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The aim of this study was to investigate and compare sexual function in individuals with colorectal cancer, with and without a colostomy bag. A quantitative, descriptive-comparative design was employed, and a cluster random sampling method was used to recruit 252 patients with colorectal cancer. Data collection tools included a participants characteristics form, the International Index of Erectile Function (IIEF) for men, and the Female Sexual Function Index (FSFI) for women. The mean IIEF total score for men with a colostomy was 26.17 ± 15.30, and for men without a colostomy, it was 29.05 ± 17.14. The mean FSFI total score for women with a colostomy was 6.40 ± 7.21, and for women without a colostomy, it was 9.10 ± 14.67. There was no statistically difference in IIEF scores between men with and without colostomy bags (p > 0.05). However, women with colostomy bags had significantly lower FSFI scores compared to women without colostomy bags (p < 0.05). Addressing sexual concerns in individuals with colorectal cancer is crucial for enhancing their sexual well-being and overall quality of life. Comprehensive support, timely interventions, and targeted services are essential to help patients navigate the challenges and improve their overall well-being., (© 2023. The Author(s).)

Background: The aim of this study was to examine the role of demographic characteristics, general health and health related quality of life on the fear control. Also, the aim of study was to explore how older people percept the COVID-19 pandemic by using the component of the expanded parallel process model (EPPM), and how the possible perception may contribute to probable behavior responses to prevention and control of COVID-19., Methods: The present study is a cross-sectional study that was conducted in Tabriz, a city in north of Iran from February to April 2021, the period that correspond with the fourth wave of COVID-19. To collect information, the Covid-19 risk perception questionnaire (based on EPPM model including efficacy, defensive responses, and perceived threat) and health related quality of life (HQOL) Short Form-36 questionnaire were used. Discriminate value was calculated to estimate fear control and danger control. Univariate and multivariable logistic regression were calculated to examine the effect of demographic characteristics, general health and health-related quality of life on the fear control., Results: The mean age of the 350 participants was 67.9 (6.4) years. A total of 83.1% of participants were engaged in danger control processes and 16.9% in fear control processes. According to the multivariable results, significant predictors for fear control were: gender 1.57 (95% CI 1.05-2.34, 0.025), education 7.38 (1.42-38.35, p = 0.017), economic status 1.31 (0.4-0.63, p = 0.029), and significant protective factors for fear control were: body pain 0.97 (0.94-0.99, p = 0.041), general health 0.96 (0.93-0.98, p = 0.032), physical health 0.94 (0.90-0.98) and total quality of life 0.024 (0.89-0.98)., Conclusions: Strong associations of fear control were found with being female, being illiterate, and having a good economic status and also body pain, general health, physical health and total HQOL were significantly associated with danger control. Since, most of elderly populations have adequately higher perceptions of efficacy to counteract their threat perceptions to continue motivating these older people to engage in COVID-19 self-protective behaviors, it is necessary to emphasis on the susceptibility of target population and the severity of the COVID-19 threats., (© 2023. The Author(s).)

Objective: Considering the rising prevalence of metabolic syndrome (MetS), this study aimed to investigate the relationship between MetS and its components with oral and dental health in the adult population of the Azar cohort., Methods: In this cross-sectional study oral health care behaviors, DMFT (decayed, missing, and filled teeth) index, and demographic data related to 15,006 patients (5112 in the MetS group and 9894 in the healthy group) of the Azar Cohort population aging from 35 to 70 were collected using appropriate questionnaires. The definition of MetS was based on the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. Then, the risk factors of MetS related to oral health behaviors were determined by proper statistical analysis., Results: The majority of MetS patients were female (66%) and uneducated (23%) (P < 0.001). In the MetS group, the DMFT index (22.15 ± 8.89) was significantly (p < 0.001) higher (20.81 ± 8.94) than the no MetS group. Not brushing at all was associated with increased odds of MetS (unadjusted OR = 1.12, adjusted OR = 1.18). Flossing less than once a day was associated with increased odds of abdominal obesity (unadjusted OR = 1.17, 95%CI = 1.03-1.32) and hyperglycemia (unadjusted OR = 1.88, 95%CI = 1.61-2.20)., Conclusions: This study showed that in MetS patients of the Azar cohort study, oral hygiene was worse compared to that in the no MetS group. Further studies are suggested to encourage oral hygiene among the general population which has more beneficiary effects than has been known before., (© 2023. The Author(s).)

