bluuebunny/crossref_metadata_2025 huggingface dataset:
Female Patients’ Experiences of Barriers to Communication with Male Nurses: A Qualitative Study
Authors: Valiee Sina , Moradi Yaser , Vatandost Salam
Published: February 2023

Background: Male nurses face various challenges in caring for female patients, such as the patients’ refusal of nursing care and sexual accusations. Communication, as a prominent element in providing high-quality health care services, can lead to or inhibit patient satisfaction and health. Professional nurse-patient communication is so important that some nursing theorists have based their theories on this type of communication and consider it an art in the nursing profession. Accordingly, this study aimed to investigate female patients’ experiences of barriers to effective communication with opposite-gender nurses. Methods: The present qualitative study was conducted using conventional content analysis. Purposive sampling was used to select 15 female patients. These patients were hospitalized in different wards and received care from an opposite-gender nurse. Interviewing was the main method of data collection. Graneheim and Lundman’s method was used to perform content analysis. The general stages of data interpretation include initial encoding and the formation of subthemes and themes based on the similarities and differences. Results: The main theme extracted following data analysis was ignorance of the patient in communication. This theme comprised of three subthemes, including negligence in maintaining patient privacy, one-way communication, and biased behavior. Conclusion: Based on the findings, the experience of female patients receiving care from male nurses was accompanied by feelings of annoyance. Male nurses are suggested to respect patient privacy, obtain permission before doing private procedures, and provide care for female patients without prejudice and abuse.
Explaining Positive Couple Interactions after Myocardial Infarction: A Qualitative Study
Authors: Sarhadi Mahdieh , Navidian Ali , Mehdipour-Rabori Roghayeh , Nouhi Esmat
Published: February 2023

Background: The quality of marital relationships can impact couples’ cardiovascular health directly and indirectly. Given that communication is essential for a happy marriage and plays an important role in health, this study aimed to explain the positive interactions of couples after myocardial infarction. Methods: The current study was conducted qualitatively with the participation of seven couples (patient and his or her spouse) in teaching hospitals affiliated with Zahedan University of Medical Sciences. Purposive sampling was used to select participants. Then, unstructured in-depth interviews were conducted after obtaining informed consent. The interviews were immediately transcribed and analyzed. MAXQDA 2020 was used to categorize the data, and the method proposed by Elo and Kingas was used for data analysis. Results: The analysis of the data revealed that myocardial infarction could affect the way couples interact through two main themes including empathetic union (acceptance of each other’s true selves, mutual understanding, adjusting expectations, increase in cooperation and joint activities) and optimizing couples’ interactions (mutual care and attention, increase in intimacy, mutual reliance). Conclusion: This study indicated that positive couple interactions affected not only marital relationships but also health status, both directly and indirectly. Therefore, the findings of this study can be used to improve nursing student education and nursing care, and would help to develop educational and supportive interventions for patients and their spouses.
Surgical Technologists’ Live Experiences of Professionalization: A Phenomenological Study
Authors: Imani Behzad , Bahrami Jalal Shima
Published: February 2023

Background: The rapid advancement of science and new technologies has brought wide-range changes in all professions, leading to the emergence of new concepts, including professionalism. This study aimed to explain the concept of professionalism from the perspective of surgical technologists. Methods: The present study was a qualitative one with conventional content analysis. A total of 11 surgical technologists were selected using purposive sampling method based on data saturation. Data were then collected using in-depth interviews. Data analysis was performed using Graneheim and Lundman’s approach. Results: In data analysis, three main themes including professional attitude, professional mastery, and holistic professional care as well as seven subthemes were extracted from the data. Conclusion: According to the findings, professionalism indicates the type of attitude of the operating room nurses towards the profession as well as the degree of their mastery in providing professional care to patients.
Explanation of the Midwifery Lecturers’ Experiences of the Challenges in an Undergraduate Midwifery Program: A Phenomenological Study
Authors: Ashrafinia Farzaneh , Ghazanfarpour Masumeh , Bagherian Behnaz , Heydari Ommolbanin
Published: February 2023

Background: Continuing professional development is an essential component of educational organizations in health care systems around the world. Such development has received attention in recent years with a broader perspective in the field of midwifery. Accordingly, the internal evaluation approach used to identify educational strengths and weaknesses can pave the way for a more purposeful future. This study aims to explore the experiences of midwifery lecturers of the challenges of the undergraduate educational program. Methods: This study employed a qualitative phenomenological approach using the data collected through individual interviews with midwifery lecturers at Kerman University of Medical Sciences, and analyzed from October to December 2020 for three months. To this end, eight semi-structured and in-depth interviews were conducted with eight midwifery lecturers who were selected using purposive sampling. The sampling was continued until the data were saturated. All interviews were analyzed after transcription using Colaizzi’s seven-step approach. Results: Analysis of the data revealed seven categories including inefficient policymaking, lack of motivation and confidence, lack of educational equipment and facilities (network of shortcomings), challenges of the curriculum and teaching methods, poor clinical conditions, disinterest in research activities, and inadequate academic output. Each category was divided into several subcategories. Conclusion: Along with achieving the fifth Millennium Development Goals, it is necessary to improve the quality of midwifery education. The challenges pointed out by midwifery lecturers highlight the need to make changes in the clinical and educational environment of the midwifery department to improve clinical skills and achieve the goals of the educational program following international education standards and consequently train skilled and educated midwifery staff.
Challenges and Strengths of Fourth-Generation Accreditation Standards from the Perspective of Nurses at Afzalipour Hospital in Kerman: A Qualitative Study
Authors: Khodaei Goki Marzieh , Manzari Tavakoli Hamdollah , Fatehi Rad Navid , Shokoh Zahra
Published: February 2023

