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Considering menstruation as a crucial factor in females' health and fertility, any factor that could change its cycle is important. This study was conducted from April 2021 to October 2022 on females who got 3 doses of vaccines against SARS‐CoV‐2 through different platforms. The participants were requested to provide the trained experts with any changes regarding menstrual cycles after each dose of the vaccine up to 6 months after the booster shots. The disturbances related to the vaccines were identified by the adverse events committee to find possible associations with the applied vaccines. Of 308 women who participated until the end of the study, 22 (7.1%) complained about at least one abnormality in their menstrual patterns. The most common disturbance was metrorrhagia as 10 (48%) incidences followed by menorrhagia as 6 events (24.2%). Notably, the identified complaints were persistent in 59% of the patients. In addition, 14 studied cases developed COVID‐19 infection after menstrual disorders. In these cases, COVID‐19 could also play a role in the persistence of postvaccine menstrual disturbances. COVID‐19 vaccination could affect menstrual cycle in women with no remarkable previous medical history. More longitudinal studies are required regarding this issue. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Dental caries are among the most common oral and dental diseases affecting adults and children. To prevent caries, either the factors that cause caries should be reduced or the host resistance should be increased. Several compounds, such as bioglass, chitosan, and silver diamine fluoride (SDF), can enhance enamel remineralization. Purpose: This study was conducted to investigate the effects of chitosan, bioglass, chitosan-bioglass, and SDF compounds on remineralizing primary enamel lesions. Materials and Method: In this in vitro study, seventy-two primary canine teeth were collected. The teeth were exposed to a demineralization solution for 72 hours to create primary caries lesions. The primary Vickers microhardness test (VMT) was conducted to measure the initial values. The samples were randomly divided into six groups (n=12): Group 1: bioglass-chitosan solution; Group 2: chitosan; Group 3: bioglass solution; Group 4: SDF; Group 5: remineralization solution; Group 6: distilled water. The solutions of Groups 1, 2, and 3 were applied to the samples for 7 days, while the SDF solution was applied only once. The samples were immersed in an artificial saliva solution, which was refreshed daily. After the treatment, the final Vickers microhardness test (VMT) values were recorded. The data were analyzed statistically using a two-way ANOVA and Tukey's test (p< 0.05). Results: The results indicated a statistically significant effect of remineralizing compounds on both pre-treatment and post-treatment microhardness (p< 0.0001). However, no significant difference in microhardness was observed between the groups studied (p= 0.225). Conclusion: All the compounds utilized in this study demonstrated a significant remineralizing effect on enamel lesions caused by primary caries in primary teeth. The chitosan-bioglass and bioglass groups exhibited the highest levels of remineralization, respectively. However, the comparison between the groups yielded insignificant results due to the dispersion of the samples. Therefore, further studies with larger sample sizes are recommended. [ABSTRACT FROM AUTHOR]

Background: The existence of various ethical challenges, the inability to resolve ethical conflicts, and, as a result, the low quality of care and the occurrence of dissatisfaction in patients and nurses have been discussed for years. By creating new ethical challenges, the Covid-19pandemic has played an important role in making the process of care for these patients more difficult and complicated. This study was conducted with the aim of designing a prescriptive model to help provide ethical-care and resolve ethical conflicts during the Covid-19pandemic. Methods: In this two-stage qualitative study, a grounded theory research method was used in the first stage, and data were collected through semi-structured interviews. Sampling started purposefully and continued theoretically. In the second step, the appropriate model was designed using the three-step method proposed by Walker and Avant. Results: The core concept was "behavior based on faith in God", based on which the grounded theory of "faithful nursing" and then "model of solving ethical challenges with nursing based on faith in God" were presented. The strategies of the model in three parts are strengthening the beliefs of nurse, strengthening environmental facilitators to help nurse, and strengthening situational analysis in duty diagnosis in nurse were presented. Conclusions: According to this model, nurses' beliefs play a key role, and the strengthening of environmental factors play a secondary role in ethical-care. [ABSTRACT FROM AUTHOR]

Background. Patients with β‐thalassemia major depend on lifelong transfusion, resulting in tissue iron overload. This longitudinal retrospective observational study aims to assess myocardial and liver iron overload using magnetic resonance imaging (MRI) and investigate the lag between myocardial and liver iron unloading in β‐thalassemia patients undergoing chelation therapy. Methods. Beta‐thalassemia major patients with at least two MRI studies between 2016 and 2020 were enrolled. Myocardial and liver iron overload were defined as T2∗ less than 20 and 2.1, respectively. Outcomes included mortality, myocardial and liver T2∗ changes, and systolic dysfunction assessed by cardiac MRI. Results. Fifty‐five patients with a mean age of 24.62 ± 7.94 years, a mean follow‐up duration of 24.3 ± 12.9 months, and a mean ferritin level of 1475.75 ± 771.12 ng/mL were enrolled. All of the abovementioned patients only took deferoxamine as the iron‐chelating medication. Mortality occurred in three patients (5.5%) during follow‐up. Liver T2∗ significantly increased (p value <0.05), while myocardial T2∗ showed a nonsignificant increase. Iron unloading of the myocardium was not significantly different from that of the liver and did not result in a significant lag (56% vs. 44%; p value = 0.419). Baseline myocardial T2∗ correlated with extramedullary hematopoiesis, weekly number of deferoxamine injections (p value <0.01), timing between the transfusions, and serum ferritin (p value <0.05). Conclusion. Liver T2∗ reduced during deferoxamine chelation therapy, while myocardial T2∗ remained unchanged. No significant lag was observed between myocardial and liver iron unloading. Further studies are required to elucidate these findings. [ABSTRACT FROM AUTHOR]

Background: The prevalence of kidney stones reduces the patients' quality of life and imposes high costs on patients and health care system. Extracorporeal shock wave lithotripsy is a safe procedure to treat urinary stones. Appropriate strategies such as self-care programs can effectively reduce the prevalence and recurrence of this disease, and increase quality of life, save costs, and prevent diseases by increasing patient participation. The aim of this study is to design and implement a web-based self-care application for patients with kidney stones undergoing extracorporeal shock wave lithotripsy. Methods: This paper is an applied study and was performed in Sabalan Hospital in Ardabil affiliated to the Social Security Organization of Iran in three stages including needs assessment, design and evaluation. For needs assessment and application design, a questionnaire was designed by searching library resources. The questionnaire was completed by clinical specialists and specialists in health information management and information technology. Then, based on the approved information elements and capabilities, a web-based self-care application was designed. The usability of the designed program was evaluated with the participation of 20 users. Results: The results of the survey showed that the experts confirmed all the identified items and components, and considered them necessary. Users rated the usability of the self-care program at a good level with an average score of 7.9 out of 9. Conclusion: The usability ofthe self-care application was satisfactory to users in various areas of overall application performance, screen, terminology and information, learning and general impressions. [ABSTRACT FROM AUTHOR]

Cervical cancer has a significant impact on the lives of caregivers of cervical cancer patients, including male partners. Disturbances in physical, psychological, sexual, spiritual, and socioeconomical aspects of life are reported by male partners of cervical cancer patients. To reduce the impact associated with cervical cancer, adaptive coping mechanisms are needed. In this regard, little is known about the coping mechanisms used by male partners of women diagnosed with cervical cancer in sub-Saharan African countries. Therefore, this study aimed to explore the coping mechanisms used by male partners of women diagnosed with cervical cancer at the Ocean Road Cancer Institute in Dar es Salaam, Tanzania. A descriptive cross-sectional study design with a qualitative approach was employed to explore coping strategies used by male partners of cervical cancer patients between December 2022 and March 2023. Participants were selected using a purposeful sampling technique guided by the principles of saturation. In-depth interviews with thirteen male partners of cervical cancer patients were carried out, and the interviews were audio-recorded and transcribed verbatim. The data were then analyzed using a thematic analysis approach. Four themes highlighting coping mechanisms used by male partners of cervical patients were identified after data analysis. They include religious coping, emotional expression and regulation strategies, support-seeking strategies, and problem-solving strategies. Male partners of cervical cancer patients used various mechanisms to cope with the stressful situations they encountered. While most of the coping mechanisms used by male partners of cervical cancer patients were adaptive, some were maladaptive. Therefore, regular assessment among this population needs to be done to identify maladaptive coping and provide relevant support. [ABSTRACT FROM AUTHOR]

