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The effect of microwave pretreatment and moisture levels of Camelina sativa seeds on the quality of extracted oil by cold press was investigated. The seed moistures were adjusted to 2.5%, 5.0%, 7.5%, and 10.0% and pretreated with microwaves for 0, 1, 2, and 3 min. Microwave pretreatment (3 min) of the seeds with 2.5% moisture increased the oil extraction yield by ∼11% compared to the control sample. The highest amount of acidity (0.564 g FFA·g−1 oil), peroxide value (2.4 meq O2·kg−1 oil), carotenoid (5.26 mg·kg−1 oil), and browning index (0.710) were found in the oil extracted from seeds with 10% moisture and 3 min microwave pretreatment. The total phenolic compound was increased by microwave pretreatment but was mitigated by the seed moisture content, and the highest amount (208.24 mg caffeic acid·100 g−1 oil) was observed at 3 min microwave pretreatment of the seeds with 2.5% moisture. Chlorophyll content decreased by both microwave pretreatment and seed moisture content in camelina oil. Generally, the fatty acid composition of the extracted oils was not affected by the seed pretreatments. In conclusion, pretreatment of the camelina seeds before oil extraction is suggested to obtain a high oil extraction yield with a good quality oil.

Performance of any control scheme in Phase II depends directly on the quality of estimators utilized in Phase I. In practice, outliers could be present in the data which would impact the performance of estimators adversely. This study deals with robust parameter estimation and monitoring linear profiles in the presence of outliers and compares the results with the least squares (LS) estimators. For this purpose, M-estimators are used as robust estimators and empirical distributions for related statistics are determined using Mont Carlo simulation to calculate control limits for two T 2 control charts and for codding independent variable method. Using a numerical example, profile parameters are estimated by ordinary least squares and M-estimators and the resulting statistics are monitored by two T 2 control schemes. Phase II control charts are determined based on the two types of estimators and compared for different out of control profiles. Empirical distributions did not follow their exact distributions obtained by least squares method. Simulation results confirm that M-estimators lead to better estimates in comparison to LS estimators and also improves classification performance. Robust estimators also lead to improvement in ARL performance in comparison to LS estimators. [ABSTRACT FROM AUTHOR]

Due to high antimicrobial activity against numerous microorganisms, silver nanoparticles (AgNPs) are being utilized in various areas. Microwave-accelerated AgNPs synthesis using Corylus avellana leaf extract was evaluated. Based on randomly central composite design, 13 mixture solutions containing different amounts of the prepared extract (0.10–0.90 mL) and 1 mM silver nitrate solution (15–25 mL) were prepared and exposed to microwave irradiation for 180 s. Response surface methodology was utilized to evaluate the effects of the two independent variables on particle size and concentration of the synthesized AgNPs, as manifested in the place of broad emission peak (λ max) and its absorbance unit, respectively. Fourier transform infrared spectroscopy analysis indicated that the two hydroxyl and carboxylic acid functional groups with reducing activity existed in the prepared extract. Dynamic light scattering and transmission electron microscopy analyses revealed that the formed spherical AgNPs using optimum amounts of C. avellana leaf extract (0.9 mL) and 1 mM silver nitrate solution (25 mL) had minimum particle size (103.5 nm) and polydispersity index (PDI) (0.209), and maximum concentration (140 ppm) and zeta potential (−21.8 mV). Results indicated that the formed AgNPs had high fungicidal effects against the spoiled fungi of Colletotrichum coccodes and Penicillium digitatum.

In order to alter the solubility and bioavailability of various functional lipids and plant essential oils (EOs), it is possible to prepare their oil in water (O/W) nanoemulsions. Thyme O/W nanoemulsions were prepared under subcritical water conditions (at 120°C and pressure of 1.5 atm for 2 h), using Tween 20, Tween 80, saponin, Arabic gum, xanthan gum, and sodium caseinate as emulsifiers. Results indicated that nanoemulsions with minimum mean droplet size of 11.5 and 12.6 nm were produced using Tween 20 and 80, respectively. Moreover, nanoemulsions with minimum polydispersity index (0.139) and maximum mean value of zeta potential (−24.5 mV) were provided utilizing xanthan gum and saponin, respectively. Results also revealed that the prepared nanoemulsions using saponin had maximum antioxidant activity based on percentage of scavenging ability (40.6%) and bactericidal effects against Streptococcus mutans as manifested in the formed clear zone (diameter of 21 mm). Morphological assessment of all the prepared nanoemulsions demonstrated that spherical thyme nanodroplets were formed in the colloidal solutions which revealed that all the prepared nanoemulsions had high thermodynamic stability due to the minimum surface energy level of the formed nanodroplets. This can increase applications of the prepared thyme O/W nanoemulsions in the aqueous food and pharmaceutical formulations.

Silver nanoparticles (AgNPs) were synthesized using Aloe vera leaf extract as both reducing and stabilizing agents via microwave irradiation method. The effects of the microwave exposure time and the amount of AgNO3 solution on the mean particle size and concentration of the synthesized AgNPs solution were investigated using response surface methodology. The synthesized AgNPs were characterized by transmission electron microscopy, UV-Vis spectroscopy, and dynamic light scattering. Well-dispersed and spherically fabricated AgNPs with mean particle size (46 nm) and maximum concentration (64 ppm) and zeta potential (+15.5 mV), were obtained at optimal synthesis conditions, using 9 ml of AgNO3 (1 mm) and 0.1 ml of Aloe vera extract during microwave exposure time of 360 s. The antibacterial activity of the synthesized AgNPs was tested using Escherichia coli and Staphylococcus aureus bacteria and the obtained results indicated their significant inhibitory effects against these two Gram-negative and Gram-positive bacteria.