Background: Accreditation is a team effort to improve service quality. Nurses, as key members of the care team, play an important role in implementing accreditation standards. This study aimed to explain the challenges and strengths of the implementation of fourth-generation accreditation from the perspective of nurses. Methods: The present study was a qualitative one conducted using content analysis. The research population included nurses of Afzalipour hospital in Kerman, Iran. Using purposive and snowball sampling, 5 nurses, 5 head nurses, and 3 supervisors were selected for accreditation. The data were collected through semi-structured interviews. The interviews were transcribed, coded, categorized, and analyzed separately. Then, using content analysis, the data obtained from the interviews were reduced and given a structure and system. Data analysis was performed using MAXQDA software (version 10). Results: The most important challenges in this study were increasing nurses’ workload and working pressure and weakening nurses’ relationship with the patient. Moreover, there was no adequate infrastructure to implement accreditation. The strengths of implementing accreditation standards included increasing nurses’ awareness, improving reporting and documentation, increasing patient safety, and improving organizational processes. Conclusion: The results of this study emphasized the need to implement accreditation standards to integrate working methods and improve the quality of services and patient safety. Solving the existing challenges is a way to ensure the quality and continuous improvement of nursing services. In general, the results of this study provide useful information to policy makers and senior managers of the health system to reform the structure of hospital accreditation.
Implementing the Internship Educational Method, a Step to Reduce the Gap between Theory and Practice, Experience of Undergraduate Nursing Students: A Qualitative Content Analysis Study
Authors: Nematollahi Monirsadat , Bagherian Behnaz , Mehdipour-Rabori Rooghayeh , Farokhzadian Jamileh , Khoshnood Zohreh , Navidi Zia
Published: February 2023

Background: An internship project can be considered as a useful step for nursing interns in the transition period and bridge the theory-practice gap in nursing. Since the acquisition of professional competence and skills by students is essential, the present study attempted to provide a deep understanding of nursing students’ experiences. Methods: This study was conducted using a qualitative content analysis approach in the School of Nursing of Kerman University of Medical Sciences in 2020. The participants in the research sample were senior undergraduate nursing students who were selected using purposive sampling. The data were collected through semi-structured interviews with the participants and each interview lasted 60 to 90 minutes. A total of 27 interviews were conducted with 25 students. The collected data were analyzed using a qualitative content analysis method (Graneheim & Lundman, 2004). MAXQDA 20 software was also used to analyze the qualitative data. Results: The core category that emerged from the analysis of qualitative data was "implementing an internship program; a step to bridge the theory-practice gap", which was divided into three main categories: "transferring knowledge and experiences", "promoting the cooperation between the faculty members and the hospital staff", and "improving the process of clinical care". Conclusion: Internship programs that are considered a new training technique can increase cooperation between nursing schools and contribute to promoting nursing knowledge in nurses by supporting students and promoting their scientific skills.
Perceived Educational Needs of Postmenopausal Iranian Women: A Qualitative Study
Authors: Rafati Foozieh , Pourshahrokhi Najme , Dastyar Neda
Published: February 2023

Background: Menopause is a natural change that almost all women experience in middle age. Just like puberty, menopause is considered a turning point in a woman’s life. Postmenopausal women experience a wide range of symptoms that may affect their health and well-being, but in most cases, they are unaware of the postmenopausal symptoms they are experiencing or will experience. This study aimed to investigate the perceived educational needs of postmenopausal women in southern Iran. Methods: This study was conducted using a conventional qualitative content analysis approach in 2021 in Jiroft (southern Iran). The main research question was, ‘What educational needs do postmenopausal women experience?’ To answer this question, 15 participants were selected using purposive sampling (seven postmenopausal women, four gynecologists, three midwifery experts, and one nutritionist). The data were collected using semi-structured interviews, which continued until data saturation. The collected data were analyzed using the method proposed by Graneheim and Lundman. The MAXQDA 12 software was used to manage qualitative data analysis. Results: Data analysis revealed one main theme (perceived educational needs) with two categories and five subcategories: (a) Perceived information and medical needs (the need to know about the healthy transition to menopause, the need for support and advice in health-related decisions, and health-promoting educational needs) and (b) The need for self-control (the need for self-management of physical symptoms and the need for self-management of psychological symptoms). Conclusion: This study showed that postmenopausal women face many physical and psychological challenges and need more education to better meet these challenges. Thus, officials and experts in charge of women’s health such as gynecologists, midwives, nurses, and care providers need to pay special attention to problems and issues of postmenopausal women and plan to promote their awareness and knowledge.
Hemodialysis Patients and Nurses’ Perspective: What Is a Qualified Nursing Care?
Authors: Rohollahi Zeinab , Moghaddam Zeabadi Sakineh , Hosseinigolafshani Seyedehzahra
Published: February 2023

