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Background: Adherence to medication adherence plays a vital role in controlling the problems and complications of epilepsy. During the COVID - 19 pandemic and limitations of face-to-face education, the use of distance education can play an important role in providing education to patients. The aim of this study is the effect of model 5A self-management training on medication adherence in epileptic patients., Methods: In this single-blind randomized controlled trial, 56 epileptic patients referred to Shiraz Namazi Hospital were divided into intervention and control groups using random allocation. Thereafter, 5A self - management training sessions were virtually held in 5 sessions in WhatsApp application for intervention group. The data collection tool was MMAS-8 at two stages of before and two months after intervention. Data analysis was performed using SPSS 21 software., Results: The results of Wilcoxon test showed that in intervention group, the mean drug adherence in patients after intervention significantly increased compared to before intervention (p = 0.005). But in control group, this was not significant (p = 0.909). According to results of Mann-Whitney test, there was no significant difference between intervention and control groups before intervention (p = 0.632). However, by passing two months from intervention, a significant difference was found between intervention and control groups (p = 0.041)., Conclusions: Based on results, the implementation of model 5A can be effective on medication adherence in epileptic patients. This program can be considered as a suitable method in epileptic patients during COVID - 19 pandemic.

Objective: Multiple sclerosis is one of the diseases of the central nervous system, which causes numerous physical and mental problems. Since stress, anxiety and depression are effective in various dimensions of chronic diseases management and considering that health literacy plays a decisive role in the quality of life of these patients. Therefore, this study was conducted with the aim of determining the association between health literacy and stress, anxiety and depression., Materials and Methods: The current research is a cross-sectional analytical study that was conducted with the participation of 164 patient's from the MS society of Jahrom city with convenience sampling. The data collection tool was the health literacy questionnaire of multiple sclerosis patients and a 21-question stress, anxiety and depression questionnaire. SPSS - 21 software, descriptive statistics and spearman and chi-square tests were used to analyze the data., Results: The findings showed that the majority of patients had a borderline health literacy (53.7%). 43.3% of patients had adequate level of health literacy. Also, the findings showed that the stress, anxiety and depression levels of the majority of patients were moderate. Spearman's test showed that there is a negative and significant correlation between health literacy and stress in multiple sclerosis patients (p=0.03) (r=-0.37). While there was no significant correlation between health literacy and anxiety and depression of patients., Conclusion: The findings showed that with the increase in the health literacy, the rate of stress in patient's decreases.

Exposure to pollutants like environmental cigarette smoke (CS) poses a major global health risk, affecting individuals from an early age. Therefore, this study explores how postnatal synbiotic supplementation affects allergic asthma symptoms in house-dust-mite (HDM)- challenged offspring maternally exposed to CS. In HDM-allergic offspring of CS-exposed dams, lung resistance was elevated, but synbiotic supplementation effectively reduced this resistance. Elevated eosinophil BALF counts following HDM challenge were intensified in pups maternally exposed to CS. Similarly, Th2 cell activation and serum IgE and IgG1 levels were more pronounced in HDM-allergic offspring of CS-exposed mothers. Synbiotics reduced eosinophil numbers and serum IgE and IgG1, and tended to decrease Th2 cell infiltration and activation. Synbiotics promoted beneficial gut bacteria like Bifidobacterium and Akkermansia. In conclusion, early-life synbiotic intervention mitigated allergic asthma associated with maternal air pollution exposure, highlighting the potential of synbiotics for clinical evaluation as a strategy to prevent allergy development in offspring., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Johan Garssen reports financial support was provided by Danone Nutricia Research. Jeroen van Bergenhenegouwen reports a relationship with Danone Nutricia Research that includes: employment. Johan Garssen reports a relationship with Danone Nutricia Research that includes: employment. Saskia Braber reports a relationship with Danone Nutricia Research that includes: employment. The remaining authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The basolateral amygdala (BLA) contains adrenergic receptors, which are known to be involved in stress, anxiety, and memory. The objective of this study was to explore whether inhibition of α-adrenergic receptors (by phentolamine, an α-adrenergic receptor antagonist) in the BLA can reduce foot-shock stress-induced anxiety-like behavior, memory deficits, and long-term potentiation (LTP) deficits within the CA1 region of the rat hippocampus. Forty male Wistar rats were assigned to the intact, control, stress (Str), Phent (phentolamine), and Phent + Str groups. Animals were subjected to six shocks on 4 consecutive days, and phentolamine was injected into BLA 20 min before the animals were placed in the foot-shock stress apparatus. Results from the elevated plus maze test (EPM) revealed a reduction in anxiety-like behaviors (by an increased number of entries into the open arm, percentage of time spent in the open arm, and rearing and freezing) among stressed animals upon receiving injections of phentolamine into the BLA. The open-field test results (increased rearing, grooming, and freezing behaviors) were consistent with the EPM test results. Phentolamine infusion into the BLA enhanced spatial memory, reducing errors in finding the target hole and decreasing latency time in the Barnes maze test for stress and nonstress conditions. Injecting phentolamine into the BLA on both sides effectively prevented LTP impairment in hippocampal CA1 neurons after being subjected to foot-shock stress. It has been suggested that phentolamine in the BLA can effectively improve anxiety-like behaviors and memory deficits induced by foot-shock stress., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Self-efficacy is one of the factors affecting on the quality of life and adjustment to the chronic diseases such as multiple sclerosis. Self-efficacy is the individual's belief that they have the ability to overcome challenges presented to them. The current study aimed to develop and validate of selfefficacy questionnaire in Iranian MS patients., Materials and Methods: This is a methodological study that was performed in three phases. In the first phase, the concept of self-efficacy was defined through qualitative content analysis approach. In the second phase, early items of questionnaire was generated according to findings of the first phase. In the final phase, validation of the developed questionnaire were evaluated using face, content and construct validity as well as reliability., Results: In exploratory factor analysis, four subscales including: adherence to medication regimens (5 items), social performance control (4 items), symptom management (4 items) and maintain independence and activity (5 items) were extracted by Eigen value above one and factor load above 0.3. Internal consistency and stability of the developed questionnaire confirmed with 0.91 and 0.88 respectively that indicated acceptable reliability., Conclusions: The 18-item developed questionnaire is valid and reliable for measurement of self-efficacy of Iranian MS patients.

Background: Hermansky-Pudlak Syndrome (HPS), a rare autosomal recessive disorder, is characterized by oculocutaneous albinism, bleeding diathesis, and sometimes severe lung problems and inflammatory bowel disease. Symptoms include skin and hair pigmentation variations, along with visual impairments. Variants in eleven genes encoding protein complexes essential for membrane trafficking and intracellular endosomal transport pathways underlie various recognized HPS subtypes. This study focuses on HPS-9, a subtype of Hermansky-Pudlak Syndrome caused by a variant in the BLOC1S6 gene, which is a subunit of the BLOC1 complex. In this study, a novel Copy Number Variation (CNV) in the aforementioned gene in an Iranian family is reported. The study aims to better understand the etiology of HPS-9 symptoms by identifying and confirming the variant and determining whether the gene is expressed despite the deletion. There have only been five reports of this syndrome in the literature thus far. Our novel CNV represents a significant contribution to understanding the genetic basis of HPS-9., Results: This study investigates a male patient presenting with albinism. Whole Exome Sequencing (WES) identified a homozygous deletion of approximately 350 bp using CNV analysis. The deletion affects the intronic region of the BLOC1S6 gene, causing uncertainties in defining the exact boundaries due to WES limitations. Primer walking and GAP-PCR techniques were used to define the deletion boundaries. Subsequent assessments of this variant across other family members helped identify homozygous affected members and heterozygous carriers. The absence of BLOC1S6 expression in the affected individual was confirmed through Real-time PCR experiments. These findings underscore the importance of understanding the implications for the patient's healthcare and potential therapeutic approaches., Conclusion: This study introduces a case of Hermansky-Pudlak Syndrome Type 9 (HPS-9) caused by a homozygous deletion in the BLOC1S6 gene. We identified an approximately 7-kb deletion encompassing exon 1 and the intronic region of the gene. The absence of BLOC1S6 expression, confirmed via Real-time PCR, highlights the importance of studying the pathogenicity of the deletion and its impact on the patient's health. Our findings contribute to the sparse knowledge on HPS-9 and underscore the need for further exploration into the genetic causes of this rare disorder., (© 2024. The Author(s).)