Naval Base as part of Integrated Fleet Weapon System has an important role in maintaining the strategic environment in the region of Indonesia. Naval Base with a strategic location will support Indonesian Navy’s main duty to carry out the administrative and logistical support. Due to the limitation of Naval Base’s condition, feasibility study will be required to relocate the Naval Base. In this feasibility study, a combination of methods between SWOT analysis and Analytical Hierarchy Process (AHP) is used. The results of the Internal Factors Evaluation (IFE) Matrix Analysis is 4.72 and External Factors Evaluation (EFE) Matrix Analysis is 2.91. In general, the balance of power between the IFE Matrix and EFE Matrix is located in Quadrants I and thus, the Aggressive Strategy is supported. While the Matrix Analysis’ result of Internal - External (IE) showed that the score of IFE and EFE located in Quadrant II and VII.

This study aimed to propose a novel method for dynamic risk assessment using a Bayesian network (BN) based on fuzzy data to decrease uncertainty compared to traditional methods by integrating Interval Type-2 Fuzzy Sets (IT2FS) and Z-numbers. A bow-tie diagram was constructed by employing the System Hazard Identification, Prediction, and Prevention (SHIPP) approach, the Top Event Fault Tree, and the Barriers Failure Fault Tree. The experts then provided their opinions and confidence levels on the prior probabilities of the basic events, which were then quantified utilizing the IT2FS and combined using the Z-number to reduce the uncertainty of the prior probability. The posterior probability of the critical basic events (CBEs) was obtained using the beta distribution based on recorded data on their requirements and failure rates over five years. This information was then fed into the BN. Updating the BN allowed calculating the posterior probability of barrier failure and consequences. Spherical tanks were used as a case study to demonstrate and confirm the significant benefits of the methodology. The results indicated that the overall posterior probability of Consequences after the failure probability of barriers displayed an upward trend over the 5-year period. This rise in IT2FS-Z calculation outcomes exhibited a shallower slope compared to the IT2FS mode, attributed to the impact of experts' confidence levels in the IT2FS-Z mode. These differences became more evident by considering the 10-4 variance compared to the 10-5. This study offers industry managers a more comprehensive and reliable understanding of achieving the most effective accident prevention performance., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Aliabadi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives. The present study aimed to review the changes in anthropometric dimensions around the world during the last 30 years. Methods. The search for this study was conducted in four databases with related keywords. Papers from 1990 to 2021 were reviewed and 4139 articles were identified, with 505 related titles. Of these, 187 articles met the eligibility criteria, and their whole text was examined; 132 articles were then included for the final review. Results. The reviewed studies showed that a large number of anthropometric dimensions of the human body have become larger than in the past, such as height. Although the increasing trend of anthropometric dimensions in the past has been faster than in recent years, decreasing changes have also been seen in some anthropometric dimensions, such as the human jaw, face width and head width. It should be noted that the main reasons for the changes mentioned in the studies are economics and family income, social conditions, health and nutrition. Conclusion. Since the process of changes in anthropometric dimensions is not always the same, anthropometric data should be updated regularly, and work environments and equipment should be reviewed or redesigned according to the new anthropometric data.

Objective: Musculoskeletal ultrasound is increasingly used as the modality of choice in diagnosing many medical situations. The present study aimed to compare the accuracy of point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to detect acute medial meniscus tears in knee., Methods: The prospective study was conducted on patients with suspected medial meniscus tears in knee. in the emergency department. In the absence of a knee fracture on x-ray, POCUS on the knee was performed. All patients underwent POCUS and MRI of the knee followed by arthroscopy. POCUS findings were then compared to MRI findings to diagnose medial meniscus tears., Results: A final total of 157 patients with a mean age of 25.04±7.41 years was included. Out of 157 patients, 94 (59.9%) were male. Medial meniscus tears were detected in 89 patients (56.7%) using arthroscopy as the gold standard. The sensitivity, specificity, positive and negative predictive values, and accuracy of POCUS to detect medial meniscus tears were 88.8% (95% confidence interval [CI], 80.3%-94.5%), 89.7% (95% CI, 79.9%-95.8%), 91.9% (95% CI, 84.8%-95.8%), 85.9% (95% CI, 77.2%-91.7%), and 89.2% (95% CI, 83.3%-93.6%), respectively. The diagnostic accuracy of MRI to detect medial meniscus injury was 93.0% (95% CI, 87.8%- 96.4%)., Conclusion: The present study demonstrated that POCUS is an accurate and reliable diagnostic tool alternative to MRI in detecting medial meniscal tears. POCUS had acceptable sensitivity, specificity, and accuracy in detecting meniscal injuries and could be performed as an effective immediate investigation to guide further modalities in patients with acute knee trauma.

