bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic potency of substituted chromones as Alzheimer’s drug: Elucidation of acetylcholinesterase inhibitory activity through spectroscopic and molecular modelling investigation
Authors: Baruah Prayasee , Rohman Mostofa Ataur , Yesylevskyy Semen O. , Mitra Sivaprasad
Published: June 2019

Introduction: Documentation on the potency of chromones as acetylcholinesterase (AChE) antagonists has paved the way for the design and usage of new chromone analogues as inhibitors of AChE modelled on the hypothesis based on cholinergic pathway of Alzheimer’s disease (AD). Here, 2 minimally substituted chromones, namely 3-cyanochromone (CyC) and 7-amino-3-methylchromone (AMC), were checked for their AChE inhibition efficacies and plasma protein modulation. Methods: Colorimetric enzymatic assay as well as fluorescence measurements were performed for obtaining the experimental results, which were further corroborated by molecular docking and simulation studies. Results: The investigated systems exhibited strong inhibition activities against AChE, with CyC (IC50= 85.12 ± 6.70 nM) acting as better inhibitor than AMC (IC50 = 103.09 ± 11.90 nM) and both having IC50 values in the range of FDA approved cholinergic drug Donepezil (IC50 = 74.13 ± 8.30 nM). Non-competitive inhibition was observed in both the cases with the inhibitors binding near the peripheral anionic site (PAS) of the enzyme. Having one planar nitrile group in CyC as compared to sp3 hybridised substituents in AMC facilitated stacking interactions in the former, accounting for its higher inhibitory efficacy. A significant decrease in the inhibition potency of CyC (~32%) was noted in comparison with AMC (~5%) when the experiments were performed in presence of human serum albumin (HSA) instead of pure aqueous buffer. Conclusion: This comparative study affirms the importance of meticulous substitution in the chromone scaffold to promote maximum inhibition potency, while considering their usage as AD drugs.
Determination of valproic acid and 3-heptanone in plasma using air-assisted liquid-liquid microextraction with the assistance of vortex: Application in the real samples
Authors: Feriduni Behruz , Barzegar Mohammad , Sadeghvand Shahram , Shiva Shadi , Khoubnasabjafari Maryam , Jouyban Abolghasem
Published: June 2019

Introduction: Valproic acid (VPA) is an antiepileptic drug used to treat epilepsy and bipolar disorder. Adverse effects of VPA were studied in many reports, however, a dose-response relationship between VPA and its metabolites in epilepsy patients are extremely limited. In this paper, a high efficient method was developed for the preconcentration and determination of VPA and its main metabolite in plasma. Methods: For the extraction and preconcentration of the selected analytes, a volume of an extractant was placed at the bottom of the microtube containing pretreated plasma. The mixture was repeatedly withdrawn from the microtube and pushed-out into it using a 1.0-mL glass syringe and resulted in a cloudy mixture. For further turbidity, the mixture was shaken on a vortex agitator. This procedure was used to analyze the plasma samples of patients with epilepsy (n = 70). Results: The results revealed that in most patients with a low level of VPA relative to its expected level, 3-heptanone concentrations were high. The limits of quantification of 3-heptanone and VPA were 0.04 mg L–1 and 0.2 mg L–1, respectively. A suitable precision at a concentration of 2 mg L-1 for each analyte was obtained (relative standard deviation ≤ 9%). Conclusion: The obtained results indicated that this procedure is easy, sensitive, and reliable, and can be used for the analysis of the selected analytes in the plasma samples of patients with epilepsy.
Spectroscopic overview of quercetin and its Cu(II) complex interaction with serum albumins
Authors: Mondal Prasenjit , Bose Adity
Published: June 2019

Introduction: Flavonoids are widely used as dietary supplements, and thus, play a significant role in the research field. In recent time, the interaction of flavonoid-metal complexes with serum albumin (SA) has widely been studied since the complexation poses a significant impact on biological activities. Additionally, the binding nature of flavonoids with SA gets modified in the presence of metal ions. Methods: In the present review, we studied the interaction of quercetin (Qu), a well-known flavonoid, and its Cu2+ complexes with SA to provide sufficient information about the beneficial role of metal-flavonoid complexes over free flavonoids. Results: Complexation with Cu(II) ion may alter the mode of binding of Qu with SAs. The strength of binding might be increased in the presence of Cu(II) as evidenced by the binding constant calculation. However, the drug binding site in bovine serum albumin (BSA) and human serum albumin (HSA) are not altered during the complexation process. Conclusion: To enhance the pharmaceutical outcomes of Qu molecules, one may use Qu-Cu(II) complex for the development and delivery of the small molecules.
Validating patient and physician versions of the shared decision making questionnaire in oncology setting
Authors: Nejati Babak , Lin Chien-Chin , Imani Vida , Browall Maria , Lin Chung-Ying , Broström Anders , Pakpour Amir H
Published: June 2019