Objective: This study was conducted with the aim of the effect of team members teaching design (TMTD) vs. regular Lectures method on the self-efficacy of the multiple sclerosis patients., Methods: This research is a randomized controlled trial study. In this study, 48 multiple sclerosis persons of members of Jahrom MS Society participated. The persons were selected by simple random sampling and then divided into three groups of: TMTD (n=16), regular lecture method (n=16), and control (n=16), by random allocation method. In the intervention groups, six training sessions were held twice a week; control group did not receive education. Data was collected by the MS self-efficacy questionnaire of Rigby et al. in the before, immediately and one month after the intervention., Results: Patients in three intervention and control groups were similar in terms of demographic variables. The results of the repeated measurement test before, immediately and one month after the intervention showed that the mean of the all dimensions of self-efficacy in two intervention groups had increased significantly (p<0.05). While these changes were not significant in the control group (p ≥ 0.05). Also, there was a significant difference in the mean of the all dimensions of self-efficacy between the intervention groups of TMTD and regular lectures., Conclusion: Based on the findings, TMTD compared to regular lectures method had a more significant effect on improving the self-efficacy of multiple sclerosis patients. Therefore, it is recommended that nursing use this educational approach to increase patients' self-efficacy., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright� by the Universidad de Antioquia.)

Objective: The current study aimed to develop and validate of human dignity questionnaire in nursing care., Methods: The present research is a sequential exploratory mixed method study. The questionnaire was developed and validated in three phases: (1) the concept of human dignity was defined through conventional content analysis qualitative approach, (2) early items of questionnaire was generated according to findings of the first phase, (3) validation of the questionnaire was evaluated using face, content and construct validity as well as reliability. The study was conducted with the participation of 13 nurses in the qualitative section and 203 nurses in the quantitative section in teaching hospitals affiliated to Jahrom University of Medical Sciences (Iran)., Results: In the qualitative section, the definition and dimensions of the concept of human dignity in nursing care were discovered. In the quantitative section, the initial pool of items for the questionnaire of human dignity in nursing care was formed using the results of the qualitative section of the study and review of texts and related questionnaires. In factor analysis, four subscales including: respectful communication, equality of patient human value, preservation of privacy and patient-centered care were extracted by Eigen value above one. Internal consistency and stability of the questionnaire were calculated as 0.85 and 0.80, respectively, indicating an excellent reliability., Conclusion: The 20-item developed questionnaire is valid and reliable for measurement of human dignity questionnaire in nursing cares., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright� by the Universidad de Antioquia.)

Canavan disease is a leukodystrophy caused by ASPA mutations that diminish oligodendroglial aspartoacylase activity, and is characterized by markedly elevated brain concentrations of the aspartoacylase substrate N-acetyl-l-aspartate (NAA) and by astroglial and intramyelinic vacuolation. Astroglia express NaDC3 (encoded by SLC13A3), a sodium-coupled transporter for NAA and other dicarboxylates. Astroglial conditional Slc13a3 deletion in aspartoacylase-deficient Canavan disease model mice ("CD mice") reversed brain NAA elevation and improved motor function. These results demonstrate that astroglial NaDC3 contributes to brain NAA elevation in CD mice, and suggest that suppressing astroglial NaDC3 activity would ameliorate human Canavan disease., (© 2024 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)

Beta-thalassemia major (B-TM) is an inherited hematological disease that affects nearly 300 million people worldwide. This study aimed to evaluate the effects of group-based mobile learning on stress, anxiety, depression, and pain among beta-thalassemia major patients. This randomized clinical study was conducted on 48 patients with beta-thalassemia major in Jahrom, Iran. Participants were randomly assigned to the control and intervention groups. Their partners in the intervention group were trained in self-care through mobile learning. The 21-item Depression, Anxiety, and Stress Scale and a visual analog scale for pain assessment were used to collect the data. Data were analyzed using the Statistical package for the Social Sciences version 23.0. Although there was no significant difference between the control and intervention groups in the mean pre-test scores of depression (P = .21), anxiety (P = .05), stress (P = .48), and pain (P = .46), the mean post-test scores of depression, anxiety, and stress in the intervention group were significantly lower than the control group (P = .0001). The mean scores of depression (P = .33), anxiety (P = .74), stress (P = .83), and pain (P = .6) did not change significantly in the control group, while all these mean scores decreased significantly in the intervention group for DASS (P = .001) and pain (P = .002). Group-based mobile learning is effective in reducing depression, anxiety, stress, and pain in B-TM.

Background: Clinical judgment is one of the most important competencies required for safe care, decision-making, and diagnosis in nursing profession. Therefore, it is necessary to examine clinical judgment in nursing care. Existing a standard questionnaire based on cultural and social conditions can accurately evaluate clinical judgment in nurses., Objective: The present study aimed to develop and validate clinical judgment capability questionnaire in nurses., Design: The current research was a sequential exploratory mixed method study., Setting: The teaching hospitals affiliated to Jahrom University of Medical Sciences in the South of Iran in 2023., Participants: Twelve clinical nurses were included in the qualitative part and 181 nurses in the quantitative part., Methods: The study was conducted in two parts: one qualitative and one quantitative. In the qualitative part, the concept of clinical judgment was explored using qualitative content analysis. Then, the initial pool of items was generated to develop a questionnaire. In the quantitative part, psychometric properties of the questionnaire were evaluated including face, content, and structure validity and reliability (internal consistency and stability)., Results: After examining the psychometric properties, 22 items were developed for the final questionnaire. The results of factor analysis led to the extraction of four factors, including noticing, interpreting, responding, and reflecting. The internal consistency of the questionnaire was confirmed with a Cronbach's alpha coefficient of 0.95 and its stability with an intraclass correlation coefficient of 0.84., Conclusion: The developed 22-item questionnaire is a valid and reliable tool for assessment of clinical judgment capability in nurses., Competing Interests: There was no conflict of interest in this study., (© 2024 The Author(s).)

Objective: The current study aimed to develop and validate of companions' satisfaction questionnaire of patients hospitalized in ICUs., Methods: This is a methodological study that was performed in three phases: In the first phase, the concept of companion's satisfaction of patients hospitalized in ICUs was defined through qualitative content analysis method. In the second phase, early items of questionnaire were generated based on findings of the first phase. In the third and final phase, validation of the questionnaire was evaluated using face, content and construct validity as well as reliability., Results: In exploratory factor analysis, three subscales including: satisfaction with nursing staff communication (5 items), satisfaction with nursing care (12 items), and satisfaction with decision making (5 items) were extracted by Eigen value above one and factor load above 0.5. Internal consistency and stability of the developed questionnaire confirmed with 0.94 and 0.95 respectively that indicated acceptable reliability., Conclusion: The 22-item developed questionnaire is valid and reliable for measurement of levels of companion's satisfaction of Iranian patients hospitalized in ICUs., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright� by the Universidad de Antioquia.)

Unexpected poor ovarian response (UPOR) occurs when nine or fewer oocytes are retrieved from a young patient with normal ovarian reserve. Bone morphogenetic protein15 (BMP15) and growth differentiation factor 9 (GDF9) are two oocyte-specific factors with pivotal role in folliculogenesis. The aim of this study was to assess the relation between BMP15 and GDF9 variants with UPOR. Hundred women aged ≤ 39 with AMH ≥ 1.27 IU/ml participated as UPOR and normal ovarian responders (NOR) based on their oocyte number. Each group consisted of 50 patients. After genomic DNA extraction, the entire exonic regions of BMP15 and GDF9 were amplified and examined by direct sequencing. Western blotting was performed to determine the expression levels of BMP15 and GDF9 in follicular fluid. Additionally, in silico analysis was applied to predict the effect of discovered mutations. From four novel variants of BMP15 and GDF9 genes, silent mutations (c.744 T > C) and (c.99G > A) occurred in both groups, whereas missense variants: c.967-968insA and c.296A > G were found exclusively in UPORs. The latter variants caused reduction in protein expression. Moreover, the mutant allele (T) in a GDF9 polymorphism (C447T) found to be more in NOR individuals (58% NOR vs. 37% UPOR (OR = 2.3, CI 1.32-4.11, p = 0.004).The novel missense mutations which were predicted as damaging, along with other mutations that happened in UPORs might result in ovarian resistance to stimulation. The mutant allele (T) in C447T polymorphism has a protective effect. It can be concluded that there is an association between BMP15 and GDF9 variants and follicular development and ovarian response., (© 2023. The Author(s), under exclusive licence to Society for Reproductive Investigation.)