Background: Ergonomic behaviors play a crucial role in preventing work-related musculoskeletal disorders (WMSDs). To measure these behaviors, this research aimed to develop and evaluate an ergonomic behaviors tool (EBET) based on the Social Cognitive Theory (SCT) among women workers on assembly lines (WwAL)., Methods: The study was conducted from December 2022 to January 2023 with a focus on the psychometric assessment of EBET. Initially, a literature review and interviews were carried out to identify crucial concepts and primary items. The questionnaire's validity was evaluated using the Content Validity Ratio (CVR) and the Content Validity Index (CVI). To determine the domains of the tool, construct validity was examined by administering the items to 270 eligible women. The reliability of the tool was assessed using McDonald's Omega coefficient., Results: From a total of 67 primary items, 50 were confirmed. The study demonstrated good validity with CVR = 0.92 and CVI = 0.97, along with reliable results indicated by McDonald's Omega coefficient of 0.74. The exploratory factor analysis (EFA) revealed ten distinct dimensions: outcome expectations, outcome expectancies, normative beliefs, perceived barriers, social support, observational learning, reinforcement, behavioral skills, self-efficacy, and intention. Together, these dimensions accounted for 66.25% of the variance in the data. Additionally, the confirmatory factor analysis results supported the presence of these ten constructs and demonstrated a satisfactory fit., Conclusions: EBET is a dependable and valid instrument for evaluating the ergonomic behaviors of workers, utilizing the principles of SCT. Researchers can employ EBET to gather data and implement suitable training interventions to enhance ergonomic behavior among WwAL. However, it is crucial to recognize that EBET may not encompass all facets of ergonomic behaviors. Therefore, it is imperative for future research to prioritize the evaluation of EBET's suitability among diverse worker populations and to consider additional dimensions of ergonomics to ensure its wider applicability and effectiveness., (© 2024. The Author(s).)

Objective: Following tonsillectomy, postoperative pain and hemorrhage from the tonsillar bed are causes of significant morbidity. Intracapsular tonsillectomy with Coblation is suggested to minimize such morbidity while remaining efficacious in long-term outcomes. This systematic review and meta-analysis assessed short-term morbidity and long-term outcomes from intracapsular tonsillectomy with Coblation, focusing primarily on posttonsillectomy hemorrhage., Data Sources: Medline, Embase, and the Cochrane Library., Review Methods: Guided by PRISMA guidelines, studies on intracapsular tonsillectomy with Coblation published between December 2002 and July 2022 evaluating frequency of posttonsillectomy hemorrhage were screened. Studies without primary data were excluded. Meta-analysis was conducted using the random-effect model. The primary outcome was the proportion of patients who experienced posttonsillectomy hemorrhage. The secondary outcomes were posttonsillectomy pain, the proportion requiring revision tonsillectomy, and severity of sleep-disordered breathing measured by polysomnography outcomes., Results: From 14 studies there were 9821 patients. The proportion of total posttonsillectomy hemorrhage was 1.0% (95% confidence interval [CI] 0.5%-1.6%, n = 9821). The proportion experiencing primary hemorrhage, secondary hemorrhage, and those requiring further tonsil surgery were 0.1% (95% CI 0.0%-0.1%; study n = 7), 0.8% (95% CI 0.2%-1.4%; study n = 7), and 1.4% (95% CI 0.6%-2.2%; study n = 6), respectively. Mean reduction in apnea-hypopnea index was -16.0 events per hour (95% CI -8.8 to -23.3, study n = 3) and mean increase in oxygen nadir was 5.9% (95% CI 2.6%-9.1%, study n = 3)., Conclusion: Intracapsular tonsillectomy with Coblation has been demonstrated to have a low rate of posttonsillectomy hemorrhage. Data regarding long-term tonsil regrowth and need for reoperation were encouraging of the efficacy of this technique., (© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)

Introduction: This study aims to investigate the effectiveness of intravenous ibuprofen or intravenous ibuprofen plus acetaminophen compared to intravenous morphine in patients with closed extremity fractures., Methods: A triple-blinded randomized clinical trial was conducted at a tertiary trauma center in Iran. Adult patients between 15 and 60 years old with closed, isolated limb fractures and a pain intensity of at least 6/10 on the visual analog scale (VAS) were eligible. Patients with specific conditions or contraindications were not included. Participants were randomly assigned to receive intravenous ibuprofen, intravenous ibuprofen plus acetaminophen, or intravenous morphine. Pain scores were assessed using the visual analog scale at baseline and 5, 15, 30, and 60 min after drug administration. The primary outcome measure was the pain score reduction after one hour., Results: Out of 388 trauma patients screened, 158 were included in the analysis. There were no significant differences in age or sex distribution among the three groups. The pain scores decreased significantly in all groups after 5 min, with the morphine group showing the lowest pain score at 15 min. The maximum effect of ibuprofen was observed after 30 min, while the ibuprofen-acetaminophen combination maintained its effect after 60 min. One hour after injection, pain score reduction in the ibuprofen-acetaminophen group was significantly more than in the other two groups, and pain score reduction in the ibuprofen group was significantly more than in the morphine group., Conclusion: The study findings suggest that ibuprofen and its combination with acetaminophen have similar or better analgesic effects compared to morphine in patients with closed extremity fractures. Although morphine initially provided the greatest pain relief, its effect diminished over time. In contrast, ibuprofen and the ibuprofen-acetaminophen combination maintained their analgesic effects for a longer duration. The combination therapy demonstrated the most sustained pain reduction. The study highlights the potential of non-opioid analgesics in fracture pain management and emphasizes the importance of initiation of these medications as first line analgesic for patients with fractures. These findings support the growing trend of exploring non-opioid analgesics in pain management., Trial Registration: ClinicalTrials.gov Identifier: NCT05630222 (Tue, Nov 29, 2022). The manuscript adheres to CONSORT guidelines., (© 2024. The Author(s).)