Background: Standard precautions (SPs) including hand hygiene are considered fundamental protective measures to manage health care-associated infections (HCAIs) and to reduce occupational health hazards. The purpose of this research was to examine the effectiveness of an infection control link nurse (ICLN) program on compliance with SPs and hand hygiene among nurses., Methods: A quasi-experimental study with a pretest-post-test design was conducted with participating of 154 clinical nurses who worked in different wards of a tertiary referral teaching hospital in Iran. The intervention group (n = 77) had 16 infection control link nurses nominated. The control group (n = 77) received only the standard multimodal approach used in the hospital. Pre- and post-test assessment of compliance with standard precautions and hand hygiene compliance was performed via the Compliance with Standard Precautions Scale (CSPS) and the World Health Organization observational hand hygiene form. Two independent sample t-tests were used to examine differences between Compliance with Standard Precautions and hand hygiene Compliance among nurses in intervention and control group. Multiple linear regression analysis was used to assess the effect size., Results: After developing and implementing the infection control link nurse program, no statistically significant improvement was found in the Compliance with Standard Precautions (β = 5.18; 95% CI= -0.3-10.65, p = 0.064). An improvement in hand hygiene compliance was observed among nurses in the intervention group that improved statistically significant from 18.80% before the program to 37.32% 6 months after the program (β = 20.82; 95% CI 16.40-25.25, p < 0.001)., Conclusions: Given the continuing level of interest that exists in improving health care workers' hand hygiene practices, the findings of this study provide significant practical implications for hospitals seeking to improve compliance with hand hygiene among nurses, showing the effectiveness of using infection control link nurse program. Further research is needed to assess effectiveness of using infection control link nurse program to improve compliance with standard precautions., (© 2023. The Author(s).)

Background: Glucagon-like peptide-1 (GLP-1), a gut-derived incretin hormone, plays a pivotal role in glucose-induced insulin secretion. Currently, the role of incretin hormones in the pathogenesis of cirrhosis is not clearly defined. This study aimed to investigate circulating levels of GLP-1 in liver cirrhosis and its association with the severity of liver disease., Methods: A total of 80 participants including 39 patients with a definite diagnosis of liver cirrhosis and 41 healthy controls recruited in this cross-sectional study. Circulating levels of GLP-1 were determined using the ELISA method. The severity of liver cirrhosis was assessed according to the Child-Pugh, MELD (i), MELD-Na, MELD New, and UK end-stage liver disease score (UKELD) criteria., Results: The mean age of patients and healthy subjects was 42.51 ± 12.80 and 42.07 ± 10.92 years, respectively ( p value = .869). The mean MELD (i), MELD-Na, MELD New, UKELD, and Child-Pugh scores were 14.36 ± 4.26, 15.26 ± 4.81, 14.74 ± 4.66, 52.33 ± 3.82, and 7.28 ± 1.50, respectively. In this study, circulating levels of GLP-1 were statistically lower in cirrhotic patients compared with healthy controls (95.26 ± 17.15 vs 111.84 ± 38.14 pg/mL; p value = .017)., Conclusion: Larger prospective studies are needed to explore the incretin effect in cirrhosis patients compared with healthy individuals.