Background: Low-grade inflammation and stress oxidative condition play a role in the pathogenesis of obesity, and the serum levels of these markers, such as pro-oxidant-antioxidant balance (PAB), high-sensitivity C-reactive protein (hs-CRP), and uric acid may indicate obesity progression. In this study, we aimed to investigate the relationship between obesity with PAB, hs-CRP, and uric acid in the Iranian population. Methods: This study was derived from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study. A total of 7985 subjects aged 35 to 65 years were divided into three groups according to body mass index (BMI) as: normal, overweight and obese groups. Anthropometric indices and biochemical parameters such as PAB, superoxide dismutase type 1 (SOD1), hs-CRP, and uric acid were measured in all the participants. We evaluated the association of obesity with inflammatory factors by using multivariate regression analysis. Also, those participants with hypertension, an endocrine disorder, history of cardiovascular diseases and diabetes mellitus were excluded from the study. Results: There was a positive significant correlation between BMI and serum PAB, hs-CRP and uric acid (p < 0.001). While no statistically significant relation was observed between BMI and SOD1 (p = 0.85). Multivariate regression analysis showed that the risk of overweight and obesity increased 1.02 and 1.03-fold according to increase 10 units of PAB raise in comparison to reference group (normal weight) [(odds ratio (OR): 1.02, 95% CI (1.01–1.03)] and [OR: 1.03, 95% CI (1.01–1.04)], respectively). In addition, hs-CRP serum concentration was significantly associated with a high risk of obesity [(OR: 1.02; 95% CI (1.01–1.03)]. While the high levels of serum uric acid were associated with increased odds of overweight and obesity risk [OR: 1.4; CI (1.39–1.58) and OR: 1.76; CI (1.63–1.89), respectively]. Conclusions: Generally, we showed a significant association between BMI and serum PAB, hs-CRP values and uric acid levels, suggesting the role of these factors as risk stratification factors for obesity. [ABSTRACT FROM AUTHOR]

Background. There is no conclusive evidence on the association between interleukin- (IL-) 6 gene polymorphism and type 2 diabetes mellitus (type 2 DM). Thus, this study is aimed at evaluating the role of rs1800795 and rs1800796 polymorphisms in the pathogenesis of type 2 DM among Ghanaians in the Ho Municipality. Materials and Methods. We recruited into this hospital-based case-control study 174 patients with type 2 DM (75 DM alone and 99 with DM+HTN) and 149 healthy individuals between 2018 and 2020. Demographic, lifestyle, clinical, anthropometric, and haemodynamic variables were obtained. Fasting blood samples were collected for haematological, biochemical, and molecular analyses. Genomic DNA was extracted, amplified using Tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) technique, and genotyped for IL-6 gene polymorphism. Logistic regression analyses were performed to assess the association between IL-6 gene polymorphism and type 2 DM. Results. The minor allele frequency (MAF) of the rs1800795 and rs1800796 polymorphisms was higher in DM alone (57.5%, 62.0%) and DM with HTN groups (58.3%, 65.3%) than controls (33.1%, 20.0%). Carriers of the rs1800795GC genotype (aOR = 2.35 , 95% CI: 1.13-4.90, p = 0.022) and mutant C allele (aOR = 2.41 , 95% CI: 1.16-5.00, p = 0.019) as well as those who carried the rs1800796GC (aOR = 8.67 , 95% CI: 4.00-18.90, p < 0.001) and mutant C allele (aOR = 8.84 , 95% CI: 4.06-19.26, p = 0.001) had increased odds of type 2 DM. For both polymorphisms, carriers of the GC genotype had comparable levels of insulin, HOMA-IR, and fasting blood glucose (FBG) with those who carried the GG genotype. IL-6 levels were higher among carriers of the rs1800796GC variant compared to carriers of the rs1800796GG variant (p = 0.023). The rs1800796 polymorphism, dietary sugar intake, and exercise status, respectively, explained approximately 3% (p = 0.046), 3.2% (p = 0.038 , coefficient = 1.456), and 6.2% (p = 0.004 , coefficient = − 2.754) of the variability in IL-6 levels, suggesting weak effect sizes. Conclusion. The GC genotype and mutant C allele are risk genetic variants associated with type 2 DM in the Ghanaian population. The rs1800796 GC variant, dietary sugar intake, and exercise status appear to contribute significantly to the variations in circulating IL-6 levels but with weak effect sizes. [ABSTRACT FROM AUTHOR]

Background: Beta thalassemia major (β-TM) is an inherited blood disorder. Affected patients require frequent blood transfusions, leading to iron deposition and end organ damage, particularly myocardial dysfunction. A 12-lead ECG is a readily available tool that could be used to screen for conduction abnormalities and arrhythmias as a marker of worsening myocardial function. Methods: A total of 108 β-TM patients were evaluated for correlation between abnormal findings on the surface ECG and severity of myocardial iron deposition in magnetic resonance imaging as measured by T2* levels. Results: Patients with T2* below 20 msec had significantly longer PR intervals, P wave durations, and QTc intervals. Patients with T2* below 10 msec had the longest QRS duration and QRS activation times. Atrial fibrillation was more prevalent in patients with lower T2* levels. With a decrease in T2*, the probability of notching of QRS in the limb and precordial leads increased. Conclusion: Abnormal ECG is prevalent in β-TM patients, and the frequency of changes increases with the severity of iron overload. A 12-lead ECG is a valuable and readily available tool for the early assessment of myocardial damage and the implementation of a timely and appropriate management strategy. [ABSTRACT FROM AUTHOR]

Objective Adolescents with visual impairments have less opportunity to adapt emotionally to the environment and, as a result, experience more social and academic problems. One of the most critical needs of adolescence is maintaining emotional balance while confronting the stressful factors of puberty and environmental expectations. As visual impairment adversely influences adolescents' emotional maturity, helping teenagers adapt to challenging conditions is one of the main goals of a social and educational system. The purpose of the present study was to determine the effect of acceptance and commitment therapy (ACT) on the emotional maturity of female adolescents with visual impairment. Materials & Methods The current quasi-experimental study employed a pre-test and post-test and a follow-up design with a control group. A total of 82 females aged 14 to 18 from an educational community special for visually impaired individuals were assessed using the emotional maturity scale (EMS) in the academic year 2020-2021. Among the 33 volunteers who scored 180 and above in the EMS, 28 individuals were selected according to the inclusion criteria and matched based on their age and educational level via convenience sampling. All participants were randomly assigned to the experimental and control groups (14 individuals each). The experimental group attended 10 therapeutic sessions and received acceptance and commitment group therapy for two months (twice a week, 60 minutes per session). However, the control group only participated in the educational community's make-up empowering programs (including lessons curriculum plans and music training). All participants completed the EMS after the last intervention session and then 8 weeks later as a follow-up. The data were analyzed using the Shapiro-Wilk test, Levene test, M. Box test, multivariate analysis of covariance, and dependent t-test by SPSS software, version 22. Results The results of the Shapiro-Wilk test, Levene test, and M. Box test confirmed the normality of the distribution of scores, the homogeneity of variances, and the homogeneity of line slope, respectively. The results of multivariate analysis of covariance indicated that attendance of the experimental group in the acceptance and commitment group therapy sessions has led to a significant increase (P<0.05) in emotional maturity scores and its components: emotional stability, emotional progression, social adjustment, personality integration, and independence. Also, the ACT program changed the experimental group's emotional maturity and components as follows: 90%, 69%, 59%, 55%, 92%, and 68% for emotional stability, emotional progression, social adjustment, personality integration, and independence, respectively. In addition, the results of the dependent t-test to compare the emotional maturity of the experimental group in post-test and follow-up stages indicated that the effect of the group therapy has remained on emotional maturity and its areas even 8 weeks later (P<0.05). In addition, the results of the dependent t-test showed a significant difference between the emotional maturity of the experimental group in the post-test and follow-up stages. It means that the effect of group therapy has remained on emotional maturity and its components even 8 weeks later. Conclusion Since the acceptance and commitment group therapy has improved the emotional maturity and its components in adolescents with visual impairment, it seems that the ACT is important as a proper and complementary method in empowerment programs for adolescents. The ACT helps adolescents recognize, accept, and control negative feelings or thoughts by increasing their emotional maturity. Therefore, the ACT is a proper method for hindering the problems relating to emotional maturity and probably prevents the occurrence of future problems in adulthood. [ABSTRACT FROM AUTHOR]