Objectives Human error has been recognized as one of the top causes of most accidents in mines. This study aimed to identify and assess cognitive errors among copper miners using the cognitive reliability and error analysis method (CREAM). Methods. This cross-sectional study was carried out in one of the copper mines in Iran. First, all tasks were analyzed by hierarchical task analysis (HTA). Then cognitive errors were assessed using the CREAM. Results. With respect to the basic CREAM results in the operational units, including extraction, crushing and processing, human error probability (HEP) was obtained as 0.056, 0.0315 and 0.0177, respectively. Based on the results of the extended CREAM, the types of errors identified for all tasks in the three operational units were mainly associated with execution (53.4%), observation (40%), interpretation (5%) and planning (1.6%). Also, the cognitive errors were related to execution, monitoring, observation, communication, diagnosis, recording and planning, respectively. Conclusion . The results showed that human error is very high in the operational units of the mine. Therefore, immediate actions are needed to improve safety performance in the mine units, which determine the role of various factors in human errors and can provide the possibility of implementing more effective interventions.

Background: This study focuses on identifying the key factors associated with ergonomic behaviors (ERBE) among women workers on assembly lines (WwAL) to prevent musculoskeletal disorders (MSDs) caused by repetitive motions and unfavorable body postures. To achieve this objective, this study employed Bayesian networks (BN) analysis based on social cognitive theory (SCT)., Methods: A cross-sectional study was conducted to examine the predictive factors of ERBE among 250 WwAL from six different industries located in Neyshabur, a city in northeastern Iran. The study used a two-stage cluster sampling method for participant selection and self-report questionnaires to collect data on demographic characteristics, variables associated with SCT, ERBE, and the standard Nordic questionnaire. The collected data were analyzed using Netica and SPSS version 21, which involved statistical analyses such as independent t-tests, Pearson correlation, and ANOVA tests at a significance level of p < 0.05. BN analysis was conducted to identify the important factors that impact ERBE., Results: The majority of individuals reported experiencing chronic pain in their back, neck, and shoulder areas. Engaging in physical activity, consuming dairy products, and attaining a higher level of education were found to be significantly associated with the adoption of ERBE p < 0.05. Among the various SCT constructs, observational learning, intention, and social support demonstrated the highest levels of sensitivity towards ERBE, with scores of 4.08, 3.82, and 3.57, respectively. However, it is worth noting that all SCT constructs exhibited a certain degree of sensitivity towards ERBE., Conclusions: The research findings demonstrate that all constructs within SCT are effective in identifying factors associated with ERBE among WwAL. The study also highlights the importance of considering education levels and variables related to healthy lifestyles when promoting ERBE in this specific population., (© 2023. The Author(s).)

Leishmaniasis is a parasitic disease caused by Leishmania parasites. Meglumine antimoniate, or Glucantime, is the primary drug used to treat this disease. Glucantime with a standard painful injection administration route has high aqueous solubility, burst release, a significant tendency to cross into aqueous medium, rapid clearance from the body, and insufficient residence time at the injury site. Topical delivery of Glucantime can be a favorable option in the treatment of localized cutaneous leishmaniasis. In this study, a suitable transdermal formulation in the form of nanostructured lipid carrier (NLC)-based hydrogel containing Glucantime was prepared. In vitro drug release studies confirmed controllable drug release behavior for hydrogel formulation. An in vivo permeation study on healthy BALB/C female mice confirmed appropriate penetration of hydrogel into the skin and sufficient residence time in the skin. In vivo performance of the new topical formulation on the BALB/C female mice showed a significant improvement in reduction of leishmaniasis wound size, lowering parasites number in lesions, liver, and spleen compared with commercial ampule. Hematological analysis showed a significant reduction of the drug's side effects, including variance of enzymes and blood factors. NLC-based hydrogel formulation is proposed as a new topical administration to replace the commercial ampule.

Background: The use of preventive behaviors of musculoskeletal disorders (MSDs) requires proper training, which leads to correct decisions regarding maintaining postures at work and performing stretching exercises. Due to very repetitive work, applying manual force, improper postures, and static contractions of proximal muscles, assembly-line female workers suffer from musculoskeletal pains. It is assumed that structured and theory-based educational intervention using a learning-by-doing (LBD) approach may increase the preventive behaviors against MSDs and reduce the consequences of these disorders., Methods: This randomized controlled trial (RCT) will be conducted in three phases: phase 1: validation of the compiled questionnaire, phase 2: determining the social cognitive theory (SCT) constructs that predict the preventive behaviors of MSDs in assembly-line female workers, and phase 3: designing and implementing the educational theory. The educational intervention is based on the LBD approach, and the study population includes assembly-line female workers in electronic industries of Iran, who are randomly divided into two intervention and control groups. The intervention group received the educational intervention in the workplace and the control group does not receive any intervention. The theory-based educational intervention includes evidence-based information along with pictures, fact sheets, and published literature about a good posture at work and the need to perform proper stretching exercises. The educational intervention aims to improve the knowledge, skills, self-efficacy, and intention of assembly-line female workers to adopt preventive behaviors of MSDs., Discussion: The present study will evaluate the effects of maintaining a good posture at work and performing stretching exercises on the adherence to preventive behaviors of MSDs among assembly-line female workers. The developed intervention is easily implemented and evaluated in a short period of time based on the improved score of the rapid upper limb assessment (RULA) method and the mean score of adherence to stretching exercises and can be provided by a health, safety, and environment (HSE) expert., Trial Registration: ClinicalTrials.gov IRCT20220825055792N1. Registered on 23 September 2022 with the IRCTID., (© 2023. The Author(s).)