The nitric oxide (NO) pathway contributes to the pathogeneses of metabolic syndrome (MetS) and asthma. NOS2 encodes inducible-NO synthase, which is an important enzyme of the pathway, and its variations could affect the risk of asthma and MetS and thereby co-susceptibility to them. This study aims to estimate the association of NOS2 -c.1823C>T with risk of asthma, MetS, and asthma with MetS condition (ASMetS), and with asthma stages: intermittent, mild, moderate, and severe asthma. The study included asthmatics ( n  = 555), MetS ( n  = 334), and ASMetS cases ( n  = 232) and 351 controls, which were genotyped by the PCR-RFLP method. The T allele was significantly associated with an increased risk of asthma and MetS in the sample population and females. CT genotype and CT+TT model were significantly associated with increased risk of ASMetS in females. A significant association between CT genotype and increased risk of ASMetS in the sample population and females was found in ASMetS versus MetS. In the sample population and among females, the T allele was significantly associated with severe asthma. The rs2297518 single nucleotide polymorphism of NOS2 contributes to the risk of MetS, asthma, and co-susceptibility to them, and this contribution may be stronger in females compared to males.

Background: The prevalence of diabetes is increasing rapidly worldwide. Nurses work collaboratively with multidisciplinary teams to improve diabetes management. Yet, little is known about nurses' role in nutritional management of diabetes. This study aimed to evaluate nurses' knowledge, attitudes, and practice (KAP) toward nutritional management of diabetes., Methods: This cross-sectional study was conducted with 160 nurses, who were recruited between July 4 and July 18, 2021 from two referral tertiary teaching hospitals in Iran. A validated paper-based self-reported questionnaire was used to assess nurses' KAP. Data were analyzed using descriptive statistics and multiple linear regression analysis., Results: The mean knowledge score of nurses about nutritional management of diabetes was 12.16 ± 2.83, and 61.2% showing a moderate knowledge level on nutritional management of diabetes. The mean attitudes score was 60.68 ± 6.11, with 86.92% of participants demonstrating positive attitudes. The mean practice score of study participants was 44.74 ± 7.81, with 51.9% having a moderate level of practice. Higher knowledge scores were observed among male nurses (B = -7.55, p = 0.009) and those with blended learning as a preferred learning method (B = 7.28, p = 0.029). Having an opportunity to provide education to patients with diabetes during shifts affected nurses' attitudes positively (B = -7.59, p = 0.017). Practice scores were higher among nurses who perceived themselves competent in the nutritional management of diabetes (B = -18.05, p = 0.008)., Conclusion: Nurses' knowledge and practice in the nutritional management of diabetes should be increased to help improve the quality of the dietary care and patient education they provide these patients. Further studies are needed to confirm the results of this study both in Iran and internationally., (© 2023. The Author(s).)

Introduction: Exposure to coronavirus disease 2019 (COVID-19) has caused many physical and psychological effects on front-line healthcare workers (HCWs). This study aimed to assess the relationship between the exposure risk to COVID-19 disease and burnout in prehospital emergency medical technicians (EMTs)., Methods: In this correlational study, 335 prehospital EMTs were selected by random sampling method from the 49 stations of emergency medical services in the northwest of Iran. Data were collected using a questionnaire developed by the world health organization for the risk assessment and management of exposure of health care workers to COVID-19. Moreover, Pines burnout measure was used for the assessment of participants' burnout. Data were analyzed using SPSS version 13., Results: Results showed that 30.7 % of prehospital EMTs had a high burnout score against COVID-19 disease. The prehospital EMTs who had a high occupational exposure risk experienced a high risk of burnout ( P =0.03). The results of the linear regression analysis showed that prehospital EMTs who had a low exposure risk of COVID-19 had a low burnout score (β=-9.30; P <0.001), and those who had less than 10 years of work experience showed less burnout (β=-10.54; P <0.001)., Conclusion: According to the results, the exposure risk to COVID-19 increases the prehospital EMT's burnout. As a result, reducing the exposure risk to COVID-19 by providing adequate access to personal protective equipment (PPE), development of training and following standards and protocols can be effective in controlling burnout in HCWs., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 The Author(s).)