Background: The human papillomavirus (HPV) infection may affect the miRNA expression pattern during cervical cancer (CC) development. To demonstrate the association between high-risk HPVs and the development of cervix dysplasia, we examined the expression patterns of hsa-miR-194-5p and hsa-miR-195-5p in Pap smear samples from southeast Iranian women. We compared samples that were HPV-positive but showed no abnormality in the cytological examination to samples that were HPV-positive and had severe dysplasia., Methods: Pap smear samples were obtained from 60 HPV-positive (HPV-16/18) patients with histologically confirmed severe dysplasia (cervical intra-epithelial neoplasia (CIN 3) or carcinoma in situ) and the normal cytology group. The expression of hsa-miR-194-5p and hsa-miR-195-5p was analyzed by real-time quantitative PCR, using specific stem-loop primers and U6 snRNA as the internal reference gene. Clinicopathological features were associated with miRNA expression levels. Furthermore, functional enrichment analysis was conducted using in silico tools. The Kaplan-Meier survival method was also obtained to discriminate survival-significant candidate miRNAs in CC, and receiver operating characteristic (ROC) curves were constructed to assess the diagnostic value., Results: Compared to HPV-positive cytologically normal Pap smear samples, hsa-miR-194-5p and hsa-miR-195-5p relative expression decreased significantly in HPV-positive patients with a severe dysplasia Pap smear. Kaplan-Meier analysis indicated a significant association between the miR-194 decrease and poor CC survival. In essence, ROC curve analysis showed that miR-194-5p and miR-195-5p could serve as valuable markers for the development of cervix dysplasia in individuals who are positive for high-risk HPVs., Conclusions: This study revealed that hsa-miR-194-5p and hsa-miR-195-5p may possess tumor suppressor capabilities in the context of cervical dysplasia progression. However, it remains uncertain whether these microRNAs are implicated in the transition of patients with high dysplasia to cervical cancer. We also showed the potential capability of candidate miRNAs as novel diagnostic biomarkers related to cervical dysplasia progression., (© 2024. The Author(s).)

Background: Aminoacylase-1 deficiency (ACY1D) is an autosomal recessive rare inborn error of metabolism, which is caused by disease-causing variants in the ACY1. This disorder is characterized by increased urinary excretion of specific N-acetyl amino acids. Affected individuals demonstrate heterogeneous clinical manifestations which are primarily neurologic problems. In neuroimaging, corpus callosum hypoplasia, cerebellar vermis atrophy, and delayed myelination of cerebral white matter have been reported., Aims: Finding disease-causing variant and expanding imaging findings in a patient with persistent basal ganglia involvement., Methods: Whole-exome sequencing was performed in order to identify disease-causing variants in an affected 5-year-old male patient who presented with neurologic regression superimposed on neurodevelopmental delay following a febrile illness. He had inability to walk, cognitive impairment, speech delay, febrile-induced seizures, truncal hypotonia, moderate to severe generalized dystonia, and recurrent metabolic decompensation., Results: All metabolic tests were normal except for a moderate metabolic acidosis following febrile illnesses. The results of serial brain magnetic resonance imaging (MRI) at ages 1 and 4.5 years revealed persistent bilateral and symmetric abnormal signals in basal ganglia mainly caudate and globus pallidus nuclei with progression over time in addition to a mild supratentorial atrophy. A homozygous missense variant [NM&#95;000666.3: c.1057C>T; p.(Arg353Cys)] was identified in the ACY1, consistent with aminoacylase-1 deficiency. Variant confirmation in patient and segregation analysis in his family were performed using Sanger sequencing., Conclusions: Our findings expanded the phenotype spectrum of ACY1-related neurodegeneration by demonstrating persistent basal ganglia involvement and moderate to severe generalized dystonia., (© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

The tomato ( Solanum lycopersicum L.) is an annual vegetable cultivated all over the world. It faces biotic and abiotic stresses, such as salinity, in arid and semiarid regions. Investigating the relationship between physiological and economic traits, such as fruit yield, under stress conditions is necessary to identify tolerant genotypes. This study was conducted to identify tolerant tomato families according to the relationship between several important physiological, morphological and phenological traits. Twenty S3 families were cultivated in a factorial experiment (factor1: families and factor2: normal conditions and salinity stress) based on a randomized complete block design with three replications in 2019. Twenty physiological, agronomic and fruit-quality-related traits were investigated. Analysis of variance was used to prove the existing effective genetic diversity. Genetic diversity and the relationships between traits were graphically shown using heatmap clustering. Finally, genetic parameters, such as Pearson's correlation, trait stability index and heritability were used to calculate the mathematical value of families using the Modified Analytical Hierarchy Process. Families exhibited different behaviours under normal and stress conditions. The tolerant families responded physiologically to the salt stress. Therefore, they reduced both cell membrane degradation and photosynthesis disruption by increasing proline, lycopene, carotenoid and sugar content. Therefore, fewer reductions in morphological traits were observed in these families. The most important traits based on the selection strategy were lycopene content, K + /Na + ratio, days to flowering and biological yield. In addition, three families, H4/T/30/1, H1/T/12/5 and H1/T/47/4, were selected as the most suitable alternatives to construct the breeding population of the next generation., Competing Interests: We declare no conflict of interest in this study. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript or in the decision to publish the results., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Annals of Botany Company.)

Background: The COVID-19 epidemic control has become a global challenge and many contributing variables are still unknown to policymakers. This case-cohort study was conducted to investigate the risk factors of mortality in COVID-19 patients., Methods: This case-cohort study was conducted on 956 samples in Ardakan and Meybod counties, Yazd Province, between February 20 and May 20, 2020. The data collection tool was a researcher-made questionnaire. Data analysis was done using descriptive statistics and paired t-test, chi-square, and logistic regression analysis., Results: Of a total cohort population of 993 in Ardakan and Meybod counties, 435 were assigned to the control group and 521 were assigned to the case group. The results of outcome analysis showed that 14.4% of the patients in the case group and 11.5% of the patients in the control group died. According to the results of logistic regression analysis in COVID-19 patients, each one-year increase in age increased the risk of mortality by 6% (HR = 1.06, p < 0.001), each one-day increase in the hospital stay increased the risk of death by 8% (HR = 1.08, p < 0.001). Moreover, the presence of cardiovascular disease, chronic neurological disease, and chronic pulmonary disease increased the risk of death. The patients who underwent mechanical ventilation had 85% less chance of survival (HR = 0.15, p < 0.001)., Conclusions: The results showed a higher mortality rate in the elderly patients as well as those with underlying diseases. Attention should be paid to at-risk and elderly patients in terms of ensuring a healthy diet, improving their self-care practices, and providing long-term medical and healthcare facilities., Competing Interests: All authors report no conflicts of interest relevant to this article., (©2023 Pacini Editore SRL, Pisa, Italy.)

Introduction: COVID-19 is a new disease infecting a large number of people, and undoubtedly have psychological impacts on healthcare workers. Among healthcare staff, nurses are the most involved ones in fighting against COVID-19. Therefore, this study aimed to explore nurses' experiences of psychological consequences during caring patients with COVID-19., Methods: The present qualitative study was conducted using the conventional content analysis approach (Graneheim and Lundman) Iran. Participants in this study included 15 nurses working with patients with COVID-19, selected by purposive sampling. Data were collected using in-depth interviews. The rigor of data was assessed using the criteria proposed by Guba and Lincoln., Results: Nurses reported the four following psychological consequences of COVID-19 pandemic on caring patients with COVID-19: post-traumatic stress disorder, depression, physical exhaustion, and aggressive behaviors., Conclusion: The data showed that nurses experienced a variety of psychological consequences during caring patients with COVID-19. Therefore, it is necessary to monitor nurses' psychological problems and implement interventions to improve their mental health., Competing Interests: There was no conflict of interest in this study., (© 2023 The Author(s).)

Purpose: A semi-quantitative food frequency questionnaire (FFQ) was developed for use in the Prospective Epidemiological Research Studies in IrAN (PERSIAN Cohort), investigating non-communicable disease risk factors. This study aimed to assess the validity and reproducibility of this FFQ, through food group intake., Methods: Participants, recruited from seven PERSIAN cohort centers, completed the FFQ at the beginning of the study (FFQ1) and at the end (FFQ2), with a 12-month interval in between, during which two 24-h dietary recalls (24 h) were completed each month. Correlation coefficients of the median intake of food groups recorded by the FFQs were compared to those of the 24 h to assess validity, and the two FFQs were compared to assess reproducibility of findings., Results: Overall, data from 978 participants were included in this validation analysis. Of the 26 food groups assessed, Tea , Sugars , Whole/Refined Grains , and Solid Fats / Oils , had the strongest correlations (0.6-0.79), while Red Meat, Chicken and Eggs showed moderate correlations (0.42-0.59). The weakest correlations observed belonged to Fresh fruit Juice and Other Meats (0.23-0.32). Reproducibility was assessed among those who completed both FFQ1 and FFQ2 ( n  = 848), revealing moderate to strong correlations in all food groups, ranging from 0.42 in Legumes to 0.72 in both Sugar and Sweetened Drinks., Conclusion: The PERSIAN Cohort FFQ is appropriate to rank individuals based on food group intake., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher., (Copyright © 2023 Eghtesad, Hekmatdoost, Faramarzi, Homayounfar, Sharafkhah, Hakimi, Dehghani, Moosazadeh, Mortazavi, Pasdar, Poustchi, Willett and Malekzadeh.)