Starch nanoparticles (SNPs) in colloidal forms were prepared using enzymatically pretreatment and four different gelatinization methods based on autoclave, microwave, ultrasonication and normal heating with stirring. Furthermore, SNPs in powder form were prepared using freeze drying technique. Results indicated that the formed SNPs using starch solution (1 % W/V) and ultrasonication technique had lowest mean particle size (151 nm) and PDI (0.173), and highest zeta potential (-8.8 mV) values. Optimization procedure using response surface methodology, based on central composite design, indicated that using 1.5 mL of α-amylase and sonication time of 15 min, SNPs with lowest particle size (49.3 nm) and highest zeta potential (-10.8 mV) were produced. Using prepared colloidal solution under optimal conditions, SNPs powder were produced by freeze dryer, adjusted at pressure and temperature of 100 Pa and - 70 °C, for 24 h. Results indicated that formed SNPs powder with squared-shape, had particle size, zeta potential, specific surface area, decomposition temperature of 197 nm, -13.9 mV, 1.9 m 2 g -1 and 162 °C, respectively. While, for native starch these values were 5018 nm, -6.01 mV, 0.68 m 2 g -1 and 170.2 °C, respectively. Results revealed that emulsification ability of SNPs powder was three times higher than that of the native starch., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Background: Skin grafting reflects a common dermatological procedure for closing skin defects. Patient education is important for managing expectation and optimising skin graft take. While health information is increasingly accessed on the internet, there are no existing studies assessing their quality., Methods: The first 25 results from Google, Microsoft Bing and Yahoo! search engines using the term 'skin graft' were analysed using a variety of standard instruments. Readability was assessed using the Flesch-Kincaid Grade score (FKG), Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG) and the New Dale-Chall Readability Index (NDC). Reliability was assessed using the DISCERN instrument and credibility with the Journal of the American Medical Association Benchmark Criteria (JAMA). Transparency was identified by presence of the Health On the Net Foundation Code certification (HON-code)., Results: Seventy-five websites were identified. After exclusion, forty-three remaining websites were analysed with average FKG, GFI and SMOG scores of 7.8, 10.1 and 10.7, respectively. The average NDC was 5.9. The average reliability was fair with a DISCERN score based on the first 15 questions of the instrument of 42.6. The mean JAMA score was 2, and 9 websites displayed the HON-code certificate., Conclusions: Readability, reliability and credibility of online health information regarding skin grafting can be improved. Health care providers should critically assess existing online patient information or develop alternative material to educate patients undergoing skin graft surgery., (© 2022 Australasian College of Dermatologists.)

Working in cold environments can have a variety of negative consequences on health, efficiency, quality, safety, and performance. The present study investigates the risk of cold stress in petroleum transfer centers in Iran's northwestern cold regions. The proposed method by ISO-15743 (E) was used to assess the risk of cold stress. The activity level (M) was calculated using the ISO 8996:2021 standard. The evaluation of local cooling, contact of cold surfaces, and hand and face temperature was performed using ISO 11079, ISO 13732-3, and ISO 9886, respectively. During their work, 28 outdoor site men and mechanics as a case group and 8 operators as a control group put through subjective analysis. According to the findings, the mean I cl,r , IREQ min, and IREQ neutral were 1.59 ± 0.33, 2.1 ± 0.44, and 2.43 ± 0.45, respectively. The mean equivalent chill temperature was -13.83 ± 5.45, and workers were at risk of local cooling stress at levels 1 and 2. The case group showed greater losses in finger skin temperatures after short term exposure to extremely cold environments than the control group (P < 0.001). Based on the questionnaire results a significant percentage of workers performing the activity during the winter have more difficulty. Prolonged general and local cold exposure can cause pain, numbness, and frostbite in site men and mechanics. Careful planning, training, extensive distribution of cold protective clothing, rest periods, a relatively short stay in the cold environment, and proper equipment can greatly reduce these hazards., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: COVID-19 is an evolving worldwide pandemic causing significant morbidity and mortality. COVID-19 vaccinations have been developed to increase immunity against the virus. In New Zealand, the Pfizer BioNTech mRNA vaccine has been provisionally approved for use. Axillary lymphadenopathy is a recognized side effect of the mRNA vaccine, however cervical lymphadenopathy has also been reported. Due to a wide range of differential diagnoses, the finding of cervical lymphadenopathy requires thorough investigation which can include imaging and invasive diagnostic procedures., Methods: Five patients were identified by otorhinolaryngology (ORL) consultants at Whangarei Base Hospital and Waikato Hospital between 15/7/2021 and 21/12/2021 after being investigated through high suspicion of cancer triage pathways set by the New Zealand Ministry of Health. Inclusion criteria were adult patients with cervical lymphadenopathy following vaccination. Exclusion criteria were no history of vaccination or lymphadenopathy present before vaccination., Results: All patients were identified to have cervical lymphadenopathy on radiological imaging and a recent history of COVID-19 vaccination with the Pfizer BioNTech vaccine. Interval vaccination to fine needle aspiration time ranged between 41 and 76 days. All patients had cytological or histological diagnosis showing reactive findings or interval imaging showing resolution of lymphadenopathy., Conclusion: With increasing levels of COVID-19 vaccination and booster vaccinations we will continue to see cases of COVID-19 vaccine associated cervical lymphadenopathy. We highlight the importance of taking a COVID-19 vaccination history and including COVID-19 associated cervical lymphadenopathy in the differential diagnosis of presentation with a neck lump., (© 2022 Royal Australasian College of Surgeons.)

