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From 2010-2016, a total of 251 stool samples were screened for norovirus using next-generation sequencing (NGS) followed by phylogenetic analysis to investigate the genotypic diversity of noroviruses in rural and low-income urban areas in northern Brazil. Norovirus infection was detected in 19.9% (50/251) of the samples. Eight different genotypes were identified: GII.4_Sydney[P31] (64%, 32/50), GII.6[P7] (14%, 7/50), GII.17[P17] (6%, 3/50), GII.1[P33] (6%, 3/50), GII.3[P16] (4%, 2/50), GII.2[P16] (2%, 1/50), GII.2[P2] (2%, 1/50), and GII.4_New Orleans[P4] (2%, 1/50). Distinct GII.6[P7] variants were recognized, indicating the presence of different co-circulating strains. Elucidating norovirus genetic diversity will improve our understanding of their potential health burden, in particular for the GII.4_Sydney[P31] variant.

Classical insect-flaviviruses (cISFVs) and dual host-related insect-specific flavivirus (dISFV) are within the major group of insect-specific flavivirus. Remarkably dISFV are evolutionarily related to some of the pathogenic flavivirus, such as Zika and dengue viruses. The Evolutionary relatedness of dISFV to flavivirus allowed us to investigate the evolutionary principle of host adaptation. Additionally, dISFV can be used for the development of flavivirus vaccines and to explore underlying principles of mammalian pathogenicity. Here we describe the genetic characterization of a novel putative dISFV, termed Guapiaçu virus (GUAPV). Distinct strains of GUAPV were isolated from pools of Aedes terrens and Aedes scapularis mosquitoes. Additionally, we also detected viral GUAPV RNA in a plasma sample of an individual febrile from the Amazon region (North of Brazil). Although GUAPV did not replicate in tested mammalian cells, 3'UTR secondary structures duplication and codon usage index were similar to pathogenic flavivirus.

Human enteric adenovirus species F (HAdV-F) is one of the most common pathogens responsible for acute gastroenteritis worldwide. Brazil is a country with continental dimensions where continuous multiregional surveillance is vital to establish a more complete picture of the epidemiology of HAdV-F. The aim of the current study was to investigate the molecular epidemiology of HAdV-F using full-genome data in rural and low-income urban areas in northern Brazil. This will allow a genetic comparison between Brazilian and global HAdV-F strains. The frequency of HAdV-F infections in patients with gastroenteritis and molecular typing of positive samples within this period was also analysed. A total of 251 stool samples collected between 2010 and 2016 from patients with acute gastroenteritis were screened for HAdV-F using next-generation sequencing techniques. HAdV-F infection was detected in 57.8 % (145/251) of samples. A total of 137 positive samples belonged to HAdV-F41 and 7 to HAdV-F40. HAdV-F40/41 dual infection was found in one sample. Detection rates did not vary significantly according to the year. Single HAdV-F infections were detected in 21.9 % (55/251) of samples and mixed infections in 37.4 % (94/251), with RVA/HAdV-F being the most frequent association (21.5 %; 54/251). Genetic analysis indicated that the HAdV-F strains circulating in Brazil were closely related to worldwide strains, and the existence of some temporal order was not observed. This is the first large-scale HAdV-F study in Brazil in which whole-genome data and DNA sequence analyses were used to characterize HAdV-F strains. Expanding the viral genome database could improve overall genotyping success and assist the National Center for Biotechnology Information (NCBI)/GenBank in standardizing the HAdV genome records by providing a large set of annotated HAdV-F genomes.

Viruses are the most diverse and abundant microorganisms on earth, highly adaptive to a wide range of hosts. Viral diversity within invertebrate hosts has gained notoriety in recent years in public health as several such viruses have been of medical importance. Aedes aegypti serves as a vector for several viruses that have caused epidemics within the last year throughout Brazil; including Dengue, Zika and Chikungunya. This study aimed to identify new viral agents within Aedes aegypti mosquito in a city of the Amazonian region, where it is highly endemic. Metagenomic investigation was performed on 60 mosquito pools and viral RNA sequences present in their microbiota were characterized using genomic and phylogenetic tools. In total, we identified five putative novel virus species related to the Sobemovirus genus, Iflavirus genus and Permutatetraviridae family. These findings indicate a diverse taxonomy of viruses present in the mosquito microbiota of the Amazon, the region with the greatest invertebrate diversity in the world.

Human Adenovirus species C (HAdV-C) is the most common etiologic agent of respiratory disease. In the present study, we characterized the nearly full-length genome of one potential new HAdV-C recombinant strain constituted by Penton and Fiber proteins belonging to type 89 and a chimeric Hexon protein of types 1 and 89. By using viral metagenomics techniques, we screened out, in the states of Tocantins and Pará, Northern and North regions of Brazil, from 2010 to 2016, 251 fecal samples of children between 0.5 to 2.5 years old. These children were presenting acute diarrhea not associated with common pathogens (i.e., rotavirus, norovirus). We identified two HAdV-C strains in two distinct patients. Phylogenetic analysis performed using all complete genomes available at GenBank database indicated that one strain (HAdV-C BR-245) belonged to type 1. The phylogenetic analysis also indicated that the second strain (HAdV-C BR-211) was located at the base of the clade formed by the newly HAdV-C strains type 89. Recombination analysis revealed that strain HAdV-C BR-211 is a chimera in which the variable regions of Hexon gene combined HAdV-C1 and HAdV-C89 sequences. Therefore, HAdV-C BR-211 strain possesses a genomic backbone of type HAdV-C89 and a unique insertion of HAdV-C1 in the Hexon sequence. Recombination may play an important driving force in HAdV-C diversity and evolution. Studies employing complete genomic sequencing on circulating HAdV-C strains in Brazil are needed to understand the clinical significance of the presented data.

