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Different top layer fabrication methods (amine‐first, acid‐first, spin coating), organic phase solvents (hexane, heptane, mixed hexane/heptane), acid acceptors (triethylamine, sodium carbonate, sodium hydroxide), and surfactant sodium dodecyl sulfate concentrations (0, 0.05, and 0.1 wt%) were utilized to fabricate thin film composite polyamide membranes for CO2/N2 separation. The results, according to an L9 orthogonal array of Taguchi approach, showed that employing acid‐first method increases both CO2 permeance and CO2/N2 selectivity of the membranes at a feed gas pressure of 3 bars. On the other hand, sodium hydroxide, and triethylamine should be used, as acid acceptors, to maximize CO2 permeance and CO2/N2 selectivity, respectively. Moreover, the use of hexane solvent and 0 wt% surfactant led to maximum permeance, while, hexane solvent and 0.1 wt% surfactant were needed to reach the highest selectivity. The above level setting of synthesis parameters also resulted in the minimum sensitivity of the fabrication process to the noise factors effects. As shown by the analysis of variance, acid acceptor, and organic solvent types were the most influential parameters on CO2 permeance and CO2/N2 selectivity, respectively. The effects of fabrication method and surfactant concentration, as single factors, on permeation/selectivity responses were also investigated. [ABSTRACT FROM AUTHOR]

Introduction: Human immunodeficiency virus infection /acquired immunodeficiency syndrome has grown to be one of the world's most momentous pandemics. The present study aimed to explore the effects of stigma on people living with HIV/AIDS (PLWHA) and recommend coping strategies to reduce this phenomenon. Materials and Methods: Using a narrative literature review, the related articles were searched, retrieved, and selected from the databases of Noor Specialized Magazines (Noormags), Elmnet, Scientific Information Database of Academic Center for Education, Culture, and Research (SID), IranMedex, and Magiran via the keywords of "Stigma, Social Stigma, Labeling, Acquired Immunodeficiency Syndrome, AIDS, Human Immunodeficiency Virus, and HIV" in Persian and in the databases of PubMed and Scopus in English. The same procedure was further performed in Google Scholar in both languages. The inclusion criteria were the full-text articles in Persian and English and the exclusion criteria were no access to the full-text articles, while review articles were removed. Results: Considering the inclusion and exclusion criteria and excluding the duplicate studies, 16 articles were recruited in total for review purposes. The effects of stigma on PLWHA consisted of individual and social consequences. As well, the most appropriate coping strategies to reduce stigma were acknowledged as "providing psychosocial support for infected people", "raising awareness in the public and medical staff", "cultivating spirituality and a close relationship with God", "developing and implementing counseling strategies", and "establishing specialty clinics for PLWHA". Conclusion: Given the study findings, it can be suggested that policy-makers and community healthcare managers pay much more attention to the individual and social consequences of HIV/AIDS and make further efforts to increase awareness in the public and medical staffs, strengthen spirituality in PLWHA, and set up specialty clinics for such individuals to cope with stigma. [ABSTRACT FROM AUTHOR]

Background: Hemodialysis patients are faced with challenges in carrying out their daily activities. Self-efficacy is a social cognitive concept that can affect behavioral control in these patients. Hence, the purpose of the present study was to investigate the effects of exercise training on physical performance and self-efficacy in hemodialysis patients. Materials and Methods: This randomized controlled clinical trial was conducted on 60 hemodialysis patients who visited hospitals affiliated to Mazandaran University of Medical Sciences in Sari, Iran. The participants were randomly divided into two groups. The patients in the intervention/exercise group received the 8-week exercise program. Patients in the control group received routine care. The Six-Minute Walk Test (6MWT) was used to assess the patients' functional ability and the Exercise Self-Efficacy Scale (ESES) and Chronic Disease Self-Efficacy Scale (CDSES) were used to assess their self-efficacy before and 2 and 8 weeks after the intervention. For statistical analysis, independent t-test and paired t-test were used. Results: The comparison of self-efficacy between the exercise group and control group after 8 weeks of intervention showed a significant difference between the groups in terms of the CDSES (F1,43 = 22.92, p < 0.001) and ESES (F1,38 = 10.84, p < 0.001) results. Moreover, the comparison of mean distance walked based on the 6MWT showed significant changes in this variable (F1 = 2.05, p = 0.015). Conclusions: The designed exercise program can improve self-efficacy and physical performance in hemodialysis patients. This intervention is recommended for hemodialysis patients due to its effectiveness, simplicity, and uncomplicated characteristics [ABSTRACT FROM AUTHOR]