Background: This study investigated the psychometric properties of the 9-Item Shared DecisionMaking Questionnaire (SDM-Q-9) and the 9-Item Shared Decision-Making Questionnaire–Physician version (SDM-Q-Doc) using comprehensive and thorough psychometric methods in an oncology setting. Methods: Cancer survivors (n=1783; 928 [52.05%] males) and physicians (n=154; 121[78.58%] males) participated in this study. Each cancer survivor completed the SDM-Q-9. Physicians completed the SDM-Q-Doc for each of their cancer patient. Confirmatory factor analysis (CFA) and Rasch model were used to test the psychometric properties of SDM-Q-9 and SDM-Q-Doc. Results: SDM-Q-9 and SDM-Q-Doc demonstrated unidimensional structure in CFA and Rasch model. In addition, the measurement invariance was supported for both SDM-Q-9 and SDM-QDoc across sex using the multigroup CFA. Rash analysis indicates no differential item functioning(DIF)across sex for all the SDM-Q-9 and SDM-Q-Doc items. SDM-Q-9 and SDM-Q-Doc were moderately correlated (r=0.41; P<0.001). Conclusion: SDM-Q-9 and SDM-Q-Doc are valid instruments to assess shared decision making in the oncology setting.
Psychometric properties of the Iranian version of the Copenhagen Burnout Inventory
Authors: Javanshir Elham , Dianat Iman , Asghari-Jafarabadi Mohammad
Published: June 2019

Background: The Copenhagen Burnout Inventory (CBI) is a commonly used tool for evaluation of job burnout in three (personal, work-related and client-related) domains. The aims of this study were to translate and investigate the psychometric properties of the Iranian (Persian) CBI. Methods: A total of 750 employees of different occupations (from educational centres, healthcare, industrial settings, and social services) participated in this descriptive methodological study. Aforward-backward procedure was applied and content validity was evaluated by a panel of10 experts. Exploratory and confirmatory factor analyses were used for construct validity. The internal consistency (using Cronbach’s alpha), test-retest reliability (using intraclass correlation coefficient – ICC), and feasibility (using ceiling and floor effect) were also assessed for this tool. Results: Content validity of the Persian CBI was established. Three-factor structure of the PersianCBI was supported by the factor analysis, and this confirmed the construct validity of the instrument. The internal consistency (Cronbach’s alpha ranged from 0.82 to 0.90) and test-retest reliability (ICC ranged from 0.85 to 0.95) were excellent and there was no ceiling or floor effect. Conclusion: The Persian CBI is a valid and reliable measurement tool for burnout in the Iranian context.
Readability of online patient-based information on bariatric surgery
Authors: Meleo-Erwin Zoë , Basch Corey , Fera Joseph , Ethan Danna , Garcia Philip
Published: June 2019

Background: Web-based patient education literature has been shown to be written at reading levels far above what is recommended. Little is known about the overall readability of current internet-based bariatric surgery information. The purpose of this study was to assess the readability of current bariatric material on the internet. Methods: The term "weight loss surgery" was searched using the Chrome browser on the first 15pages of URLs that appeared with content written in English. Using five readability measures, scores were generated using Readable.io for written content on a sample of 96 websites. Scores were sorted into the readability categories of "easy," "average," and "difficult." Results: Almost 93% of websites, both .com and .org, sampled received an unacceptable readability score on each assessment. Conclusion: Accurate and appropriate information about bariatric procedures is critical for patient comprehension and adherence to recommended protocols.
Effect of the Sacred Hour on Postnatal Depression in Traumatic Childbirth: a Randomized Controlled Trial
Authors: Abdollahpour Sedigheh , Bolbolhaghighi Nahid , Khosravi Ahmad
Published: June 2019

Introduction: the implementation of the baby’s nine instinctive stages as a sacred hour after birth is very effective in starting breastfeeding. About half of newly delivered mothers have reported a traumatic childbirth experience often associated with mental health problems. The present study aimed to examine the effect of the sacred hour on the depression in traumatic childbirths. Methods: In this clinical trial, 84 mothers who had experienced a traumatic childbirth were randomly allocated into the intervention (n = 42) and control (n = 42) groups. The intervention group received sacred hour (baby’s nine instinctive responses), but the control group received only the routine care. Postnatal depression was evaluated as primary outcome at 2 week, 4-6 week and 3 month intervals after the delivery. The data were analyzed using t test, chi-square test and the repeated measures analysis of variance. Results: The results showed that the marginal total mean (SD: standard deviation) scores of depression in the intervention and control groups were 7.5 (2.6) and 9.6 (2.6); therefore, the mean difference (95% CI) between the groups (-2.1, (-3.2,-0.95)) was significant. Conclusion: The implementation of the sacred hour is recommended as a preventive approach to reduce the postnatal depression in women with a traumatic childbirth experience.
The Effect of Reflection on Nurse-Patient Communication Skills in Emergency Medical Centers
Authors: Pangh Bahman , Jouybari Leila , Vakili Mohamad Ali , Sanagoo Akram , Torik Aysheh
Published: June 2019