Background: With the high prevalence of chronic diseases such as chronic kidney disease (CKD) and consequently, the increasing number of hemodialysis (HD) patients, providing high-quality care has become a health concern in many countries. Therefore, the present study aimed to explore the concept of "qualified care" from HD patients’ and nurses’ points of view. Methods: This qualitative study was conducted using a content analysis approach. A total of 48 patients and nurses in the HD wards were selected through purposive and snowball sampling methods. Sampling continued until data saturation. Finally, a total of 54 interviews were conducted with the participants. The interviews were recorded with the participants’ permission and analyzed using Graneheim and Lundman approach. Results: In this study, 16.7% of the nurses were male, and their mean age was 35.4±7.47 years. Moreover, 50% of the HD patients were male, and their mean age was 53.1±8.6 years. The results of the analysis of the interviews in response to the main question were classified into four main themes including (a) physical care, (b) psychological care, (c) ethical care, and (d) extensive skills and knowledge of the nurse. Conclusion: From the patients’ and nurses’ perspective, empathy and companionship in sessions, fulfilling daily needs, social support, and high-quality dialysis are the components of the concept of care. Therefore, these concepts should be considered in the care programs for HD patients designed by the healthcare team.
Abdominal Imaging Findings in Patients with COVID-19 Part 2: Solid Organs
Authors: Shokri Varniab Zahra , Pourabhari Langroudi Ashkan , Amouei Mehrnam , Pak Neda , Khosravi Bardia , Radmard Amir Reza
Published: February 2023

Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first appeared in China in December 2019, the globe has been dealing with an ever-increasing incidence of coronavirus disease 2019 (COVID-19). In addition to respiratory disorders, 40% of patients present with gastrointestinal (GI) involvement. Abdominal pain is the most common indication for computed tomography (CT) and ultrasonography. After GI tract involvement, solid visceral organ infarction is the most prevalent abdominal abnormality in COVID-19. This review aims to gather the available data in the literature about imaging features of solid abdominal organs in patients with COVID-19. Gallbladder wall thickening and distension, cholelithiasis, hyperdense biliary sludge, acalculous cholecystitis, periportal edema, heterogeneous liver enhancement, and liver hypodensity and infarction are among hepatobiliary imaging findings in CT, particularly in patients admitted to ICU. Pancreatic involvement can develop as a result of direct SARS-CoV2 invasion with signs of acute pancreatitis in abdominal CT, such as edema and inflammation of the pancreas. Infarction was the most prevalent renal and splenic involvement in patients with COVID-19 who underwent abdominal CT presenting with areas of parenchymal hypodensity. In conclusion, although solid abdominal organs are rarely affected by COVID-19, clinicians must be familiar with the manifestations since they are associated with the disease severity and poor outcome.
Potential Modifiers and Different Cut-offs in Diagnostic Accuracy of Fecal Immunochemical Test in Detecting Advanced Colon Neoplasia: A Diagnostic Test Accuracy Meta-analysis
Authors: Yaghoobi Mohammad , Mehraban Far Parsa , Mbuagbaw Lawrence , Yuan Yuhong , Armstrong David , Thabane Lehana , Moayyedi Paul
Published: February 2023

Background: Fecal immunoglobulin test (FIT) has been advocated as the first line of screening for colorectal cancer (CRC) in several jurisdictions. Most studies have focused on CRC as the outcome of interest. Our goal was to quantify the diagnostic accuracy of different thresholds of FIT as compared with colonoscopy for detection of advanced colonic neoplasia and potential modifiers using proper Cochrane methodology. Methods: A comprehensive electronic search was performed for studies on FIT using colonoscopy as the reference standard to detect advanced neoplasia. Cochrane methodology was used to perform a diagnostic test accuracy (DTA) meta-analysis. Diagnostic accuracy of different cut-offs of FIT, including 25, 50, 75, 100, 150, and 200 ng/mL, were calculated separately. Meta-regression analysis was also performed to detect potential a priori modifiers, including age, location of the tumor, and time from FIT to colonoscopy. Results: Twenty-four studies were included with no evidence of publication bias. The sensitivity of FIT did not decrease with lowering the cut-off, although specificity increased in higher cut-offs. Commonly used cut-offs of 50 ng/mL, 75 ng/mL, and 100 ng/mL for FIT provided sensitivity of 39%, 36%, 27% and specificity of 92%, 94%, 96%, respectively. Diagnostic accuracy of FIT did not significantly differ in proximal versus distal lesions or in individuals below or over the age of 50 years. The results remained robust in a meta-regression of the location of the study, time from FIT to colonoscopy, and methodological quality. Conclusion: The sensitivity of FIT might have been overestimated in previous studies focusing on CRC, and it seems to be independent of age, location of neoplasia, or cut-offs, contrary to some previous studies. Lowering the cut-off will reduce the diagnostic odds ratio (DOR) by increasing specificity but without any effect on sensitivity.
Serum Selenium, Vitamin A, and Vitamin E Levels of Healthy Individuals in High‐ and Low‐Risk Areas of Esophageal Cancer
Authors: Darbani Torshizi Mehdi , Younesian Ommolbanin , Aboomardani Maryam , Roshandel Gholamreza , Hosseinzadeh Sara , Hosseini Alarzi Seyedeh Somayeh , Joshaghani Hamidreza
Published: February 2023