Background and Study Aim Excessive physical activity poses a risk of injury, particularly when coupled with high exercise intensity. Factors such as Body Mass Index (BMI) and foot morphology may contribute to this risk. This study seeks to evaluate the relationship between BMI, foot shape, and the likelihood of injury among sports students. Material and Methods A total of 119 sports students, comprising 33 females and 86 males, participated in this study. Purposive sampling was employed to select participants. BMI was determined using height and weight measurements, while foot shape was assessed through footprint measurements. The Functional Movement Screening (FMS) instrument, encompassing 7 movements: Deep Squats, Hurdle Steps, Inline Lunges, Shoulder Mobility, Active Straight Leg Raises, Trunk Stability Pushups, and Rotary Stability, was utilized to assess injury risk. Data analysis was conducted using Microsoft Excel and IBM SPSS v.25.0, employing descriptive statistics. Results Based on data analysis, the FMS value in females shows a mean of 18.7 and a standard deviation of 1.21. At the same time, the FMS value in males shows 18.5 and a standard deviation of 1.41. BMI values in females showed a mean of 21.6 and a standard deviation of 3.03. At the same time, BMI values in males showed a mean of 22.9 and a standard deviation of 4.62. The results were that all FMS scores were ≥14. While of BMI measurements, some samples obtained <18 kg/m² and >30kg/ m². BMI measurements according to gender were mainly in the normal weight category. However, those who fall into the obesity category are primarily males. With the results of measuring the foot’s shape, the percentage of flat feet is only 0.84% in females and 7.59 in males, while the rest of the sample has a normal foot shape. Conclusions Individuals with a BMI in the overweight to obese category are more susceptible to high-category injuries, likely due to limited motion range. However, the study did not find evidence linking flat foot shape to high-category injury risk. This inability to establish a correlation may be attributed to the predominantly normal foot shape observed in the sample, resulting in a prediction of lowcategory injury risk. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Bond strength of furcation repair materials is an essential factor in clinical success. Studies on the effect of adding titanium dioxide (TiO2) nanoparticles on the push-out bond strength of commonly used endodontic cements for furcation perforation repair is limited. Purpose: This study aimed to evaluate the effect of adding TiO2 nanoparticles to white Portland cement (PC), white mineral trioxide aggregate (MTA), and calcium enriched mixture cement (CEM) on their push-out bond strengths. Materials and Method: In this in vitro study, 120 endodontically treated molars were assigned to six groups (n=20) based on the material used to repair the perforation. In three groups, the cements (white PC, white MTA, and CEM) were placed in pure form, and in the three remaining groups, 1 weight % of TiO2 was added. The push-out bond strength was measured using a universal testing machine at a strain rate of 0.5 mm/min. Data were analyzed using one-way ANOVA and post hoc Games-Howell test (p< 0.05). Results: One-way ANOVA showed significant differences in the mean bond strength values between the six groups (p= 0.002). The post hoc Games-Howell test showed that the bond strengths in MTA+TiO2 and PC+TiO2 groups were significantly higher than those in MTA and PC groups, respectively. However, there was no significant difference in the bond strength between CEM and CEM+ TiO2 groups. Conclusion: The incorporation of TiO2 into MTA and PC increased their push-out bond strength. However, it did not affect the push-out bond strength of CEM cement. [ABSTRACT FROM AUTHOR]

Background Producing therapeutic proteins can be done quickly and on a large scale through Transient Gene Expression (TGE). Chinese hamster ovary (CHO) cell lines are commonly used to achieve this. Although there are few comparative studies, TGE has been observed in suspension-adapted CHO cells. Objectives We tested TGE's effectiveness in DG-44, CHO-S, and ExpiCHO-S cell lines with four transfection reagents. Methods A design of experiments (DoE) was followed to optimize transfection using a recombinant monoclonal antibody (mAb) construct. To evaluate the efficacy, flow cytometry and ELISA were used. Feeding strategies and temperature shifts were implemented to enhance transfection effectiveness. The quality of the mAb was assessed through ELISA, SDS-PAGE, and proliferation inhibition assays. Results We adapted all cell lines to grow in suspension using a serum-free medium. Our findings from flow cytometry and ELISA tests indicate that PEI and Pmax reagents had a higher rate of transfection and mAb production than the ExpiCHO commercial transfection reagent. While DG-44 cells had better transfection efficiency than CHO-S and ExpiCHO-S, there was no significant difference between CHO-S and ExpiCHO-S. Our TGE system was more productive at 32 °C than at 37 °C. In the optimized TGE of Pmax-based transfection in DG-44 at 37 and 32 °C, the production level of mAb was more than half of the amount of the commercial ExpiCHO-S expression system. Still, the number of transfected cells was three times higher, making it more efficient. The purified mAb from all transfected cell lines had similar structural and functional properties under different conditions. Conclusion Our research shows that using Pmax and DG-44 cells in the TGE system is a cost-effective and efficient way to produce humanized monoclonal antibodies. We discovered that this method outperforms the ExpiCHO-S kit. [ABSTRACT FROM AUTHOR]

The aim of this study was to use latent profile analysis to identify specific profiles of burnout syndrome in combination with work engagement and to identify whether job satisfaction, psychological well-being, and other sociodemographic and work variables affect the probability of presenting a profile of burnout syndrome and low work enthusiasm. A total of 355 healthcare professionals completed the Spanish Burnout Inventory, the Utrecht Work Engagement Scale, the Job Satisfaction Scale, and the Psychological Well-Being Scale for Adults. Latent profile analysis identified four profiles: (1) burnout with high indolence (BwHIn); (2) burnout with low indolence (BwLIn); (3) high engagement, low burnout (HeLb); and (4) in the process of burning out (IPB). Multivariate logistic regression showed that a second job in a government healthcare institution; a shift other than the morning shift; being divorced, separated or widowed; and workload are predictors of burnout profiles with respect to the HeLb profile. These data are useful for designing intervention strategies according to the needs and characteristics of each type of burnout profile. [ABSTRACT FROM AUTHOR]

The Positive Mental Health Questionnaire (PMHQ) has been validated across various populations but has displayed diverse psychometric structures depending on the procedures used. The original version of the PMHQ includes 39 items organized into 6 factors, although there are reports that indicate a reduced structure of between 1 and 4 factors. The aim of this study was to assess the psychometric properties of the PMHQ with 1, 4 and 6 factors. A total of 360 healthcare workers aged 23 to 77 (M = 37.06; SD = 10.79) participated. Construct validity was assessed through confirmatory factor analysis using weighted root mean square residual. The original 6-factor (χ2/df: 3.40; RMSEA: 0.085; CFI: 0.913; TLI: 0.906) and a reduced 4-factor (χ2/df: 2.90; RMSEA: 0.072; CFI: 0.931; TLI: 0.926) structure showed acceptable fit. The fit of the 1-factor model was unacceptable. The internal consistency was evaluated through McDonald's ω, and it was acceptable for 4 of 6 factors of the original structure and for 3 of 4 factors of the reduced structure. In conclusion, these findings suggest that the 6-factor and 4-factor models are valid for measuring positive mental health. However, issues with internal consistency must be investigated. [ABSTRACT FROM AUTHOR]

Context: Chronic ankle instability is documented to be followed by a recurrence of giving away episodes due to impairments in mechanical support. The application of ankle Kinesiotaping (KT) as a therapeutic intervention has been increasingly raised among athletes and physiotherapists. Objectives: This study aimed to investigate the impacts of ankle KT on the lower-limb kinematics, kinetics, dynamic balance, and muscle activity of college athletes with chronic ankle instability. Design: A crossover study design. Participants: Twenty-eight college athletes with chronic ankle sprain (11 females and 17 males, 23.46 [2.65] y, 175.36 [11.49] cm, 70.12 [14.11] kg) participated in this study. Setting: The participants executed 3 single-leg drop landings under nontaped and ankle Kinesio-taped conditions. Ankle, knee, and hip kinematics, kinetics, and dynamic balance status and the lateral gastrocnemius, medial gastrocnemius, tibialis anterior, and peroneus longus muscle activity were recorded and analyzed. Results: The application of ankle KT decreased ankle joint range of motion (P =.039) and angular velocities (P =.044) in the sagittal plane, ground reaction force rate of loading (P =.019), and mediolateral time to stability (P =.035). The lateral gastrocnemius (0.002) and peroneus longus (0.046) activity amplitudes also experienced a significant decrease after initial ground contact when the participants' ankles were taped, while the application of ankle KT resulted in an increase in the peroneus longus (0.014) activity amplitudes before initial ground contact. Conclusions: Ankle lateral supports provided by KT potentially decreases mechanical stresses applied to the lower limbs, aids in dynamic balance, and lowers calf muscle energy consumption; therefore, it could be offered as a suitable supportive means for acute usage in athletes with chronic ankle instability. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effects of trauma-focused cognitive behavioral therapy (TF-CBT) among maltreated children, and to examine the role of potential moderators. Methods: A search of eight databases was conducted. Eighteen studies involving 11 randomized and quasi-randomized controlled trials with 965 maltreated children were included, and the effect sizes were pooled using random-effect models. Results: There were large effect sizes for posttraumatic growth and emotional management. Moderate to large effects were evident for PTSD and depression, while small effects were found for anxiety, internalizing behavior, sexualized behavior, and parenting practice. Effects were maintained at 3–12 months for some outcome domains. The effectiveness of TF-CBT was better when delivered to older children, and versions of TF-CBT, delivery format, sessions, and treatment length will not affect effectiveness. Conclusions: TF-CBT effectively reduces abuse-related symptoms and improves positive psychosocial outcomes among maltreated children. [ABSTRACT FROM AUTHOR]