Introduction: Reflection is formed through deep reflection on the event or a certain clinical position. The aim of this study was to determine the effect of reflection on nurse-patient communication skills of nurses working in emergency departments. Methods: This interventional study was conducted on intervention and control groups and with a pretest-posttest design. 142 nurses working in the emergency departments of hospitals affiliated to Golestan University of Medical Sciences were enrolled in the study in 2015, and randomly divided into two groups. During eight weeks of the study, the intervention group was asked to write their clinical experiences with regard to communication issues with their patients. Before the intervention, the communication skills of both groups were compared using a questionnaire. Data analysis was performed, using independent t-test, paired t-test, Mann-Whitney and Wilcoxon tests. Results: Of the 142 nurses, 122 nurses had full participation. In the intervention group the mean scores of verbal communication skills, non-verbal communication skills, general communication skills and communication skills based on patient safety were statistically significant, but there was no significant difference in the control group. Conclusion: The results showed that eight weeks of reflection by nurses is an effective intervention in dimensions of communication skills. We therefore suggest that a reflective writing be encouraged as a vital tool for improving communication competency among emergency department nurses.
Lifestyle of Patients with Atrial Fibrillation Following Self-Management Interventions: a Randomized Clinical Trial
Authors: Rakhshan Mahnaz , Najafi Hojatolah , Valizadeh Gholam Abbas
Published: June 2019

Introduction: Cardiovascular diseases are the most common cause of death in most countries, such as Iran. Cardiac arrhythmias, including Atrial Fibrillation (AF) comprise an important category of these diseases. During recent years, AF has become a serious medical condition. This study aimed to investigate the effect of self-management interventions on the lifestyle of patients with AF. Methods: In this Randomized Clinical Trial study, 88 patients were selected and randomly assigned to intervention and control groups. The intervention group received self-management interventions, including education and telephone follow-ups. The data were collected using a demographic questionnaire and Walker’s health-promoting lifestyle profile II, before the intervention and four and twelve weeks after the intervention. The significance level was considered to be 0.05. Results: The results showed a significant increase in the intervention group’s lifestyle mean score, four and twelve weeks after the intervention as compared with control group However, this increase was not similar in all the lifestyle dimensions. Conclusion: In conclusion, implementation of self-management interventions could improve the lifestyle of the patients with Atrial Fibrillation. The results can help nurses to conduct self-management interventions into such patients’ care plan and prevent many physical, psychological, and social problems that negatively affect patients and their lifestyle.
Mycophenolate mofetil versus cyclophosphamide for idiopathic membranous nephropathy; a double blind and randomized clinical trial
Authors: Hayati Fatemeh , Shahbazian Heshmatollah , Ghorbani Ali , Ahmadi Halili Shahla , Rezaei Eisa , Sabetnia Leila , Beladi Mousavi Seyed Seifollah
Published: June 2019

Introduction: The current treatment regimens for patients with idiopathic membranous nephropathy (MN) are based on cyclophosphamide-glucocorticoid or calcineurin inhibitor-glucocorticoid. Objectives: We evaluated whether mycophenolate mofetil (MMF) -glucocorticoid could be an option for first-line therapy among these patients. Patients and Methods: In a double-blinded, randomized and controlled clinical trial, we compared the effect of MMF with cyclophosphamide in inducing complete or partial remission (PR) among patients with nephrotic syndrome due to idiopathic MN. All of the patients in both groups also received steroid, renin-angiotensin blockers and statins. Diuretics were also used in the patients who had edema. The primary end point of our study was change in urinary protein/creatinine ratio. Results: A total of 30 patients completed the study. Around 17 patients received MMF (2 g/d) and 13 patients received intravenous or oral cyclophosphamide for 6 months. At the start of the study, no significant differences in demographic and biochemical parameters of patients including the urinary protein excretion rate between two groups (P = 0.432). The proportion of proteinuria was 5235 ± 1655 mg/24 in MMF group and 8781 ± 8741 mg/24 in the cyclophosphamide group at the beginning of the study. The rate of complete and PR were 5.9% and 52.9 in MMF group versus 16.7% and 100% in cyclophosphamide group which it is significantly lower in MMF group. Kidney function was stable in both groups during treatment. Conclusions: According to the result of our study, a 6-month therapy with MMF-glucocorticoid is not recommended for treatment of patients with nephrotic syndrome due to idiopathic MN.
The effect of the omega-3 supplement on uremic pruritus in hemodialysis patients; a double-blind randomized controlled clinical trial
Authors: Shayanpour Shokouh , Beladi Mousavi Seyed Seyfollah , Lakhaye Rizi Parastoo , Cheraghian Bahman
Published: June 2019

Background: Chronic kidney disease (CKD) and uremic syndrome cause malfunction in most of organs including skin. Objectives: This study was designed to investigate the effects of omega-3 supplement on uremic pruritus in chronic hemodialysis patients. Patients and Methods: In this double-blind randomized controlled clinical trial study (#IRCT cod; 29363; http://irct.ir/trial/29363), the effect of the omega-3 supplement on uremic pruritus was assessed in 64 chronic hemodialysis patients (using standard 5-D itch scale questionnaire). Patients were surveyed at the hemodialysis department of Imam Khomeini and Razi hospitals in Ahvaz city, Iran. Results: We found that the mean score of itching degree in the intervention and the placebo groups decreased from 3.56 to 1.72 (P<0.001) and 3.63 to 3.09 (P<0.05) respectively. Conclusions: In our study, the omega-3 supplement could reduce uremic pruritus in chronic hemodialysis patients.
The complete genome sequence BK polyomavirus study in kidney transplanted patients
Authors: Makvandi Manoochehr , Kaydani Gholam Abbas , Shahbazian Heshmatollah , Teimoori Alireza , Rahim Fakher , Aslani Sajjad
Published: June 2019