Background: Esophageal cancer is one of the main causes of cancer mortality in the world. Golestan province, in the northern part of Iran, has the highest esophageal cancer rate in the world. The north and south districts of Golestan province can be classified as low and high-risk areas for esophageal cancer. One of the potential risk factors for esophageal cancer in this population is a nutrient-deficient diet. Dietary antioxidant compounds such as selenium, vitamin E, vitamin A, and β-carotene are reactive oxygen species (ROC) scavengers that play a key role in cellular responses to oxidative stress and preventing DNA damage. This study aims to compare the serum levels of selenium, vitamin E, and vitamin A in healthy individuals in high and low-risk areas of esophageal cancer. Methods: This study is a population of 242 healthy individuals. Serum selenium levels were assessed by atomic absorption spectroscopy. Vitamin E and A were assessed by reversed-phase high-performance liquid chromatography. Results: Vitamin E levels of healthy individuals in high-risk areas were significantly lower than in low-risk areas, while there was no significant difference between the selenium and vitamin A levels of healthy individuals in high-risk areas and low-risk areas. Also, there was no significant difference between selenium, vitamin E, and vitamin A levels in urban and rural areas and men and women in Golestan province. Conclusion: High levels of selenium with lower levels of vitamin E, along with other risk factors, may be associated with esophageal squamous cell carcinoma in high-risk areas of Golestan province.
Mortality Trends of Gastrointestinal, Liver, and Pancreaticobiliary Diseases: A Hospital-Based Prospective Study in the Southeast of Iran
Authors: Zahedi Mohammad Javad , Shafieipour Sara , Hayatbakhsh Abbasi Mohammad Mahdi , Nakhaie Mohsen , Rezaei Zadeh Rukerd Mohammad , Lashkarizadeh Mohammad Mehdi , Noorbini Farbood , Baghaei Mohammad Hasan , Pourjafari Abbas , Aminian Ebrahim , Karami Robati Fatemeh , Dehghani Azam
Published: February 2023

Background: Gastrointestinal (GI), liver, and pancreaticobiliary diseases, in addition to the high health care utilization, account for a significant proportion of disability and death in Iran. We aimed to assess the incidence of in-hospital mortality for the total GI, liver, and pancreaticobiliary diseases in all hospitals in Kerman, Iran. Methods: In a cross-sectional study from May 2017 to April 2018, we collected the data of in-hospital death records due to GI, liver, and pancreaticobiliary diseases in all hospitals in Kerman city. GI and liver diseases were classified into three main categories: 1. Non-malignant GI diseases, 2. Non-malignant liver and pancreaticobiliary diseases, and 3. GI, liver, and pancreaticobiliary malignancies. All data were analyzed using SPSS software, version 22 (IBM). Results: Of 3427 in-hospital mortality, 269 (7.84%) deaths were due to GI, liver, and pancreaticobiliary diseases, of which 82 (30.48%) were related to non-malignant GI disorders, 92 (34.20%) to the non-malignant liver and pancreaticobiliary diseases, and 95 (35.31%) were associated with GI, liver and pancreaticobiliary malignancies. Most patients were male (62.08%), and the most common age was between 60-80 years (40.5%). GI bleeding occurred in 158 (58.73%) patients, and variceal bleeding was the most common cause (28.48%). Additionally, cirrhosis was reported in 41 out of 92 (44.56%), and hepatitis B virus (HBV) was the most common cause of cirrhosis among 17 out of 41 (41.46%). Conclusion: Our results show that gastric, colorectal, and pancreatic cancers and cirrhosis due to HBV were the most common causes of mortality associated with GI, liver, and pancreaticobiliary diseases in the hospitals of Kerman.
Association between Thyroid Hormones and Non-alcoholic Fatty Liver Disease and Non-alcoholic Steatohepatitis in Obese Individuals Undergoing Bariatric Surgery
Authors: Ashraf Ganjooei Narges , Jamialahmadi Tannaz , Nematy Mohsen , Shah Najeeb Zaheer , Jangjoo Sara , Emami Nima , Jangjoo Ali , Faridnia Reyhaneh , Alidadi Mona , Sathyapalan Thozhukat , Sahebkar Amirhossein
Published: February 2023

Background: Non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), and hepatic fibrosis have emerged as one of the leading causes of chronic liver disease. The prevalence of the NAFLD spectrum has increased, which can be attributed to the rise in obesity. As NAFLD can ultimately lead to liver cirrhosis, it is imperative to identify modifiable risk factors associated with its onset and progression to provide timely intervention to prevent potentially disastrous consequences. Considering the pivotal role of the endocrine axis in several metabolic pathways such as obesity and insulin resistance, thyroid hormones are crucial in the pathophysiology of NAFLD. The study is focused on the identification of an association between thyroid function and radiographic and histological parameters of NAFLD in patients with severe obesity. Methods: Ninety patients were recruited for this study and underwent initial assessments, including demographic profiles, anthropometric measurements, hepatic biopsy, and basic laboratory tests. Liver stiffness was evaluated using two-dimensional shear wave elastography (2D-SWE) at least 2 weeks before liver biopsy. Results: Among the 90 participants, 80% were women. The mean age was 38.5±11.1 years, and the mean body mass index (BMI) was 45.46±6.26 kg/m2 . The mean levels of serum T3 and free T4 in patients with positive histology were not statistically significant compared with patients with negative histology. Furthermore, there was no statistical significance in the mean T3 and free T4 levels between patients diagnosed with hepatic steatosis or fibrosis (on ultrasonography and elastography) and those with negative hepatic imaging. Serum levels of thyroid-stimulating hormone (TSH) were negatively correlated with ultrasonography (P=0.007). Binary logistic regression analysis revealed that none of the thyroid hormones was a predictive factor for liver histology in both adjusted and crude models. Conclusion: The results from our analysis did not suggest an association between thyroid hormones and NAFLD, which is in line with several previously published studies. However, the authors note that there are published data that do propose a link between the two entities. Therefore, well-designed large-scale clinical studies are required to clarify this discrepancy.
Impact of Multimedia CD Education on the Quality of Colon Preparation; A Single-Blind Randomized Study
Authors: Ejtehadi Fardad , Safarpour Ali Reza , Nemati Rasoul , Aminlari Ladan , Zare Ehsan , Sivandzadeh Gholam Reza , Niknam Ramin
Published: February 2023