Corrosion has caused significant annual costs for building construction and civil architectural designs. In this study, Monosodium glutamate (GLU) was proposed as a potential candidate for long-lasting corrosion inhibition to slow down the rate of corrosion in the concrete pore environment. In this regard, the electrochemical and morphological properties of the various GLU concentrated systems between 1 to 5 wt% in the simulated concrete pore solution media were investigated. According to the EIS results, adding 4 wt% of GLU could reduce the mild steel corrosion process by 86% through a mixed inhibition mechanism. Also, the polarization records represented that the samples' corrosion current density was diminished to 0.169 µA cm -2 after the addition of 4 wt% GLU into the harsh environment. Using the FE-SEM method, the growth of the GLU layer over the metal substrate was demonstrated. The results of spectroscopic methods, i.e., Raman and GIXRD, demonstrated that GLU molecules were successfully adsorbed over the surface of the metal. Contact angle test outcomes showed that by increasing the GLU concentration to its optimum level (4 wt%), the surface hydrophobicity was dramatically raised to 62°., (© 2023. The Author(s).)

MXene nanosheets (MXenes), a brand-new classification of two-dimensional (2D) nanomaterials, are assumed to be highly functional components in anticorrosion polymeric systems. In general, MXenes possess many advantageous features that can be utilized to improve the polymeric matrices' anticorrosion performance. In this work, zinc ions (Zn) were deposited on the sulfonated polyaniline (SPANI) that was polymerized on Ti 3 C 2 -MXene surfaces (MXP-Zn) in order to achieve a high-performance anticorrosion nanofiller for epoxy coating (EP-MXP-Zn). Field-emission scanning electron microscopy-transmission electron microscopy images, Fourier transform infrared, Raman, X-ray diffraction, UV-vis, derivative thermogravimetry, and thermogravimetric analysis have evidenced the successful characterization of the MXP-Zn nanocomposite. Likewise, the excellent barrier properties of SPANI, in conjunction with the cathodic protection of Zn, resulted in a novel nanocomposite that could mitigate the negative consequences of destructive ions' attack on the metal surface in an aggressive media. Quantitative and qualitative anticorrosion measurements verified the outstanding anticorrosion performance of EP-MXP-Zn over time in severe conditions. According to the electrochemical impedance spectroscopy assessments, the | Z 0.01 Hz | value for EP-MXP-Zn was 10 10.04 Ω cm 2 , which was over 10 5 times greater than that of neat EP (10 4.66 Ω cm 2 ) over a 6-week period of immersion in a 3.5 wt % NaCl solution.

Background: The South Asian Association for Regional Cooperation (SAARC) covers Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. We conducted a comparative analysis of the trade-off between the health policies for the prevention of COVID-19 spread and the impact of these policies on the economies and livelihoods of the South Asia populations., Methods: We analyzed COVID-19 data on epidemiology, public health and health policy, health system capacity, and macroeconomic indicators from January 2020 to March 2021 to determine temporal trends by conducting joinpoint regression analysis using average weekly percent change (AWPC)., Results: Bangladesh had the highest statistically significant AWPC for new COVID-19 cases (17.0; 95% CI = 7.7-27.1, P < 0.001), followed by the Maldives (12.9; 95% CI = 5.3-21.0, P < 0.001) and India (10.0; 95% CI = 8.4-11.5, P < 0.001). The AWPC for COVID-19 deaths was significant for India (6.5; 95% CI = 4.3-8.9, P < 0.001) and Bangladesh (6.1; 95% CI = 3.7-8.5, P < 0.001). Nepal (55.79%), and India (34.91%) had the second- and third-highest increase in unemployment, while Afghanistan (6.83%) and Pakistan (16.83%) had the lowest. The rate of change of real GDP had the highest decrease for Maldives (557.51%), and India (297.03%); Pakistan (46.46%) and Bangladesh (70.80%), however, had the lowest decrease. The government response stringency index for Pakistan had a see-saw pattern with a sharp decline followed by an increase in the government health policy restrictions that approximated the test-positivity trend., Conclusions: Unlike developed economies, the South Asian developing countries experienced a trade-off between health policy and their economies during the COVID-19 pandemic. South Asian countries (Nepal and India), with extended periods of lockdowns and a mismatch between temporal trends of government response stringency index and the test-positivity or disease incidence, had higher adverse economic effects, unemployment, and burden of COVID-19. Pakistan demonstrated targeted lockdowns with a rapid see-saw pattern of government health policy response that approximated the test-positivity trend and resulted in lesser adverse economic effects, unemployment, and burden of COVID-19., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose the following activities and/or relationships: FBI reports grant from NorthStar Anesthesia, and personal fees for consultancy from Silicon Valley Innovation Center, Infineon Technologies AG, unrelated to this publication. All other authors declare no relevant interests., (Copyright © 2023 by the Journal of Global Health. All rights reserved.)

Duchenne muscular dystrophy (DMD) is associated with distinct mitochondrial stress responses. Here, we aimed to determine whether the prospective mitochondrial-enhancing compound Olesoxime, prevents early-stage mitochondrial stress in limb and respiratory muscle from D2. mdx mice using a proof-of-concept short-term regimen spanning 10-28 days of age. As mitochondrial-cytoplasmic energy transfer occurs via ATP- or phosphocreatine-dependent phosphate shuttling, we assessed bioenergetics with or without creatine in vitro. We observed that disruptions in Complex I-supported respiration and mH 2 O 2 emission in D2. mdx quadriceps and diaphragm were amplified by creatine demonstrating mitochondrial creatine insensitivity manifests ubiquitously and early in this model. Olesoxime selectively rescued or maintained creatine sensitivity in both muscles, independent of the abundance of respiration-related mitochondrial proteins or mitochondrial creatine kinase cysteine oxidation in quadriceps. Mitochondrial calcium retention capacity and glutathione were altered in a muscle-specific manner in D2. mdx but were generally unchanged by Olesoxime. Treatment reduced serum creatine kinase (muscle damage) and preserved cage hang-time, microCT-based volumes of lean compartments including whole body, hindlimb and bone, recovery of diaphragm force after fatigue, and cross-sectional area of diaphragm type IIX fiber, but reduced type I fibers in quadriceps. Grip strength, voluntary wheel-running and fibrosis were unaltered by Olesoxime. In summary, locomotor and respiratory muscle mitochondrial creatine sensitivities are lost during early stages in D2. mdx mice but are preserved by short-term treatment with Olesoxime in association with specific indices of muscle quality suggesting early myopathy in this model is at least partially attributed to mitochondrial stress.

Background and Aims: The diabetes is one of the most common noncommunicable diseases, the prevalence of which is increasing worldwide. This study aimed to determine the prevalence, and correlates the factors of diabetes in the setting of Shahedieh cohort study in Yazd, Iran., Method: The present study is a cross-sectional study conducted on the data of the initial stage of Shahdieh Yazd cohort. This study examined the data of 9747 participants aged from 30 to 73 years. The data included demographic, clinical, and blood test variables. Multivariable logistic regression was used to calculate the adjusted odds ratio (OR), and the risk factors of diabetes were studied. Meanwhile, population attributable risks for diabetes were estimated, and reported., Results: The prevalence of diabetes was 17.9% (CI95%: 17.1-18.9); 20.5% in women, and 15.4% in men. Based on the results of multivariable logistic regression showed female sex (OR = 1.4, CI95%: 1.24-1.58), waist-hip ratio (OR = 1.4, CI95%: 1.24-1.58), high blood pressure (OR = 2.1, CI95%: 1.84-2.4), cardiovascular diseases (CVD) (OR = 1.52, CI95%: 1.28-1.82), stroke (OR = 1.91, CI95%: 1.24-2.94), age (OR = 1.81, CI95%: 1.67-1.96), hypercholesterolemia (OR = 1.79, CI95% triglyceride: 1.59-2.02), and low-density lipoprotein (LDL) (OR = 1.45, CI95%: 1.4-1.51), as risk factors for diabetes. Among the modifiable risk factors, high blood pressure(52.38%), waist-to-hip ratio (48.19%), the history of stroke (47.64%), hypercholesterolemia (44.13%), history of CVD (34.21%), and LDL ≥ 130 (31.03%) had the greatest population-attributable, respectively., Conclusion: The results showed that some of the main determinants of diabetes are the modifiable risk factors. Therefore, implementing early detection, and screening programs for people at risk and preventive measures, such as lifestyle modification programs, and control of risk factors can prevent this disease., Competing Interests: The authors declare no conflicts of interest., (© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Background: Selection is one of the essential skills whereby breeders reduce the population size and increase the chance of success. Various selection methods with special applications have been developed. Superior genotypes are assessed according to interesting traits, including univariate, multivariate, phenotypic, genotypic, etc. METHODS: Mathematical calculation of the traits' importance based on the genetic makeup of investigated population (average degree of dominance/additive involved in the action of genes) and arbitrary genetic parameters is functional. In this paper, a general model for multivariate selection has been presented whereby the selection can be made for (a) more than one interesting trait, (b) the trait(s) with complex inheritance, (c) finding superior genotypes from among a large-scale population, (d) finding superior genotypes in segregating generations and (f) finding tolerant genotypes to stresses. This model is developed based on biometric concepts in four steps. MATLAB script is provided for the model, and users can easily apply that to identify the most suitable genotypes after data collection according to the breeding purposes., Results: The main features of this model are simplicity, precision, repeatability, and speed (improving several traits simultaneously). All the steps and the analysis of the results are explained step by step in a case study., (© 2023. The Author(s).)

