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Introduction: The quality and quantity of dietary protein are primary factor influencing growth and feed costs. Seeds of faba bean (Vicia faba L), similarly as soybean meal, belong to high-protein feeds. The use of faba beans in poultry feed is limited despite having a suitable chemical composition, the main reason of which is the presence of anti-nutritional factors in this seed. Golestan Agricultural and Natural Resources Research and Education Center has produced a zero-tannin faba bean seeds variety (Mahta cultivar) that does not have the nutritional limiting factors of normal beans. The aim of this study was to investigate the effect of different levels of zero-tannin faba bean seeds (Mahta cultivar) on growth performance, some immune and biochemical parameters of blood, morphology and microbial population of small intestine and meat quality of broiler chickens.Materials and Methods: 320 of one-day-old Ross 308 broilers with 4 treatments were used in a completely randomized design with 4 replications and 20 equal mixed birds of each sex in each replication for 42 days. Experimental treatments included 1- control diet (without faba beans and based on corn-soybean meal) 2- diets containing 10% zero-tannin faba bean 3- diets containing 20% zero-tannin faba bean and 4- diets containing 30% zero-tannin faba bean. Then, the growth performance of chickens, blood biochemical (triglyceride, cholesterol, LDL, VLDL and HDL concentrations) and immune (heterophil and lymphocyte percentage) indicators, intestinal jejunum morphological (villi length, villi width, crypt depth and thichness of muscle layer) and ileum contents microbial population (lactobacillus and escherichia coli) parameters and meat quality (pH, malondialdehyde, peroxide number and free fatty acids) of broiler chickens were measured and recorded. Finally, the analysis of data was performed using GLM method by SAS software. The means were compared using Tukey's multiple range tests.Results and Discussion: The results showed growth performance (feed intake, weight gain and feed conversion ratio) of the whole period (1 to 42 days) of birds fed with different levels of diets containing zero-tannin faba bean (0, 10, 20 and 30%) was not significant. There was also no difference between the growth performance of birds fed diets containing zero-tannin faba bean compared to birds receiving the control diet (without beans). A decreasing linear change in the weight gain of the whole period was observed with the increase in the percentage of zero-tannin faba bean (P0.10). Also, morphological parameters of intestinal jejunum were not affected by different levels of zero-tannin faba bean in the diet. However, citizenship analysis showed linear changes in villi length, villi width and crypt depth of broiler intestines. The tendency to increase villi length was observed in birds fed diets containing 10% zero-tannin faba bean compared to other diets (P= 0.08). Villi width (P

Abstract Background and aim Chest tube removal (CTR) can cause severe acute pain which is usually described by patients as a painful experience. This study compared the effects of cold compress, transcutaneous electrical nerve stimulation (TENS), and combined cold compress-TENS on CTR-associated pain among patients with coronary artery bypass grafting (CABG). Methods This randomized controlled trial was conducted in 2018–2019 using a double-blind four-group design. Participants were 120 patients with CABG selected from Shafa hospital, Kerman, Iran, and randomly allocated to a cold compress, a TENS, a combined cold compress-TENS, and a placebo group (compress with room temperature) and TENS with an off TENS device. Each participant received the intervention for 15 min immediately before CTR. CTR-associated pain was assessed before, during, immediately after, and 15 min after CTR. Data were analyzed using the SPSS program (v. 22.0) at a significance level of less than 0.05. Results The data of 29 participants in the placebo group, 26 in the TENS group, 30 in the cold compress group, and 26 in the combined cold compress-TENS group was gathered. Baseline demographic and clinical characteristics and pain intensity scores of participants had no statistically significant differences among all four groups (P > 0.05). The mean score of pain intensity in all groups was at its highest level during CTR and gradually decreased afterwards, but this pain intensity reduction in the compress-TENS group was significantly greater than other groups (P

Abstract Background and aim There are few studies and inconsistent findings on the role of sleep-related parameters in the development of metabolic syndrome (MetS) among youths. In this study, we aim to investigate the relationship between sleep-related parameters and MetS among youths in a large sample size in Rafsanjan, a region in the southeast of Iran. Methods The current cross-sectional study was performed on 3,006 young adults aged 15–35, who registered for Rafsanjan Youth Cohort Study (RYCS), as part of Rafsanjan Cohort Study (RCS)). In fact, RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, we included 2,867 youths after excluding some subjects with missing information on MetS components. MetS was diagnosed based on Adult Treatment Panel III (ATP III) criteria. Besides, data on sleep-related parameters were collected by self-report questionnaires. Results The overall prevalence of MetS was 7.74% among the participants. In addition, bedtime, wake time, napping, night shift work, and sleep duration per night and day had no association with the higher odds of having MetS. In contrast, long sleep duration at night was associated with the lower odds of high waist circumference (WC) (OR: 0.82,95% CI :0.67–0.99). Conclusion In the present study, long sleep duration at night was associated with lower odds of central obesity. However, more longitudinal studies with the objective measurement of sleep-related parameters are needed to verify the associations reported in the current study.