The current investigation evaluates metal (loid)s biomonitoring using algae as well as the metal(loid) pollution of seawaters and sediments in the northern part along the Persian Gulf. Algae, seawater, and sediment samples were collected from four coastal areas with different land applications. The concentration of Ni, V, As, and Cd in abiotic samples (seawater and sediment) and four species of algae (Enteromorpha intestinalis, Rhizoclonium riparium, Cystoseira myrica, and Sargassum boveanum) was measured using an ICP-AES device. Concentrations of potentially toxic elements in seawater, sediments, and algae species followed the trend of "Ni˃V˃As˃Cd." The area of Asaloyeh (with the highest industrial activity) and the Dayyer area (with the lowest industrial activity) provided the highest and lowest amounts of metal(loid)s pollution, respectively. The average concentrations of V and As in four algae species significantly differed for all sampled areas. Obtaining the bio-concentration factor (BCF) > 1 for seawater and < 1 for sediment indicated that the studied algae have the ability to efficiently concentrate metal(loid)s from seawater and the limited accumulation of metals in sediments. According to the Nemerow pollution index, the order of metal(loid)s pollution for the studied areas estimated as Asaloyeh>Ganaveh>Bushehr>Dayyer. Algae species of C. myrica and E. intestinalis can often serve as suitable biological tools for monitoring seawater and sediment quality.

Aedes aegypti is associated with epidemic diseases in Brazil, such as urban yellow fever, dengue, and more recently, chikungunya and Zika viruses infections. More information about Ae. aegypti infestation is fundamental to virological surveillance in order to ensure the effectiveness of control measures in use. Thus, the present study aims to identify and compare infestation and infectivity of Ae. aegypti females in Macapa city, Amapa State (Amazon region), Brazil, between the epidemiological weeks 2017/02 and 2018/20. A total number of 303 Ae. aegypti females were collected at 21 fixed collection points, 171 at the 10 collection points in the Marabaixo neighborhood and 132 at the 11 collection points in the Central neighborhood. Among the collected samples, only two were positive for dengue virus, with a 2.08% (2/96 pools) infectivity rate for Marabaixo. The difference between the medians of Ae. aegypti females captured in Central and Marabaixo sites was not statistically significant. The findings indicate similar mosquito infestation levels between the neighborhoods, and a low-level of mosquito infectivity, although dengue virus was found only in Marabaixo. Virological surveillance of Ae. aegypti was important to identify sites of infection and determine possible routes of transmission to enable health surveillance teams to adopt preventive strategies where infected mosquitoes are present and act faster.

Background: Work-related musculoskeletal disorders (WMSDs) are one of the major problems in industrial societies. Awkward postures in theworkplace are considered as a main reasons for these disorders. Therefore, the study and investigation of postures to improve them (in the workplace) have a significant role in appropriate intervention., Objective: This study aimed to design an ergonomic chair for near-ground welding operations and evaluate its impact on the electromyography (EMG) activity of a select group of lower limb muscles., Methods: The EMG activity of lower limb muscles was measured in eight postures consisting of three postures identified via observing welders at work, and five on-chair postures suggested for chair use during welding. The usability of the designed chair was evaluated through the use of the System Usability Scale (SUS)., Results: The results showed that the suggested on-chair postures had significantly lower mean muscle activity compared with the identified postures (p < 0.001). Among the identified postures, kneeling posture had the lowest mean muscle activity (p < 0.01), still significantly higher than the mean activity of the on-chair postures (p < 0.001). Applying a 15° slope to the seat pad led to a decrease in muscle activity and an increase in usability score. The usability score of the chair was acceptable in all postures except KCC-90 posture., Conclusions: Using a suitable chair or support for different work postures can prevent detrimental muscle activities during work and the development of musculoskeletal disorders caused by intense muscle activity due to awkward postures.

Diarrhea remains one of the most common causes of deaths in children. Although many studies have investigated the prevalence of enteric pathogens around the globe some diarrheal episodes remain unexplained. It is possible that some yet-unidentified viral agents could be related to these cases of gastroenteritis. By using viral metagenomics techniques, we screened 251 fecal samples of children between 0.5 to 2.5-year-old with acute diarrhea not associated with common pathogens. These children live in rural areas and have different levels of contact with animals such as pigs, cows and bats. Here we report a complete genome of one mammalian orthoreovirus (MRV) type 3, denoted TO-151/BR, detected in a female child in the state of Tocantins (north of Brazil). Brazilian TO-151/BR strain was classified as MRV-3 based on S1 phylogeny and was closely related to porcine Asian strains. Phylogenetic analyses showed that other segments were more similar to MRV-3s of different geographic locations and hosts, including human and bats, highlighting genome reassortment and lack of host-specific barriers. This is the first report of MRV-3 in South America and a hypothesis of a silent long-term circulation of this virus in Brazil has been raised.

Background: Asalouyeh (southern Iran) contains many pollution sources like petrochemical and gas refinery companies. Few studies were conducted on the body burden of metal(loid)s in occupationally exposed workers of the companies in this area., Objectives: The urine concentration of metal(loid)s in workers of gas refinery and petrochemical companies in Asalouyeh (who have been worked as "two weeks work-two weeks rest" schedule) was evaluated during a before-and-after observational study. The risks of metal(loid)s in drinking water and dust particles in the studied area were also assessed., Methods: Urinary samples (n = 179) were gathered at the first day of two weeks of work (before) and at the end of two weeks of work (after). The concentration of V, Ni, Mn, Cd, and As was measured using a graphite furnace atomic absorption spectrometry. The health hazards of metal(loid)s in the air dust and drinking water of workers were also evaluated., Results: The median concentration of metal(loid)s for workers of gas refinery and petrochemical companies for before and after two weeks of work was measured, respectively, as: As (11.44 and 9.31 μg/L), Ni (1.06 and 0.51 μg/L), Cd (0.36 and 0.31 μg/L), Mn (0.29 and 0.24 μg/L), and V (0.08 and 0.05 μg/L). After two weeks work, the median of all metal(loid)s in the urine of petrochemical and gas refinery workers was significantly increased. The non-cancer risk due to intake metal(loid)s from drinking water was more than the threshold value and the cancer risk from drinking water and inhaled air dust was less than the threshold., Conclusion: Our results revealed the effect of gas refinery and petrochemical activities on increasing the metal(loid)s concentration of the worker's body and the necessity to protect this group. Additionally, the metal(loid)s intake from drinking water and inhaled dust posed no cancer risk to the workers., (Copyright © 2019 Elsevier GmbH. All rights reserved.)