Background: Routine bowel preparation instructions are usually given to patients in the form of oral explanations with written instructions. The purpose of this study was to evaluate the effectiveness of multimedia training in the form of video CDs on the quality of colon preparation and other related indicators. Methods: 201 outpatients in three referral academic colonoscopy centers were randomly assigned to two groups. The first group (n=100) received supplementary video CD education besides the routine instructions (VCD group). The second group (n=101) received only routine instruction, which included oral and printed instructions (non-VCD group). Results: Complete use of colon cleansing medication was statistically and significantly better in the VCD group (P=0.038). Duration of colonoscopy was shorter in the VCD group (P=0.001), demand for conscious sedation was lesser in the VCD group (P=0.049), and the quality of colon preparation was better in the VCD group (P<0.00). There was no statistically significant difference in pain sensation (P=0.1), cecal intubation rate (P=0.3), and technical difficulty of the colonoscopy (P=0.1) in both groups. Conclusion: Supplementary education in the form of multimedia CD increases the patients’ compliance to cleansing mediation consumption, improves the quality of bowel preparation, and decreases the duration of colonoscopy with lesser demands for conscious sedation.
The Role of Fundoplication after Laparoscopic Heller Myotomy in Reducing Postoperative Symptoms in Patients with Achalasia: A Controlled Clinical Trial
Authors: Elyasinia Fezzeh , Sadeghian Ehsan , Gapeleh Reza , Eslamian Reza , Najjari Khosrow , Soroush Ahmadreza
Published: February 2023

Background: Laparoscopic Heller myotomy (LHM) is considered the standard surgical approach in patients newly diagnosed with achalasia worldwide. However, proceeding to fundoplication after LHM remains controversial due to the observed postoperative symptoms, including dysphagia and regurgitation. This study was conducted to compare the postoperatively experienced regurgitation and dysphagia between those undergoing LHM with fundoplication and those with mere LHM. Methods: This four-year controlled clinical trial was performed on adult patients with esophageal type two achalasia, referring to the Shariati Hospital, who gave their written informed consent to enroll. The diagnosis of achalasia was confirmed using manometric assessments. The control group underwent LHM with fundoplication, while the cases received LHM without fundoplication. The validated Achalasia Patients Questionnaire was used for assessing the experienced symptoms pre- and postoperatively. Also, esophagography was used to investigate the alterations of the symptoms pre- and postoperatively. Results: A total of 48 patients were evaluated. 23 were assigned to the case group, while 25 were considered the controls (male to female ratio: 25 to 23). The mean age of the patients was 36.94 years, and the average disease duration was 6.22 years. Cases and controls were matched demographically. There was no statistically significant difference between the cases and controls regarding postoperative active or passive regurgitation or dysphagia to either solids or fluids. Also, the mean score of total clinical symptoms after the surgery was not significantly different between cases and controls. Lastly, esophagography revealed significant improvement regarding all the symptoms postoperatively (P=0.001); however, no statistically significant difference existed in this regard between cases and controls. Conclusion: Our results indicate no significant difference regarding the postoperative achalasia-related symptoms, namely regurgitation and dysphagia, between those patients undergoing LHM with and without fundoplication. However, further studies are required to thoroughly investigate the effects of various fundoplication techniques in relation to all achalasia-related symptoms to confirm these results.
Predicting Factors of Complete Pathological Response in Locally Advanced Rectal Cancer
Authors: Latif AmirHossein , Shirkhoda Mohammad , Rouhollahi Mohammad Reza , Nemati Saeed , Yahyazadeh Seyed Hossein , Zendehdel Kazem , Soroush Ahmad Reza , Yaghoobi Notash Aidin
Published: February 2023