Background & Aim: Reducing pain after surgery, especially cesarean section is one of the most important factors for maternal and infant health. Choosing the way of reducing pain with fewer complications has drawn the attention of researchers. The aim of this study was to compare the effect of Hugo point pressure and auricular seed acupressure on pain after cesarean section. Methods & Materials: In this clinical trial, 168 pregnant women who were candidates for cesarean section, referred to the educational and medical centers of Rafsanjan University of Medical Sciences in 2020, were selected through purposive sampling and randomly divided into three groups: Hugo point pressure, auriculotherapy, and control. In the Hugo group, massage was applied on the li4 point (between the thumb and forefinger) for 10 minutes. 24 hours later, the intervention was repeated. Before and after the intervention, pain intensity was measured using the Visual Analogue Scale (VAS). In the auriculotherapy group, earrings were placed on the Shenmen point located in the earlobe. Pain was assessed by the VAS 20 minutes after the intervention and 24 hours later. No intervention was performed for the control group and only the researcher was present next to the studied subjects for 10 minutes. Data were analyzed by the SPSS software version 20 using paired t-test and one-way analysis of variance (ANOVA). P

Introduction: Uncertainty and sudden occurrence of disasters require special attention and nurses, as the largest human resource, have a critical role in maintaining and promoting the health. The use of telenursing care during disaster is an applicable way to provide care. The aim of this was to prioritizing telenursing care in disasters from the view of nurses. Method: This descriptive-analytical study was part of a larger mixed methods on prioritizing telenursing care in disasters from the view of nurses. Samples were selected using census. The data were analyzed using SPSS software. Results: The prioritizing extracted care included:(1) Management of trauma, (2) Technical skills, (3) Care and decision-making in stressful situations (triage), (4) Management of patients with special needs, (5) Life-saving intervention, and (6) Psychological and emotional supports. Conclusion: According to the shortage of specialized nurses in disastrous areas, a telenursing program will provide a new window and provide help to victims of disasters.

Background and purpose: Phototherapy is the most common treatment for hyperbilirubinemia. Foot reflexology can possibly be suitable for reducing bilirubin levels by affecting meconium excretion. The aim of this study was to compare the effect of foot reflexology massage and whole body massage on bilirubin serum levels in neonates with hyperbilirubinemia. Materials and methods: In this randomized clinical trial, 90 neonates undergoing phototherapy admitted to the neonatal ward in Rafsanhan Hospital were selected using convenience and purposive sampling. The samples were divided into two intervention groups and a control group. The intervention groups, in addition to phototherapy, received massage therapy or foot reflexology massage three times daily for 20minutes over two consecutive days.The control group received only phototherapy. Demographic characteristics were recorded and serum bilirubin levels were measured before, 24, and 48 hours after the intervention. Results: Before the intervention, the mean bilirubin levels were 18.39±3.15, 18.51±2.24, and 18.23±2.44 in foot reflexology group, massage therapy group, and controls, indicating no significant differences between the three groups (P=0.923). But, 48 hours after the intervention, the mean bilirubin levels showed significant differences between the foot reflexology group (8.20±0.96), massage therapy group (8.67±0.68), and control group (9.33±1.22), (P

Introduction: Cesarean section is considered as one of the most common gynecological surgeries. Pain after cesarean section can cause adverse effects to the mother. This shows the need to pay more attention to complementary therapies to reduce pain. Since prioritizing and evaluating the effectiveness of complementary therapies is of great importance, so this study was performed with aim to compare the effects of foot reflexology and auriculotherapy on pain after selective cesarean section. Methods: This randomized controlled clinical trial was performed on 168 cesarean candidates referred to teaching health centers of Rafsanjan University of Medical Sciences in 2018. The subjects were randomly assigned into 3 groups of reflexology, Auriclotherapy and control. Reflexology was performed twice in 24-hour interval and Auriculothera was performed continuously for 24 hours. In the control group, only the researcher was present without intervention. Data collection tools were demographic data form and VAS. Data were analyzed by SPSS software (version 21), and using one-way ANOVA and Tukey Multiple Comparison Test. p < 0.05 was considered statistically significant. Results: Mean pain intensity changes in the foot reflexology group (1.86±1.62) immediately after each intervention were lower than uriclotherapy group (1.45 ± 1.98) and the control group (0.64 ± 2.08) )p < 0.001). But in the uriclotherapy group, pain severity in the interval between the interventions was significantly decreased compared to the reflexology group. Conclusion: Foot reflexology was effective on immediate and short-term pain after cesarean section, and the effect of uriclotherapy with continuous stimulation of the shenmen point is more gradual and lasting. This reduced the need for analgesic use in the uriclotherapy group compared to other groups. Therefore, these two methods can be recommended to relieve pain in post-cesarean care.