Objective: Olfactory impairment is a very common symptom in Parkinson's disease (PD). However, individuals often overestimate their ability to smell. Hyposmia and metacognitive errors are also related to aging, depression, male gender and cognitive impairment. The current study investigated the awareness of olfactory functioning in PD and the influence of additional factors., Method: A sample of 124 nondemented PD patients and 154 elderly controls was assessed with the Sniffin' Sticks Odor Identification Test (OIT) and the Subjective Olfactory Capability (SOC) domain of the Assessment of Self-Reported Olfactory Functioning and Olfaction-Related Quality of Life, additional to measures of depressive symptoms, verbal memory and executive functioning. Olfactory awareness groups were formed by means of the cut-offs of the OIT and the SOC., Results: Significant correlations between the OIT and the SOC were moderate in participants with PD and small in controls. Of all PD patients, 52% overrated their sense of smell while 27% correctly identified themselves as being hyposmic, as opposed to corresponding 6% and 1% of healthy elderly. Overrating and aware of being hyposmic participants with PD showed worse executive functions than PD patients who were objectively and subjectively normosmic., Conclusions: The findings imply that, although people with PD are aware of hyposmia to some extent, the majority is affected by overestimation of the ability to smell, making self-reported functioning an unreliable source of information. Moreover, reduced odor identification and impaired executive functioning might underlie the same pathological changes within the brain and could serve as a marker for cognitive impairment in PD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Background: Dutch Musculoskeletal Questionnaire (DMQ) is used to examine physical and environmental risk factors and to identify high-risk groups for exposure to the risk factors of musculoskeletal disorders at workplace. The aim of this study was to develop the Persian version of the DMQ and to assess its psychometric properties. Methods: This study was conducted on 212 employees of Gas Transmission Company. Using a standard forward-backward translation procedure, the English version of the questionnaire was translated into Persian and culturally adapted. Content validity was established by 10 expert opinions. The intraclass correlation coefficient (ICC) was used for the statistical analysis of reproducibility. Kuder-Richardson-20 was used for internal consistency and confirmatory factor analysis for structural validity. Results: This study revealed high internal consistency and good test-retest reliability for the Persian version of the questionnaire. The means of the content validity ratio (CVR) and content validity index (CVI) for the total 35 items of the questionnaire were 0.96 and 0.91, respectively. The internal consistency of the factors was satisfactory, ranging from 0.83 to 0.88. Confirmatory factor analysis confirmed the existence of 7 factors in the questionnaire and an acceptable fit for the Persian version of the DMQ. Conclusion: The Persian version of the DMQ has acceptable psychometric properties. Thus, it can be used as a valid instrument to assess workload and to identify high-risk groups of musculoskeletal disorders at workplace.

Background: Colorectal cancer is a major public health problem. A way to decrease this cancer is through dietary behavioural changes. The aim of this study was to determine the effects of education on dietary behaviour based on the health belief model (HBM) using multimedia., Methods: In this clinical trial study, 98 participants were randomly allocated to an HBM group ( n = 48) and a control group ( n = 50). The HBM group received an audiovisual compact disc (CD) that contained information about nutritional behaviour of colorectal cancer (CRC) prevention based on HBM that lasted 45 min. Both groups completed questionnaires regarding demographic factors, knowledge and HBM constructs, and a three-day dietary recall at the beginning of the study, 1 week after, and 3 months after the education. The outcome of this study was measured by the amount of food servings consumed and dietary micronutrient intake., Results: At the baseline, there were no significant differences between groups regarding demographic factors. Findings showed that self-efficacy ( P < 0.001), severity ( P < 0.001), and benefits ( P < 0.001) were perceived to be higher, and knowledge ( P < 0.001) was increased in the HBM group compared to control group 3 months after education. There was a significant increase in fruit and vegetable ( P < 0.001) and dairy ( P = 0.001) intake and a significant decrease in red meat servings ( P = 0.016) in the HBM group compared to the control group. Also, intake of vitamin D ( P < 0.001), folate ( P < 0.001), calcium ( P = 0.008), and dietary fibre ( P < 0.001) was increased in the HBM group compared to the control group 3 months after education., Conclusion: Education plans based on HBM and implemented through multimedia can change nutritional beliefs and behaviours for the prevention of colorectal cancer., Competing Interests: Conflict of Interest Authors of this study have no conflict of interest to declare.

The purpose of this study is to assess the effectiveness of a theory-based self-care intervention with the application of health literacy strategies in patients with high blood pressure and limited health literacy. This is a randomized controlled trial, with measurements at baseline and 1 and 3 months follow-up. 100 patients with high blood pressure and limited health literacy will be randomly allocated to either an intervention group or a usual care control group. We will mainly establish the intervention model based on the principal health belief model components. Patients randomized to the intervention group will receive four educational sessions during four weeks. Considering the limited health literacy level of the patients of the study, health literacy strategies will be used in educational material design for enhancing the quality of the intervention. In order to cover these strategies, we will design four standard animated comics and fact sheets with illustrations and photos consistent with the health belief model constructs and educational sessions' topics. Data will be collected using some questionnaires and will be analyzed using the SPSS software. The findings of this study may assist with the development of a theoretical model for self-care intervention in patients with high blood pressure and limited health literacy.