Background: Current treatment of choice for locally advanced rectal cancer is neoadjuvant chemoradiotherapy (neo-CRT) followed by surgical resection and adjuvant chemotherapy. Some patients may experience complete pathological response (cPR) after the neoadjuvant treatment. However, the predicting factors are still debated. Methods: In this registry-based retrospective cohort study, 258 patients with locally advanced rectal cancer were included. Patients were categorized into two groups with or without cPR. Logistic regression analysis was recruited to investigate the odds ratio for all independent variables, and those with significant results were included in multivariate regression analysis. Results: Achievement of cPR was 21.3%. The odds ratio of cPR was significantly lower when the tumor distance from the anal verge was>10 centimeters (OR=0.24, P=0.040). Also, the odds of cPR with N1 involvement in comparison with N0 involvement decreased for 0.41 (P=0.043). It was also true for patients with N2 involvement in comparison with N0 involvement (OR=0.31, P=0.031). Higher odds ratio of cPR was observed in patients who underwent surgery in>12 weeks after neo-CRT (OR=2.9, P=0.022). Furthermore, the odds of cPR decreased for 0.9 with increasing in carcinoembryonic antigen (CEA) level (P=0.044). Conclusion: Patients with rectal cancer in clinical stage II or lower, without the involvement of the lymphatic system at diagnosis, and with tumors located in the lower parts of the rectum, with lower levels of CEA, and longer duration between neo-CRT and surgery were more likely to achieve cPR after neo-CRT. With the current knowledge, the "wait and watch policy" is still debated and needs to be defined more precisely by upcoming studies.
Role of Traumatic Events and Motivational Structure in Ambiguity Tolerance of Irritable Bowel Syndrome
Authors: Mohammadi Habibeh , Afshar-Zanjani Hamid , Goli Farzad , Hasanzadeh Kashtli Ammar , Abolmaali Khadijeh
Published: February 2023

Background: The main purpose of this study was to delineate the role of motivational structure and traumatic events in the prediction of ambiguity tolerance in patients with irritable bowel syndrome (IBS). Methods: A total of 200 patients with the diagnosis of IBS, referred to the Shariati hospital in 2018, were enrolled using a correlational design and convenience sampling. All participants were asked to complete the ambiguity tolerance questionnaire, the life event checklist, and the personal concerns inventory. Data analysis was performed by Pearson correlation method and regression analysis test in SPSS software. Results: Findings showed that there was a significant relationship between traumatic events (r=- 0.66, P=0.01) and adaptive (r=0.24, P=0.01) and non-adaptive motivational structure (non-AMS) (r=- 0.10, P=0.01) with tolerance of ambiguity (P<0.05). With increasing non-AMS and with decreasing non-AMS and traumatic events, the tolerance of ambiguity is increased. Moreover, the motivational structure (adaptive and non-adaptive) and traumatic events could define and predict 43% of the variance in ambiguity tolerance. Conclusion: Thus, regarding the important role of motivational structure and traumatic events in predicting ambiguity tolerance in IBS patients, it is prudent to put emphasis on these measures to improve patients’ overall health and probably alleviate symptoms and provide psychologic rehabilitation.
The Effects of Risk Factors on One- and Five-Year Survival of Patients with Gastric Cancer in Isfahan in 2016
Authors: Tabesh Elham , Karimi Nima , Soheilipour Maryam , Rezaeisadrabadi Mohammad , Ravankhah Zahra , Adibi Peyman
Published: February 2023

Background: Gastric cancer (GC) is a frequent and multifactorial malignancy worldwide. The aim of this study was to investigate the relationship between some risk factors of GC and the 1-year or 5-year survival rates in newly diagnosed patients in Isfahan in 2016. Methods: We included 274 newly diagnosed patients in this survival analysis from a database of 484 GC cases. We used a checklist to collect information. To inform about missed data, we call the patients or their families in non-survived cases. We evaluated each patient’s age, sex, body mass index (BMI), education, salt, salty foods, and red meat consumption. In addition, we asked patients about the intake of fresh fruits and vegetables, tobacco smoking, opium usage, and alcohol consumption. We surveyed the patient’s job, physical activity, Helicobacter pylori infection, family history of GC, history of gastric surgery, and survival status after 1 or 5 years. Variables were evaluated between survived and dead patients and compared for means and frequencies using the independent samples t-test or Mann-Whitney, or chi-square test. The univariate relationship of each risk factor, with 1- and 5-year survival, was examined by the log-rank test and the Kaplan-Meyer method and their multivariate relationship with Cox regression. Results: 1- and 5-year survived patients were younger than dead patients with GC (P<0.001; HR for 1-year survival: 1.014, 95% CI: 0.997 to 1.030; HR for 5-year survival: 1.005, 95% CI: 0.994 to 1.017), and had more frequent higher educational levels (P<0.05; HR for 1-year survival: 1.887, 95% CI: 1.046 to 3.406; HR for 5-year survival: 1.482, 95% CI: 0.987 to 2.223). The death rate after 5 years was higher in men than in women (P=0.009; HR: 1.009, 95% CI: 0.593 to 1.717) and depended on the job status of the patients (P=0.021). The other studied variables were not significantly different between 1- or 5-year survived and dead patients. Conclusion: GC development depends on genomic changes, environmental factors, and lifestyle status. But all risk factors that play a role in its development are not notable for a patient’s survival. We suggest that risk factors for these patients’ survival become elucidated in future studies. It helps to gather the necessary pieces of evidence for the enhancement of survival in patients with GC.
Common Variable Immunodeficiency Enteropathy and Its Unpredictable Biopsy Findings: Not Everything Is Black and White
Authors: Osama Md Ali , Dhawan Shashi , Rao Seema , Arora Anil Kumar
Published: February 2023