Introduction: Low serum vitamin D has been shown to be a risk factor for Coronavirus 2019 (COVID-19). The aim of this study was to assess the effects of high dose vitamin D supplementation on hs-CRP, ESR and clinical outcomes, including duration of hospitalization, quality of life and New York Heart Association (NYHA) Functional Classification, in adults with COVID-19. Methods: This double-blind, randomized control trial will be conducted on patients with RT-PCR and/or chest CT scan diagnosis of COVID-19 admitted in Imam Reza Hospital, Mashhad, Iran. Participants will be randomized into control and intervention groups based on randomization sampling. The intervention group will receive soft gel containing 50,000 IU vitamin D on the first day followed by 10,000 IU/day through a supplement drop daily for 29 days. The control group will receive 1000 IU vitamin D daily through supplement drop and a placebo soft gel. All participants will undergo laboratory assessment including inflammatory markers, serum 25)OH)D, complete blood count (CBC), liver and renal profile, lipid profile and erythrocyte sedimentation rate (ESR) at baseline and at day 30. The mortality rate will be recorded in both groups. Results: Data will be presented using descriptive statistics. Comparison of changes in study parameters over the study period will be performed using analysis of covariance adjusting for possible confounders. Conclusions: The findings of this will provide evidence on the effects of high dose vitamin D supplementation on inflammatory markers in hospitalized COVID-19 patients.

Background: Hazards of the workplace and their impacts on the healthcare industry affect the quality of patient care and safety and impose high costs on the healthcare industry. Occupational health in this industry requires proper identification of hazards and managing the related risks. In this study, the researchers attempted to develop an easy-to-use and high applicability occupational health risk assessment model with a fuzzy approach to evaluate risks more precisely., Methods: In this study, a fuzzy inference system (FIS) was designed and applied to develop a risk assessment model., Conclusions: This study showed that the developed model could be applied as a practical model for evaluating occupational health risks. The weight of each risk criterion was used to calculate the risk level by adopting a fuzzy approach. The risk assessment results construed using the fuzzy set theory provided a broad picture of risks and could work adequately in the presence of inaccurate and insufficient data to calculate the risk. This model calculates risk levels and provides us with the dispersion and distribution of the calculated value of the risk number.

Introduction: The use of point-of-care ultrasonography (POCUS) for identifying medial collateral ligament (MCL) tears has increased in recent years. This study aimed to evaluate the diagnostic accuracy of POCUS in the diagnosis of acute MCL tears of the knee., Methods: This prospective cross-sectional study was performed on patients with suspected MCL tear of the knee in the emergency department (ED). After history taking and primary physical examination, radiographic imaging of the knee was done. If there was no fracture in the knee X-ray, the POCUS examination was done. All of the patients were asked to refer to an orthopedic clinic, 7-10 days after discharge from ED, for Magnetic Resonance Imaging (MRI) evaluation. The second POCUS was done in the orthopedic clinic. Finally, the findings of POCUS and MRI were compared in diagnosing MCL injury., Results: Two hundred and fifty patients with a mean age of 25.05 ± 9.12 years were analyzed (86.8% male). According to the MRI findings, as the gold standard, 55(22.0%) patients had MCL injury. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of ultrasound in detection of MCL injury, in comparison with MRI were 83.64 (95% CI, 71.20 to 92.23), 94.36% (95% CI, 90.13 to 97.15), 80.70% (95% CI, 69.95 to 88.25), 95.34% (95% CI, 91.83 to 97.38), and 92.00% (95% CI, 87.92 to 95.05), respectively. The area under the receiver operating characteristic (ROC) curve of POCUS was 0.890 (95% CI, 0.844 to 0.926)., Conclusion: It seems that POCUS can be applied in screening patients with MCL tears following blunt knee trauma., Competing Interests: The authors declare no conflict of interest.