Introduction: Nurses are responsible for providing primary care to millions of patients, and emergency nurses serve on the frontline in providing care for mildly to severely critically ill patients. Objectives: This study aims to assess and evaluate the clinical competence and its related factors among emergency nurses in Palestinian hospitals. Methods: A cross-sectional study was conducted among 170 nurses working in the emergency units of hospitals in the West Bank, Palestine. Data collection utilized the Nurse Competence Scale, and the Job Satisfaction Scale. Results: The results showed that only 33(19.4%) of the participants exhibited a good level of clinical competence, with none reaching the very good level. Among them, the highest proportion of good level 60 (35.3%) was in the helping role, while the lowest 38 (22.4%) was in ensuring quality. About 35% of nurses reported very low or low job satisfaction, while 58% had high or very high job satisfaction. Additionally, the results revealed a statistically significant relationship between clinical competence and job satisfaction (P < 0.05). Both clinical competence and job satisfaction were positively correlated with age and experience. Conclusion: The study found a significant relationship between demographic characteristics (e.g., education, experience, and marital status) and clinical competency among emergency nurses. Notably, less than half of the participants demonstrated good clinical competency, with none reaching a very good level. The highest scores were observed in the helping role domain, while the lowest were in the ensuring quality domain. Furthermore, clinical competence was found to be significantly associated with job satisfaction. Consequently, enhancing nurses' clinical competency will lead to an improvement in the quality of patient care. [ABSTRACT FROM AUTHOR]

Background: Neck pain is one of the most common musculoskeletal disorders among office workers. This study aimed to investigate the impact of strengthening the neck muscles on pain prevalence and neck disability among office workers. Materials & Methods: This interventional study was performed among 85 University office workers (female=50 and male=35). Participants were randomly divided into the two groups (exercise group=42 subjects and control group=43 subjects). The exercise intervention was performed for 12 weeks, five sessions per week, and each session lasted approximately 15 minutes in the experimental group. Evaluations were performed at baseline and after 12 weeks: demographic questionnaire, Nordic questionnaire for measuring neck pain prevalence, and Neck Disability Index (NDI) for measuring functional disability were applied. The neck pain prevalence and NDI were compared before and after the intervention using McNemar and paired t-tests. Results: 47.05% and 40% of all participants reported neck pain during the last 12 months and the last seven days, respectively. The neck pain prevalence during the last seven days (P<0.05) and NDI (P<0.01) after exercise were significantly decreased comparing to the other group. Conclusion: About half of the office workers suffer from neck pain, and exercise intervention can improve and reduce the prevalence of neck pain and NDI by strengthening neck muscles. [ABSTRACT FROM AUTHOR]

Background: During the Coronavirus disease 2019 (COVID-19) pandemic, there was always concern about damage to different organs of the body. In this study, we aimed to determine if coronavirus 2 (SARS-CoV-2) could influence the sperm parameters in inpatient adult men with COVID-19. Materials and Methods: In this prospective study during 2021, 22 patients with COVID-19 diagnosed with polymerase chain reaction (PCR) test and clinical symptoms and history of admission and 19 volunteer healthy men as the control group participated. They were asked to provide semen samples at 2 and 6 months after hospital discharge and the same time for the control group. The following parameters were measured in all semen samples and beside the demographic data, they compared between the two groups: volume (mL), sperm concentration (106/mL), total motile sperm percentage, progressive percentage, normal morphology percentage, and DNA fragmentation index (DFI). Results: The mean ± SD age of the participants in the COVID and control groups was 46.36 ± 9.94 and 45.84 ± 10.21 years, respectively (P=0.869). The mean ± SD body mass index (BMIs) of the participants in the COVID and control groups were 28.6 ± 5.460 and 29.6 ± 6.092, respectively (P=0.579). The mean ± SD number of children was 1.41 ± 1.054 in the COVID group and 1.47 ± 1.073 in the control group (P=0.847). All the sperm parameters were significantly impaired after 2 months in the COVID group in comparison with the control group (P<0.05). After 4 months from first sampling, all the parameters were improved significantly (except normal morphology) but had not yet reached the level of the control group. Conclusion: SARS-CoV-2 affected semen parameters in patients admitted because of COVID-19, in the short term. It is expected that this will improve with time. [ABSTRACT FROM AUTHOR]

Introduction: Food insecurity represents a public health issue that has been associated with poor birth outcomes. We describe the methodological steps followed to structure and validate a questionnaire, which has the potential to contribute to the planning and conduction of future studies investigating the possible association between maternal food insecurity and fetal structural anomalies. Methods: We first conducted a literature review to structure and validate the questionnaire. Subsequently, we drafted the questionnaire based on the results of this review, further refined through two focus groups. Afterward, the questionnaire was submitted using the Delphi Method to a panel of experts for validation. We conducted a pilot study prior to recruiting the final sample. Results: The questionnaire consisted of sections covering information about socio-demographic characteristics, women's health and lifestyle, pregnancy, and food security status. After the first Delphi round, the Content Validity Index (CVI) for each section ranged 0.81–0.85, while after the second round all items had a CVI of 1. The final version of the questionnaire, consisting of 87 items, was pilot tested among 20 participants. Cronbach's Alpha for each section resulted in values higher than 0.6. The response rate ranged from 78 to 100%. A situation of food security was present in 85% of the participants, while 5% were in a situation of mild food insecurity and 10% of moderate food insecurity. Conclusion: The questionnaire has appropriate measurement properties, and is an adequate instrument to evaluate the association between maternal food insecurity and fetal structural anomalies. Significance: What is already known? Food insecurity in pregnant women is a public health concern, since it affects both the woman and her child. This condition leads to poor health outcomes, such as gestational hypertension, preeclampsia, gestational diabetes, and anemia for the woman, and low birth weight, shorter gestational age, and chronic diseases in adulthood for the child. However, to date, few studies have investigated the potential association between food insecurity in women during pregnancy and fetal structural anomalies. What this study adds? To our knowledge, in Europe this is the first study to evaluate the association of interest. Understanding and assessing the potential association of food insecurity in pregnant women and fetal structural anomalies might help policymakers design and implement policies, interventions, and screening strategies to mitigate food insecurity in pregnant women. In this regard, there is the need for validated instruments, and through this study we provide the detailed methodology process in developing and structuring a questionnaire that might be used as a guide tool for future studies. Identifying women at risk of food insecurity and assisting them might help in preventing poor health outcomes and fetal structural anomalies, which could also decrease the burden on health systems. [ABSTRACT FROM AUTHOR]

Aims: The evidence supporting the efficacy of dietary preventive therapy in migraine is rising, particularly regarding the ketogenic diet. However, less evidence exists for the Low-Glycemic Index Diet and the 2:1 KD. This retrospective single-center real-life study aims to evaluate the efficacy of a 2:1 ketogenic diet and a Low-Glycemic-index Diet in chronic and high-frequency episodic migraine. Methods: Sixty patients with high-frequency episodic and chronic migraine were treated with either a Low-Glycemic-index diet (39 patients) or a 2:1 (21 patients) ketogenic diet for three months. We collected data on the migraine frequency and intensity and the MIDAS and HIT-6 scores through the headache diary. Anthropometric measurements (BMI, fat mass, free fat mass, and weight) were also collected and analyzed similarly. Data obtained at the baseline and after three months of each diet were compared. Results: Migraine intensity, frequency, MIDAS and HIT-6 scores, fat mass, weight, and BMI improved in both diet groups. Conclusions: Both diets are effective in reducing migraine symptoms and migraine-related disability. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the impact of theobromine and casein phospho-peptides/amorphous calcium phosphate with fluoride (CPP-ACPF) on the resin-dentine bond strength, microhardness, and dentine morphology. Methods: A total of 18 sound human molars for micro-tensile bond strength (µTBS), 20 sound human premolars for microhardness, and 30 premolars for Scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDX) were used. Based on the pre-treatment used, teeth were split into six groups; sound dentine, demineralized dentine, and demineralized dentine treated with theobromine (Sigma Aldrich) and MI paste plus (GC International, USA) for two-time intervals; 5 min and 1 month. The bonded teeth were sectioned to produce 1 mm2 resin-dentine sticks which were evaluated for µTBS using a universal testing device (Instron 3365, USA). The dentine microhardness was tested by using the Vickers microhardness tester (Nexus 4000 TM, Netherlands). The pre-treated dentine surface was examined using SEM/EDX (Neoscope JCM-6000 plus Joel benchtop SEM, Japan). µTBS results were analysed with two-way ANOVA. Microhardness and EDX results were analysed with two-way mixed model ANOVA. The significance level was set at (p ≤ 0.05). Results: While both remineralizing materials at the two-time intervals demonstrated µTBS comparable to sound dentine (46.38 ± 12.18), the demineralized group demonstrated statistically the lowest µTBS (p < 0.001). Whether used for 5 min or 1 month, theobromine significantly increased the microhardness (50.18 ± 3.43) and (54.12 ± 2.66) respectively (p < 0.001), whereas MI paste only increased the hardness (51.12 ± 1.45) after 1 month (p < 0.001). Conclusions: The pre-treatment of demineralized dentine with theobromine for 5 min or 1 month could enhance its bond strength and microhardness while for MI paste plus, only 1-month application was efficient to ensure remineralization. [ABSTRACT FROM AUTHOR]