Introduction: Multiple sclerosis is associated with decrease in health-promoting behaviors (HPBs) and require appropriate nursing interventions. Telenursing can play an important role in education of patients during the COVID-19 pandemic in which face-to-face education is limited. This study aimed to investigate the effect of self-care education with telenursing approach on HPBs in patients with MS., Materials and Methods: In this clinical trial, 68 patients with MS were selected using simple random sampling from Jahrom MS Society and randomly assigned to the intervention (n = 34) and control (n = 34) groups. In the intervention group, educational sessions were held three days a week for six weeks. Data were collected using demographic information and Walker's Health-Promoting Lifestyle questionnaires before and immediately after the intervention. Data were analyzed by Mann-Whitney and Wilcoxon tests using SPSS software (Ver. 21)., Results: Based on the findings, immediately after the intervention, the mean score of HPBs was significantly higher (p = 0.005) in the intervention group (145.38 ± 26.66) than the control group (129.18 ± 22.35). The means of nutrition, exercise, health responsibility, and stress management were significantly different between the intervention and control groups immediately after the intervention (p < 0.05)., Conclusion: results this study indicated that self-care education with telenursing approach was effective on HPBs in patients with MS. It can be beneficial to employ as an educative-supportive approach in MS patients., Competing Interests: Declaration of Competing Interest There were no conflicts of interest in this study., (Copyright © 2023. Published by Elsevier B.V.)

The fungicide mancozeb increases oxygen-free radicals in the central nervous system. As an antioxidant, L-carnitine protects DNA and cell membranes from damage caused by oxygen-free radicals. The present study investigated how L-carnitine affected the acoustic startle response (ASR) in rats exposed to mancozeb. In this experimental study, male Wistar rats were gavaged orally with mancozeb (500, 1000, and 2000 mg/kg), L-carnitine (100, 200, and 400 mg/kg), or L-carnitine (200 mg/kg) + mancozeb (500 mg/kg) three times in 1 week. In the sham group, saline (0.9%, 10 mL/kg) was gavaged at a volume equivalent to that of the drugs. The control group did not receive any treatment. The results showed that locomotor activity and the percentage of prepulse inhibition in the mancozeb groups decreased compared to the sham group while these parameters increased in the L-carnitine group (200 mg/kg) compared to sham rats. In conclusion, mancozeb may increase the risk factor for cognitive diseases such as schizophrenia in people exposed to it while pretreatment with L-carnitine can attenuate the toxic effect.

Background: Nursing students face mental and emotional issues due to the nature of their profession. The role of protective factors such as psychological capital and spiritual well-being is vital in improving mental health. This study investigated the mediating role of psychological capital as a mediator in the relationships between spiritual well-being and mental health in Iran., Methods: The present study was descriptive, cross-sectional research conducted on 426 undergraduate nursing students within a four-year educational program in Iran from July to December 2021. The participants were selected via convenience sampling. This research used psychological capital scale, spiritual well-being, and general health questionnaire. The collected data were then analyzed using descriptive tests, Pearson correlation, and a structural equation model., Results: Spiritual well-being positively affects mental health and psychological capital. Psychological capital also is positively related to mental health. Psychological capital partially mediated the effect of spiritual well-being on mental health., Conclusion: According to the results, High level of spiritual well-being can improve nursing students' mental health and the relationship is partially mediated Psychological capital. Therefore, psychological capital is an important factor in improving nursing students' mental health., (© 2022. The Author(s).)

Corrosion is a natural process between a metal and its environment that can gradually cause catastrophic damage to the metal equipment, which would have economic implications. Consequently, several protective methods have been utilized to prevent metals from severe degradation. Organic polymeric coatings have been widely used as the most convenient and cost-effective method to boost metals' anti-corrosion properties. Nonetheless, these coatings have a significant amount of solvent, resulting in shrinkage and micro defects in the films during the curing process. Many studies have verified that transition metal carbides/nitrides (MXenes) can form a "labyrinth effect" in the polymeric coatings due to their "nano-barrier effect". Furthermore, based on their sheet-like structures, they can considerably cover the surface defects of the polymeric films. Therefore, the penetration of corrosive elements can be substantially curbed. It is the first review that specifically focused on the new family of 2D nanomaterials, i.e., MXenes, and discussed their applications in corrosion protection systems. The MXenes' pros and cons in the polymeric matrixes as nanofillers will be clarified. Moreover, the synthesis and functionalization methods of the MXenes, their applications, and corrosion protection mechanism will be explored. Subsequently, the MXenes' superiority over other 2D nanomaterials will be highlighted while their future perspectives and industrial applications will be predicted., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Lapse has been one of the major challenges in the treatment of drug dependence sometimes leading to its relapse., Objectives: The aim of this study was to determine the lapse rate in drug dependent patients as for the 2 methods of methadone maintenance treatment (MMT) and buprenorphine maintenance treatment (BMT) in Yazd city., Methods: In this cross-sectional study, 626 female and male patients who had referred to 5 SUD treatment centers in Yazd and had been treated with methadone and buprenorphine maintenance were studied. Participants were divided into 2 groups of MMT and BMT and were evaluated based on lapse within 6 months., Results: In this study, 60.9% of patients were treated with methadone but the rest were treated with buprenorphine. Overall, 33.1% of patients lapsed (35.2% for methadone and 29.8%for buprenorphine). Lapse in methadone treatment was correlated with age, occupational status, and duration of treatment ( P  < .05); it failed to correlated with any other demographic and clinical characteristics ( P  > .05). Lapse rate in buprenorphine treatment was also related to marital status and the drug used ( P  < .05). The mean dose of buprenorphine consumed showed no significant relationship with lapse ( P  > .05). The results demonstrated that given the low dose, lapse stood higher in the buprenorphine group than the methadone group; however, as to high dose, the buprenorphine group showed lower lapse than the other group., Conclusions: In regard with the high rate of lapse, it is recommended to consider the factors related to the 2 methods of treatments, and provide counseling and training programs to lower lapse in the patients. Ethics Committee (REC) approval code: IR.SSU.REC.1394.158., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran., Method: The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged >  = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve., Results: The mean age of participants was 49.38(SD =  ± 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN., Conclusion: The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers., (© 2022. The Author(s).)