Background: Hot flashes (HF) are a common symptom during the menopausal transition. It is therefore important to identify effective drugs that can alleviate HF. This study aimed to systematically review published clinical trials on the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) in the treatment of HF in healthy menopausal women. Methods: In this systematic review, articles published during 2003-2019 in PubMed, MEDLINE, Web of Science, Scopus, Science Direct, PsycINFO, CINAHL, the Cochrane Central Register of Controlled Trials, and Google Scholar as well as Iranian databases such as SID, and Magiran were searched. The quality of the selected articles was assessed using the Jadad score calculation. Results: Thirty-six articles on randomized controlled trials were included in this study, out of which 27 articles had acceptable, and nine had weak methodological quality. Findings on SSRIs class of drugs indicated that escitalopram, paroxetine, and fluoxetine have higher efficacy and safety in the treatment of menopausal HF than other drugs. Studies on the effectiveness of sertraline, citalopram, and fluvoxamine are limited in number or show inconsistent results. Therefore, further high-quality studies are required to confirm their effectiveness in alleviating HF. Within the SNRIs class, venlafaxine and desvenlafaxine showed significant efficacy in the treatment of menopausal HF. However, studies on the effectiveness of duloxetine are also limited, which requires further research. Conclusion: Most studies have indicated the efficacy and safety of some antidepressants, such as SSRIs and SNRIs, in decreasing the frequency and severity of HF. These drugs are therefore recommended for the treatment of menopausal HF. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the occupational burnout (OB) and spiritual well-being (SWB) of emergency nurses as well as the associations between these variables., Method: This cross-sectional study was conducted in six hospitals and emergency medical centers affiliated with Ardebil University of Medical Sciences (Ardebil, Iran), in 2020. Data were collected via socio-demographic, Spiritual Well-Being Scale (SWBS), and Maslach Burnout Inventory (MBI) questionnaires., Results: This study included 239 emergency department nurses. The mean age of the participants was 34.4±6.4 years. The mean of existential well-being and religious well-being was 40.3±8.7 and 41.0±9.2, respectively. The results indicated that moderate (P=0.007) and severe (P<0.001) personal accomplishment was a positive and significant predictor of the SWB in emergency department nurses., Conclusion: Proper planning and provision of suitable educational programs in the dimension of the SWB of nurses prevent the creation and continuation of OB and increase the self-efficacy and job satisfaction of emergency medical staff, resulting in better patient care., Competing Interests: None declared.

OBJECTIVE. The objective of our study was to determine the accuracy of ultrasound (US) and CT in diagnosing appendicitis at our institution while taking into account the number of indeterminate examinations in accordance with the Standards for Reporting Diagnostic Accuracy (STARD) guidelines. MATERIALS AND METHODS. We retrospectively evaluated 790 patients who underwent US, CT, or both for evaluation of suspected appendicitis between May 1, 2013, and April 30, 2015. Patient characteristics and US and CT examination results were recorded. The reference standard was histopathology or 3 months of medical record follow-up if surgery was not performed; 3 × 2 tables were generated, and sensitivity, specificity, overall test yield, and accuracy were calculated according to STARD guidelines. For surgical cases, time to surgery (one-way ANOVA) was compared among patients who underwent US alone, CT alone, or both US and CT. RESULTS. A total of 473 of 562 US examinations had indeterminate findings (overall test yield, 15.8%); sensitivity and specificity in the 89 diagnostic examinations were 98.5% and 54.2%, respectively. Thirteen of 522 CT examinations were indeterminate (overall test yield, 97.5%); sensitivity and specificity in the remaining 509 CT examinations were 98.9% and 97.2%, respectively. Taking indeterminate studies into account, the accuracy was 13.7% for US and 95.6% for CT. The negative appendectomy rates were 17.7% (11/62) for US and 3.3% (9/276) for CT ( p = 0.0002). Time to surgery was longer for patients who underwent US and CT (mean ± SD, 17.7 ± 8.9 hours) than US alone (12.9 ± 6.4 hours; p = 0.002) but was not longer for patients who underwent CT alone (16.3 ± 8.4 hours; p = 0.45). CONCLUSION. At our institution, a large proportion of US examinations are indeterminate for appendicitis. CT is the preferred first-line imaging test for evaluating appendicitis in nonobstetric adult patients.

Background: Cisplatin is a cytotoxic agent in cancer therapy. Nephrotoxicity is considered as a side effect of cisplatin usage. Using rate models, we studied the possible protective impact of corn-silk (CS) extract against cisplatin-induced nephrotoxicity., Materials and Methods: Thirty-five experimental rats were divided into five groups (n=7 per each group) as follow: C1: Control received distilled water only; C2: received one dose of cisplatin, and CS: received 300 mg/kg/day of CS. Both CS1 and CS2 received 200 and 300 mg/kg/day of the CS extract orally, individually, for eight consecutive days. CS1 and CS2 received a single dose of cisplatin on the first day only. The specific biochemical markers and histopathological alterations were evaluated., Result: According to our results, cisplatin administration could have induced severe degeneration in all parts of the nephron tubules and liver. Pre-treatment with CS exhibited a significant decrease in the malondialdehyde (MDA) levels as compared to the values obtained after treatment with cisplatin alone (P<0.01). Moreover, the CS extract with 200 mg dose showed significant (P<0.01) protection against the cisplatin-induced elevation of blood urea nitrogen. Further, the serum levels of alanine transaminase and aspartate transaminase were higher in the cisplatin-treated groups, when compared to the control group (P<0.05). Furthermore, the hepatic function was also improved in cisplatin-treated animals, which were pre-treated with CS., Conclusion: CS has the potential to attenuate nephrotoxicity and lipid peroxidation induced by cisplatin in rats., Competing Interests: All authors declare there is no any conflict of interest in presenting the current work., (Copyright© 2018, Galen Medical Journal.)

Background: Flax is a food and fiber crop that is grown in some regions of the world. Its value will account for its great popularity as a food, medical and cosmetic applications. Flax fibers are taken from the stem of the plant and are two to three times as strong as cotton. In this study, we compared brain weight and plasma sex hormone levels in young and aged mice after the administration of Linum usitatissimum (flax seed) hydro alcoholic extract., Methods: In this study, 32 aged and 32 young mice were divided into 4 groups. Controls remained untreated and experimental groups were fed with flax seed hydroalcoholic extract by oral gavages during 3 weeks. After 3 weeks, the brain was removed and blood samples were collected to measure sex hormone levels by ELISA. Data analysis was done by statistical ANOVA test using SPSS version 18 (P<0.05)., Results: The results of this study shows that the brain weight of mice did not change significantly, but the sex hormone levels in the experimental groups in comparison with the control groups increased significantly (P<0.05)., Conclusion: The hydroalcoholic extract of flax seed had no effect on the brain weight, but this extract improved the sexual hormone levels.