Background: Cardiopulmonary resuscitation and subsequent care are subject to various ethical and legal issues. Few studies have addressed ethical and legal issues in post-resuscitation care., Objective: To explore nurses' experiences of ethical and legal issues in post-resuscitation care., Research Design: This qualitative study adopted an exploratory descriptive qualitative design using conventional content analysis., Participants and Research Context: In-depth, semi-structured interviews were conducted in three educational hospital centers in northwestern Iran. Using purposive sampling, 17 nurses participated. Data were analyzed by conventional content analysis., Ethical Considerations: The study was approved by Research Ethics Committees at Tabriz University of Medical Sciences. Participation was voluntary and written informed consent was obtained. For each interview, the ethical principles including data confidentiality and social distance were respected., Findings: Five main categories emerged: Pressure to provide unprincipled care, unprofessional interactions, ignoring the patient, falsifying documents, and specific ethical challenges. Pressures in the post-resuscitation period can cause nurses to provide care that is not consistent with guidelines, and to avoid communicating with physicians, patients and their families. Patients can also be labeled negatively, with early judgments made about their condition. Medical records can be written in a way to indicate that all necessary care has been provided. Disclosure, withdrawing, and withholding of therapy were also specific important ethical challenges in the field of post-resuscitation care., Conclusion: There are many ethical and legal issues in post-resuscitation care. Developing evidence-based guidelines and training staff to provide ethical care can help to reduce these challenges.

Background: The economic burden of asthma is a major public health concern. This study estimates the economic burden of asthma in Northwest of Iran., Methods: A longitudinal study was conducted between 2017 and 2018 in Tabriz (Iran) using the Persian version of the Work Productivity and Activity Impairment (WPAI) questionnaire. Direct and indirect costs associated with asthma were estimated based on the societal perspective, prevalence-based approach, and bottom-up method. Annual indirect costs were estimated using the human capital (HC) method. The structural equation model was used to evaluate the relationship between costs, sex, and asthma severity., Results: A total of 621 patients with asthma were enrolled in the study. Significant differences were found between female and male patients for the mean cost of radiology (P=0.006), laboratory (P=0.028), and diagnostic (P=0.017) tests at baseline, and for laboratory (P=0.012), and diagnostic (P=0.027) tests at one-year follow-up. The more severe asthma, the more significant the costs for annual physician office visits (P=0.040) and medications (P=0.013). As asthma severity increased, significantly higher expenditures were observed in women for days lost from work at baseline (P=0.009) and one-year follow-up (P=0.001), and in men for productivity loss at work due to impairment at baseline (P=0.045). A significant association between indirect costs and the cost of impairment-related lost productivity at work (β=3.29, P<0.001), and between severe asthma and indirect costs (β=32.36, P<0.001) was observed., Conclusion: High costs are incurred by Iranian asthma patients, especially because of impairment-related productivity loss at work associated with asthma exacerbation., Competing Interests: None declared., (Copyright: © Iranian Journal of Medical Sciences.)