Background & Aim: Providing self-care education to patients and their family leads to improvement in the quality of life and increase in participation in self-care programs. The aim of this study was to compare the effect of education by peer and nurse on self-care in hemodialysis patients. Methods & Materials: In this quasi-experimental study, 105 hemodialysis patients from three selected hospitals in three cities of Isfahan province (Zarinshahr, Falavarjan and Mobarakeh) were selected by the simple random sampling method from February 2016 to September 2016. Three centers were randomly assigned to three groups including education by peer, education by nurse and control. The individual face-to-face education was provided by the peer or the nurse to hemodialysis patients, and the control group only received routine education. Data gathering tool was the hemodialysis patients’ self-care questionnaire which was completed for three groups before and one month after education. The data were analyzed using the SPSS software version 18 through Chi-square test, paired t test, the analysis of variance and Tukey’s post-hoc test at the significance level of P0.05). The Tukey’s multiple comparisons tests showed that the effect of nurse intervention on self-care improvement was significantly more than peer intervention and the control group (P

Objective: To determine the effects of the implementation of the telephone cardiopulmonary resuscitation (T-CPR) program on the outcomes of out-of-hospital cardiac arrest (OHCA).Methods: In this prospective study, Emergency Medical Service (EMS) dispatchers and all bystanders attending to patients with OHCA were included. The consensus sampling was carried out based on inclusion and exclusion criteria. The data collection tool was consisted of a demographic questionnaire for patients and bystanders accompanied by a checklist for CPR outcomes. Data were collected 6 months before and after the implementation of the T-CPR program and analyzed using SPSS version 18.Results: The results revealed that the percentages of successful and unsuccessful CPR cases before the implementation of the T-CPR program were 28.1% and 71.9%, respectively. However, in total, 32% and 67.8% of the CPR cases were successful and unsuccessful, respectively, after the implementation of the mentioned program. The survival rate increased from 56.5% in the pre-intervention phase to 72.4% in the post-intervention one. In terms of the outcomes, brain complications decreased from 40% in the pre-intervention phase to 32.1% in the post-intervention one; however, the Chi-square test showed no significant difference in terms of CPR outcomes in the two time periods (p=0.797).Conclusion: According to the results, it is recommended that T-CPR programs be developed and dispatchers be trained in the area of this research. The results could be regarded as a guide to EMS managers, healthcare professionals, and the basis for further studies on this subject.

Background & Aim: Anxiety is one of the most common psychiatric disorders in the family of patients with traumatic brain injury. This study aimed to determine the effect of providing information about the patient’s condition on the anxiety level of the family members of hospitalized patients with traumatic brain injury. Methods & Materials: This quasi-experimental study was conducted on 90 family members of traumatic brain injury patients admitted to Shahid Bahonar hospital in Kerman in 2016. The participants were selected by the consecutive sampling method and were assigned to intervention and control groups. In the intervention, the participants were informed by the nurse about changes in the patient’s condition during the first three days of admission to intensive care unit. During this period, the control received routine care. Data collection tool was the Spielberger anxiety inventory. Independent and paired t-test were used to compare the mean scores of anxiety using the SPSS software version 16. Results: There was no statistically significant difference in the mean scores of overt, covert and general anxiety between the two groups before the intervention (P>0.05). However, after the intervention in the experimental group, the mean scores of overt anxiety (45.51±7.26), covert anxiety (45.42±6.51) and general anxiety (90.93±12.72) decreased (P

The aim of the present study was to compare the effects of topical anesthesia and acupressure at the Yintang (Extra 1) and the Laogong (P-8) points on the severity of venipuncture pain among hospitalized 6–12-year-old children. A sample (n = 120) of 6–12-year-old hospitalized children was recruited from two teaching hospitals located in Rafsanjan, Iran. The children were allocated to the topical anesthesia, acupressure, and control groups. For children in the topical anesthesia and the acupressure groups, eutectic mixture of local anesthetic (EMLA) cream and two-point acupressure were used, respectively, prior to performing venipuncture, whereas children in the control group only received routine prevenipuncture care. The severity of venipuncture pain was evaluated 5 minutes after performing venipuncture by using the Face, Leg, Activity, Cry, and Consolability behavioral pain assessment scale. The findings revealed that pain severity in both experimental groups was significantly lower than that in the control group, whereas there was no significant difference between the experimental groups regarding pain severity. Although acupressure was as effective as topical anesthesia cream in alleviating children's venipuncture pain, nurses are recommending to use acupressure instead of pharmacological pain management agents because of its greater safety, cost-effectiveness, and applicability.