Objectives: This study assessed the efficacy of oral consumption of N-acetyl cysteine (NAC) and melatonin (ML) in reducing early reperfusion injury and acute oxidative stress in patients undergoing coronary artery bypass grafting (CABG) with respect to the measurements of cardiac troponin I, lactate, malondealdehyde (MDA), and tumor necrosis factor-α (TNF-α) levels in the blood., Methods: This study was a randomized, open-label, placebo-controlled trial. Eighty eight patients, aged between 39 to 76 years and eligible for CABG, were recruited and randomly assigned into 3 intervention groups through a simple randomization method and underwent CABG surgery. Blood samples were withdrawn from arterial line, before the induction of anesthesia (before the start of surgery), after incision (before aortic cross-clamping), during global ischemia (during aortic cross-clamping), after aortic cross-clamping (on set of reperfusion), 15 minutes after reperfusion, and after recovery at the intense care unit. The blood samples were analyzed for troponin I, lactate, MDA and TNF-α levels., Results: There was no significant difference in influencing variables among the groups at the baseline. Overall mean troponin I, lactate, and TNF- α levels were significantly different between the intervention groups (all P < .001) at the recovery phase. Post-hoc pairwise comparisons showed that the differences of mean serum levels between ML and control groups were statistically significant for MDA, TNF- α, lactate, and troponin I (P < .001, P = .001, and P = .001, respectively). The differences between NAC and control groups and between ML and NAC groups were only significant for mean lactate level (P < .001)., Conclusion: The current study revealed that ML and NAC are potent antioxidants with similar efficacy in terms of reducing CABG related cardiac injury and oxidative stress with the dosage employed for the intervention.

Occurrence and frequency of six most prescribed antibiotics (tetracycline, norfloxacin, azithromycin, anhydro erythromycin, cephalexin, and amoxicillin) were assessed in three wastewater treatment plants (WWTPs), and in water and sediments of the Persian Gulf at Bushehr coastline, Iran. The antibiotics concentration in the influent and effluent of septic tank (the hospital WWTP), activated sludge (the hospital WWTP), and stabilization pond (municipal WWTP) ranged between 7.89 and 149.63, 13.49-198.47, 6.55-16.37 ng/L, respectively. Conventional treatment resulted in incomplete removal of most of the studied antibiotics. Furthermore, the activated sludge was more effective in terms of antibiotic elimination compared to the stabilization pond or septic tank. The mean concentration of antibiotics ranged 1.21-51.50 ng/L in seawater and 1.40-25.32 ng/g in sediments during summer and winter. Norfloxacin was the dominant detected antibiotic in seawater, sediments, and influent of two hospital WWTPs. Seasonal comparisons showed significant differences for erythromycin and amoxicillin concentrations in seawater. Spatial variation indicated the role of physicochemical properties on distribution of antibiotics in seawater and sediments. The results emphasize the need to pay attention to antibiotic contamination in water and sediments of the Persian Gulf., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Introduction: Physical activity is the most important self-management behaviour in diabetes. The aim of this study was to evaluate the impact of a short message service (SMS) based on a health promotion model (HPM) on the physical activity of diabetic patients., Methods: This quasi-experimental study consisted of 37 type II diabetes patients in an SMS group and 36 type II diabetes patients in a control group. The patients in both groups completed written consent forms and questionnaires at the beginning of the study. The patients in the SMS group received training messages within two weeks (two or three messages daily) in the field of physical activity based on HPM constructs. Both groups completed questionnaires in three stages (at the beginning of the study, four weeks after the first visit, and three months later) comprising demographic factors, questions regarding the constructs, and 7-day physical activity recall. After data collection, statistical analysis was conducted using an independent t -test, a Chi-square test, and a repeated measures analysis of variance (ANOVA)., Results: As compared with the control group, changes in mean scores of perceived self-efficacy ( P = 0.001) and family support ( P = 0.046) of physical activity in the training group were significantly greater and perceived barriers ( P < 0.001) were significantly lower over time. The physical activity performance of the SMS group was better three months after training as compared with that of the control group ( P < 0.001)., Conclusion: The results demonstrated the efficacy of training messages in changing the beliefs and physical activity behaviours of diabetic patients., Competing Interests: Conflict of Interest Authors have no conflicts of interest.

The aim of this study was to determine the factors influencing adherence to self-care behaviors among low health literacy hypertensive patients based on health belief model. A cross-sectional study was conducted among 152 hypertensive patients with low health literacy. Patients with limited health literacy were identified by S-TOFHLA. The data were collected using H-scale for assessing self-care behaviors and, HK-LS for assessing knowledge of hypertension. A researcher-made questionnaire was applied for collecting data of health belief model constructs. Data were analyzed by SPSS version 22 with using multiple logistic regression analyses. Perceived self-efficacy was associated with all self-care behaviors except medication regimens. There was a significant association between perceived susceptibility and adherence to both low-salt diet (OR = 3.47) and nonsmoking behavior (OR = 1.10). Individuals who had more perceived severity (OR = 1.82) had significantly greater adherence to their medication regimens. Perceived benefits and barriers were not significantly associated with either type of hypertension self-care behaviors. It seems that designing and implementation of educational programs to increase self-efficacy of patients and promote their beliefs about perceived susceptibility and severity of complications may improve self-care behaviors among low health literacy hypertensive patients.