Background: BK polyomavirus is a member of the Polyomaviridae. This virus has spread worldwide and up to 82% of the world populations are serologically positive. BK polyomavirus usually transmits through inhalation or fecal-oral way in childhood, as well as is likely to cause an asymptomatic disease. The virus can be reactivated in people who are immunocompromised. Objectives: In this study we aimed to determine the complete genome sequence of BK polyomavirus in 5 patients receiving kidney transplantation in Golestan hospital, Ahvaz, south west of Iran. Materials and Methods: The study was performed on urine and blood samples from kidney transplant ward, Golestan hospital, Ahvaz, Iran. To amplify the whole genome of BK polyomavirus AccuPower ProFi Taq PCR PreMix kit (Bioneer, South Korea) was used. Then, purified fragments were cloned into the vector. Sequences derived from the sequencing process were assembled by MEGA7 software. Data were analyzed using MEGA7 software and a phylogenetic tree was built based on the maximum likelihood ratio method. Results: Overall, 40 urine samples (40%) and two plasma samples (12%) were positive for BK virus DNA. For the selected samples, W.G. Long PCR was performed and 5.1 kbp fragment was observed in all five samples. These fragments were cloned and sequenced. Genomic sequence analysis of the 5 strains studied showed 97.6% homology and all our study samples were of the same clade, which could be a reason for our patients to be infected with the same strain. Comparing the 5 isolates in our study with reference strains, showed more than 98% of homology, and variation was observed in less than 2% of nucleotides. Conclusion: These five isolates showed more than 98% homology compared to the reference sequences, which can be attributed to the fact that these patients are infected with a common strain or that the genomic stability in the strain exists in our geographic area. We can conclude that in our geographic region there is a genomic stability and this strain can also be used as a positive control sample in other parts of the country.
Mitochondrial dysfunction and kidney disease
Authors: Al Dalbhi Sultan Khalid , Alqarni Fatimah Abdullah , Bahatheq Nawaf Messad , Alrasheed Reem Saleh , Alkhowaiter Rufaydah Ali , Alnughaimshi Areej Abdulaziz
Published: June 2019

Context: Mitochondria play a vital role in producing the energy needed for different cellular activities. The role of mitochondria in different diseases and the aging process is gradually being clarified. Different studies have suggested that mitochondrial dysfunction due to mutations in genes that maintain the integrity of mitochondrial DNA (mtDNA), mitophagy, and apoptosis can lead to many neurological and muscular phenotypes as well as diseases in other organ systems including liver, gastrointestinal tract, heart, and kidneys. We examined the current knowledge of mitochondrial dysfunction and its role in renal pathophysiology. Additionally, we examined how chronic kidney diseases can lead to mitochondrial dysfunction through oxidative stress accumulation, which can subsequently lead to other pathological complications. Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed (NLM), LISTA (EBSCO), and Web of Science have been searched. Results: The renal pathological manifestation of mitochondrial dysfunction includes tubular defects, focal segmental glomerular sclerosis (FSGS), glomerular dysfunction, interstitial nephritis, and cystic kidney disease or renal tumors. These conditions can be caused by mutations in the nuclear genes that are involved in mtDNA replication and transcription or due to mtDNA mutations in the genes involved in the respiratory chain. Conclusions: Clearly, mtDNA plays an important role in renal pathology, and mitochondria may serve as a potential therapeutic target to treat different renal pathologies.
Nonuremic calciphylaxis in a post renal transplant patient
Authors: Srour Maria , Bastani Bahar
Published: June 2019

Background: Calciphylaxis is a potentially fatal condition previously observed in patients with poor renal function. We present a case of atypical presentation in a patient with good renal function after transplantation. Case Presentation: A-68-year old African American female with history of end-stage renal disease (ESRD) secondary to type II diabetes mellitus on hemodialysis for ten years, status post living related donor kidney transplant from her son three years prior to this presentation, parathyroidectomy, and atrial fibrillation on warfarin presented to our institution with progressively worsening, severely tender bilateral thigh lesions that were diagnosed as calciphylaxis. She was treated with sodium thiosulfate infusions for six months and continues to do well. Conclusions: Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), has traditionally been associated with ESRD patients on maintenance dialysis, however several nonuremic cases of CUA have been reported in recent years. Multiple pathophysiologic mechanisms for CUA development have been proposed expanding the scope of known risk factors and possible triggers. CUA can be a life-threatening condition that is important for clinicians to recognize and treat as soon as possible.
Evaluation of antibacterial and antifungal properties of a tissue conditioner used in complete dentures after incorporation of ZnO‒Ag nanoparticles
Authors: Mousavi Seyed Amin , Ghotaslou Reza , Akbarzadeh Abolfazl , Azima Niloufar , Aeinfar Ali , Khorramdel Azin
Published: June 2019