Introduction: Self-care is the core concept of health care and may be considered as one’s stabilization, and restoration as well as the improvement of his/her health and well-being. Looking at the process of Self-care from patients’ perspective who suffer from thalassemia may assist the nurses and health care providers to facilitate the health process. Thus this study was conducted to discover the process of self-care in patients with major thalassemia. Methods: This qualitative study was conducted with grounded theory approach. 21 patients with major thalassemia from a Medical Research Center, supervised by Kerman Medical University, were selected through purposeful and theoretical sampling. Data were collected by unstructured interviews which lasted 30-60 minutes. These data were analyzed using the method of Corbin and Strauss. Results: The main theme of "struggling to improve life quality" that included the sub-themes of "focus on needs of illness, "activating resources" and "restoring a new identity with thalassemia" were extracted from the data. This theme implies that participants endeavor to strengthen their self- efficacy via thalassemia. "Looking for strengthening self-efficacy in light of thalassemia" was the core theme in this study. Conclusion: Facilitating the process of self-care in patients with major thalassemia requires that they be helped so that their self-efficacy, influenced by real life conditions, might be strengthened in light of thalassemia. Increasing public awareness and social support may affect the recognition of individual, family and society.

Postoperative ileus (POI) is a common complication after most abdominal surgeries including cesarean section. It is associated with longer hospitalization and increased medical costs. This study is a randomized controlled trial investigating the effect of acupressure, and low-cost noninvasive traditional treatment, on POI symptoms after cesarean section. A total of 120 patients were randomly divided into two groups; the treatment group received two sessions of acupressure (an hour after attending the women's division; and 3 hours after the first session), each lasting 20 minutes. The time of flatus and defecation, time to presence of bowel sounds, and duration of postoperative bed rest were monitored. Patients in the treatment group had a shorter time to presence of bowel sounds compared with those in the control group (p

Background: Many patients with heart failure grapple with related problems that threaten their feeling of well-being and quality of life. Patients look for ways to cope with the new situation. The present study aimed to explore religious coping from the perspective of patients with heart failure Methods: This qualitative study used the content analysis of the semi-structured interviews. The data were collected from 18 participants referring to training hospitals in Kerman University of Medical Sciences in southeastern Iran. The data were analyzed using Lundman and Graneheim qualitative content analysis. Results: The main theme of “Spiritual coping, a dominant strategy” was extracted with two categories: 1- “religious belief” having the sub-categories of “inner faith” and “search of meaning” 2- “connection to God as the supreme power” with sub-categories of “seeking healing through supplication and rituals”, “worship as a barrier to the flood of problems”, and “submission to and trust in God”. Conclusion: The findings suggest that a spiritual strategy helps the patients effectively to cope with heart failure. Patients learn to use religious beliefs and faith to accept the reality of the disease and its stages and to manage their condition with patience, tolerance, and hope calmly and confidently for a bright future.

Background: Vegetative state (VS) occurs through return of the brain stem after coma state. After hospital discharge, responsibility of caring for VS patients is transferred to their families, which causes a high burden on them. Nurses have an important role in helping the family caregivers to meet their needs and cope with difficulties. To explore the role of nurses during coping process of family caregivers of VS patients. Methods: This study is a part of a larger qualitative study which was performed in Kerman province, Iran during 2014- 2015. Purposive and theoretical sampling was used. 14 caregivers participated in the study. Data were gathered using face-to-face in-depth interviews and managed by MAXQDA 10 software. Analysis was done through constant Comparative Method. Results: Three themes of “nurse as a pursuer teacher”, “nurse as a compassionate caregiver”, and “nurse as a supporter” were derived from analysis that represent various roles of a nurse in the coping process of family caregivers of vegetative patients during the care process. Conclusion: Nurses can play an effective role in improving the caregivers’ well-being by considering the importance of training at discharge time and during home care, helping families in providing care and support them during care process.

Background & Aim: Desirable bishop score is necessary for having a successful delivery. Prostaglandins are effective on cervical ripening and primrose contains precursors of these materials. Therefore, the present study was conducted to evaluate the effect of vaginal Evening primrose on the bishop score among term nulliparous women. Methods & Materials: The present double-blind randomized clinical trial was conducted on 86 nulliparous women who referred to the comprehensive health service centers of Rafsanjan from November 2017 to May 2018. The samples were selected through convenient sampling method and allocated into two intervention and placebo groups with simple random assignment. The intervention group used a daily dose of 1000 mg vaginal capsules of Evening primrose from the 38th week of pregnancy until delivery and the placebo group received similar placebo with similar administration method. The Information about the women’s bishop score was gathered from the participants’ medical files in the hospital and then was analyzed using SPSS software version 16 and Kolmogorov-Smirnov test, Chi-square test and independent t-test. Results: The total mean and standard deviation of the bishop score in the intervention and placebo groups was respectively 7.83 ± 2.09 and 4.46 ± 2.39 and the simplified bishop score in the intervention and the control groups was respectively 5.93 ± 2.42 and 2.81 ± 2.02. The difference between the two groups considering both of the bishop scores was statistically significant (p = 0.001). Conclusion: Vaginal Evening primrose is effective to ripen the cervix of term nulliparous women and so, it could be administered for this purpose.