MicroRNA (miR), as non-coding small RNA, are key regulators of cancer-related biological cell processes and contribute to tumor growth through regulation of groups of pro- and anti-apoptotic genes. The present study aimed to investigate the effects of miR-29a on the expression of genes involved in apoptosis, including p21, B-cell lymphoma 2 (BCL-2), p53 and survivin. The MCF-7 breast cancer cell line was transfected with anti-miR-29a and treated with Taxol in subdivided treatment groups including: Scramble; anti-miR-29a; anti-miR-29a + Taxol; Taxol; and control. Expression levels of p21, BCL-2, p53 and survivin were evaluated using reverse transcription-quantitative polymerase chain reaction. miR-29a knockdown resulted in p21 and p53 upregulation and a decrease in survivin expression. These results indicated that miR-29a inhibition regulates apoptosis. The present data suggested that miR-29a inhibition may be a promising strategy for the induction of apoptosis of tumor cells.

Background: By high prevalence of inactivity, particularly in diabetic patients, the need to effective interventions to promote physical activity is essential. The aim of this study was to determine the effects of education based on health promotion model (HPM) through multimedia on the physical activity in diabetic patients., Method: In this quasi-experimental study, 76 patients with type II diabetes were evaluated (40 patents in intervention group and 36 patients in control group). The intervention group members and a friend or a family member, that could be supportive in physical activity, received teaching CD based on health promotion model. Both group members at the beginning of the study, two weeks and three months after the training, completed questionnaires. After data collection, statistical analysis was conducted using independent T-test, chi-square test, and repeated measurement of ANOVA., Results: Finding showed that self-efficacy (P<0.001), health status (p=0.032), benefits (P<0.001) and friends support in physical activity (P<0.001) were perceived to be higher, and barrier of physical activity (P<0.001) was perceived to be lower in multimedia group compared to control group 3 months after training. There was a significant difference in average of metabolic equivalent of task (MET) between two groups after the intervention (P<0.001)., Conclusion: Planning of education based on the HPM and implementation through multimedia can change belief about physical activity and increase participation in physical activity., (Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Background: Pap smear is an effective screening method for early detection of cervical cancer. This study aimed to investigate the effect of education based on Health Belief Model (HBM) through Telegram instant messaging services on the Pap smear test. Material and methods: This research was a quasi-experimental study which was performed on 106 eligible women (48 participants in the intervention group and 47 participants in the control group). The patients in both groups completed the written consent form and questionnaires at the beginning of the study. In intervention group, the educational content based on HBM was regularly sent via Telegram during one month. After education and three months later, both groups completed questionnaires. Then, the data was analyzed with using SPSS version 22. Results: The findings showed that the two groups at first were similar in demographic characteristics. In the intervention group, the mean difference of the scores before and immediate post training on the knowledge and all of the constructs were significant (P<0.001). Also, the mean difference of the scores before and three months after training on knowledge and all of the constructs (except for perceived barriers) has increased and about the perceived barriers this difference has decreased significantly compared to the score before the training. In the control group, changes in knowledge and other constructs were not significant in during the study. Within the three months after the training, 23 participants (47.9%) in the intervention group, and 4 participants (5.8%) in the control group performed Pap smear which indicates a statistically significant difference (P<0.001). Conclusion: With regard to the individuals’ access to mobile phone, content posted by Telegram on the HBM-based education affects the women’s belief and behavior regarding Pap smear test., (Creative Commons Attribution License)

This data is obtained from analyzing the concentration of metals include Al, Co, Cr, Cu, Fe, Mo, Pb, and Zn in the urine of schoolchildren in Asalouyeh city in vicinity to a heavily industrialized site and comparison with a reference city. The significance of sex groups on urine metal level was evaluated through this data. The urinary content of metals was measured by inductively coupled plasma atomic emission spectroscopy (ICP-OES). Statistical analyze of data were done by Mann-Whitney test. The herein presented date could beneficial for health assessment of gas and petrochemical companies.

Breast cancer is the most commonly occurring cancer among women. MicroRNAs as noncoding small RNA molecules play pivotal roles in cancer-related biological processes. Increased levels of microRNA-29a in the serum of breast cancer patients have been reported. Since heat shock proteins (HSPs) play important roles in cell events, the quantitative fluctuations in their cellular levels could be deemed as key indicators of how the exerted treatment alters cell behavior. In this regard, using an antisense small RNA, we attempted to investigate the effects of miR-29a knockdown on the expression of HSPs genes in the MCF-7 breast cancer cell line. MCF-7 cells were cultured in high-glucose Dulbecco's modified Eagle's medium with 10% FBS. Studied cells were subdivided into five groups: treated with scramble, anti-miR-29a, anti-miR-29a + Taxol, Taxol, and control. Taxol was added 24 h post-anti-miR transfection and RNA extraction, and cDNA synthesis was done 48 h later. The changes in expression of HSP27, HSP40, HSP60, HSP70, and HSP90 were evaluated by real-time PCR. Our results revealed that inhibitors of microRNA-29a promote apoptosis through upregulation of HSP60 level and downregulation of HSP27, HSP40, HSP70, and HSP90 levels and could be contemplated as a compelling alternative for Taxol employment with similar effects and/or to sensitize cancer cells to chemotherapy with fewer side effects.

Background: It is important to validate scales related to cancer screening beliefs in order to better understand perceptions. The aim of this study was to test the psychometric properties of the colorectal cancer screening belief scale based on Health Belief Model (HBM) constructs., Materials and Methods: Data were collected from 600 persons referred to outpatient laboratory units in Iran through a convenience sampling procedure. In this cross-sectional study, exploratory and confirmatory factor analyses were used to examine construct validity of scale., Results: Through exploratory factor analysis, 52 items of the scale converged to five constructs of HBM with 4 items omission. Construct validity was determined by confirmatory factor analysis through which correlated model was supported. Cronbach's alpha coefficient for the whole scale was obtained as 0.78, which indicates reliability of the scale., Conclusions: The study findings showed that this scale is a valid and reliable instrument that can be used for measuring HBM constructs about colorectal cancer screening with the fecal occult blood test.