It is crucial to have access to clean water resources during the COVID-19 pandemic for hygiene, since virus infection through wastewater leaks in metropolitan areas can be a threat. Accurate monitoring of urban water resources during the pandemic seems to be the only way to confirm safe and infected resources. Here, in this study, the amount of Severe Acute Respiratory Syndrome Coronavirus 2's Ribonucleic Acid (SARS-CoV-2 RNA) in the Tabriz urban water network located in the northwest of Iran was investigated by an extensive sampling of the city's water sources at a severe peak of the COVID-19 pandemic. The sampling process comprised a range of water sources, including wells, qanats, water treatment facilities, dams, and reservoirs. For each sample, a combination of polyethylene glycol (PEG) and sodium chloride (NaCl) was used for concentration and a laboratory RNA-based method was conducted for quantification. Before applying the extraction and quantification procedure to real samples, the proposed concentration method was verified with synthetic serum samples for the first time. After the concentration, RNA extraction was done by the BehPrep extraction column method, and Reverse Transcription Polymerase Chain Reaction (RT-PCR) detection of the virus was done by Covitech COVID-19 RT-PCR kit. In none of the water supply resources, SARS-COV-2 RNA has been detected except in a sample grabbed from a well adjacent to an urban wastewater discharge point downstream. The results of molecular analysis for the positive sample showed that the CT value and concentration of the virus genome were equal to 32.57 and 5720 copies/L, respectively. Quantitative analysis of real samples shows that the city's water network was safe at the time of the study. However, given that the positive sample was exposed to wastewater leakage, periodic sampling from wells and qanats is suggested during the pandemic until it can be proven that the leakage to these water sources is impossible., Competing Interests: Conflict of interestThe authors have no competing interests to declare that are relevant to the content of this article., (© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Chemical accidents have imposed casualties and high economic and social consequences to Iranian industries and society., Objective: This study investigated the effect of risk factors involved in occurrences of the chemical accidents and predicted the time of occurrences in Iranian chemical factories., Methods: A cross-sectional study was implemented in 574 chemical facilities with more than 25 employees from 2018 to 2020. Collecting data instruments were 2 checklists with 15 and 25 three-point Likert scale questions, respectively. Chi square and Monte Carlo tests assessed the relationships between independent risk factors and dependent hazardous chemical accidents. Cox semi-parametric and log-normal parametric models were used to predict the upcoming time of chemical accidents based on the impacts of risk factors understudy. Data analyses were performed using Stata and R software., Results: The results showed that safety data sheets, labeling, fire extinguishing system, safe chemicals storage, separation, loading, transportation and training were statistically significant with occurrences of the chemical accidents (P-value < 0.05). Loading and transportation were mostly related to chemical incidents and reduced significantly the expected time of chemical events (P-value = 0.028)., Conclusion: Establishing a comprehensive chemical accidents dataset and strict governmental supervision on chemical safety regulations are suggested to decrease the chemical accidents at regional and local levels in chemical plants.

Background: We aimed to determine the role of demographic, lifestyle, and personality trait factors in predicting control of blood pressure (BP) among patients with hypertension (HTN) in West Azerbaijan, Iran. Methods: In this case control study we recruited participants from all primary health centers of Salmas city; who were at least 18 years of age, had a HTN diagnosis during the previous six months, and had a mandatory household record. Of 490 random subjects approached, 441 (84.2%) fulfilled our inclusion criteria (case: 221; control: 220). The age-matched controls were recruited from the same source population and were required to have controlled HTN. Data were collected through demographic Checklist, Ten-Item Personality Inventory (TIPI) and International Physical Activity Questionnaire (IPAQ). Results: Upon multivariate analyses, factors related to personality traits subdomains including extraversion personality (odd ratio [OR]: 0.85; CI: 0.73, 0.97) was effective in control of BP. Factors related to uncontrolled BP were agreement and consciences subdomains (OR 1.26 [CI: 1.07, 1.48] and OR 1.21 [CI: 1. 02, 1.44]), rare fruit consumption (OR 5.95 [CI: 1.24, 12.1]), Grade 1 and 2 obesities (OR 2.29 [CI: 1.28, 4.09] and OR 7.11 [CI: 2.21, 12.52]) and smoking (OR 3.27 [CI: 1.56, 6.89]). Conclusion: In addition to regular physical activity and fruit consumption and quitting smoking; personality traits such as Agreement and conscience personality traits were predictive of HTN control. We believe our work provides the required knowledge to design comprehensive HTN prevention programs by taking into account the multi-level causality approach., (© 2022 The Author(s).)