Introduction: The pilgrimage to Ka’beh (God’s house in Mecca) is a special opportunity in the life of most Muslims. Female pilgrims try to postpone menstruation during the pilgrimage by taking hormonal medicines. However, women are seen in this disorder. This paper aimed to determine the frequency of menstrual disorders and related factors among female pilgrims of Umrah Mufradah in 2012.Methods: This study was a descriptive type, the population of which comprised 400 female Iranian pilgrims aged 15-50 years who were selected through random cluster sampling from Umrah caravans. Data was collected with a questionnaire developed by the researchers that contained questions about menstrual disorders. The questionnaire was distributed among participants at their hotels three days prior to their return to Iran.Results: Among all the participants, 98.7% of them reported taking pills to suppress menstruation. Of this group, 74.7% successfully prevented menstruation, 26% reported spotting, and 11.6% reported menstruation. There was no significant difference between consumption of medicine and factors such as marital status, city, and educational background of the individuals. Participants reported that spotting and menstruation caused them to experience stress and anxiety when performing Umrah rituals.Conclusion: Experiencing menstrual disorders during pilgrimage can be stressful for pilgrims. To reduce such problems, counseling sessions on menstruation postponement as part of the justification classes before departing for Hajj and compiling an equal and coordinated nationwide protocol seem necessary.

Background: Heart failure as a chronic disease poses many challenges for a patient in his or her everyday life. Support in various aspects of life positively affects coping strategies and influences the well-being and health outcomes of heart failure patients. Inadequate support may lead to a worsening of symptoms, increased hospital readmissions, psychological disorders, and a reduced quality of life. Objective: This study explored obstacles to coping related to support for heart failure patients as viewed by the patients themselves and their family members and caregivers. Design: This qualitative study was conducted using content analysis. The 20 Iranian participants included 11 patients with heart failure, three cardiologists, three nurses, and three family members of heart failure patients selected through purposive sampling. Data were collected through semi-structured interviews and analyzed using the Lundman and Graneheim qualitative content analysis method. Results: During data analysis, ‘defective support network’ developed as the main theme along with four other categories of ‘inadequate family performance’, ‘inadequate support by the healthcare team’, ‘distorted societal social support’, and ‘inadequate welfare support’. Conclusion: The findings of the current study can assist health authorities and planners in identifying the needs of patients with heart failure so as to focus and plan on facilitating their coping as much as possible by obviating the existing obstacles.

INTRODUCTION: Unusual impacts of disasters on normal living conditions pose challenges to the health system. Nurses who take care of disaster victims may face situations that make decision-making difficult; hereon, the use of new technologies can be a useful solution. The study aimed to identify the telenursing care during incidents and disasters. METHODS: The study was conducted at a medical science university in Iran from 2018 to 2019. This was a semi-structured interview-based qualitative study using content analysis. Eighteen nurses, nursing teachers, and emergency medical technicians were included in the study. Data analysis was performed using inductive content analysis and coding with MAXQDA (2010) software. The Lincoln and Guba (1985) trustworthiness criteria were used for the reliability and validity of the data. RESULTS: Telenursing in critical and supportive care was the main theme identified from data analysis. This theme included six main categories: (1) management of trauma, (2) technical skills, (3) care and decision-making in stressful situations, (4) management of patients with special needs, (5) life-saving intervention, and (6) psychological and emotional supports. CONCLUSIONS: Telenursing in disasters is the turning point of the care management of victims. In order to achieve this goal, nurses should acquire the relevant knowledge, skills, and abilities.

Background: Premenstrual syndrome (PMS) is consisted of multiple psychological and emotional symptoms. This disorder possesses adverse effects on women’ economic, social, familial and professional issues, therefore various medical therapies have been suggested, thus all have own side effects. Aim: To compare the effects of relaxation and vitamin B6 on emotional and physical symptoms of PMS. Method: This is a randomized clinical trial study with pre- and post-test design. The study was conducted on 150 girls living in public dormitory whom were randomly divided into three groups. The relaxation group trained in two sessions and then one week before menstruation, the taught techniques were carried out on a daily basis. The second group received 80mg vitamin B6 tablets QD for one week before menstruation and then three times a week for one cycle. The third group received no intervention as control group. Each day, data were collected using a researcher-made questionnaire and where analyzed using SPSS version 14 with paired T and ANOVA tests. Results: The mean age of the participants was 20.6±1.5 and their average weight was 54.1± 6.6. The mean scores of psychological symptoms after the interventionwere 1.2± 0.2 in vitamin B6 group, 0.3± 0.7 in relaxation group, and 1.6 ± 0.4 in the control group (p