Background. Incorporation of antifungal and antimicrobial agents into tissue conditioners might inhibit the formation of microbial plaque and prevent complications such as denture stomatitis. The present study was carried out to evaluate the antibacterial and antifungal properties of a tissue conditioner after incorporation of ZnO‒Ag nanoparticles into their structure. Methods. In this in vitro study, 4 microorganisms were evaluated at 6 concentrations of ZnO‒Ag nanoparticles at 24- and 48-hour intervals, using 168 samples. The nanoparticles were mixed at a ratio of 50% Ag and 50% ZnO and were homogenized with the tissue conditioner at 0.625, 1.25, 2.5, 5, 10 and 20 wt% according to the MIC technique principles. After culturing the microorganisms, a spectrophotometer was used for determining proliferation of microorganisms with the use of turbidity after 24 and 48 hours of incubation at 37ºC. Results. Complete inhibition of the proliferation of Candida albicans, Enterococcus faecalis and Pseudomonas aeruginosa was observed at 24- and 48-hour intervals at a concentration of 10%; such inhibition was observed at 20% concentration of nanoparticles with Streptococcus mutans. In addition, the most effective concentration of ZnO‒Ag nanoparticles at both 24- and 48-hour intervals was 5% with C. albicans and 2.5% with E. faecalis. In addition, the most effective concentration at 24- hour interval with S. mutans was 10% and with P. aeruginosa they were 5% at 24-hour and 2.5% at 48-hour intervals. Conclusion. Incorporation of ZnO‒Ag nanoparticles into tissue conditioners resulted in the inhibition of bacterial proliferation.
Nickel ion release from dental alloys in two different mouthwashes
Authors: Jafari Karim , Rahimzadeh Saeed , Hekmatfar Somayeh
Published: June 2019

Background. Mouthwashes are widely used as adjuncts to mechanical oral hygiene procedures. Nonetheless, there is little information regarding the effect of various mouthwashes on the amount of ions released from the nickel-chromium (Ni‒Cr) alloys used in the fabrication of fixed prostheses. Therefore, the present study was conducted to evaluate the effect of two types of mouthwash on the release of Ni ions from dental alloys. Methods. Forty-two disk-shaped specimens were prepared with a diameter of 10 mm and a height of 2 mm. Two mouthwashes were examined in this study: Oral B and Listerine. A control group was also considered using distilled water. Each Ni‒Cr disk was immersed in the mouthwashes and distilled water in polypropylene test tubes, and then incubated at 37°C to simulate the oral temperature. After 45 days of incubation, the samples were tested for Ni ions using inductively coupled plasma mass spectroscopy. Data were analyzed using ANOVA. Results. In the Halita group subjects exhibited 2.04±0.65 reduction in OLS. OLS reduction in the chlorhexidine group was 1.95±0.74. Statistical analysis showed no significant difference between the two groups (P>0.05). Conclusion. As the results indicated, the amount of ion release was within the safe limits in the two experimental groups. However, it is recommended that prescribe Listerine mouthwash should not be prescribed for the patients with a history of Ni allergy.
Oral mucosal lesions and risk factors in elderly dental patients
Authors: Bozdemir Esin , Yılmaz Hasan Hüseyin , Orhan Hikmet
Published: June 2019

Background. The aim of this study was to determine the prevalence of oral lesions in terms of sex, age, educational status, medication use, systemic diseases, the duration of denture use and tobacco or alcohol use. Methods. A total of 709 voluntary patients (375 males and 334 females), aged ≥60 years, were interviewed by one investigator for demographic data, systemic diseases, tobacco or alcohol use, denture use and the duration of denture use. Results. The majority of the participants (87.6%) had one or more oral mucosal lesions. The prevalence of oral mucosal lesions was 46.3% in males and 41.3% in females (P=0.76). The most common oral mucosal lesion was a sublingual varicosity in both males and females. A statistically significant difference was observed between the three age groups (60–64, 65–69, and ≥70 years) with regard to the prevalence of oral mucosal lesions (P=0.02). There was a significant relationship between the presence of systemic diseases and oral mucosal lesions (P=0.01). There was also a significant relationship between denture use and oral mucosal lesions (P=0.001). Smoking and a history of smoking were also significant predictive factors for oral mucosal lesions (OR: 3.385, P=0.045). Conclusion. Although the majority of oral mucosal lesions detected in the present study were benign, there were some patients with premalignant and malignant lesions. Therefore, periodic oral examinations for detection of precancerous and cancerous lesions are important, especially in the elderly, smokers and denture users.
Effect of Halita mouthwash on oral halitosis treatment: A randomized triple-blind clinical trial
Authors: Jamali Zahra , Alipour Mahdieh , Ebrahimi Syamand , Aghazadeh Marzie
Published: June 2019

Background. Halitosis (oral malodor) is a common problem all over the world and its prevalence has been estimated at 23‒ 50%. Halitosis originates from oral cavity in 85% of patients. This clinical trial was conducted to evaluate the efficacy of the Halita mouthwash in oral halitosis treatment. Methods. Fifty subjects with an organoleptic score of >2 at baseline participated in this triple-blinded clinical trial. Subjects were divided into 2 groups. Group I subjects (N=25) were instructed to rinse with 0.2% chlorhexidine (CHX) mouthwash twice a day for 1 week. Group II subjects (N=25) used Halita mouthwash with the same instruction. Halitosis was evaluated at baseline and one week after using the mouthwashes by organoleptic method. Data were analyzed with chi-squared and Mann-Whitney U tests (P<0.05). Results. In the Halita group subjects exhibited 2.04±0.65 reduction in OLS. OLS reduction in the chlorhexidine group was 1.95±0.74. Statistical analysis showed no significant difference between the two groups (P>0.05). Conclusion. Based on the results, Halita mouthwash has the same effect on oral halitosis as routine 0.2% CHX mouthwash. Halita mouthwash has fewer side effects because of lower concentration of chlorhexidine. Therefore 0.2% CHX mouthwash could be replaced by Halita mouthwash for the treatment of halitosis.
Prevention of white spot lesions using three remineralizing agents: An in vitro comparative study
Authors: Tahmasbi Soodeh , Mousavi Seyedezahra , Behroozibakhsh Marjan , Badiee Mohammadreza
Published: June 2019