Introduction: Intracranial aneurysms are common. Receiving this diagnosis can have a profound impact on patients and their families and this is compounded by the nuanced complexities around their management. An overwhelming majority of patients research health information using the internet. Patient-centred care and informed consent requires patients to have access to information that is readable and reliable. The aim of this study was to assess the readability and reliability of online health information about intracranial aneurysms., Method: A Google search was conducted using the terms 'brain aneurysm', 'cerebral aneurysm', and 'intracranial aneurysm' and the first 75 websites were screened for assessment. The readability of each website was assessed using the Flesch reading ease score (FRE), the Flesch-Kincaid grade level (FKGL), the gunning fog index (GFI) and the simple measure of gobbledygook (SMOG) indices. Reliability was assessed using the DISCERN instrument and the Journal of the American Medical Association benchmark criteria (JAMA)., Results: Following exclusion, 36 websites were analyzed. The websites collectively scored as 'difficult' readability and 'poor' reliability on average. Statistically significant differences in readability were observed between websites categorized as patient health information and commercial compared with academic and physician. Differences in readability were also observed between search results of 'brain aneurysm' compared with 'intracranial aneurysm'., Conclusion: The readability and reliability of online health information about intracranial aneurysms is suboptimal. Health professionals must ensure their patients are well informed which includes directing them to high quality resources which are readable and reliable and use layperson-oriented language during the consultation., (© 2021 Royal Australasian College of Surgeons.)

Background: In recent years, musculoskeletal ultrasound has increasingly become the common method for diagnosis for many medical specialties. Therefore, the present study was performed to evaluate the diagnostic value of point-of-care ultrasonography (POCUS) as a primary triage tool in the diagnosis of the acute medial meniscus injury of the knee., Materials and Methods: The present cross-sectional study was performed on patients with a suspected medial meniscus injury of the knee in the emergency department (ED). After history taking and primary physical examination, radiographic imaging of the knee was done. If there was no fracture in the knee X-ray, the POCUS examination on the knee was carried out. All the patients were asked to refer to an orthopedic clinic 2 weeks after discharge from ED for the Magnetic Resonance Imaging (MRI) evaluation. Finally, the POCUS findings were compared with the MRI findings in diagnosing medial meniscus injury., Results: Fifty-five patients with a mean age of 35.48 ± 11.58 years were analyzed in the study (69.1% male). In comparison with MRI scan, the sensitivity and specificity of POCUS in the detection of medial meniscus injury were 85.0 [95% confidence interval (CI), 54.0 to 98.9] and 65.7% [95% CI 42.2 to 85.7], respectively. Its positive and negative predictive values were 58.6% [95% CI 33.8 to 81.5] and 88.5% [95% CI 62.1 to 99.3], respectively. (Area under the ROC curve = 0.726, P value = 0.003)., Conclusion: The present study demonstrated that POCUS can reasonably be applied in comparison with MRI to evaluate medial meniscus injury. POCUS is an effective initial diagnostic modality in patients with suspected medial meniscus injuries., (© 2022. The Author(s).)

Background: The outbreak of COVID-19 has adversely affected both global economy and public health around the world. These effects have also been observed in many workplaces, including mines., Objective: This study aimed to examine the human error of copper miners during the pandemic., Method: This descriptive-analytical, cross-sectional study was performed on 192 workers of a copper mine in Iran. For this, occupation tasks were firstly analyzed using the Hierarchical Task Analysis (HTA), and then the human error in different subunits was assessed using the basic Cognitive Reliability and Error Analysis Method (CREAM). The prevalence of COVID-19 among miners was determined by assessing positive PCR test records., Results: The probability of human error in the operational subunits including mining, crushing, processing, and support subunits was estimated to be 0.0056, 0.056, 0.0315, and 0.0177, respectively. All three operational units were found to be in the scrambling control mode. The support unit was determined to be in the tactical control mode. Approximately 50% of all workers had been infected with COVID-19, with the highest prevalence in support units., Conclusion: The results suggest that during the COVID-19 pandemic, copper miners are at higher risk of human error induced by poor working conditions. Therefore, it is recommended to employ some management strategies such as promotion of safety, health monitoring, and adopting supportive measures to control occupational stresses and therefore the probability of human error in the mine's operational units.

Background: Considering that the frequency of a factor contribution to accidents occurrence is not always a reason for the importance of that factor, in addition to studying the participation of basic risk factors (BRFs) in the occurrence of the accidents, their importance must be investigated., Objective: The purpose of the present study is to propose a quantitative methodology for monitoring BRFs based on Tripod Beta and Tripod Delta methods., Methods: In the present study, first, the accidents that took place in the manufacturing companies were analyzed using a reactive approach, ie Tripod Beta. In the second step, a proactive, ie Tripod Delta was used to identify the weaknesses in the companies using safety performance indicators. Finally, a quantitative methodology for monitoring BRFs was proposed., Results: According to the results of the accident analysis, training with 33 cases, hardware with 30 cases, procedures with 25 cases and error induce conditions with 14 cases were the most frequent contributing basic risk factors to the accidents. The lowest score of the basic risk factor indicators was related to the organization (4.9), design (8.8), training (8.3), procedures (8.3), and hardware (8.7). Based on the results, maintenance management, hardware, and training have the highest weight in the occurrence of accidents, 0.23, 0.179, and 0.125, respectively., Conclusions: he proposed methodology helps the organization to continuously improve safety performance by identifying system's weaknesses before the accident and invest optimally in the system's critical points.