Introduction: Resuscitation self-efficacy is defined as a judgment of perceived capability to organize and execute the process of care during cardiopulmonary resuscitation. It is believed to be an important factor in teaching vital nursing skills especially cardiopulmonary resuscitation. Therefore, this study aimed to investigate the impact of mannequin-based simulation and computer-based simulation on nursing students’ perception of self-efficacy in cardiopulmonary resuscitation. Methods: This quasi-experimental study was performed on 64 nursing students who were randomly assigned to computer-based simulation and mannequin-based simulation groups. Data collection tool was a two-part questionnaire including demographic information and the perceived self-efficacy of cardiopulmonary resuscitation. The data were collected before and after two methods of teaching. Data were analyzed using measures of central tendency and dispersion, Mann-Whitney, and Wilcoxon tests. Results: There was a significant difference in mean score and standard deviation of students’ perception of self-efficacy between mannequin-based group (Z=-5.23,P

Background & Aim: Pain is the main stressful factor in patients hospitalized in intensive care units(ICU). Non-pharmacological methods for pain relief are preferred by ICU patients due to lack of considerable side effects. The present research aims to determine the effect of TENS on pain intensity followed by surgery in patients hospitalized in intensive care units. Setting of the study was Besat Hospital in Hamadan, Iran. In this cross over clinical trial, thirty five patients hospitalized in intensive care unit with level of consciousness 9-12 based on Glasgow Coma Scale (GCS), assigned randomly to active/placebo TENS(18 patients) or placebo/active TENS (17 patients) sequence. Methods & Materials: Patients received each intervention for two hours by a random order. A card was allocated to each patient on which the order of interventions was written. In placebo TENS, the system was off and no electrical simulation was applied. Active TENS was applied by conventional TENS with frequency of 80 Hz within 330 milliseconds that is a subset of high TENS. Pain intensity were measured and recorded using Behavioural Pain Scale (PBS)before and 6 hours after intervention. Statistical analysis used: Data were analysed using SPSS 19 and independent t-test, chi square and Wilcoxon tests. Results: Mean scores of pain intensity before and after active TENS was significantly different in both intervention order (P= 0.001). Mean scores of pain intensity after placebo TENS was not significantly different in both groups. None of patients suffered from side effects after using TENS. Conclusion: Based on results, application of active TENS reduced significantly pain intensity in patients after surgery. Concerning the simplicity of using this method and lack of considerable side effects, it is suggested to be used as pain relief in similar situations.

Geothermal energy has a wide range of uses in our life. It is very important to characterize the temperature and the depth of geothermal reservoirs. The aim of this paper is the determination of type, origin source of water temperature, and depth of water circulation in the Ayub-Peighambar and Shafa (AP and SH) hot springs, located in NE Iran, using hydrogeochemistry and environmental isotopes (2H and 18O). AP hot spring has elevated temperature (36–40°C) and as such is very important for balneotherapy and geotourism industry purposes. The average values of δ18O and δ2H for this hot spring (−10‰ and −73‰, resp.) are analogous to that of geothermal and meteoric waters. This indicates that the heat source cannot be related to volcanic activities (with average δ18O value of about 5‰) and it is most probably associated with geothermal gradient with deep circulation of groundwater through faults. Based on Na-K geothermometers coupled with isotopic (18O and 2H) geochemistry the temperature of the AP geothermal reservoir was estimated to be in the range of 100–150°C with 3–5 and 4.2 kilometres’ depth, respectively. Chemically, the AP samples are CaSO4 facies with a chemically homogeneous source and steam heated waters type.

Abstract Chronic prostate inflammation in patients with benign prostate hyperplasia (BPH) correlates with the severity of symptoms. How inflammation contributes to prostate enlargement and/or BPH symptoms and the underlying mechanisms remain unclear. In this study, we utilize a unique transgenic mouse model that mimics chronic non-bacterial prostatitis in men and investigate the impact of inflammation on androgen receptor (AR) in basal prostate stem cells (bPSC) and their differentiation in vivo. We find that inflammation significantly enhances AR levels and activity in bPSC. More importantly, we identify interleukin 1 receptor antagonist (IL-1RA) as a crucial regulator of AR in bPSC during inflammation. IL-1RA is one of the top molecules upregulated by inflammation, and inhibiting IL-1RA reverses the enhanced AR activity in organoids derived from inflamed bPSC. Additionally, IL-1RA appears to activate AR by counteracting IL-1α's inhibitory effect. Furthermore, using a lineage tracing model, we observe that inflammation induces bPSC proliferation and differentiation into luminal cells even under castrate conditions, indicating that AR activation driven by inflammation is sufficient to promote bPSC proliferation and differentiation. Taken together, our study uncovers mechanisms through which inflammation modulates AR signaling in bPSC and induces bPSC luminal differentiation that may contribute to prostate hyperplasia.