Background: Breast cancer is one of the most common cancers among women in the world. Early detection is necessary to improve outcomes and decrease related costs. The aim of this study was to assess the predictive power of health locus of control as a modifying factor in the Health Belief Model (HBM) for prediction of breast self-examination., Materials and Methods: In this cross- sectional study, 400 women selected through the convenience sampling from health centers. Data were collected using part of the Champion's HBM scale (CHBMS), the Health Locus of Control Scale and a self administered questionnaire. For data analysis by SPSS the independent T test, Chi square test, logistic and linear regression modes were appliedl., Results: The results showed that 10.9% of the participants reported performing BSE regularly. Health locus of control did not act as a predictor of BSE as a modifying factor. In this study, perceived self-efficacy was the strongest predictor of BSE performance (Exp (B) =1.863) with direct effect, while awareness had direct and indirect influence., Conclusions: For increasing BSE, improvement of self-efficacy especially in young women and increasing knowledge about cancer is necessary.

Colorectal cancer is a major cause of mortality worldwide. Fecal occult blood testing has proven a very effective screening tool for early detection and mortality reduction. The aim of this study was to determine predictors factors related to fecal occult blood testing using the Health Belief Model method among residents of Bushehr, Iran. A cross sectional study was performed on a sample of 600 men and women more than 50 years of age. The sample was selected by a convenience method from patients referred to public and private laboratories throughout the city. Each subject filled out a questionnaire which was designed and developed based on Health Belief Model constructs. Statistical analysis was conducted using ANOVA, T-test, chi-square test, and logistic regression. Fecal occult blood tests were performed on 179 (29.8%) out of 600 subjects, of which 95 patients (58.1%) did a periodic examination test and 84 patients (46.9%) had a doctor's advice for testing. According to the logistic regression model, the perceived barriers (P=0.0, Exp(B)= 0.3), perceived benefits (P <0.01, Exp(B)= 1.9) and self-efficacy (P<0.01, Exp(B)= 1.6) were predictive factors related to occult blood testing among subjects.The results showed that reducing people's perception of barriers to testing, increasing perceived benefits of screening, and reinforcing self efficacy can have major effect in increasing the rate of fecal occult blood screening for colorectal cancer prevention.

Purpose: The main objective of the Bushehr Elderly Health Programme, in its first phase, is to investigate the prevalence of cardiovascular risk factors and their association with major adverse cardiovascular events., Participants: Between March 2013 and October 2014, a total of 3000 men and women aged ≥ 60 years, residing in Bushehr, Iran, participated in this prospective cohort study (participation rate=90.2%)., Findings to Date: Baseline data on risk factors, including demographic and socioeconomic status, smoking and medical history, were collected through a modified WHO MONICA questionnaire. Vital signs and anthropometric measures, including systolic and diastolic blood pressure, weight, height, and waist and hip circumference, were also measured. 12-lead electrocardiography and echocardiography were conducted on all participants, and total of 10 cc venous blood was taken, and sera was separated and stored at -80 °C for possible future use. Preliminary data analyses showed a noticeably higher prevalence of risk factors among older women compared to that in men., Future Plans: Risk factor assessments will be repeated every 5 years, and the participants will be followed during the study to measure the occurrence of major adverse cardiac events. Moreover, the second phase, which includes investigation of bone health and cognition in the elderly, was started in September 2015. Data are available at the Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran, for any collaboration., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Hemodialysis patients, due to a dysfunction of the immune response, are prone to a variety of opportunistic infections. Studies of intestinal parasitic infections in these patients are limited. Therefore, the present study was performed to determine the prevalence of these infections in patients on hemodialysis in Bushehr. In this cross-sectional study, fecal samples have been collected from all hemodialysis patients who were continuously referred from September 2011 to September 2012 to the dialysis center at Bushehr and tested using routine parasitological methods. From a total of 88 patients studied, 25 patients (28.4%) were infected with one or more intestinal parasites. Blastocystis hominis and Entamoeba coli with 13.6% and 6.7% prevalence had the highest prevalence among the patients, respectively. The age group 51-70 years had the highest rates of infection. Statistical analysis showed no relationship between sex and the risk of intestinal parasites. Seventeen percent of infected patients showed up with diarrhea and this relationship was statistically significant. Considering the high prevalence of intestinal parasitic infection among hemodialysis patients in Bushehr and also the high probability of infection in these patients, it is recommended that periodic examinations and screening patients during dialysis and before kidney transplantation should be a part of routine medical care., (© 2015 International Society for Hemodialysis.)

Objective: Flatfoot is one of the most common foot disorders, which not only influences the performance of the foot but also affects the alignments of the ankle, knee, and hip joints. The performance of the flat-arched individuals differs from that of normal individuals during walking. However, there is not enough information in the literature regarding their standing stability. Moreover, the influence of use of foot insole on standing stability has not been evaluated. Therefore, the aim of this study was to evaluate standing stability in individuals with flatfoot with and without insole., Methods: Two groups of normal and flat-arched individuals were recruited into this study. A Kistler force plate was used to measure the center of pressure (CoP), which is recognized as a good approximation of sway of center of gravity in a horizontal plane. Stability was determined by calculating the CoP excursions, path length, and velocity in the mediolateral and anteroposterior directions. The difference between stability in normal individuals and those with flatfoot was examined using the independent t test. The paired t test was used to determine the difference between stability in each group with and without insole. Significant P value was set at α ≤.05., Results: There was a significant difference between stability of flat-arched and normal individuals based on CoP velocity and total velocity. In addition, there was no direct correlation between the severity of flatfoot and instability during quiet standing. However, the mean values of CoP total velocity during standing with and without insole were significantly different (P < .001)., Conclusion: This study suggests that individuals with flatfoot are more unstable when compared with normal individuals during quiet standing. It seems that the foot insole improves the alignment of foot structure and reduces the forces applied on the ligament, thus, improving standing stability. Therefore, stability assessment in patients with flatfoot may be important, and the insole is a useful modality that can be used to improve stability in this patient group., Levels of Evidence: Therapeutic, Level II: Prospective, comparative trial., (© 2014 The Author(s).)