Background. Enamel demineralization around orthodontic brackets is an important clinical problem. This study sought to compare the efficacy of sodium fluoride (NaF), casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACP-F; MI Paste Plus) and a water-based cream (Remin Pro), which contains hydroxyapatite and fluoride for prevention of enamel demineralization. Methods. Fifty-six sound human premolars extracted for orthodontic purposes were collected. After cleaning, the crowns were mounted in acrylic resin and all the surfaces were coated with nail varnish except for a 3×4-mm window on the buccal surface. The samples were randomly divided into four groups of 14 and subjected to pH cycling for 14 days, during which the teeth were immersed in artificial saliva for 21 hours and in demineralizing agent for three hours daily. Before transferring the samples from the saliva to the demineralizing solution, the remineralizing agent (0.05% NaF, MI Paste Plus or Remin Pro Paste, depending on the group) was applied on the samples once a day for five minutes. No remineralizing agent was used in the control group. Surface microhardness of samples was measured by Vickers microhardness tester at baseline and after the intervention. The data were analyzed using one-way ANOVA, ANCOVA, Bonferroni test and Tukey test. Statistical significance was set at P<0.05. Results. The mean microhardness was significantly different between the test and control groups (P<0.0001). Other differences were not significantly different (P>0.05). Conclusion. The results showed that 0.05% NaF was more efficient than Remin Pro and MI Paste Plus for prevention of white spot lesions (WSLs). Remin Pro and MI Paste Plus were not significantly difference from the control group in this regard.
Evaluation of parents’ views about etiologic factors of severe early childhood caries: A qualitative study
Authors: Arefi Arian Hesam , Shamsaddin Hoda , Balvardi Mojgan , Poureslami Hamidreza , Danesh Masumeh , Sayadizadeh Mahsa
Published: June 2019

Background. Severe early childhood caries (S-ECC) is a rapid form of dental caries that firstly affects primary upper incisors of children less <3 years of age and can cause interference in child’s health by pain, nutritional deficiencies and sleep disorders. It seems there are many unknown factors in the etiology as well as progression of S-ECC. The aim of this study was to assess parents' views in this relation. Methods. In this qualitative study parent’s views and their 1‒3-year-old children were studied when they visited pediatric medical clinics in Kerman. After cleaning the children teeth and examination of them to discover caries, they were placed in 2 groups with or without S-ECC. Then each parent was interviewed separately and their comments were collected and studied. Examinations and interviews continued with parents until they did not express anything new. Results. Parents of children without S-ECC had better understanding about S-ECC related factors than parents of children with S-ECC and greater number of them (without significant differences) expressed known reasons for occurrence of S-ECC. There were differences among known reasons and proposed reasons mostly in parents of children with S-ECC, although the differences were not significant. Maternal stress and amount of breast milk’s lactose were factors that were reported by some parents while there were unknown factors related to the etiology of S-ECC. Furthermore, no parents mentioned factors like saliva or mode of delivery. Conclusion. The most important achievement of the study was the attention of some parents to the role of their chronic stress in the occurrence of S-ECC. Another important consideration was that none of the parents mentioned the important role of the quality and quantity of saliva in preventing S-ECC, which should be promoted in the community.
Clinical and radiographic evaluation of applying 1% metformin biofilm with plasma rich in growth factor (PRGF) for treatment of two-wall intrabony periodontal defects: A randomized clinical trial
Authors: Khalifehzadeh Shabnam , Haghanifar Sina , Jenabian Niloofar , Kazemi Sohrab , Hajiahmadi Mahmoud
Published: June 2019

Background. The ultimate aim of periodontal treatment is to regenerate periodontium and regenerative treatment after that. The aim of this study was to evaluate the effect of PRGF with 1% metformin biofilm in the treatment of two-wall intrabony periodontal defects. Methods. In this clinical trial, 8 patients with moderate chronic periodontitis and two-wall intrabony defect were selected. The defects were assigned to 4 groups: debridement, 1% metformin, PRGF, PRGF and metformin. The parameters of vertical probing depth, vertical clinical attachment level and gingival index were measured at baseline, immediately before surgery, and 3 and 6 months after surgery. In addition, the radiographic changes were evaluated with digital subtraction radiography before and 6 months after surgery. Analysis of the results was performed with repeated measurements, Friedman test and chisquared test. Results. All the groups exhibited improvements in all the clinical parameters after 6 months. Inter-group comparison of GI, CAL and PPD parameters revealed no statistically significant differences. Radiographic changes in the group of 1% metformin with PRGF revealed statistically significant differences compared with other groups; however, there were no statistically significant differences in other groups. Conclusion. Application of PRGF with 1% metformin in intrabony two-wall periodontal defects was effective in improving the clinical parameters but this effect revealed no difference compared with other groups; however, in terms of radiographic changes significant improvements were noted.
Prognosis of acute kidney injury based on pRIFLE criteria among patients admitted to pediatric intensive care unit in Northern Iran; a single center study
Authors: Safaei-Asl Afshin , Jilani Mahsa , Heydarzadeh Abtin , Maleknejad Shohreh
Published: June 2019

