Allied medical sciences students\u27 experiences with technology: are they digitally literate?

Objective: The ability to use digital resources is important for medical students. In order to use digital resources, they need the capabilities of digital technology utilizing, which is referred to as digital literacy. However, how much effectively students can use these facilities is a subject that needs to be addressed. So, the present study intended to investigate the digital literacy level of students of the Allied medical sciences of Shahid Beheshti University of Medical Sciences. Materials and methods: This cross-sectional study was performed at the Faculty of Allied medical sciences of Shahid Beheshti University of Medical Sciences in academic year of 2016-2017 using a researcher-made questionnaire containing 23 closed questions in four sections. A total of 115 students in three educational grades: bachelor, master and the PhD grade were included in this study. Z-test was used to evaluate the relationship between internet skills and students\u27 academic achievements if any exist. Results: Almost half of the students (51.3%) have not completed any computer courses regarding basic ICT skills. The findings showed that 41.2% of PhD students are aware of digital literacy concept; meanwhile, only 11% of bachelor students and 20.6% of master ones knew the actual meaning of this concept. The use of public search engines was a favorite alternative for finding specialized terminologies at all grades. Furthermore, there was a significant difference between the level of familiarity with the Internet and the students\u27 grade (p≤0.05). Conclusion: Digital literacy training courses can enhance digital literacy skills significantly. Most students agreed with the inclusion of digital literacy courses in their curriculum. Therefore, they should be supported by educators and librarians in order to effectively use the Internet and information technology as well as to overcome the problems of finding and using information to gain academic achievement

Metabolic fingerprinting of feces from calves, subjected to gram-negative bacterial endotoxin

Gram-negative bacteria have a well-known impact on the disease state of neonatal calves and their mortality. This study was the first to implement untargeted metabolomics on calves' fecal samples to unravel the effect of Gram-negative bacterial endotoxin lipopolysaccharide (LPS). In this context, calves were challenged with LPS and administered with fish oil, nanocurcumin, or dexamethasone to evaluate treatment effects. Ultra-high-performance liquid-chromatography high-resolution mass spectrometry (UHPLC-HRMS) was employed to map fecal metabolic fingerprints from the various groups before and after LPS challenge. Based on the generated fingerprints, including 9650 unique feature ions, significant separation according to LPS group was achieved through orthogonal partial least squares discriminant analysis (Q(2) of 0.57 and p-value of 0.022), which allowed the selection of 37 metabolites as bacterial endotoxin markers. Tentative identification of these markers suggested that the majority belonged to the subclass of the carboxylic acid derivatives-amino acids, peptides, and analogs-and fatty amides, with these subclasses playing a role in the metabolism of steroids, histidine, glutamate, and folate. Biological interpretations supported the revealed markers' potential to aid in disease diagnosis, whereas beneficial effects were observed following dexamethasone, fish oil, and nanocurcumin treatment

The Effect of Using Different Fat Sources in Close-Up Diets on the Feed Consumption, Blood Parameters, Body Measurements and Performance of Holstein Dairy Calves