Background: Stroke is a global public health challenge. Frailty models can detect and consider the effects of the unknown factors influencing survival along with other known factors. This study aims to evaluate health care providers' effect, along with the demographic and clinical factors, on the stroke patients' survival by using the shared frailty survival models., Methods: In the 2-year follow-up, a total of 1036 patients with first-ever stroke were recruited from 2013 up to 2015 with census sampling method from two hospitals of Iran, as the health care providers. For model selection, we fitted parametric and semiparametric survival models with parametric shared frailty and used the goodness of fit criteria to compare the models., Result: The median follow-up was 730 days. The rate of mortality was 38% during the follow-up period. The Weibull model with gamma frailty had a better fit than the other survival models. The significant variables from the Weibull model were NIHSS score as the stroke severity (score < 5: reference category; scores 5-19: HR = 2.99, p value < 0.001; score ≥ 20: HR = 5.66, p value < 0.001) and age (HR = 1.03, p value < 0.001). Even with the incorporation of the demographic and clinical factors in the survival model, the effect of health care providers as the shared frailty effect was significant (p < 0.001)., Conclusions: Despite considering the known demographic and clinical prognostic factors, health care providers' effect on the patients' survival after stroke was still significant. This may be due to the existing difference between two hospitals in facilities, management, coordination, and efficiency of treatment., (© 2022. Fondazione Società Italiana di Neurologia.)

Due to the need for face-to-face administration of many cognitive screening tests, it is not always feasible to screen large-scale samples., Objective: This study aimed to assess the discriminant validity of the Persian version of Telephone Interview for Cognitive Status (P-TICS-m) and Mini-Mental State Examination in the middle-aged Iranian population., Methods: The P-TICS-m and MMSE were administered to 210 randomly selected middle-aged community-dwelling adults who had been registered in the Neyshabur Longitudinal Study on Ageing. Participants also underwent psychological examination by two neurologists to assess cognitive impairment based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. To evaluate the discriminant validity of P-TICS-m and MMSE with DSM-V criteria, the sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (LR + and LR - ) were calculated., Results: The mean age of the participants was 59.6±6.8 years. The TICS and MMSE were highly correlated (r=0.635, p<0.001). The sensitivity, specificity, PPV, NPV, LR + , and LR - to discriminate cognitive impairment were, respectively, 83%, 92%, 68%, 96%, 10, and 0.182 for MMSE and 100%, 13%, 19%, 100%, 1.16, and 0 for TICS-m. The receiver operating characteristic curve analysis results showed no statistically significant differences between P-TICS-m and MMSE., Conclusions: Our findings indicate that the TICS-m test can be used as a screening tool instead of the MMSE. Due to the low specificity and low PPV of the TICS-m compared to MMSE, the diagnosis should be confirmed using definitive diagnostic tests when a subject is classified as having cognitive impairment., Competing Interests: Disclosure: The authors report no conflicts of interest.

In this study, nanozeolite L was applied for the removal of toxic methylene blue dye (MB) to evaluate its feasibility as an effective adsorbent. Synthesized nanozeolite L was characterized by X-ray diffraction (XRD), Fourier transform infrared (FTIR), scanning electronic microscopy (SEM), Brunauer-Emmett-Teller (BET), and energy-dispersive X-ray analysis (EDX) methods to determine its basic physicochemical properties. Batch adsorption studies were performed as a function of pH, adsorbent dose, contact time, initial MB concentration, and temperature. The adsorption behavior of MB was fitted better by the Langmuir isotherm than by the Freundlich isotherm, and the maximum adsorption capacity of nanozeolite L was obtained 80.64 mg g-1. The negative values of Gibbs free energy change (ΔG°) and the positive value of the standard enthalpy change (ΔH°) affirmed that the adsorption process is spontaneous and endothermic. Based on these findings, nanozeolite L, with high surface area, great adsorption capacity, and low synthetic cost, can be an effective and economical adsorbent for MB removal.

