups. Thirty measures of inequity, presented to participants, represented the following domains: Health promotion (11 indicators), acute and chronic morbidity (11), life expectancy and mortality (2), health infrastructures and affordability of care (4), education and employment (2). Of the 77 individuals contacted, 75 (97%) expressed willingness to participate, and 55 (73%) completed all three scoring rounds. The leading ten indicators were: Diabetes care, childhood obesity, adult obesity, distribution of healthcare personnel, fatal childhood injuries, cigarette smoking, infant mortality, ability to afford care, access to psychotherapy and distribution of hospital beds. Agreement among raters, measured as intra-class correlation coefficient (ICC), was 0.75. Conclusion: A diverse range of consultants reached a consensus on the most important national equity indicators, including both clinical and system indicators. Results should be used to guide governmental decision-making and inter-sectoral strategies, furthering the pursuit of a more equitable healthcare system.
Forecasting Future Demand of Nursing Staff for the Oldest-Old in China by 2025 Based on Markov Model
Authors: Zhang Liangwen , Shen Shuyuan , Guo Yaqian , Fang Ya
Published: July 2021

Background: An aging population and an increase in the proportion of disabled elderly have brought an unprecedented global challenge, especially in China. Aside lack of professional long-term care facilities, the shortage of human resource for old-age care is also a major threat. Therefore, this study tries to forecast the demand scale of nursing staff for the oldest-old in 2025 in China servicing as a reference for the development plan of human resource for elderly nursing. Methods: Based on CLHLS (Chinese Longitudinal Healthy Longevity Survey) 2011 and 2014, Logit model was used to construct the transition probability matrix of the elderly’s health status (health/mild/moderate/severe disability and death). By using the data of the elderly population aged 65 or over in the 2010 national population census, we projected the number of Chinese oldest-old population in different health status by 2025 through Markov model and projected the scale of the demand of nursing staff combined with the human population ratio method. Results: The forecast shows that the Chinese oldest-old population is about 52.6 million, among which 46.9 million are healthy, 3.7 million are mild, 0.8 million are moderate, and 1.2 million are severely disabled in 2025. Concurrently, the demand scale of nursing staff will be 5.6 million according to the low standard and 11.5 million according to the high standard. Thus, human resource supply of long-term care is worrying. Conclusion: In 2025, the population size of the Chinese oldest-old will be further expanded, and the demand of care will increase accordingly, leading to a vast gap in the nursing staff. Therefore, it is urgent to build a professional nursing staff with excellent comprehensive quality and reasonable quantity, to ensure the sustainable development of China’s elderly care service industry.
Prosociality and Social Responsibility Were Associated With Intention of COVID-19 Vaccination Among University Students in China
Authors: Yu Yanqiu , Luo Sitong , Mo Phoenix Kit-han , Wang Suhua , Zhao Junfeng , Zhang Guohua , Li Lijuan , Li Liping , Lau Joseph Tak-fai
Published: July 2021

Background: Coronavirus disease 2019 (COVID-19) vaccination is expected to end the pandemic; a high coverage rate is required to meet this end. This study aimed to investigate the prevalence of behavioral intention of free/self-paid COVID-19 vaccination and its associations with prosociality and social responsibility among university students in China. Methods: An anonymous online cross-sectional survey was conducted among 6922 university students in five provinces in China during November 1-28, 2020. With informed consent, participants filled out an online survey link distributed to them via WeChat study groups. The response rate was 72.3%. Results: The prevalence of behavioral intentions of free COVID-19 vaccination was 78.1%, but it dropped to 57.7% if the COVID-19 vaccination involved self-payment (400 RMB; around 42 USD). After adjusting for background factors, prosociality (free vaccination: adjusted odds ratio [ORa] = 1.10, 95% CI: 1.09-1.12; self-paid vaccination: ORa = 1.08, 95% CI: 1.07-1.09) and social responsibility (free vaccination: ORa = 1.17, 95% CI: 1.14-1.19; self-paid vaccination: ORa = 1.13, 95% CI: 1.11-1.14) were positively associated with the two variables of COVID-19 vaccination intention. Conclusion: The present study demonstrated the positive effects of prosociality and social responsibility on the intention of COVID-19 vaccination. Accordingly, modification of prosociality and social responsibility can potentially improve COVID-19 vaccination. Future longitudinal and intervention studies are warranted to confirm such associations across populations and countries.
Sero-prevalence of Leptospira spp. in Household and Stray Dogs by Microscopic Agglutination Test
Authors: Shabestari Asl Ali , Bafandehzendeh Mohammad , Abdollahpoor Gholamreza
Published: July 2021

Background: Leptospirosis is a zoonotic disease of worldwide significance in human beings and many animals. This zoonotic disease causes infection in dogs and other pet animals and these animals can influence human’s health. Given the unknown prevalence of leptospirosis in dogs in our area, this study was performed to investigate the sero-epidemiology of leptospirosis and evaluate the seroprevalence of Leptospira serovars in both household and stray dogs by microscopic agglutination test (MAT). Methods: Serum samples of 90 dogs in two household and stray groups (45 dogs for each group) were collected. Specimens were examined by MAT (in accordance with the procedure recommended by WHO) against antigens of serovars Canicola, Grippotyphosa, Icterohaemorrhagiae, Pomona, Hardjo, Autumnalis, and Ballum. Results: In total, 6.7% of (n=6) dogs (1 stray and 5 household dogs) had a serum titer of 1:100 or more against Leptospira serovars. Dominant serovars were Canicola (8.9%), Grippotyphosa (2.2%), and Pomona (2.2%), respectively. The antibody titer against more than one serovar was observed only in one dog. The sero-prevalence was 11.1% in household dogs and 2.2% in stray dogs. Since 4 pet dogs had been vaccinated recently, it seems that the actual percentage of infection in household dogs must be just 2.2% and actual infection in dogs including stray dogs is approximately 4.4% in Tabriz. Conclusion: Fortunately, the rate of infection in Tabriz is low and this can be due to special geographical and climatic conditions, regular and annual vaccination of household dogs against this disease, and lack of suitable conditions for the growth and survival of such micro-organisms in the environment