This study was performed to determine the differences between two commercial species of fish harvested off near the Kharg Island (one of the largest oil terminals in the world) in the Persian Gulf in terms of toxic metals, macro, and trace elements. Samples were analyzed using inductively coupled plasma-optical emission spectrometry (ICP-OES). The results showed that Ca, Li, Mg, P, Se, Sn, Sr, and Zn concentrations were significantly different between the skin and muscle tissues of Scomberomorus guttatus but with the exception of P, there was no significant difference between element levels in the skin and muscle tissues of Otolithes ruber. The S. guttatus contained significantly higher levels of As, Sn, Se, and P in the muscle tissue and Zn in the skin tissue compared to the muscle and skin tissues of Otolithes ruber. The estimated daily intake of the toxic elements including As, Cd, Sb, Pb, and Sn via consumption of these fish were below the established guidelines but due to the potential contamination by oil activities near the island, continuous and permanent monitoring in this region is highly recommended.

Aeroallergens continue to have a key role in the pathogenesis of asthma and allergic diseases and have recently received increased attention in medical research throughout the world. The prevalence of aeroallergens vary in different regions, depending on the type of climate. The aim of the present study was to determine prevalence of the sensitivity to aeroallergens among patients with asthma and allergic rhinitis (AR), based on skin prick test (SPT) reactivity in the province of Bushehr, Iran. In this cross-sectional study, 743 patients were enrolled. The participants had asthma and AR and reacted to at least one allergen with SPT. Skin prick test with standard extracts including house dust mites (HDMs), animal dander, molds and pollens were performed on patients according to the herbal geography of the area. The male to female ratio and mean age of the patients were 1.03 and 27.6± 15.4 year, respectively. Out of 567 patients with AR, the common aeroallergens were HDMs (88.5%), molds (82.9%), animal dander (79.5%), weeds (77.6%), trees (75.5%) and grass pollen (71.5%). Moreover, among 176 patients with asthma, the prevalence of aeroallergens were HDMs (90.5 %), molds (80.7%), animal dander (77.5%), weeds (73.3%), trees (73.3%) and grass pollen (67.9%). The sensitivity to animal dander, Chenopodium album and Russian thistle pollens were significantly associated with the severity of AR. Moreover, sensitivity to animal dander such as cat and feather of birds, cockroach, Bermuda grass and Chenopodium album pollens were significantly associated with the severity of asthma. The results of this study revealed that HDM was the most common sensitizing aeroallergen in patients with asthma and AR. Molds and animal dander as indoor allergens were also common aeroallergens. We suggest that the hot weather and ambient humidity in the region may be the main cause of the change in the pattern of SPT reactivity.

Diabetes self-management (DSM) is a complex behavior and various factors influence it. Despite continual recommendations to DSM, implementation of this behavior still remains a major health problem for diabetic patients. Identifying effective factors in DSM is useful to promote health in diabetic patients. The purpose of this study was to test the effects of individual and environmental factors on DSM. Path analysis was used to examine both one-way direct and indirect effects of 7 constructs and 3 demographic factors on DSM in this population (N = 396). Data were collected from a convenience sample of 104 (26.3%) males and 292 (73.7%) females with a median age 53 years. The final model provided a good fit to the data explaining 25% of the variance in DSM. Illness perception and provider-patient communication were the most effective factors in DSM. Knowledge and self-efficacy affected DSM indirectly via illness perception. The results of this study showed that effective DSM interventions should be designed to change illness perception and patient-provider communication, especially in patients with low duration of diabetes and low level of education., (© 2013 APJPH.)

Concerns have been raised about the adverse impact of dusty air pollution (DAP) on human health. The aim of this study was to find the association between dusty air pollution based on air quality index (AQI) and the risk of allergic diseases in southwestern provinces of Iran, with assessing cytokine profiles and lymphocyte immunophenotypes.In this case control study 148 individuals participated. The sampling was done in hazardous condition (AQI>300) as the case and clean air (AQI<50) as the control. We measured cytokine production by using ELISA method and phenotypes of T-lymphocytes (CD4+ and CD8+), CD19+ B-lymphocytes, CD25+, CD4+ CD25+ cells by FACSort flow cytometer.The mean serum level of IL-4 (33.4 ± 2.9 vs 0.85 ± 0.65 pg/dl) and IL-13 (15.1 ± 4.4 vs. 0.12 ± 0.7 pg/dl) in the subjects exposed to ambient DAP was increased significantly compared to the individuals in the clean air condition. Also, CD19+ B-lymphocytes (12.6 ± 4.9 vs 8.9 ± 3.2%) and CD4+ CD25+ cell count (13.6 ± 4.6 vs 7.7 ± 3.8%) in peripheral blood were increased significantly in subjects exposed to ambient DAP compared with the controls.The result of our study suggested that ambient DAP affected immune system in a way that might lead to allergic diseases in the population.

Asthma and allergic diseases present a major health burden. Information on the prevalence of these diseases indicates that these diseases are increasing in various parts of the world. It was hoped that this study would be helpful to health system policy-makers in planning allergy prevention programs in the region.The prevalence of asthma and allergic diseases and relation between the various risk factors involved were assessed among schoolchildren in the city of Bushehr, Iran. The ISAAC Phase I and III questionnaires were completed by parents of 1280 children aged 6-7 years and self-completed by 1115 students aged 13-14 years.The prevalence of atopic eczema, allergic rhinitis and asthma among 6-7 year-old students were 12.1%, 11.8% and 6.7%, respectively. While, the prevalence of these diseases among 13-14 year-old students were found to be 19%, 30% and 7.6%, respectively. There was an association between asthma and allergic rhinitis as well as eczema (p<0.05). Consumption of fast food as a risk factor was significantly associated with asthma (p=0.03).The prevalence of asthma and allergic diseases was high among schoolchildren in the city of Bushehr, Iran. Also an association was observed between the fast food consumption and asthma.