Background & Objective: Cisplatin as a chemotherapy drug causes liver damage by increasing inflammation. Hepatoprotective agents with antioxidant properties can be useful for preventing this complication. Capparis spinosa, as a natural antioxidant source, can help to eliminate these productions. The purpose of this study was to determine the effect of two different doses of hydroalcoholic extract of Capparis seed on cisplatin-induced liver damages in rats. Materials & Methods: Forty male rats were divided into five groups (the control group, Cis (cisplatin) group, 200 C/S (Capparis spinosa), Cis + 50 C/S, and Cis + 100 C/S). Biochemical and histopathological evaluations were made. At the end of the study, all animals were euthanized with a CO2 gradient. Statistical analyses were performed through Graph Pad Prism Statistics software 9.1.2. The level of significance was set at p < 0.05. Results: Liver function tests, antioxidant and inflammatory markers and histopathological changes were evaluated. Significant changes in the pathology results were noticeable. Central vein, portal vein and bile duct diameter, thickness of the hepatic artery wall, and hepatic sinusoids were significantly increased in the Cis and 200 C/S-fed groups, compared to the controls, and also changes in favor of improvement were evident in the treatment groups, especially in the Cis + 100 C/S group compared to the Cis and 200 C/S groups. Conclusion: Based on pathology results, treatment with C. spinosa seed extract may be helpful in preventing cisplatin hepatotoxicity. [ABSTRACT FROM AUTHOR]

Background: Nurses' clinical competence is one of the fundamental necessities for providing safe and effective care. Moral distress, as one type of occupational stressors, can affect various aspects of clinical competence, especially under conditions of complicated medical settings such as the coronavirus disease 2019 (COVID-19) epidemic. This study was conducted with the aim of determining the relationship between moral distress and clinical competence in nurses working in COVID-19 intensive care units (ICUs). Methods: The study was a cross-sectional study. A total of 194 nurses working in COVID-19 ICU affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, central Iran, participated in the study. Data were collected using Demographic Information Questionnaire, Moral Distress Scale, and Clinical Competence Checklist. Data were analyzed with SPSS20 using descriptive and analytical statistics. Results: The mean score of moral distress, clinical competence, and skills application were 1.79 ± 0/68, 65.16 ± 15.38, and 145.10 ± 38.20, respectively. Based on Pearson correlation coefficient, there was an inverse and significant relationship between the moral distress score and its dimensions with clinical competence and skills application (P < 0.001). Moral distress was a significant negative predictor that accounted for 17.9% of the variance in clinical competence (R2 = 0.179, P < 0.001) and 16% of the variance in utilization of clinical competence (R2 = 0.160, P < 0.001). Conclusion: Considering the relationship between moral distress, clinical competence and skills application, to maintain the quality of nursing services, nursing managers can strengthen clinical competence and skills application by using strategies to deal with and reduce moral distress in nurses, especially in critical situations. [ABSTRACT FROM AUTHOR]

Background: Irrational beliefs, maladaptive emotions, and unhealthy lifestyle behaviors can adversely affect health status. However, limited research has examined the association between irrational beliefs and cardiovascular disease (CVD). The aim of this study was to evaluate the association between irrational beliefs and the 10-year CVD incidence among apparently healthy adults, considering the potential moderating or mediating role of particular social and lifestyle factors. Methods: The ATTICA study is a population-based, prospective cohort (2002–2012), in which 853 participants without a history of CVD [453 men (aged 45 ± 13 years) and 400 women (aged 44 ± 18 years)] underwent psychological evaluations. Among other tools, participants completed the irrational beliefs inventory (IBI, range 0–88), a self-reported measure consistent with the Ellis model of psychological disturbance. Demographic characteristics, detailed medical history, dietary, and other lifestyle habits were also evaluated. Incidence of CVD (i.e., coronary heart disease, acute coronary syndromes, stroke, or other CVD) was defined according to the International Coding Diseases (ICD)-10 criteria. Results: Mean IBI score was 53 ± 2 in men and 53 ± 3 in women (p = 0.88). IBI score was positively associated with 10-year CVD risk (hazard ratio 1.07, 95%CI 1.04, 1.13), in both men and women, and more prominently among those with less healthy dietary habits and lower education status; specifically, higher educational status leads to lower IBI score, and in conjunction they lead to lower 10-year CVD risk (HR for interaction 0.98, 95%CI 0.97, 0.99). Conclusions: The findings of this study underline the need to build new, holistic approaches in order to better understand the inter-relationships between irrational beliefs, lifestyle behaviors, social determinants, and CVD risk in individuals. [ABSTRACT FROM AUTHOR]

Background: Despite of long-lasting efforts, in more than 50% of cases, the etiology of recurrent spontaneous abortion (RSA) remains unknown. Leukemia inhibitory factor (LIF) has an essential role in the reproductive process, such as modulating inflammatory responses. This study aimed to evaluate the relationship between the LIF gene expression as well as serum levels of inflammatory cytokines and occurrence of RSA in infertile women with a history of RSA. Materials and Methods: In this case-control study, the relative gene expression levels of LIF, concentrations of tumor necrosis factor-alpha (TNF-α), and interleukin (IL)-17 were measured in peripheral blood and serum of women with a history of RSA (N=40) compared with non-pregnant and fertile women as the control group (N=40) using quantitative real-time polymerase chain reaction and the enzyme-linked immunosorbent assay, respectively. Results: The mean age of patients and controls was 30.1 ± 4.28 and 30.03 ± 4.23, respectively. Patients had a history of at least 2 and at most 6 abortions. The mRNA levels of LIF were significantly lower in the women with RSA in comparison with the healthy participant (P=0.003). Regarding cytokine levels, no significant difference was seen between the two groups (P≥0.05). There was no correlation - between the LIF mRNA levels and TNF-α and IL-17 serum concentrations. The U-Mann-Whitney test and the Pearson correlation coefficient were applied to comparison variables between groups as well as a correlation between LIF mRNA and cytokine levels in serum. Conclusion: Despite a significant reduction in the LIF gene mRNA level in patients with RSA, it was not associated with increases in inflammatory cytokines. Dysfunction in the production of LIF protein may be involved in the onset of RSA disorder. [ABSTRACT FROM AUTHOR]

Background and Objectives: One of the non-pharmacological interventions is gratitude, which has received less attention in the neonatal intensive care unit (NICU). The present study was conducted to investigate the effect of an educational intervention based on gratitude on the stress and mental health of mothers with preterm infants hospitalized in the NICU. Methods: A quasi-experimental controlled study was conducted on 50 mothers with infants hospitalized in the NICU of Shahrekord City, Iran, who were divided into two intervention and control groups. The intervention group was trained by the researcher in three two-hour sessions every week for two weeks. The results related to mothers' general health and stress were analyzed by the parental stress questionnaire and Goldberg and Hiller's general health questionnaire (GHQ-28) before and after the intervention by the paired t-test. Results: The mean stress score of mothers in the intervention group significantly reduced (P<0.001). Stress was reduced in the mothers of the control group who only received routine training, but this reduction was not statistically significant (P>0.05) (before training: 35.72 and after training: 34.08). In the intervention group, the mean score of mental health improved significantly two weeks after the gratitude-based training program (P<0.05) (before training: 26.56 and after training: 19.20). Conclusion: This is the first study on the effectiveness of gratitude on the health of Iranian mothers with preterm infants hospitalized in the NICU. Gratitude improves the stress level and increases the quality of mental health. The belief that gratitude will increase blessings is a crucial part of Iranian women's religious beliefs and is a critical factor in the effectiveness of mind and body interventions. [ABSTRACT FROM AUTHOR]

Social capital predicts many positive health outcomes, including food and water access and sufficiency. Hence, increasing social capital has emerged as one potential strategy to improve food and water security. In this study, we investigate whether social capital generated through participation in a community-based microlending programme based in semi-rural Kenya is associated with water and food insecurity, and explore the interconnectedness of water and food insecurity through mediation analysis. Randomly-selected women participants of the community-based programme (n = 400) were interviewed in June 2018 and again in June 2019. Survey measures included water insecurity, food insecurity and an index of social capital constructs, namely group cohesion, trust, expectations of mutual support, sense of belonging and frequency of attendance in the programme. Random effects linear regression showed that an increase the social capital index was associated with lower water and food insecurity. The mediation analysis indicated that the association between social capital and food insecurity was completely mediated by water insecurity. This study demonstrates the need for further investigation into how social capital-generating programmes can contribute to systems approaches for collaborative food and water security programmes, especially among rural communities in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background & Aim: The ability of nurses in cultural understanding in order to provide care in harmony with the patient's culture is a symbol of nurses' cultural competence. This study was conducted with the aim of determining the cultural competence of nurses working in Intensive Care Units (ICUs) and its relationship with demographic factors. Methods: This cross-sectional study was conducted in 2019 on 160 nurses working in ICUs and Coronary Care Unit (CCU) of two centers; 5- Azar and Shahid Sayad Shirazi, as referral centers for patients across the province and affiliated to Golestan University of Medical Sciences. For data collection, convenience sampling method was used based on the inclusion criteria. The data collection instrument was a demographic form and a cultural competence questionnaire (51 items and 4 subscales). The reliability of the present study was 0.94. After obtaining an informed consent from the nurses, the questionnaires were completed. Data analysis in spss16 with descriptive statistics; frequency, average and standard deviation, as well as after determining normality with the Shapiro-Wilk test, with inferential statistics; multiple and univariate regression were performed. The significance level was 0.05. Results: Most of the nurses in ICU (59.1%, 75 people) and CCU (57.6%, 19 people) were male. The minimum age of research samples in both ICUs and CCUs was 23 years. The highest average score of cultural competency in both wards was related to the attitude towards cultural care (0.54±0.22), (0.56±23) and the lowest score was cultural care knowledge (0.48±0.23) (0.44±0.22). The level of cultural competency in both ICUs and CCUs was reported to be weak (82.7%, 81.8%). Totally, the average score of cultural competency in the ICU was higher than the CCU, but there was no statistically significant difference. Also, none of the independent variables alone or in the presence of the other variables had a significant effect on cultural competence. Conclusion: : Considering the weak view of nurses towards cultural competency and regarding the fact that cultural care attitude had the highest average and cultural care knowledge had the lowest average, cultural competency training seems necessary to provide the highest level of care in CCUs. In this way, health system policy makers and nursing managers can move the cultural competency from cultural attitude to the preparation and implementation of cultural care by conducting educational workshops about culture and communication. [ABSTRACT FROM AUTHOR]