Background: Burn is one of the most significant injuries in industrial and developing societies and is one of the most important traumas leading to hospitalization. The aim of this study was to identify the epidemiology, geographical distribution, and outcome of electric burns in Fars province and to present the distribution map., Methods: In this descriptive-analytical study, the study population involved all electrical burn victims admitted to Amir al-Momenin and Ghotbeddin Hospitals from 2008 to 2019 in Fars province in the south of Iran. Data were analyzed using SPSS software version 22., Results: Among a total of 246 patients, the average age was 30.78 ± 11.07. The highest frequency among educational levels was among under-diploma patients (38.6%), and the majority were employed (87.4%). Also, most of the patients were from urban areas (70.3%). The majority of burn incidences occurred at the workplace (57.7%). Also, among the high voltage patients, 25 patients (30.9%) had an amputation, while among low voltage only 12 patients (16.2%) had an amputation. Non-surgical treatment was applied in 68 (28%) cases, while Escharotomy was performed in 28 (11.4%) patients. There was also a statistically significant association between burn voltage and amputation (P= 0.039)., Conclusion: Based on our report, the rate of electrical burn injuries in Iran is still high, which underlines the need for stronger efforts in effective prevention, such as better public education and the establishment of strict regulations regarding the distribution and use of electricity., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: Chronic kidney disease (CKD) is one of the major global causes of mortality, described as the most neglected chronic disease. This study aimed to determine the prevalence and determinants of CKD in the setting of the Shahedieh cohort study in Yazd, Iran., Methods: This cross-sectional study was conducted on adults in the baseline phase of the Shahedieh cohort study in Yazd, Iran. In this study, 9781 participants aged 30-73-year-old were investigated. The data used in this study included demographic and clinical variables and blood samples. Adjusted odds ratios were employed using multivariate logistic regression; meanwhile, population attributable risks for CKD were calculated and reported., Results: CKD prevalence was 27.5% (95%CI: 26.57-28.34) in all participants, 24% in male, and 30.3% in female. The results of multivariate logistic regression analysis identified age (OR = 1.89, 95%CI:1.082-1.96), women (OR = 1.62, 95%CI: 1.45-1.79), BMI ≥ 30 (OR = 1.40,95%CI: 1.20-1.62), diabetes (OR = 1.38, 95%CI: 1.22-1.57), hypertriglyceridemia(OR = 1.20, 95%CI: 1.01-1.43), history of cardiovascular disease (OR = 1.20, 95%CI: 1.01-1.43), hypertension (OR = 1.18, 95%CI: 1.04-1.33), smoking (OR = 1.17, 95% CI: 1.02-1.33), LDL ≥ 130 (OR = 1.15, 95%CI: 1.01-1.31), history of kidney stone (OR = 1.14, 95%CI: 1.01-1.32) and hypercholesterolemia (OR = 1.14, 95%CI: 1.01-1.32) as risk factors for CKD. Among individual factors, obesity (11.25%), Hypertriglyceridemia (9.21%), LDL ≥ 130 (7.12%) had the greatest Population-Attributable Fraction, followed by Hypercholesterolemia (5.2%), diabetes (5.05%), smoking (3.73%) and high blood pressure (2.82%)., Conclusion: The results showed that the main determinants of CKD are potentially modifiable risk factors. Therefore, implementing early detection and screening programs in people at risk as well as preventive measures such as lifestyle modification programs and risk factors controlling can prevent the disease., (© 2022. The Author(s).)

Due to its high prevalence and fatality, the current Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) virus, which first emerged in China in 2019, quickly spread around the world and immediately became a serious global health concern. Although respiratory issues were initially the most prominent symptom of coronavirus disease 2019 (COVID-19), it became obvious rapidly that COVID-19, like many other coronavirus family members, could affect the central nervous system (CNS). During the pandemic, CNS involvement expressed itself in a variety of forms, including insomnia, anosmia, headaches, encephalopathies, encephalitis, cerebrovascular accidents, cognitive and memory impairment, and increased psychiatric disorders. Almost everyone who has been infected has at least one of these neurological symptoms, demonstrating that the virus has a high ability to impact the CNS. As the coronavirus pandemic passes its second year, the manifestations it can cause in the long run, such as its psychological sequels, have not yet been thoroughly studied. Given the high importance of this issue in today's society and due to the lack of reliable knowledge about the COVID-19 landscape on psychiatric disorders, we intend to investigate coronavirus's possible effect on mental illnesses based on available literature. Because the majority of the psychological effects of the coronavirus can continue for a long period after the pandemic ends, our research can give insight into potential psychiatric sequels associated with COVID-19., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Relapsing-remitting MS (RRMS) is characterised by the patients' experience of periods of exacerbation in symptoms. The fear associated with the relapse influence the quality of life in patients and their relationship with bodily experiences. Previous studies suggested that health anxiety (HA) contributes to fear of relapse but have not investigated cognitive mechanisms involved in developing and maintaining the fear of relapse in patients and we were interested to test this relationship. We used the online interpretation paradigm to investigate biased interpretation of ambiguous bodily information and its relationship to HA among patients and healthy controls (65 subjects in each group). Patients had higher levels of HA than controls. Patients also interpreted ambiguous bodily information more negatively than controls. There was a significant positive correlation between HA and negative interpretation of information in the whole sample. Among patients, HA mediated the relationship between interpretation bias and fear of relapse. Findings of this study suggest that negative interpretation bias can contribute to higher HA which in turn contributed to more fear of relapse among patients with RRMS. These findings have important implications for improving the quality of life in patients suffering from MS., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Air pollution exposure is a public health emergency, which attributes globally to an estimated seven million deaths on a yearly basis We are all exposed to air pollutants, varying from ambient air pollution hanging over cities to dust inside the home. It is a mixture of airborne particulate matter and gases that can be subdivided into three categories based on particle diameter. The smallest category called PM 0.1 is the most abundant. A fraction of the particles included in this category might enter the blood stream spreading to other parts of the body. As air pollutants can enter the body via the lungs and gut, growing evidence links its exposure to gastrointestinal and respiratory impairments and diseases, like asthma, rhinitis, respiratory tract infections, Crohn's disease, ulcerative colitis, and abdominal pain. It has become evident that there exists a crosstalk between the respiratory and gastrointestinal tracts, commonly referred to as the gut-lung axis. Via microbial secretions, metabolites, immune mediators and lipid profiles, these two separate organ systems can influence each other. Well-known immunomodulators and gut health stimulators are probiotics, prebiotics, together called synbiotics. They might combat air pollution-induced systemic inflammation and oxidative stress by optimizing the microbiota composition and microbial metabolites, thereby stimulating anti-inflammatory pathways and strengthening mucosal and epithelial barriers. Although clinical studies investigating the role of probiotics, prebiotics, and synbiotics in an air pollution setting are lacking, these interventions show promising health promoting effects by affecting the gastrointestinal- and respiratory tract. This review summarizes the current data on how air pollution can affect the gut-lung axis and might impact gut and lung health. It will further elaborate on the potential role of probiotics, prebiotics and synbiotics on the gut-lung axis, and gut and lung health., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In low-salinity water flooding (LSWF), modifying the injected brine composition leads to greater oil recovery from carbonate reservoirs. The processes that control improved recovery during LSWF are not totally clear, which could lead to ambiguities in finding optimum brine composition regarding wettability alteration (WA) toward water wetness. One of the methods to determine WA is bound product sum (BPS) calculation using geochemical tools. In the case of wettability improvement, the BPS value of a crude oil-brine-rock (COBR) system should be at its minimum value. In this study, an improved geochemical model is developed, which includes the effects of oil composition (i.e., acid number, base number, and weight percent of nonhydrocarbon components) and physical properties of oil (i.e., density, viscosity, and solution gas-oil ratio) on COBR interactions. The proposed method generates BPS as a function of temperature, pressure, oil and brine composition, and pH for carbonate rocks. The model applicability was validated using several experimental data sets available in the literature. The results of the improved BPS model were in line with the results of contact angle and zeta potential measurements as the major indices of rock wettability. BPS calculations using the available geochemical tools sometimes failed to predict the correct WA trend since they overlooked the impact of oil properties on COBR interactions. The model predictability was also compared with the results of an available geochemical tool, PHREEQC, and the results demonstrate just how important the effect of oil properties and composition inclusion on wettability determination is. The improved BPS approach could be successfully utilized as an optimization tool to optimize the water composition during LSWF for a given COBR system., (© 2022. The Author(s).)

Background: One of the global problems is to control the coronavirus epidemic, and the role of different medicines is still unknown to policymakers. This study was conducted to evaluate the effects of losartan on the mortality rate of COVID-19 in hypertensive patients., Methods: The research sample of analytical study included 1458 patients presenting to COVID-19 diagnostic centers in Yazd that were examined in the first six months of 2020. Data were analyzed using descriptive statistics as well as chi-square, Fisher's exact test, t test, and logistic regression., Results: Of 1458 subjects that were studied, 280 were hypertensive of whom 179 tested positive for SARS-CoV-2 PCR. The results showed a lower chance of death by more than 5 times in hypertensive patients who used losartan (P = 0.003). Moreover, regarding the effect of losartan on the prevention of COVID-19 in hypertensive patients, it was found that this medicine played a protective role although this relationship was not statistically significant (P = 0.86)., Conclusions: The results showed that losartan reduced the chance of mortality in hypertensive patients. It is recommended that the effect of losartan and other blood pressure medicines on COVID-19 patients be investigated in larger studies as well as laboratory investigations., (© 2022. The Author(s).)