Background: On March 11 th , 2020, the World Health Organization (WHO) proclaimed Coronavirus Disease of 2019 (COVID-19) a pandemic. In addition to severe health problems, the disease has had a major psychological impact on the public. The aim of this research was to examine the association between Post-Traumatic Stress Disorder (PTSD) related to COVID-19 in emergency staff and self-compassion and perceived social support., Methods: Data were collected from 222 emergency staff working in two referral educational and health centers for COVID-19 affiliated to Tabriz University of Medical Sciences. The participants were recruited six months following the first case of hospitalization for COVID-19 in these two hospitals in Tabriz, Iran. Four questionnaires were used to measure the variables, including a researcher-made demographic checklist, PTSD Checklist for DSM-5 (PCL-5), the Multidimensional Perceived Social Support Scale (MSPSS) and the Self-Compassion Scale., Results: The findings showed that age (r = 0.17, P = 0.034), self-judgment (r = 0. 36, P < 0.001), isolation (r = 0.44, P < 0.001) and over-identification (r = 0.15, P = 0.031) were associated with PTSD score, and there was also a statistically significant inverse relationship between the score of the self-kindness (r = - 0.19, P = 0.006) subscale and the overall score of PTSD in the emergency staff., Conclusion: During the COVID-19 pandemic, emergency staff have persistently faced potentially traumatic situations as first-line healthcare workers, suggesting the direness of this group's mental health. By identifying the predisposing factors of the psychological pathology under study, this research can be applied in clinical practice and provide useful information for designing special interventions and protocols for emergency staff., (© 2022. The Author(s).)

Background: B-cell lymphoma 2 (BCL-2) and BCL-2 associated X (BAX) polymorphisms are important in the apoptosis process, response to treatment and survival in Acute Lymphoblastic Leukemia (ALL) patients. We aimed to investigate the effect of these genes with other predictors corresponding to the survival of ALL patients with an appropriate frailty survival model., Methods: Our study was performed in 2020 on sixty-two cases of childhood aged 3-16 (year) with ALL disease who were selected by convenience sampling from the two hospitals of Tabriz, Iran. RFLPPCR method was used for genotyping the promoter region of the BAX and BCL-2 genes. We used different frailty survival models, to control heterogeneity between individuals due to unmeasured factors affecting their survival. All analyses were implemented using Stata 16., Results: Based on the result of log-logistic model along with frailty gamma, the proportional odds (standard error) of survival for a CC allele of BCL-2 patient compared to a AA allele patient were 6.0 (1.47); P <0.001 and for a AC of BCL-2 allele patient were 0.57 (1.23); P =0.009. Patients with AG allele of BAX had 2.05 (1.26) times greater odds of surviving than a AA allele patient ( P =0.003). The odds of survival of patients with abnormal white blood cell (WBC) were 92% less than normal WBC ( P <0.001)., Conclusion: With controlling unmeasured factors affecting, the BCL-2 and BAX genes promoter polymorphism are effective in the survival rates for ALL., Competing Interests: Conflict of interest No potential conflict of interest was reported by the authors., (Copyright © 2022 Nikmohammadi et al. Published by Tehran University of Medical Sciences.)

Background: Determining people's healthy behaviors related to COVID-19 could be effective in providing preventive measures. The present study aims to investigate preventive behaviors associated with COVID-19 including wearing masks and keeping physical distance among the passengers on buses and public taxis measures to evaluate the ventilation systems in these vehicles., Methods: This cross-sectional study was performed on 753 passengers on buses and taxis in Tabriz, northwestern Iran, from 15 February to 1 March 2021. Multistage sampling method was used to select the participants. Tabriz was socioeconomically divided into three areas, including high, moderate, and low socioeconomic status. Three researchers were observed passengers behaviors standing at the selected stations and assessed their behaviors according to study checklist., Results: In total, the data were gathered from 358 (47.5%) female and 395 (52.5%) male in public transport systems. The results of this study indicated that female passengers used masks significantly more than men (P < 0.001). About 40% of men and women did not keep a physical distance of at least one meter in the public transportation system. Failing to keep social distancing was mostly observed among people with low SES (N = 103, 54%) and those who were in city center (N = 88, 48.5%). According to the multivariate regression analysis, for not wearing mask: being male [OR 4.94; 95%CI (2.62-9.28)] and using bus [(OR 3.27, 95%CI (1.73,6.19)], and for not physical distancing: having age under 25 years [OR 2.58; 95%CI (1.53,4.36)] and low socioeconomic status (SES) [OR 5.19; 95%CI (3.25,8.30)], and for no ventilation: using bus [OR 1.57; 95%CI (1.05,2.34)] were significant predictors., Conclusion: Our results suggest that gender, type of vehicle, age, and SES were significant predictors of non-adherence to COVID-19 preventive behaviors in public transport during the pandemic. Given that social distancing is less observed in the public transportation system in Tabriz, Iran, it is necessary for government to consider and monitor guidelines to protect the passengers from COVID-19 infections by providing measures to maintain physical distance in public transportation systems. It may be possible to force vehicle owners who do not comply with health protocols to keep some distance by imposing fines., (© 2021. The Author(s).)