Objective Early language skills predict the child's future language skills and literacy. So, screening and assessment of speech and language at an early age are important. One cost-effective way of assessing a child's communication is through parents reporting tools. MacArthur-Bates Communicative Development Inventories (CDIs) are the most widely used forms by professionals in more than 70 live languages worldwide to screen children's communication skills. The main purpose of this study was to provide the Persian version of the third form of CDI (CDI-III) and determine its psychometric properties, including face and content validity and internal consistency in 30 to 37 months old Iranian Persian-speaking children. Materials & Methods In a cross-sectional methodological study of instrument validation, a Persian-adapted form of CDI-III was developed. At first, the English form was adapted to Persian, and a Delphi method was used to provide the initial list of the items. The face and content validity rates were examined by asking the opinion of ten Persian-speaking speech and language pathologists with at least three years of clinical experience in the field of child speech/language development and disorders. The final form was compiled based on the results of the content validity ratio (CVR) and content validity index (CVI) of the items. The final form consisted of three sections, including vocabulary, sentences, and use of sentences. The parents of 356 Persian-speaking children aged 30 to 37 months recruited by multi-stage cluster random sampling from health centers in Isfahan City were asked to complete the form. The Kuder-Richardson coefficient assessed internal consistency, and the Spearman coefficient examined correlation. Results The items with CVIs≥0.7 and CVRs≥0.6 remained, and other items were reviewed or removed based on the suggestions of panelists and developers. The final form included 100 words, 22 pairs of sentences, and 16 questions about using sentences. A total of 356 children (Mean±SD age: 34.03±2.12 months) were included in the study. According to the English CDI-III guidelines, the data were divided into four age groups with two-month intervals: 30-31, 32-33, 34-35, and 36-37. The internal consistency of the whole form was 0.97, and internal consistency values of vocabulary, sentences, and sentence usage were calculated as 0.98, 0.88, and 0.88, respectively. The Spearman correlation values between the scores of the form sections and each section with age indicated a significant positive correlation between all sections of the form. Also, the significant positive correlation between age and all three parts showed that the number of expressive words, the grammatical complexity of sentences, and the proper use of sentences increase with age. Conclusion The Persian CDI-III form possesses a good face and content validity and internal consistency to be used as a valid tool for screening language competence of 30-37 months old Persian-speaking children. The results of the mean and standard deviation of the current study can be used as a comparison for screening children suspected of being language deficient. [ABSTRACT FROM AUTHOR]

Background: Present study assessed whether Sinopharm, AstraZeneca, Sputnik V, and Covaxin's vaccinated women reveal a distinct incidence of menstruation disturbances, hirsutism, and metrorrhagia. Materials and Methods: Data collection was performed from June to August 2021, and 427 women working in seven selected hospitals in Tehran were studied in this descriptive-analytical cross-sectional study. All of these women had received one or both doses of the vaccines with one of the assessed vaccines. Required data was collected via questionnaire and imported to SPSS 16 for further assessment and analysis. Fisher's Exact Test and Chi-Squared test were main statistical tests used to understand whether any significant relation exists or not. Results: The participant's mean age and body mass index (BMI) were 29.78 ± 10.55 and 23.27 ± 3.82, respectively. Three hundred ninety-five cases (92.4%) had received both doses of the vaccines. Also, 154 cases (36.1%) had a history of COVID-19. A total of 38 cases (8.8%) of menstruation disturbances, 20 cases (4.6%) of metrorrhagia, and 7 cases (1.6%) of hirsutism were reported after receiving the vaccines. There was a significant difference among the vaccinated groups with the vaccines as mentioned earlier in terms of menstruation disturbances (hypermenorrhea, dysmenorrhea, Amenorrhea) (P=0.01). The highest and the lowest incidence of menstruation disturbances were recorded in the group vaccinated with Covaxin (17.6%) and Sputnik V (5%), respectively. There was also no significant difference amongst the vaccinated groups with the four vaccines regarding the incidence of metrorrhagia and hirsutism (P=0.10 and P=0.12, respectively). There was no significant relationship between all three complications incidence with the previous infection concerning all vaccines (coefficient=0.46, 1.27, -0.15 respectively for menstruation disturbances, metrorrhagia, and, hirsutism). Conclusion: Seemingly, Covaxin revealed the most side effects in terms of menstruation disturbances. As a result, professionals must carry out several studies with reasonable samples to recommend the vaccine to those women confidently. [ABSTRACT FROM AUTHOR]

Background. Mothers caring for children with epilepsy are commonly exposed to feelings such as guilt, failure, sadness, isolation and lack of interest in interaction with others. Objectives. The present study aims to examine the relationship between perceived social support and self-care and marital satisfaction in mothers of children with epilepsy in one hospital in Shiraz, Iran. Material and methods. In this descriptive correlational study, the sample included 98 mothers caring for children with epilepsy admitted to Namazi Hospital. For data collection, four questionnaires were used including demographics, perceived social support, self-care and marital satisfaction. After completion of the questionnaires, the data was analysed using SPSS Statistics 21.0. A significance level of 0.05 was considered in the study. Results. The mothers had an average perceived social support score of 30.48 ± 7.04. The average self-care score of the mothers of epileptic children was 87.45 ± 14.41. Concerning marital satisfaction, the mothers had an average score of 118.93 ± 19.6. The research findings indicated a positive and significant correlation between perceived social support and self-care in the mothers. In other words, the self-care scores were increased with an increase in the perceived social support score (r = 0.332; p = 0.001). Furthermore, a positive and significant correlation was also found between perceived social support and marital satisfaction, i.e. with an increase in the perceived social support score, the marital satisfaction scores of the mothers also increased (r = 0.201; p = 0.047). Conclusions. The results of the current study indicated that perceived social support has a positive relationship with self-care and marital satisfaction in mothers. Therefore, the provision of social support by the family, friends and society will result in better self-care and higher marital satisfaction in mothers caring for children with epilepsy, which in turn can improve the quality of the care provided to these children by their mothers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Work-related musculoskeletal complaints (WMSCs) are induced or aggravated by work activities and/or work conditions. OBJECTIVE: The aim was to evaluate the impact of work as a massage practitioner, with a special emphasis on WMSCs. METHODS: Massage practitioners were invited to participate in the study through an advert in the rehabilitation medical clinics. The participants completed a self-administered questionnaire, collecting general data and questions about WMSCs. RESULTS: Thirty-seven subjects (88.09%) reported pain in at least one body part in the last 4 weeks. The most common WMSCs was pain in the neck region (69.04%), followed by pain in the shoulder region (54.76%), upper back (52.38%), lower back (40.48%), wrist-hand (33.33%) and elbow (21.43%). The massage practitioners aged between 21 and 30 years old reported significantly more frequently WMSCs localized in neck, shoulders, wrist-hand, upper back and lower back. CONCLUSIONS: This study shows that WMSCs are widely reported among massage practitioners. The most common complaints were reported in the neck and shoulder regions, especially in younger massage practitioners. [ABSTRACT FROM AUTHOR]

Background. The outbreak of coronavirus disease 2019 (COVID-19) dates back to December 2019 in China. Iran has been among the most prone countries to the virus. The aim of this study was to report demographics, clinical data, and their association with death and CFR. Methods. This observational cohort study was performed from 20th March 2020 to 18th March 2021 in three tertiary educational hospitals in Tehran, Iran. All patients were admitted based on the WHO, CDC, and Iran's National Guidelines. Their information was recorded in their medical files. Multivariable analysis was performed to assess demographics, clinical profile, outcomes of disease, and finding the predictors of death due to COVID-19. Results. Of all 5318 participants, the median age was 60.0 years, and 57.2% of patients were male. The most significant comorbidities were hypertension and diabetes mellitus. Cough, dyspnea, and fever were the most dominant symptoms. Results showed that ICU admission, elderly age, decreased consciousness, low BMI, HTN, IHD, CVA, dialysis, intubation, Alzheimer disease, blood injection, injection of platelets or FFP, and high number of comorbidities were associated with a higher risk of death related to COVID-19. The trend of CFR was increasing (WPC: 1.86) during weeks 25 to 51. Conclusions. Accurate detection of predictors of poor outcomes helps healthcare providers in stratifying patients, based on their risk factors and healthcare requirements to improve their survival chance. [ABSTRACT FROM AUTHOR]