Abstract Correctly identifying perturbed biological pathways is a critical step in uncovering basic disease mechanisms and developing much-needed therapeutic strategies. However, whether current tools are optimal for unbiased discovery of relevant pathways remains unclear. Here, we create “Benchmark” to critically evaluate existing tools and find that most function sub-optimally. We thus develop the “Pathway Ensemble Tool” (PET), which outperforms existing methods. Deploying PET, we identify prognostic pathways across 12 cancer types. PET-identified prognostic pathways offer additional insights, with genes within these pathways serving as reliable biomarkers for clinical outcomes. Additionally, normalizing these pathways using drug repurposing strategies represents therapeutic opportunities. For example, the top predicted repurposed drug for bladder cancer, a CDK2/9 inhibitor, represses cell growth in vitro and in vivo. We anticipate that using Benchmark and PET for unbiased pathway discovery will offer additional insights into disease mechanisms across a spectrum of diseases, enabling biomarker discovery and therapeutic strategies.

Abstract In advanced hepatocellular carcinoma (HCC), RNA helicase DDX5 regulates the Wnt/β-catenin-ferroptosis axis, influencing the efficacy of the multi-tyrosine kinase inhibitor (mTKI) sorafenib. DDX5 inhibits Wnt/β-catenin signaling, preventing sorafenib-induced ferroptosis escape. Sorafenib/mTKIs reduce DDX5 expression, correlating with poor patient survival post-sorafenib treatment. Notably, DDX5-knockout in HCC cells activates Wnt/β-catenin signaling persistently. Herein, we investigate the mechanistic impact of Wnt/β-catenin activation resulting from DDX5 downregulation in the progression and treatment of HCC. RNAseq analyses identified shared genes repressed by DDX5 and upregulated by sorafenib, including Wnt signaling genes, NF-κB-inducing kinase (NIK) essential for non-canonical NF-κB (p52/RelB) activation, and cytoprotective transcription factor NRF2. We demonstrate, Wnt/β-catenin activation induced NIK transcription, leading to non-canonical NF-κB activation, which subsequently mediated NRF2 transcription. Additionally, DDX5 deficiency extended NRF2 protein half-life by inactivating KEAP1 through p62/SQSTM1 stabilization. In a preclinical HCC mouse model, NRF2 knockdown or DDX5 overexpression restricted tumor growth upon sorafenib treatment, via induction of ferroptosis. Importantly, DDX5-knockout HCC cells exhibited elevated expression of Wnt signaling genes, NIK, p52/RelB, and NRF2-regulated genes, regardless of sorafenib treatment. Transcriptomic analyses of HCCs from TCGA and the Stelic Animal Model (STAM) of non-alcoholic steatohepatitis revealed elevated expression of these interconnected pathways in the context of DDX5 downregulation. In conclusion, DDX5 deficiency triggers Wnt/β-catenin signaling, promoting p52/RelB and NRF2 activation, thereby enabling ferroptosis evasion upon sorafenib treatment. Similarly, independent of sorafenib, DDX5 deficiency in liver tumors enhances activation and gene expression of these interconnected pathways, underscoring the clinical relevance of DDX5 deficiency in HCC progression and therapeutic response.

Introduction: Diabetes is one of the chronic diseases that cause physical and psychological problems and decreases the quality of life in these patients. This study aimed to evaluate the impact of education on the quality of life in type II diabetic patients at Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Materials and Methods: This is a pre-and post- randomized trial study. The intervention included an educational program to increase the quality of life which was performed on type II diabetic patients at the Diabetes Clinic of Rafsanjan University of Medical Sciences, Rafsanjan, Iran. The patients in this study were randomly divided into experimental and control groups. The sample size for each study group was calculated to be 27 individuals considering the standard deviation (SD) of quality of life reported in previous studies (i.e., 1.7) and based on the effect size of 1.5, confidence interval: 95%, and test power of 90%. However, considering the rate of attrition, the sample size was increased to 30 people. The standard quality of life questionnaire (SF-36) with eight subscales was used to assess the quality of life in type II diabetic patients. Data were analyzed using SPSS software (version 23). Results: The mean±SD age of patients was estimated to be 54.1±9.8 and 54.8±9.5 years in the control and intervention groups, respectively. The mean score of quality of life in the control group before and after the intervention was obtained at 83.7±8.3 and 82.9±7.7, respectively. These scores in the intervention group were 82.1±14.5 and 91.9±12.2, before and after the intervention, respectively. A significant increase was observed in the mean score of quality of life in the intervention group after the intervention. The subscale of physical functioning, energy-fatigue, emotional well-being, pain, and general health increased after the training program. However, sub-scales of disorder did not change physical health, emotional disorder, and social functioning in the intervention and control groups. Conclusion: Based on the obtained results, the quality of life of the elderly and their active years can be increased through the implementation of educational programs on self-care and using new educational models. [ABSTRACT FROM AUTHOR]