Common variable immunodeficiency syndrome (CVID) is a diverse entity characterized by hypogammaglobinemia and a propensity for recurrent infections. Involvement of the gastrointestinal tract has a variable manifestation ranging from asymptomatic involvement to florid signs and symptoms. Due to these incongruous findings, multiple concurrent biopsies are to be done for tissue diagnosis. Here, we present two cases diagnosed with CVID on the basis of clinical findings, lab investigations, and morphological features on biopsy.
Volvulus Due to Mesenteric Cysts in Infants and Children; A Case Report
Authors: Romadhon Brenda Desy , Pratama Henggar Allest , Candy Gilang Vigorous Akbar Eka , Kosasih Jane , Supangat Supangat , Qodar Tegar Syaiful , Tohari Achmad Ilham , Mulyono Bagus Wahyu , Hidayat Muhammad Rijal Fahrudin , Nugrah Muhammad Yuda
Published: February 2023

Mesenteric cysts are defined as benign intra-abdominal tumors located in the mesentery. It was a rare disease with an incidence of 1:20000 in children. The most common location was in the small bowel mesentery. Most patients with mesenteric cysts are asymptomatic and have unspecific symptoms like dyspepsia, abdominal enlargement, and abdominal pain. The fewer others could present with an acute abdomen. We describe two cases of volvulus due to the mesenteric cyst; one case in an infant and one case in a child. There is a different clinical presentation and histopathology between infants and children. In the infant, it presented with an acute abdomen, while in the child acute abdomen was not present. We found a chylous cyst in the child while the enterogenous cyst was present in the infant. We found a volvulus due to the mesentery cyst in the infant. This comparison of mesenteric cysts between the infant and the child could help to diagnose mesenteric cysts, especially in infants.
Primer characterization of in-house real time PCR (RT-PCR) for BCL2 gene using saliva sample
Authors: Nufroha Indra Wahyu , Nora Adri , Saraswati Henny
Published: February 2023

In organisms, cells perform apoptosis to remove damaged or mutated cells from the body. The Bcl-2 family protein encoded by the BCL2 gene plays a role in regulating apoptosis. Abnormalities in the function and expression level of the Bcl-2 protein are associated with several cancers. Saliva is a body fluid that can be used for biomedical research because it contains essential biomarkers of the body and genetic material derived from free cells in the oral cavity. This study aims to get primer characterization for the RT-PCR method for the BCL2 gene. We used RNA samples isolated from saliva to optimize the primers' annealing temperature, concentration, and combination pairs. Previous studies produced three primer candidates, i.e., primers A, B, and C, used in this research. The optimization results showed that primer C was the best primer to be used in the real-time PCR of this study. The optimal annealing temperature used was 60.3°C with a primer concentration of 400 nM. This study also shows the potential of saliva as a material for biomedical studies on the BCL2 gene. The results of the primer characterization resulting from this research are the first step in establishing the in-house RT-PCR method. The validation research will use a larger sample to validate this method.
Simple approach for expression and rapid purification of Taq DNA polymerase in three Escherichia coli strains
Authors: Teng Xue Chi , Ang See Yin , Citartan Marimuthu , Tang Thean Hock , Ahmed Siti Aminah
Published: February 2023

Background and objectives: One of the most commonly employed bacterial hosts for the synthesis of recombinant proteins is Escherichia coli (E. coli). Choosing an ideal host for the production of the protein of interest is an important step in the large-scale production process. Due to its thermostable characteristic, Taq Pol I, which was first isolated from the bacterium Thermus aquaticus (Taq), is now a typical enzyme found in many laboratories. This study aimed to identify the ideal host for large-scale production of Taq Pol I and purify the enzyme under a simple and rapid purification method. Methods: Taq Pol I gene in pSE420 plasmid was overexpressed in E. coli strains DH5α, TOP10 and BL21(DE3) pLysS. The enzyme was purified using Pluthero’s method and dialyzed using Amicon® Ultra-4 Centrifugal Filter. Results: The host strain E. coli TOP10 produced the highest amounts of Taq Pol I, followed by DH5α and BL21(DE3) pLysS. An estimated 4.5 U/μL of Taq Pol I was produced from a 200 mL culture of TOP10 host. Conclusion: This study provides data on the capacity of the E. coli strains used for Taq Pol I protein production. This information can be used to accelerate future targeted strain selection for the production of a specific protein of interest.
Siyah Çay ve Siyah Çay Atığı Örneklerinin Farklı Çözgen konsantrasyonlarında Elde Edilen Ekstraktlarının Biyoaktif Özellikleri ve Antimikrobiyel Aktivitelerinin Belirlenmesi
Authors: OTAĞ Mustafa
Published: February 2023