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The present study aimed to evaluate the effects of different supplemental fat sources (soyabean oil (SBO) as a source of n-6 fatty acid (FA) and fish oil (FO) as a source of n-3 FA) in the starter feed of milk-fed dairy calves during the hot season. Forty Holstein calves (3 d of age; 39·67 kg of body weight; ten calves per group) were randomly assigned to the experimental treatments as follows: (1) starter feed supplemented with no fat source (CON), (2) starter feed supplemented with 3 % SBO (DM basis), (3) starter feed supplemented with 3 % FO (DM basis) and (4) starter feed supplemented with an equal mixture of SBO and FO (1·5 % each, DM basis). The milk feeding schedule was constant for treatments and all calves were weaned on day 65 of age. Results show that calves had greater starter intake, average daily gain and body length when fed SBO compared with the other treatments. However, feed efficiency was increased and inflammatory indicators (TNF-α, serum amyloid A and haptoglobin) concentrations were reduced in the calves fed FO compared with the other treatments. In summary, it was revealed that SBO rich in n-6 FA improved starter intake and growth performance, while FO rich in n-3 FA could improve the immune function of calves. Due to the current experimental condition, an equal mixture of SBO and FO (1·5 % each, DM basis) can be recommended to have an optimum growth performance and immune function while the calves are reared under the heat conditions. [ABSTRACT FROM AUTHOR]

The evaluation of the effectiveness of education plays an important role in the improvement of training processes. The aim of the present study was to evaluate and compare the short form training courses for methadone maintenance treatment (MMT) in Iranian general physicians (GPs) and psychologists. This was a descriptive cross-sectional study with 203 participants (91 GPs and 112 psychologists) in three 10-day short form MMT training courses at the School of Behavioral Sciences and Mental Health - Tehran Institute of Psychiatry. After the courses, participants were asked to complete the Kirkpatrick Training Evaluation Questionnaire. Overall, the GPs evaluated the short form MMT training course significantly more positively than did the psychologists. Evaluation scores for Levels 1, 2, and 4 were good, average, and average, respectively. The Level 2 (learning) scores of both GPs and psychologists increased after the short form MMT training course compared with before the short form MMT training course. Similarities in the views of the GPs and the psychologists were more than differences between them. Research findings raised concerns about the implementation, management, monitoring, new guidelines, support, and training for this training course while providing valuable information in helping to facilitate more involvement of GPs and psychologists in the short form MMT training course. [ABSTRACT FROM AUTHOR]

Women with severe mental illnesses are a vulnerable population and little is known about their reproductive planning needs. The aim of our study was to describe rates of unintended pregnancies, postpartum contraception, identify use and knowledge of prenatal/pregnancy vitamins and identify modifiable lifestyle risks. Mixed methods study incorporating a cross-sectional survey and prospective pregnancy data collection A multidisciplinary antenatal clinic in Australia Thirty-eight pregnant women with severe mental illnesses: schizophrenia, schizoaffective, bipolar and severe post-traumatic stress disorder Unintended pregnancy rates, immediate postpartum contraception, use of prenatal and pregnancy vitamins and knowledge sources, obesity, and use and cessation rates for smoking, and substances, and comorbid medical conditions Overall 42% of women had unintended pregnancy, with those with schizophrenia at most risk (56%). A long acting reversible contraception was inserted in 5 women (13%), with 45% having no immediate contraception prescribed prior to postnatal discharge. Women's main source of vitamin supplementation for pregnancy was from general practitioners. Prenatal folic acid use occurred in 37%, with rates differing for those with a diagnosis of bipolar disorder (52%) and schizophrenia (25%). Vitamin deficiencies occurred in pregnancy, with iron deficiency (ferritin <30 ng/mL) (n = 27, 73%) the most frequent. Overall 21% of women smoked cigarettes and 35% were obese. Addressing gaps in use of effective contraception, proactive reproductive planning and lifestyle management may improve outcomes for women with mental illnesses and their babies. Women with severe mental illnesses have complex health needs that require targeted reproductive counselling. This study adds to what is known by highlighting that: •Women with schizophrenia appear more likely to have unintended pregnancy. •Prenatal counselling for women with severe mental disorders should include recognition and optimisation of management for the high rates of pre-existing medical comorbidities, obesity and elevated nicotine and substance use. •Many women with severe mental illness need increased doses (5 mg) of prenatal folic acid due to psychotropic medication risk and obesity, as well as treatment for high rates of iron and vitamin D deficiency in pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether Kinesio taping technique, applied to ankles of healthy people as a preventive intervention and people with ankle injuries, is superior to sham or alternative interventions on ankle function. Data Sources: Medline, Embase, Amed, CINAHL, SPORTDiscus, Cochrane Library and Web of Science, from inception to August 2020. Review methods: The terms "ankle" and "kinesio taping" were used in the search strategy. Included studies were randomized controlled trials (including crossover design) investigating Kinesio taping effects on ankle functional performance compared to any alternative or control/sham technique. Results: From 5,572 studies, 84 met the eligibility criteria which evaluated 2,684 people. Fifty-eight meta-analyses from 44 studies were performed (participants in meta-analyses ranging from 27 to 179). Fifty-one meta-analyses reported ineffectiveness of Kinesio taping: moderate evidence for star excursion balance test (anterior direction), jump distance, dorsiflexion range of motion, and plantar flexion torque for healthy people (effect size = 0.08–0.13); low to very-low evidence for balance, jump performance, range of motion, proprioception, muscle capacity and EMG for healthy people; balance for older people; and balance and jump performance for people with chronic instability. Seven meta-analyses reported results favoring Kinesio taping (effect size[95% CI]): low to very-low evidence for balance (stabilometry, ranging from 0.42[0.07–0.77] to 0.65[0.29–1.02]) and ankle inversion (0.84[0.28–1.40]) for healthy people; balance for older people (COP velocity, 0.90[0.01–1.78]); and balance for people with chronic instability (errors, 0.55[0.06–1.04]). Conclusions: Current evidence does not support or encourage the use of Kinesio taping applied to the ankle for improvements in functional performance, regardless the population. [ABSTRACT FROM AUTHOR]

Background: Pre‐eclampsia (PE) is dangerous complication, which leads to adverse pregnancy outcomes. Aims: The study was to explore the correlation between serum level of fibroblast growth factor (FGF) 21 and PE. Methods: A total of 80 cases were involved in this study containing PE group (49 cases) and control group (31 cases, normal pregnancy). PE group was divided into early‐onset PE (EOPE) and late‐onset PE (LOPE). Serum level of FGF21 and biochemical parameters were measured before delivery. Results: Maternal serum FGF21 level was higher in PE especially in EOPE than that in control groups (P < 0.05). In PE patients, serum FGF21 level was positively correlated with mean arterial pressure, diastolic blood pressure and low‐density lipoprotein cholesterol (P < 0.05). Levels of FGF21, uric acid and low‐density lipoprotein cholesterol were risk factors for PE. Conclusion: Maternal serum FGF21 level in PE particularly in EOPE was higher and was associated with blood pressure and lipid profile. [ABSTRACT FROM AUTHOR]

Background: Studies have indicated that diabetic children are at risk of developing other diseases such as depression. Objectives: This study was conducted to determine the prevalence of depression in diabetic children and identify factors that influence it. Methods: This cross-sectional study was performed on 125 diabetic children in the 7 - 16 age range who had attended the EndocrinologyandMetabolism Clinic of the Children's Medical Center affiliated to Tehran University of Medical Sciences. Children's Depression Inventory (CDI) was used to assess depression. Results: The study showed 44% of the children were nondepressed, 14.4% depressed and 41.6% borderline. Depression in the diabetic children was not significantly associated with age, gender, injection tools, socioeconomic status, body mass index, number of siblings, disease duration, frequency of injections, number of injected units, and frequency of blood glucose monitoring. Depression was significantly associated with the level of mother's education (P < 0.001), father's education (P = 0.01), frequency of hospitalization (P = 0.04) and level of HbA1c (P = 0.03). Conclusions: According to the results of the study, metabolic control reduces the HbA1c level and the frequency of hospitalization, thereby mitigating the risk of depression in the diabetic children. The educational level of parents, especiallymother, is also effective in minimizing this risk in diabetic children. [ABSTRACT FROM AUTHOR]

We investigated the association between physical activity (PA) before pregnancy and pregnancy rate according to intensity and amount of exercise. Eleven prospective cohort studies were included in this meta-analysis. Any amount of moderate-intensity PA was associated with a statistically higher rate of pregnancy compared to that in patients with no PA (p <.05). Any amount of vigorous PA was associated with decreased pregnancy rate; regular PA was associated with decreased infertility (p >.05). In contrast, vigorous PA was associated with increased infertility (p >.05). Therefore, women who are preparing for pregnancy are recommended to perform regular, moderate-intensity PA. [ABSTRACT FROM AUTHOR]