Background: Burns are among the most common causes of injury and result in long-term morbidity, psychological complications, and reduced quality of life. We aimed to evaluate and compare the results of skin grafting versus nonsurgical treatment in patients with deep second-degree burn wounds of the back and posterior trunk., Methods: This is a descriptive-analytical cross-sectional study of patients with trunk and buttock burns admitted to Burn Hospital in Shiraz, Iran from 2017 to 2019. The skin surface with burns and the final repaired tissue was measured. The Vancouver Scar Score (VSS) and pigmentation, vascularity, thickness, and pliability were assessed. VSS, pigmentation, vascularity, thickness and pliability were considered as outcomes., Results: Seventy-five patients met the criteria for participation; thirty-two patients had skin grafts. The mean age was 27.79±20.03 yr and 53 patients (70.7%) were male. Scars were compared based on pigmentation, vascularity, thickness, and pliability, which was also statistically significant ( P <0.001). The mean of VSS was higher in patients with skin graft than those without graft ( P <0.001)., Conclusion: The mean VSS was significantly higher in patients with grade 2 deep burns who received skin grafting than in patients without skin grafting. Due to the lack of donor sites and the need to prioritize skin grafts in burn patients with high total body surface area, it is better to perform skin grafts on the posterior trunk and buttocks in areas with deep grade 2 burns as a last priority and treat this wound with conservative therapy., Competing Interests: The authors declare that there is no conflict of interests.

The present study was conducted to investigate the effect of job stress management training on observance of professional ethics by nurses. This quasi-experimental study was performed on 50 clinical nurses in Shiraz, Iran. Data collection tools included a questionnaire. The research intervention consisted of six two-hour sessions of stress management training. SPSS 21 were used to analyze the data. Data analysis showed that before intervention, the level of professional ethics of 64% of nurses was relatively good, but after intervention, the level of professional ethics of the majority of nurses (94%) was at the desired level. The results showed that the levels of professional ethics after job stress management training has increased significantly compared to before. The results showed that stress management training has led to improving the level of professional ethics of nurses.

Hypothesis: Silane (sol-gel)-based coatings have been introduced as an eco-friendly system for reducing the metals' corrosion in NaCl solutions. However, due to the lack of active protection property for this type of coatings, their modification is totally recommended for achieving durable protection properties. The present study introduces Beta-cyclodextrin (β-CD) as a novel/effective organic nano-container for Benzimidazole (BM) encapsulation to obtain reliable active protection property via a controlled-release property., Experiments: The chemical structure of the β-CD-BM macromolecule was explored by Fourier-transform infrared spectroscopy (FT-IR), X-Ray diffraction (XRD), and Ultraviolet-visible spectroscopy (UV-Vis). Besides, the Electrochemical Impedance Spectroscopy (EIS) and polarization (potentiodynamic) tests were carried out for investigating the inhibition impacts of the constructed containers. The exposed and unexposed samples' surfaces were analyzed by Field Emission Scanning Electron Microscope (FE-SEM), Energy Dispersive Spectroscopy (EDS)/mapping, and Grazing incidence X-ray diffraction (GIXRD) experiments. Also, the EIS test was conducted over the Silane-based composite film (SCF) for analyzing the anti-corrosion performance of the constructed composites., Findings: The EIS achievements demonstrated that by the addition of β-CD-BM complexes to the saline solution, the mild steel corrosion was mitigated by about 84%. The EIS results also displayed that the total resistance of the modified composite was enhanced from 5540 Ω.cm 2 to 10967 Ω.cm 2 and the intact coating provided a total resistance of 80254 Ω.cm 2 . The dispersion-corrected Density Functional Theory (DFT)-D explorations ascertained the inclusion capacity of benzimidazole inside the β-CD. The Monte Carlo/Molecular Dynamics (MC/MD) calculations strongly affirmed the adsorption of BM and β-CD-BM over the substrate., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Patients with multiple sclerosis face numerous problems during their lifetime. A self-report measurement of disease - specific problems is required to be developed for patients with multiple sclerosis based on different cultural factors. Accordingly, this can advance our understanding on the disease-specific problems for care planning as well as improving coping ways and quality of life. This study aimed to develop and validate the scale of disease-specific problems of Multiple Sclerosis., Methods: This was an exploratory sequential mixed method study conducted in three phases. Correspondingly, in the first phase, the concept of disease-specific problems was defined using the content analysis approach in patients with MS. In the second phase, the item pool was generated from the findings of the first phase, and in the third phase, psychometric properties of the scale, including face, content, and construct validity and reliability, were evaluated., Results: After examining both validity and reliability, 28 items were developed in the final questionnaire. As well, by performing the factor analysis, five factors were revealed as follows: physical problems, psychological problems, emotional problems, family problems, and socio-economic problems. Internal consistency and stability of the questionnaire were calculated as 0.82 and 0.90, respectively, indicating an excellent reliability., Conclusion: The 28-item questionnaire is valid and reliable for measurement of level of disease - specific problems in Iranian people with MS., (© 2021. The Author(s).)

Objective: To investigate the prevalence of chemical burns among the patients admitted to Shiraz burn treatment centers., Methods: It is a descriptive study that was conducted on 62 patients with chemical burns who were admitted between 2008 and 2018. The patients' records were used in the research using the census sampling process. A questionnaire with questions about age, sex, the extent of the burn, the cause of the burn, duration of hospital stay, level of education, incident location, and clinical outcome was used to collect data (survival-death). The data was analyzed by using descriptive statistical methods., Results: The prevalence of chemical burns was 1% during 2008-2018. Acid and alkali burns were accounted for 93.5% and 6.5% of burns, respectively. 77.4% of patients were male, and 22.6% were female. The mean age of patients was 27 years. The average burn percentage was 16%. 70.6% of patients were illiterate or had primary education. Burns occurred at the workplace and home in 12.9% and 66.1% of cases, respectively. Moreover, Burns occurred due to accident (61%), acid attack (29%), and self-immolation (10%). The average length of hospital stay was 20 days. One patient (1.6%) died from burns., Conclusion: The study's findings revealed that chemical burns were more common in men than women, and the majority of chemical burns occurred at home. To minimize the occurrence of chemical burns and acid attacks, teaching methods of preventing burns is important at home and work, as well as restricting non-specialists' access to chemicals., Competing Interests: None declared.