Introduction: Acute kidney injury (AKI) is a frequent problem in pediatric intensive care units, while it is associated with significant mortality. Objectives: The aim of this study was to determine the prevalence and prognosis of AKI based on pRIFLE (pediatric risk, injury, failure, loss, end-stage renal disease) criteria among children admitted to a pediatric intensive care unit Patients and Methods: This research included 323 children from 1 month to 14 years old age, admitted to the pediatric intensive care unit. The pRIFLE was determined in patients along with urinary output and creatinine level. The pediatric risk of mortality (PRISM) score was also assessed. Results: Mean PRISM III score was 34.66 ± 15.97 and 17.72 ± 6.06 respectively in children with and without AKI (P=0.001). It was found that variables of encephalopathy, PRISMIII score and gender were the only variables affecting the incidence of AKI. Conclusion: While pRIFLE criteria are appropriate and efficient criteria for early diagnosis of AKI, their role alone as prognostic factors of mortality require further studies.
Biochemical urinalysis of healthy kidney and stone-generating kidney in unilateral urolithiasis
Authors: Mohammadalibeigi Feramarz , Shirani Majid , Seyed-Salehi Hamed , Afzali Lotfollah
Published: June 2019

Introduction: Oxalate, calcium, uric acid, and citrate are among the most widely known biochemical factors for urinary stone formation. In most cases, urolithiasis occurs as unilateral despite the role of systemic metabolic factors in kidney stone formation. Objectives: The present research aimed to compare these urinary biochemical factors in healthy and stone-generating kidneys in patients with unilateral urolithiasis. Patients and Methods: Forty patients with unilateral urolithiasis participated in this cross-sectional, descriptive-analytical study. The patients were hospitalized in kidney surgery and kidney urology ward of Kashani hospital of Shahrekord, southwest Iran. After the implementation of crushing stone using transurethral lithotripsy (TUL), 5-10 cc of urinary sample was collected from each kidney. An AutoAnalyzer (Mindray Company, Bs–360 model) and laboratory kits (Bionic Company) were used to measure calcium, uric acid, and creatinine. Moreover, a manual method and Darman Faraz Kave company kits were applied to measure the levels of oxalate and citrate. Results on the healthy and stone-generating kidneys of each patient were separately analyzed using the Stata 13 software. Results: The difference in the mean ratio of uric acid, oxalate, and citrate to creatinine in the healthy kidneys and stone-generating kidneys was not significant. However, the mean UCa/UCr ratio in the healthy kidneys was 0.27±0.07 and relatively greater than that in the stone-generating kidneys (0.11±0.04) (P=0.06). Conclusion: The studied topical factors and secretory disorders had not any significant relationship with unilateral urolithiasis. The cause of unilateral urolithiasis should be searched in other factors such as metabolic factors, main positions of individual during 24 hours and sleeping, and anatomic disorders of kidney stone, or multifactorial.
A Short-Term Intervention for Adolescents with Callous-Unemotional Traits and Emotion-Processing Deficits
Authors: Lui Joyce H. L. , Barry Christopher T. , Marcus David K.
Published: June 2019

Introduction: Research documents a robust relation between callous-unemotional (CU) traits and impairments in emotion-processing in youth, yet few evidence-based treatments targeting these deficits exist for youth with CU traits. This study examined a novel Emotion-Processing Skills Training (EPST) to target emotion recognition and perspective-taking deficits in adolescents with CU traits through an additive design.

Methods: Fifty-six adolescents (Mage = 16.54, SD = .57, 83.9% male, 67.9% White/Caucasian) attending a voluntary residential program received treatment as usual (TAU) or the EPST intervention plus TAU (EPST + TAU) in a partially randomized trial. Assessments were conducted at four time-points, and they involved adolescent-, parent-, peer-, and staff-report. Outcomes of interest included emotion recognition, perspective-taking, CU traits, empathy, prosocial behaviors, social problems, and externalizing problems.

Results: Participants who received EPST significantly improved more on perspective-taking at post-treatment than those who only received TAU. Those who only received TAU significantly declined on self-reported empathy and prosocial behaviors from baseline to 12-week follow-up, but those who received EPST declined less or had minimal change. Participants across conditions improved on self-reported CU traits, social problems, and externalizing problems and parent-reported CU traits, social problems, and externalizing problems across time.