Background: Melanoma is the most lethal skin cancer. Excision biopsy is generally recommended for clinically suspicious pigmented lesions; however, a proportion of cutaneous melanomas are diagnosed by shave biopsy. A systematic review was undertaken to investigate the impact of shave biopsy on tumor staging, treatment recommendations, and prognosis., Methodology: The MEDLINE, Embase, and Cochrane Library databases were searched for relevant articles. Data on deep margin status on shave biopsy, tumor upstaging, and additional treatments on wide local excision (WLE), disease recurrence, and survival effect were analyzed across studies., Results: Fourteen articles from 2010 to 2020 were included. In total, 3713 patients had melanoma diagnosed on shave biopsy. Meta-analysis revealed a positive deep margin in 42.9% of shave biopsies. Following WLE, change in tumor stage was reported in 7.7% of patients. Additional treatment was recommended for 2.3% of patients in the form of either further WLE and/or sentinel lymph node biopsy. There was high heterogeneity across studies in all outcomes. Four studies reported survival, while no studies found any significant difference in disease-free or overall survival between shave biopsy and other biopsy modalities., Conclusions: Just over 40% of melanomas diagnosed on shave biopsy report a positive deep margin; however, this translated into a change in tumor stage or treatment recommendations in relatively few patients (7.7% and 2.3%, respectively), with no impact on local recurrence or survival among the studies analyzed., (© 2021. Society of Surgical Oncology.)

Introduction: Glioblastoma Multiforme (GBM) represents one of the most common and most aggressive forms of brain tumours with a poor prognosis. There is often uncertainty around diagnosis and prognosis amongst patients diagnosed with cancer. Most patients rely on internet to access health-related information. The aim of this study was to assess the readability and reliability of online information on GBM., Methods: The terms 'Glioblastoma' and 'GBM' were used to search Google and the first 50 websites identified were screened. For each website, the quality of each website was assessed using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria and the Health on the Net Foundation code certification (HON-code). The readability was assessed using the Flesch Reading Ease Score (FRE), the Flesch-Kincaid grade level (FKGL) and the Gunning Fog Index (GFI). The relevant patient information by 4 International patient information websites were also assessed., Results: Following screening, 31 websites met the inclusion criteria with only four websites displaying the HON-code (12.9%). The median DISCERN score was 43 (range: 17-70) corresponding to 'fair' quality, and the median JAMA benchmark criteria score was 1. Display of the HON-code certificate or the publication date was associated with higher quality websites. The median FRE score corresponded to 'difficult' to read (34.4). The median GFI score (15.9) and FKGL score (13.3) corresponded to a 'college' level of education reading ability. The Cancer Australia online information was the most readable website while Cancer Research UK had the highest quality information., Conclusion: The readability and reliability of online information relating to GBM is inadequate. Health professionals need to provide or guide patients to information that is both readable and reliable.

The confirmed and suspected cases of the 2019 novel coronavirus disease (COVID-19) have increased in the entire world. There is still no vaccine or definitive treatment for this virus due to its unknown pathogenesis and proliferation pathways. Optimized supportive care remains the main therapy, and the clinical efficacy for the subsequent agents is still under investigation. Enormous demand for handling the COVID-19 outbreak challenged both the health-care personnel and medical supply system. As outbreaks of COVID-19 develop, prehospital workers, emergency medical services personnel, and other emergency responders are potentially asked to follow specific practice guidelines to mitigate the effects of an escalating pandemic. In this article, we have summarized the current guidance on potential COVID-19 management options. The recent experience with COVID-19 provided lessons on strategy and policymaking that the government and ministry of health should be on the alert and concentrate more on capacity to manage an outbreak like COVID-19. It is important to consider the new data that emerge daily regarding clinical characteristics, treatment options, and outcomes for COVID-19., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Research in Medical Sciences.)

Introduction: In recent years, several scoring systems have been developed to assess the severity of trauma and predict the outcome of trauma patients. This study aimed to compare Rapid Emergency Medicine Score (REMS), Modified Early Warning Score (MEWS), Injury Severity Score (ISS), and Glasgow Coma Scale (GCS) in predicting the in-hospital mortality of trauma patients., Methods: This diagnostic accuracy study was done on adult patients admitted to the emergency department (ED) between June 21, 2019, and September 21, 2020, following multiple trauma. Patients were followed as long as they were hospitalized. The REMS, MEWS, GCS, and ISS were calculated after data gathering and comprehensive assessment of injuries. Receiver operating characteristics (ROC) analysis was performed to examine the prognostic performance of the four different tools., Results: Of the 754 patients, 32 patients (4.2%) died and 722 (95.8%) survived after 24 hours of admission. The mean age of the patients was 38.54 ± 18.58 years (78.9% male). The area under the ROC curves (AUC) of REMS, MEWS, ISS, and GCS score for predicting in-hospital mortality were 0.942 (95% CI [0.923-0.958]), 0.886 (95% CI [0.861-0.908]), 0.866 (95% CI [0.839-0.889]), and 0.851 (95% CI [0.823-0.876]), respectively. The AUC of REMS was significantly higher than GCS (p=0.035). The sensitivities of GCS ≤ 11, ISS ≥ 13, REMS ≥ 4, and MEWS ≥ 3 scores for in-hospital mortality were 0.56, 0.97, 0.81, and 0.94, respectively. Also, the specificities of GCS, ISS, REMS, and MEWS scores for in-hospital mortality were 0.93, 0.82, 0.81, and 0.85, respectively., Conclusion: It seems that REMS is more accurate than GCS, ISS, and MEWS in predicting in-hospital mortality ≥ 24 hours of multiple trauma patients.