In this work, we focused on facile preparation of ternary nanocomposites containing TiO 2 nanosheets, reduced graphene oxide, and different quantities of silver for photocatalytic treatment of tetracycline (TC) antibiotic wastewater. Plasmonic silver nanoparticles were deposited on TiO 2 nanosheets/reduced graphene oxide nanocomposite via a photodeposition method (TGA(x) samples). The as-obtained samples were identified by variety of techniques such as XRD, UV-Vis DRS, FESEM/EDX, TEM, and Raman spectroscopy. The photocatalytic degradation experiments of TC (in concentration of 30 mg/L) were carried out by synthesized nanocomposites, and the degradation efficiency of TGA (0.076) (the optimal sample) was evaluated as 52.56% after 3 hr of irradiation under visible light. The obtained results showed that in TGA(x) samples, the reduced graphene oxide acts as a bridge for transferring photoinduced electrons from plasmonic silver nanoparticles to TiO 2 nanosheetes. A three-layered artificial neural network model with four input variables (irradiation time, catalyst dosage, initial concentration of TC, and silver nitrate content) and one output variable (% degradation) was optimized with 11 hidden neurons. The relative importance of the independent variables was calculated using Garson formula and the initial concentration of TC was found as the most influencing parameter (relative importance of 31%) on the treatment efficiency. PRACTITIONER POINTS: TiO 2 nanosheets synthesized on the reduced graphene oxide by hydrothermal method. Plasmonic silver nanoparticles deposited on TNs/rGO by photodeposition method The photocatalytic degradation of tetracycline (TC) was modeled by artificial neural network., (© 2019 Water Environment Federation.)

Background: The prevalence of overweight and obesity have increased dramatically worldwide and together they constitute a major risk factor for coronary heart disease (CHD). The aim of this study was to assess the repeated measurements of body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WHtR) in predicting CHD incidence., Methods: This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study between 1999-2011, on 1959 women and 1371 men participants' ages ≥30 yr, without a history of CVD. A joint modeling approach was utilized for data analysis using R software. The resulting joint model allowed measuring α (quantifies the association between anthropometric indices up to time t and the hazard for CHD event at the same time point)., Results: About 9% of the participants (7.1% of the women and 11.7% of the men) experienced CHD event during follow-up. The results indicated a significant linear increasing trend in BMI, WC, WHR, and WHtR over time ( P <0.001). The increased risk of CHD event in females increases with the values of BMI (α= 0.004, P =0.023), WC (α= 0.018, P =0.009), WHR (α= 0.067, P =0.014) and WHtR (α= 0.106, P =0.002). Furthermore, in males the risk of CHD risk increases by the values of BMI (α= 0.005, P =0.032), WC (α= 0.019, P =0.008), WHR (α= 0.043, P =0.015) and WHtR (α= 0.096, P =0.002)., Conclusion: By jointly modeling longitudinal data with time-to-event outcomes, our study revealed that WHtR is superior to other indices in predicting CHD incidence., Competing Interests: Conflict of Interests The authors have no conflicts of interest regarding this study.