Micronutrient interactions give rise to complex issues that have an impact on preventive strategies when multiple micronutrient deficiencies coexist. The aim of this population-based study was to determine the prevalence of vitamins A and E and iron deficiencies among women 15 to 49 years of age in the northern Persian Gulf region. We hypothesized that serum retinol levels may show correlations with hemoglobin (Hb) concentrations, independent of iron status. A total of 1242 nonpregnant women of reproductive age were selected via a multistage stratified random cluster sampling technique. Serum ferritin and soluble transferrin receptor levels were measured using enzyme immunoassay techniques. Serum retinol (vitamin A) and α-tocopherol (vitamin E) were determined for 727 women by high-performance liquid chromatography. The prevalence of anemia (Hb <12 g/dL), iron deficiency (serum ferritin <15 μg/L), and iron deficiency anemia was 8.7%, 25.4%, and 4.6%, respectively. Vitamin A (<0.7 μmol/L) and vitamin E (<11.6 μmol/L) deficiencies were found in 1.2% and 5.9% of the studied population, respectively. Multiple regression analysis revealed that serum retinol levels exhibit a significant association with Hb concentrations after controlling for serum ferritin levels, anemia associated with chronic disease, and risk factors for anemia. Therefore, most nonpregnant women of reproductive age in the northern Persian Gulf were found to have adequate serum vitamin A and E levels. However, the status of anemia and iron deficiency anemia could be considered a mild public health problem in this region. On the basis of multivariate analyses, we conclude that low serum retinol levels may contribute to anemia, independent of iron homeostasis., (Copyright © 2013 Elsevier Inc. All rights reserved.)

A new solid-phase microextraction fiber based on alumina/titania sol-gel-coated on copper wire for headspace sampling of chlorinated organic solvents (chloroform, carbon tetrachloride, trichloroethene, and tetrachloroethene) from urine samples is introduced. The influences of fiber coating composition and microextraction conditions (extraction temperature, extraction time, and ionic strength of the sample matrix) on the fiber performance were investigated. Also, the influence of temperature and time on desorption of analytes from fiber was studied. The proposed fiber has high capacity and demonstrates fast sampling of chlorinated organic solvents from urine samples with high sensitivity. The relative standard deviation (RSD, n=5) for all analytes was below 6.5%., (Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Breast cancer is one of the most common cancers among women. Screening behavior rates are low in the world. Therefore, the purpose of the current study was to investigate breast self-examination (BSE) rate and the relationships of Health Belief Model (HBM) constructs for predicting BSE. Path analysis was used to examine both one-way direct and indirect effects of HBM factors on BSE in this population (N = 382). Data were collected by a part of Champion's HBM Scale (CHBMS) and a self-administered questionnaire. The results showed that 7.6% of the participants reported performing BSE regularly. The final model provided a good fit to the data, with 13 variables explaining 62% of the variance in BSE. Perceived self-efficacy was intermediate construct between modifying factors and HBM constructs. Also, perceived self-efficacy and perceived benefits were the most highly related to BSE. The results suggest that HBM is a useful framework for identifying factors influencing the use of BSE in Iranian women.

Ion pair of cationic surfactant (cetytrimethylammonium bromide) and tungestosilicic acid incorporated in PVC matrix, was used for coating a piece of copper wire as a new high sensitive SPME fiber in extraction and determination of BTEX compounds from the headspace of water samples prior to GC/FID analysis. Under optimum extraction conditions, limits of detection for benzene, toluene, ethylbenzene, p-xylene, m-xylene and o-xylene were found to be 1.18, 5.61, 0.87, 0.29, 0.22 and 0.33 ng L(-1) respectively. Low detection limits, wide linear dynamic ranges, good reproducibility (RSD% 1.48-4.27), high fiber capacity and high mechanical durability are some of the most important advantages of the new fiber., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Background: Early detection of breast cancer is of great importance to improve women's health and to decrease the cost related to cancer death. Therefore, recognition of variables related to breast cancer screening behaviors is necessary. Objectives of this study were to identify the rates of breast self-examination (BSE) performance and mammography use in Iranian women, and to characterize the demographic and cognitive factors associated with their breast cancer screening behavior., Method: Data were collected from a convenience sample of 388 females, using an adapted version of Champion's revised Health Belief Model Scale., Results: The results showed that 7.5% of the participants performed BSE on a regular monthly basis, and among the women aged 40 and older, 14.3% reported having had at least one mammography in their lifetime. Perceived self-efficacy and perceived barriers to BSE were significant predictors for BSE performance. For having mammography, health motivation was the main predictor., Conclusion: Eliminating barriers and increasing perceived self-efficacy with an emphasis to make the women acquainted with BSE performance; as well as increasing health motivation of women and persuading of physicians for clinical breast examination (CBE) performance with low cost and free access to m ammography, are important to promote BSE and mammography.

A new fiber based on titania-chitin sol-gel coated on a silver wire for the headspace solid phase microextraction of aliphatic alcohols from apple juice samples was developed. The influences of fiber coating composition and microextraction conditions (extraction temperature, extraction time, and ionic strength of the sample matrix) on the fiber performance were investigated. Also, the influence of temperature and time on desorption of analytes from fiber were studied. Under the optimized conditions, a porous fiber with a high extraction capacity and good thermal stability (up to 250 degrees C) was obtained. The proposed headspace solid-phase microextraction-GC method was successfully used for the analysis of aliphatic alcohols in apple juice and concentrate samples. The recovery values were from 92.8 to 98.6%. The RSD (n=5) for all analytes were below 7.8%.