Discussion: The EPST intervention yielded largely comparable changes to TAU, but in some cases, EPST may have buffered participants from decline in their affective, social, and behavioral functioning. Implications for treatment of adolescents with CU traits are discussed.
Do Psychopathic Traits Statistically Protect Against PTSD? A Retrospective Study of Vietnam Veterans
Authors: Bowes Shauna M. , Brown April L. , Thompson William W. , Sellbom Martin , Lilienfeld Scott O.
Published: June 2019

Although psychopathy traits are traditionally associated with maladaptivity, certain traits may statistically buffer against risk for posttraumatic stress disorder (PTSD). Research suggests that psychopathy traits are differentially associated with PTSD, as boldness traits are negatively related to PTSD whereas disinhibition features are positively related. The authors sought to clarify the relations between psychopathy and PTSD in a large sample of Vietnam veterans (N = 2,598) and to examine the statistical interactions among (a) psychopathy traits and (b) combat exposure and psychopathy traits in predicting PTSD. Results indicate that psychopathy traits are differentially associated with PTSD in combat-exposed veterans, although the authors found little evidence that boldness was protective against PTSD. Nonetheless, meanness was significantly, albeit weakly, protective against PTSD in the presence of combat exposure. The authors consider the implications of these findings for future research, including the need to consider fearlessness as a heterogeneous construct, and they examine whether the findings generalize to PTSD in DSM-5.
Temporal Dynamics of Inhalation-Linked Activity across Defined Subpopulations of Mouse Olfactory Bulb Neurons ImagedIn Vivo
Authors: Short Shaina M. , Wachowiak Matt
Published: June 2019

In mammalian olfaction, inhalation drives the temporal patterning of neural activity that underlies early olfactory processing. It remains poorly understood how the neural circuits that process incoming olfactory information are engaged in the context of inhalation-linked dynamics. Here, we used artificial inhalation and two-photon calcium imaging to compare the dynamics of activity evoked by odorant inhalation across major cell types of the mouse olfactory bulb (OB). We expressed GCaMP6f or jRGECO1a in mitral and tufted cell (MTC) subpopulations, olfactory sensory neurons (OSNs), and two major juxtaglomerular interneuron classes and imaged responses to a single inhalation of odorant. Activity in all cell types was strongly linked to inhalation, and all cell types showed some variance in the latency, rise times, and durations of their inhalation-linked response. Juxtaglomerular interneuron dynamics closely matched that of sensory inputs, while MTCs showed the highest diversity in responses, with a range of latencies and durations that could not be accounted for by heterogeneity in sensory input dynamics. Diversity was apparent even among “sister” tufted cells innervating the same glomerulus. Surprisingly, inhalation-linked responses of MTCs were highly overlapping and could not be distinguished on the basis of their inhalation-linked dynamics, with the exception of a subpopulation of superficial tufted cells expressing cholecystokinin (CCK). Our results are consistent with a model in which diversity in inhalation-linked patterning of OB output arises first at the level of sensory input and is enhanced by feedforward inhibition from juxtaglomerular interneurons which differentially impact different subpopulations of OB output neurons.
Epidemiological evidence for the developmental origins of health and disease: effects of prenatal undernutrition in humans
Authors: Roseboom Tessa J
Published: June 2019

This paper describes the findings of studies among men and women who were born around the time of the Dutch famine of 1944–1945, investigating the effects of undernutrition during critical periods of development on later health and disease. The Dutch famine was remarkable in several ways and its unique features have allowed scientists to investigate the long-term consequences of prenatal undernutrition in humans. The effects of undernutrition depended on its timing during gestation, and the organs and tissues undergoing critical periods of development at that time. Early gestation appeared to be the most vulnerable. The effects of famine were widespread and affected the structure and function of many organs and tissues, resulted in altered behaviour and increased risks of chronic degenerative diseases, which in turn led to reduced participation in the labour market and increased mortality. Also, the effects of famine were independent of size at birth, which suggests that programming may occur without altering size at birth. Studies in other settings show that those faced with undernutrition during the critical earliest stages of development have increased rates of chronic generative disease in adult life. This suggests that these findings reflect biologically fundamental processes that describe human plasticity. These findings teach us the fundamental importance of a good start in life. Adequately feeding women before and during pregnancy will allow future generations to reach their full potential and lead healthier and more productive lives, ultimately leading to healthier and more equal future.
Implementing Evidence-Based Strategies to Improve HPV Vaccine Delivery
Authors: Gilkey Melissa B. , Parks Michael J. , Margolis Marjorie A. , McRee Annie-Laurie , Terk Jason V.
Published: June 2019

BACKGROUND:

High-quality evidence indicates that intervening with health care providers improves human papillomavirus (HPV) vaccine delivery. However, scaling up evidence-based strategies in real-world clinical practice remains challenging. We sought to improve the reach and impact of strategies for HPV vaccination quality improvement (QI) through local adaptation and implementation in a large, not-for-profit health care system.

METHODS:

We conducted an HPV vaccination QI program using existing materials to support physician training coupled with assessment and feedback. Local physicians with high HPV vaccination rates facilitated training, which included didactic instruction and video vignettes modeling effective communication. We randomly assigned 25 clinics with 77 physicians to the QI arm or the wait-list control arm. We used hierarchical linear models to assess HPV vaccination coverage (≥1 dose) over 6 months among patients aged 12 to 14.

RESULTS:

Of 45 physicians in the QI arm, the program reached 43 (95%) with training plus assessment and feedback. In the overall sample, HPV vaccination coverage increased in both the QI and control arms (8.6 vs 6.4 percentage points, respectively), although the 2.2–percentage point difference did not reach statistical significance. Sensitivity analyses that excluded physicians with poor data quality indicated a statistically significant advantage of 3.3 percentage points for QI versus control (b = 0.034; SE = 0.015; P < .05).

CONCLUSIONS:

Our locally adapted QI program achieved excellent reach, with small improvements in HPV vaccination coverage. Future implementation research is needed to bolster program impact and support health systems in leveraging local resources to conduct these programs efficiently.