Abstract Reduced expression of the RNA helicase DDX5 associated with increased hepatocellular carcinoma (HCC) tumor grade and poor patient survival following treatment with sorafenib. While immunotherapy is the first-line treatment for HCC, sorafenib and other multi-tyrosine kinase inhibitors (mTKIs) are widely used when immunotherapy is contra-indicated or fails. Herein, we elucidate the role of DDX5 in sensitizing HCC to sorafenib, offering new therapeutic strategies. Treatment of various human HCC cell lines with sorafenib/mTKIs downregulated DDX5 in vitro and in preclinical HCC models. Conversely, DDX5 overexpression reduced the viability of sorafenib-treated cells via ferroptosis, suggesting a role for DDX5 in sorafenib sensitivity. RNAseq of wild-type vs. DDX5-knockdown cells treated with or without sorafenib identified a set of common genes repressed by DDX5 and upregulated by sorafenib. This set significantly overlaps with Wnt signaling genes, including Disheveled-1 (DVL1), an indispensable Wnt activator and prognostic indicator of poor survival for sorafenib-treated patients. DDX5-knockout (DDX5KO) HCC cells exhibited DVL1 induction, Wnt/β-catenin pathway activation, and ferroptosis upon inhibition of canonical Wnt signaling. Consistently, xenograft HCC tumors exhibited reduced growth by inhibition of Wnt/β-catenin signaling via induction of ferroptosis. Significantly, overexpression of DDX5 in HCC xenografts repressed DVL1 expression and increased ferroptosis, resulting in reduced tumor growth by sorafenib. We conclude that DDX5 downregulation by sorafenib mediates adaptive resistance by activating Wnt/β-catenin signaling, leading to ferroptosis escape. Conversely, overexpression of DDX5 in vivo enhances the anti-tumor efficacy of sorafenib by suppressing Wnt/β-catenin activation and induction of ferroptosis. Thus, DDX5 overexpression in combination with mTKIs is a promising therapeutic strategy for HCC.

Imaging of nanoscale magnetic textures within extended material systems is of critical importance to both fundamental research and technological applications. While high-resolution magnetic imaging of thin nanoscale samples is well established with electron and soft x-ray microscopy, the extension to micrometer-thick systems currently requires hard x rays, which limits high-resolution imaging to rare-earth magnets. Here, we overcome this limitation by establishing soft x-ray magnetic imaging of micrometer-thick systems using the pre-edge phase x-ray magnetic circular dichroism signal, thus making possible the study of a wide range of magnetic materials. By performing dichroic spectroptychography, we demonstrate high spatial resolution imaging of magnetic samples up to 1.7 μm thick, an order of magnitude higher than conventionally possible with soft x-ray absorption-based techniques. We demonstrate the applicability of the technique by harnessing the pre-edge phase to image thick chiral helimagnets, and naturally occurring magnetite particles, gaining insight into their three-dimensional magnetic configuration. This new regime of magnetic imaging makes possible the study of extended non-rare-earth systems that have until now been inaccessible, including magnetic textures for future spintronic applications, non-rare-earth permanent magnets for energy harvesting, and the magnetic configuration of giant magnetofossils.

Kaposi's sarcoma herpesvirus (KSHV) is a leading cause of malignancy in AIDS and current therapies are limited. Like all herpesviruses, KSHV infection can be latent or lytic. KSHV latency-associated nuclear antigen (LANA) is essential for viral genome persistence during latent infection. LANA also maintains latency by antagonizing expression and function of the KSHV lytic switch protein, RTA. Here, we find LANA null KSHV is not capable of lytic replication, indicating a requirement for LANA. While LANA promoted both lytic and latent gene expression in cells partially permissive for lytic infection, it repressed expression in non-permissive cells. Importantly, forced RTA expression in non-permissive cells led to induction of lytic infection and LANA switched to promote, rather than repress, most lytic viral gene expression. When basal viral gene expression levels were high, LANA promoted expression, but repressed expression at low basal levels unless RTA expression was forcibly induced. LANA's effects were broad, but virus gene specific, extending to an engineered, recombinant viral GFP under control of host EF1α promoter, but not to host EF1α. Together, these results demonstrate that, in addition to its essential role in genome maintenance, LANA broadly regulates viral gene expression, and is required for high levels of lytic gene expression during lytic infection. Strategies that target LANA are expected to abolish KSHV infection.