This study aimed to investigate the effect of exposure to pesticides and the prevalence of type 2 diabetes (T2D). In a cross-sectional study with a population of 9088, the data were collected through Persian Adult Cohort Questionnaire in Shahedieh area of Yazd, Iran. Based on the results, variables such as age, gender, body mass index, physical activity, and education level in the studied population had a significant association with the prevalence of diabetes. Although the obtained data in this study did not show a relationship between exposure to pesticides and the risk of developing T2D, further prospective studies are needed to determine the association between exposure to pesticides and the development of T2D., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Amniocentesis is one of the methods for diagnosing prenatal abnormalities. Pregnant women with high-risk fetal screening results are the candidates for amniocentesis. Most of these women are afraid of this procedure because they predict that the test will be painful and worried about its adverse effects on pregnancy, fetal injury, or the risk of maternal death. Therefore, the aim of this study was to determine the effect of education on the perceived stress of mothers who are the candidates for amniocentesis., Materials and Methods: The present study was a quasi-experimental, two-group clinical trial with a parallel design. This study was in three stages: pretest (before intervention), posttest (after intervention), and after amniocentesis. This study was performed on 80 pregnant women who were the candidates for amniocentesis (15-20 weeks of pregnancy) with high-risk fetal screening results referred to the perinatology clinic in Yazd in 2020. The intervention package included training and using breathing techniques, broadcasting educational animations on how to perform amniocentesis, expressing experiences by people who had experienced amniocentesis, and finally visiting the amniocentesis site and getting to know the relevant perinatologist. Data collection tools were demographic and midwifery profile questionnaires and Cohen perceived stress. SPSS software version 16 was used for statistical analysis of data., Results: The results showed that the research units had high stress at the beginning of the study. The perceived stress score at the beginning of the study in the intervention group was 30.1750 ± 6.53153 and in the control group was 28.2750 ± 8.57841. After the intervention, the participants' stress level decreased below the cutting point. In the experimental group, the mean stresses after the intervention and after amniocentesis were significantly lower than before the intervention; however, after amniocentesis, it was somewhat higher than the postintervention stage. In the preintervention stage, the mean stress score between the two groups was not statistically significant. The difference after the intervention between the two groups was significant ( P < 001.0); however, in the postamniocentesis stage, the difference in stress was not significant. After the intervention and after amniocentesis, the perceived stress of pregnant mothers in the experimental group was less than the control group., Conclusion: Considering that the perceived stress in amniocentesis candidate mothers was high in the present study, so that after performing the method, mothers left the center with high stress, it is very important to pay attention to its psychological aspects. Therefore, it is suggested that educational interventions before and during amniocentesis be considered for them along with psychological support and follow-up care after amniocentesis., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Background: Quality of relationship marital status affects all aspects of family functioning, including sustainability of cohabit living, supporting children, and happiness of couples. This study was conducted to examine the effect of group cognitive-behavioral counseling on optimism and self-esteem of women during the 1 st month of marriage that referring to marriage counseling center., Materials and Methods: A semi-experimental study was designed by a test, posttest, and follow-up. Participants consisted of 30 women admitted to premarriage counseling center of Farsan city in 2018 with using purposive sampling by random numbers' table into experimental and control groups. The experimental group participated in eight consecutive 2-h group counseling sessions. Data collection tools were demographic questionnaire, Rosenberg's Self-Esteem Scale, and optimism designed by Mir Ahmadi (reliability and validity are calculated and was 0.96) and completed in three rounds. Women's self-esteem retested was done after 1 month. Data were analyzed with independent t -test and repeated measures ANOVA (significance level <0.005). Quantitative variables were analyzed using the Kolmogorov-Smirnov test., Results: There were no significant differences between optimism scores in the experimental (M = 150.47, standard deviation [SD] = 22.07) and control groups (M = 149.2, SD = 21.54) prior to intervention ( P = 0.875). The mean optimism score was significantly different in intervention (M = 169.33, SD = 17.01) and control (M = 147.2, SD = 22.22) groups immediately after counseling ( P = 0.005) and 1 month after counseling ( P = 0.002, M = 171.08, SD = 17.98). The mean self-esteem scores were statistically significant in both groups immediately after counseling ( P = 0.023, I: M = 37.06, SD = 8.69, C: M = 31.4, SD = 4.83) and 1 month after counseling ( P = 0.028, I: M = 34.73, SD = 4.93, C: M = 30.06, SD = 4.8)., Conclusion: Cognitive-behavioral counseling enhances women's optimism by emphasizing the training of communication and conflict resolution skills, which leads to positive attitude and life satisfaction. Therefore, using cognitive-behavioral counseling in marriage counseling sessions can improve couples' relationships., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Background: Pregnant women are classified as one of the vulnerable groups. Physiological and psychological changes during pregnancy predispose them to serious psychiatric disorders; if not identified and treated in time, it can have a negative and long-term impact on mental health. The aim of this study was to determine the effect of cognitive-behavioral counseling of pregnant women with the presence of a spouse on the level of stress, anxiety, and postpartum depression., Materials and Methods: The present study is a clinical trial that was performed on 40 pregnant women with a gestational age of 32-28 weeks (20 in the intervention group, 20 in the control group) who were randomly assigned to the intervention group and the control group according to the inclusion criteria. Cognitive-behavioral group counseling in the presence of spouses was performed by the midwife and under the supervision of a psychologist, in eight sessions, each session lasting 90 min, once a week for the intervention group. The control group received routine care and a counseling session. Data collection tools were demographic information questionnaire and Depression-Anxiety-Stress Scale 21, which were completed before the intervention, immediately after the intervention, and on the 14 th day after delivery in both groups. Data analysis was performed using statistical tests, independent t -test, repeated measures test, Bonferroni post hoc test, and Kolmogorov-Smirnov test., Results: The results of this study showed that the mean scores of stress, anxiety, and depression in the two groups in the preintervention stage were not significantly different ( P < 0.05), but in the postintervention stage and follow-up, the mean scores of stress ( P < 0.001), depression ( P = 0.010), and anxiety ( P = 0.029) in the intervention group were significantly reduced compared to the control group., Conclusion: According to the research findings, cognitive-behavioral group counseling can be effective as an approach in improving the symptoms of stress, anxiety, and depression in pregnant women. Therefore, it is necessary to plan properly to use this counseling approach to manage stress, anxiety, and depression in women during pregnancy., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Introduction: Health literacy is one of the effective factors in health promotion of chronic patients. However, little attention has been paid to it; no exact and clear definition of health literacy has ever been accessible in chronic diseases. This study was conducted with aim of defining and clarifying attributes, antecedents, and consequences of health literacy in multiple sclerosis (MS) patients. Methods: Rodgers' evolutionary method of concept analysis was used to clarify the concept of health literacy in MS patients. A literature review was conducted with key terms "multiple sclerosis", "health literacy", "information literacy", "functional health", "health education", "health promotion" and "health behavior". Eight hundred and sixty papers for the period 1980- 2019 were found and finally 23 articles and texts were selected for the analysis. Data analysis was carried out using a thematic analysis. Results: Health literacy in MS patients is a multidimensional concept with forth attributes: health information evaluation, understand disease and its related issues, reading skills and capacity to use knowledge. Ability to read and comprehend, interacting with health personnel, and interacting with peers as an antecedents and improved self-care, health promotion, medication adherence, and decreased use of health care services to be the consequences of these attributes were found. Conclusion: The findings can add knowledge about the concept of health literacy in MS patients. Also, health care professionals can use a deeper understanding of the concept of health literacy in providing care plan for MS patients., (© 2021 The Author(s).)

Background: Pregnancy alone is associated with many anxieties and worries for many women. Prenatal diagnosis of fetal malformations is one of the most important anxious events for women. Increasing knowledge empowers the person to identify the important issues and by increasing understanding, creates a positive attitude in people. Therefore, the aim of this study was to investigate the effect of education on the level of anxiety of pregnant mothers before invasive screening for fetal abnormalities (amniocentesis)., Materials and Methods: This is a quasi-experimental study with two parallel designs in three stages: Pretest (before intervention), posttest (after intervention), and after amniocentesis. This study was performed on 80 pregnant women candidates for amniocentesis (40 pregnant women in the control group and 40 pregnant women in the intervention group) referred to the perinatology clinic in Yazd in 2020. Data collection tools were demographic and midwifery questionnaires and Spiel Berger anxiety questionnaires. In the experimental group, the intervention was performed as group training for 90 min immediately before amniocentesis. In the control group, only routine procedures (brief description by a perinatologist during amniocentesis) were performed. SPSS software version 16 was used to analyze the data., Results: The mean age of the research units was 67/5 ± 5/33 years. The results of Mann-Whitney intergroup test showed that the mean scores of overt anxiety before the intervention between the control and intervention groups were not significant ( P < 0.014) but were significant after training and after amniocenter ( P < 0.001). Furthermore, the results of Mann-Whitney group test showed that the mean scores of overt anxiety in the intervention group before and after training were significant ( P < 0.001). Furthermore, the results of the control group showed significant results ( P < 0.001). The results of the independent t -test showed that the mean scores of latent anxiety before the intervention between the control and intervention groups were not significant ( P < 0.194) but were significant after the training ( P < 0.57) but The results were not significant after amniocentesis ( P < 0.216). Furthermore, the results of paired t -test within the group showed that the mean scores of overt anxiety in the intervention group before and after training was significant ( P < 0.001). Furthermore, the results of the control group showed significant results ( P < 0.001)., Conclusion: The findings of the present study indicate the positive effect of education on anxiety of pregnant women candidates for amniocentesis. The results also show the important role of education on the psychological dimension of high-risk pregnant women in relation to the consequences of pregnancy and childbirth. According to the research results, it seems that education affects the cognitive system and information processing by increasing people's awareness of the amniocentesis process and its consequences., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Background: Patients with multiple sclerosis (MS) require health literacy to manage the symptoms and problems of the disease, which improves their quality of life. Health literacy is recognized as a critical indicator of health care outcomes. This study aimed to compare the effect of peer-led and lecture-based education on health literacy in MS patients., Methods: This quasi-experimental study was conducted on MS patients in Jahrom from December 2018 to November 2019. 90 patients were selected using convenience sampling and then assigned into control (n=45) and intervention groups (n=45). While routine education was presented to patients in the control group, peer education intervention was held for the intervention group. The number of sessions held for both groups was six sessions (one session per week). For data collection, MS health literacy questionnaire (MSHLQ) was used before and one month after the intervention in both groups. Data were analyzed through SPSS version 21 using Chi-square, Fisher's exact test and t-test. The significance level was considered P<0.05., Results: Paired t-test showed that there was a significant difference between the mean of health literacy in the intervention group before and after the intervention (P=0.001), while this difference was not observed in the control group (P=0.39). Independent t-test showed a significant difference in the mean of health literacy between the intervention and control groups after the intervention (P=0.001)., Conclusion: The results showed that peer group experiences were more effective than lecture-based education in improving health literacy. It can be beneficial to employ as an educative-supportive approach in MS patients., (Copyright: © International Journal of Community Based Nursing and Midwifery.)