BACKGROUND: Physiotherapists are advocates of workplace health and safety. Despite the high prevalence of work-related musculoskeletal disorders (WMSDs), there is limited knowledge of ergonomic principles have been successfully applied in the workplace by Nigerian physiotherapists. OBJECTIVES: This study evaluates the knowledge and practice of ergonomic principles in patient handling among physiotherapists in Nigeria. METHOD: A cross-sectional survey design was used to sample 360 physiotherapists practicing in Nigeria. Participants responded to a three-part structured questionnaire that had a reliability coefficient of 0.77. Data was analyzed using descriptive statistics and Chi-Square. RESULTS: The majority (95.9%) of the participants had good knowledge of the ergonomic principles in patient handling while only 48.6% reported practicing them. Poor practice was mainly due to a lack of patient handling equipment. There was no significant association between knowledge and practice of ergonomic principles among study participants. Specific areas of physiotherapy practice showed a significant association with ergonomic knowledge and practice. Years of physiotherapy practice and highest educational qualifications showed a significant association with the levels of practice and knowledge respectively. CONCLUSION: Physiotherapists in Nigeria reported a good level of knowledge of ergonomic principles, but a poor practice level. Perhaps this non-adherence contributed to the high prevalence of WMSDs among physiotherapists in Nigeria. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer have significant impacts on the quality of life (QOL) of the women experiencing it. Limited studies are exploring QOL among Indonesian women diagnosed with cervical cancer. Purpose: This study aimed to investigate the QOL of women with cervical cancer who received radiation therapy and chemotherapy. Methods: A cross-sectional study was conducted to evaluate the QOL among 164 women with cervical cancer undergoing treatment. A consecutive sampling technique was used to recruit the samples. The EORTC QLQ-C 30 and QLQ-CX 24 were used to measure the QOL and sexual-related symptoms. The data collected were analyzed and presented as descriptive statistics in the form of means and standard deviations. Results: The mean of the global health status of general well-being and QOL of the women was 54.56 ± 25.47. In the QOL subgroups of functional status, the physical function (55.94) and role functions (55.34) were most frequently reported to affect QOL. Regarding sexual-related symptoms of the women, sexual worry (52.72) and menopause symptoms (48.03) were the two most prevalent symptoms which impacted QOL. Conclusions: The quality of life of women with cervical cancer in Indonesia was generally at the higher end of the scale, and yet the majority of the women reported high prevalent symptoms of cancer and adverse effects of treatments. Comprehensive, high quality and culturally sensitive care for women with cervical cancer needs to be implemented in Indonesia, which has unique social and cultural beliefs. [ABSTRACT FROM AUTHOR]

Objective: Pregnancy is one of the most stressful periods a woman experiences in her life. The present study was an attempt to determine the relationship between maternal stress during pregnancy and cortisol plus maternal serum leptin concentrations as well as pregnancy outcomes. Material and Methods: This longitudinal study was conducted on 90 pregnant women in Miandoab city between 2015 and 2016. The samples were chosen from mothers with a gestational age of 24 to 28 weeks. The participants were asked to complete Cohen's Perceived Stress Scale (PSS) and a demographic questionnaire and blood samples were taken from them. The mothers were then tracked with four-week intervals until the time of delivery and were asked to complete Cohen's PSS each time along with a questionnaire related to maternal outcomes. Again, a blood sample was taken at the time of delivery. Data analysis was performed using SPSS 16. Descriptive statistics, Pearson's correlation coefficient, and the t-test were employed for analysis. Results: A significant relationship was found between maternal stress and preeclampsia (p=0.008). The relationships between preterm childbirth and maternal cortisol concentrations in weeks 24-28 (p=0.015), and between preterm childbirth and maternal leptin concentrations at the time of delivery (p=0.007) were also found to be significant. Conclusion: Pregnancy and labor, as physically and mentally stressful events, can affect women's physiologic and psychological indicators. As a consequence, during pregnancy, the cortisol and leptin index changes in response to the activity of the hypothalamic-pituitary axis and autonomic nervous system under stress. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is increasing around the world. Compared with developed countries, the rate of increase is 30% higher in developing countries, where the monitoring of obesity and overweight is essential. This study investigated the prevalence of obesity, overweight, thinness, and stunting in primary school students in Shahroud, Iran. Methods: A total of 5,620 primary students were enrolled during 2015. In rural areas all students were invited to participate, while cluster sampling was used in urban areas and 200 classrooms were selected randomly as clusters. Height, weight and body mass index Z‐scores for age (HAZ, WAZ and BAZ) were calculated based on World Health Organization standard. The mean indices and prevalence of obesity, overweight, thinness, and stunting were calculated by education level, gender, and place of residence. Prevalence of obesity and overweight was estimated also by international obesity task force definition. Results: The mean WAZ, HAZ, and BAZ were 0.050 ± 1.25, 0.005 ± 0.98, and 0.076 ± 1.35, respectively. These indices in rural areas were significantly lower than those in urban areas (P < 0.001). Overall, 25.7% of children in urban areas (95%CI: 24.1–27.4) and 14.8% in rural areas (95%CI: 12.3–17.3) were overweight or obese, and 5.1% of rural girls (95%CI: 3.1–7.0) were stunted. Conclusions: Compared with previous studies, obesity and overweight are still rising in Iranian school children, thus more serious interventions are needed. These interventions must also deal with underweight and stunting, particularly in rural areas. [ABSTRACT FROM AUTHOR]

Aims: The trend of withdrawal from groundwater resources in Kashan plain has been increased during the recent 40 years. For example, the number of deep wells has been increased from 67 in 1965 to 927 in 2003. As a result, the well discharges and water quality have been diminishing. Hence, this research was aimed to study the salinity variation modeling in Kashan plain groundwater resource. Materials and Methods: This descriptive research was done based on recorded data for some wells in Kashan plain. First, the data from 112 wells were considered then, 16 wells with more complete data were selected for analysis. Total dissolved solids (TDSs) were considered as the salinity index. Results: The results showed that, in Kashan plain, the mean of salinity has been increased from 1190 mg/L to more than 1400 mg/L during 7 years. Although the salinity has been somewhat less after each annual precipitation, the trend is upward. Minimum and maximum of TDS were identified taken samples from wells number 27 and 47, respectively. Maximum rate of salinity was found in wells number 53 and 55, while the minimum was related to well number 54. Conclusions: The groundwater salinity in Kashan plain has an upward trend. The groundwater salinity can be related to some major factors such as distance from Salt Lake, less annual precipitation, and more withdrawal from the aquifer in the recent decades. Since the later can be managed withdrawal, especially for agricultural activities have to be minimized as the most effective way for prevention of the groundwater quality degradation. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to compare the push-out bond strength of mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM) as root end fi lling materials. Materials and Methods: A total of 40 root dentin slices (1 ± 0.2 mm) were prepared from freshly extracted human maxillary central teeth and their lumens were enlarged to 1.3 mm. The slices were randomly divided into two groups (n = 20). MTA and CEM cement were mixed according to manufacturer's instruction and introduced into the lumens. The specimens were wrapped in pieces of wet gauze soaked in distilled water and incubated at 37°C for 3 days. The push-out bond strength was measured using a universal testing machine. The slices were then examined under a light microscope at ×10 magnifi cation to determine the nature of bond failure. The data were analyzed using Mann-Whitney test (P < 0.001). Results: The mean push-out bond strength for CEM cement and MTA were 1.68 ± 0.9 and 5.94 ± 3.99 respectively. The difference was statistically signifi cant (P < 0.001). The bond failure was predominantly of adhesive type in MTA group and cohesive type in CEM group. Conclusion: CEM cement showed signifi cantly lower bond strength to the dentinal wall compared to MTA. [ABSTRACT FROM AUTHOR]

Introduction: Developments in the field of information technology has profoundly affected our educational system. The efficacy of Computer-Assisted Learning (CAL) has already been evaluated in medical education, but in this study, we examined the efficacy of CAL in combination with Lecture-Based Education. Methods: This quasi-experimental before and after study included 33 senior-year pharmacy students who had passed the preliminary hospital pharmacy internship course. Pre-test questionnaires were given to the students in order to examine their knowledge and attitudes. Then, three chemotherapy prescriptions were given to them. Pharmacology recourses also were available virtually. At the end, students were asked to answer post-test questionnaires with questions based upon knowledge and attitude. Results: The mean score of their knowledge was 3.48±2.04 of 20 before intervention and 17.82±2.31 of 20 after intervention. There was a statistically significant difference between the pre-test and post-testing scores (p<0.001). The mean attitude score of students before intervention was 42.48±15.59 (medium) and their score after intervention was 75.97±21.03 (high). There was a statistically significant difference between pre-test and post-test results (p<0.000). Conclusion: The combination of Lecture-Based Education and Computer-Assisted Learning improved senior pharmacy students' knowledge and attitude in hospital pharmacy internship course. [ABSTRACT FROM AUTHOR]