Bu çalışma siyah çay atıklarının antioksidan ve antimikrobiyal fenolik bileşik kaynağı olarak katma değerli bir ürün potansiyeli olup olamayacağının belirlemek amacıyla gerçekleştirilmiştir. Ekstraksiyon çözücüsünün (su, %50, %80 ve %96 etanol) siyah çay ve siyah çay atığı örnekleri üzerine etkileri ve bunların toplam fenolik, antioksidan özellik (DDPH ve ABTS) ve antimikrobiyal aktivite üzerindeki etkileşimi incelenmiştir. Siyah çay ve Siyah çay atığı örneklerinin toplam fenolik madde içerikleri sırasıyla 48,79–82,61 ve 42,37–74,03 mg GAE/g aralığında değiştiği saptanmıştır. Farklı etanol konsantrasyonları ile ekstrakte edilen Siyah Çay Atığı örneklerinin antioksidan özellikleri karşılaştırıldığında en yüksek DPPH radikal süpürme etkisi ve ABTS antioksidan kapasite değeri %80 etanol ile ekstrakte edilen örneklerde gerçekleştiği ve sırasıyla %41,86 ve 2,23 µmol TE/mg ekstrakt değerlerinde olduğu saptanmıştır. Genel olarak, Siyah çay atığı ekstraktlarının seçilen patojen mikroorganizmalara karşı gösterdikleri antimikrobiyel etkinlikler, ilave edilen ekstrakt miktarına bağlı olarak Siyah çay ekstraktlarına göre daha yüksek değerlere sahip olduğu belirlenmiştir. Siyah çay atığı örneklerinin gıda takviyesi, ilaç ve yenilebilir ambalaj sektörlerindeki uygulamalar için antioksidan ve antimikrobiyal özelliklere sahip katma değerli ürünlerin geliştirilmesi için hammadde olarak kullanılabilir olduğu düşünülmektedir.
Hurdles to the adoption of solar energy technologies in the Comcaac nation, Desemboque, Sonora, México, a case study
Authors: Sotelo-Medina Demetrio , León-Balderrama Jorge Inés , Cabanillas-Lopez Rafael
Published: February 2023

The Comcaac nation (seri) resides mainly in two towns of the State of Sonora: Desemboque and Punta Chueca. Currently, the Comcaac people face conditions of vulnerability due to the absence of water and energy. In 2020, a project with solar energy technologies was carried out in the community of Desemboque to ensure water supply and electrical energy, financed by the Honnold foundation. However, the results of this effort have not fulfilled the expectations. What happened? Through the analysis carried out by the transdisciplinary research collective, which is made up of 16 researchers from 7 institutions, national and foreign, obstacles to the development of local sustainability were identified, and the need to expand the analysis in different dimensions is recognized. This research is developed within the context of the execution of the project with funding from FORDECYT-PRONACES 315254 "Energy, water and food security for indigenous peoples in semi-arid coastal regions of Northern Mexico". (CONACYT, 2021a).
Community land use planning in la Gloria community
Authors: Muñoz-Rojas Marco Antonio , Vázquez-Hernánde Gabriel , Pérez-Esteban Guillermo , Leguizamo-Hernández Miriam
Published: February 2023

The environmental deterioration in the Gloria Primera Seccion community due to the traditional land use and the natural resources has generated a preoccupation in the population, who before this panorama are looking for formalize their practices. In this research were identified the problems that are present in the community, in the social, economic, and environmental ambit, this based on the article 41 of the Reglamento de la Ley General de Equilibrio Ecologico y Proteccion al ambiente en Materia de Ordenamiento Ecologico. A Community Land Use Planning was made in the Gloria Primera Seccion community, this with the goal to distribute the land use in a correct way, through a land management action plan, posing activities that entail to a sustainable human development.
Technological Adaptation Model; an integrated application process to the productive chain in MyPyMES
Authors: Peña-Montes De Oca Adriana Isela , Orozco-Magallanes Rubén Ulises , Macías-Brambila Hassem Rubén
Published: February 2023

The purpose of this work is to develop a new analysis proposal an integrate the tools in the management of productive technological evolution projects in the industrial area, through a technological and procedural assurance plan for change management, focused on the creation of value and innovation, in order to face the challenges of globalized competition, respond to a productive logic with characteristics of the so-called smart factory and thus close the technological gap. Among the significant tasks, the review and analysis of the means of integration was developed, to associate them with the existing knowledge generated in the interaction, with practical purposes in decision-making activities, for the construction of strategies, and daring actions to face challenges, that promote the change to contemporary technologies, rapid methodologies, for the design and management of engineering and industrial automation projects, in order to generate competitive advantage in MyPyMES. The results allowed the construction of a Technological Adaptation Model that supports MyPyMES.
Large Language Models and Artificial Intelligence, the End of (Language) Learning as we Know it—or not quite?
Authors: Mahlow Cerstin
Published: February 2023

The rapid advancements in large language models (LLM) and artificial intelligence (AI) have been a subject of recent significant interest and debate. This paper explores the impact of these developments on language learning. I discuss the technology underlying AI-based tools and the natural language processing (NLP) tasks they were originally designed for. This will help us to identify opportunities and limitations regarding their use in the context of language learning. I then examine how such technology can be used efficiently and effectively in language teaching and learning. The availability of such tools will require language teaching to focus on the non-mechanical aspects of writing. Similarly, automatically produced personalized teaching and learning materials will not replace human teachers, but give space for and support human–human interaction.
Equitable Access: A Course Completion Rate Analysis from a 4-Year Institution
Authors: Moore Michael
Published: February 2023

In higher education, course materials are experiencing an active disruption. This disruption is coming from equitable access, a course materials intervention model aimed at reducing the cost of and increasing access to course materials for students. The purpose of this study was to examine the use of an equitable access course materials model and its effect on student course completion rates. This study had a total population of 48,967. The analysis documented statistically significant differences between the before and after equitable access implementation samples for seven of the twelve categories examined. Black students (+1.75%), Pell grant students (+1.67%). Male students (+1.82%), Native American students (+16.51%), and Students Age ≥ 25 (+2.44%) had the largest increase in course completion rates when comparing the before and after equitable access implementation populations.