Introduction Raising healthy calves is indeed a critical concern in the dairy industry. Close up diets have important effects on the quantity and quality of produced colostrum, on the other hand, colostrum and milk are considered the most important sources of food that contain energy, protein, and other nutrients for the newborn calf’s growth. Including fatty acids in the late pregnancy supplements are controversial because of the potential reduction of cows DMI. Also, the growth and health of calves can be influenced by feeding linoleic acid to pregnant cows. Safflower as a rich source of linoleic acid (55-70%) is a significant oil alternative product, and has a high nutritional value. This study aimed to examine the effects of safflower seeds and palmitic fatty acids on the transition diet in cow feed consumption, colostrum quality, blood parameters, body measurements and Holstein calf performance.   Materials and methods Thirty pregnant Holstein cows, 15 primiparous and 15 multiparous, were used 21 days prior to the expected calving date. The experiment was conducted using a completely randomized experimental design with three treatments and ten replicates in every treatment. Cows were randomly assigned to experimental treatments so that each treatment have an average body weight 659.34 ± 84.2 kg, parity 2.04 ± 1.31 and body condition score (BCS) 3.23 ± 0.15 The experimental rations have similar energy and protein content. Diets were thoroughly mixed and fed to cows based on the recommendations of the US National Research Council (NRC, 2001). The experimental rations included: 1) Control diet without fat source (Ctrl), 2) Diet with palmitic fatty acid (SFA), and 3) Diet with safflower seed (UFA). Daily feed intake was calculated by subtracting distributed feed to every cow from the leftover amount on following day. Newborn calves were weighed immediately after birth. An individual colostrum yield for every cow was recorded at each milking. The quality of colostrum was determined using an optical refractometer (ATC., China). The body weight and skeletal parameters of calves were evaluated at birth day, 21 d, and 49 d. Blood samples were taken immediately after birth, two hours after colostrum feeding and on days 3, 7, 21, and 49 via the jugular vein. Samples were centrifuged at 3000× g and the plasma was stored at −20°C until analysis. Plasma metabolites were analyzed using an autoanalyzer (Alcyon 300., USA). Colostrum composition (fat, protein, lactose, solids, solids not fat) was determined using a Milkoscan (Foss Electric, Hillerød, Denmark). Fatty acids profile were measured according to O'Fallon (2007) et al., using gas chromatography (GC) equipped FID detector and 100 meter column. Data were analyzed using the MIXED procedure of SAS using a completely randomized design with ten replications.    Results and Discussion Using sources of SFA (palm oil powder) and UFA (safflower seeds) in the transition diets were not affected on dry matter intake in Holstein dairy cows (P>0.05). Dry matter intake in Ctrl, SFA, and UFA were 10.29, 10.98, and 10.80 kg per day, respectively. We found that  using SFA and UFA did not have any significant effect on colostrum parameters such as colostrum volume, the percentage of fat, protein, lactose, total solids, fat not solids, and also, immunoglobulin concentration, and Brix number of colostrum (P>0.05). The colostrum volume in UFA and SFA treatments was higher than in the Ctrl treatment, but this difference was not significant (5.82, 5.23, and 4.19 kg, respectively). According to the results, the researchers stated that adding raw and processed safflower seeds to the diet did not have any significant effect on milk production, milk fat, protein, and lactose in Holstein dairy cows (Paya and Taghizadeh, 2020). Feeding omega-6 sources in the transition period (35 days before calving) caused higher colostrum protein and Brix values (Salehi et al., 2016) but was not consistent with our results. Feeding palm fat powder as a source of SFA and safflower seeds as UFA did not have any significant differences in concentration of short chain, medium chain, and long chain fatty acids in colostrum. It was reported that various fat sources in the rations of dairy and transition cows did not affect colostrum fatty acid and milk fatty acid. However some studies showed that different fat sources in the diet of dairy cows changed the fatty acid profile in milk. In general, it can be stated that because of the high-producing dairy cows experience a negative energy around calving, the diet energy meets the requirements, which probably causes the fatty acid composition of the colostrum not to be affected. Our results showed that blood factors such as glucose, cholesterol, triglycerides, blood urea nitrogen, ALT, AST, total antioxidant capacity, malondialdehyde, total protein, albumin, calcium, magnesium, phosphorus, and HDL did not differ between treatments. It was observed that the addition of SFA and UFA had no significant effect on the birth weight of calves, weight at d 21 and 49, and dry matter intake during the experimental period. Skeletal parameters such as hip height and width, withers height, chest circumference, and body length at 3, 21, and 49 days had no significant differences in the treatments.     Conclusion It seems that using saturated and unsaturated fatty acids sources in the transition diets did not reduce feed intake. Moreover, it had no significant influence on the calves' performance, bone condition, the colostrum's quality and the colostrum fatty acids profile

Relationship between the Presence of the nalC Mutation and Multidrug Resistance in Pseudomonas aeruginosa

Objectives. The current study was conducted to determine the relationship between the presences of significant multidrug resistance in Pseudomonas aeruginosa (P. aeruginosa) having intact mexR genes (nalC) to different antibiotics. Methods. In order to identify nalC, fifty strains of P. aeruginosa were obtained. All isolates were found in urinary tract infections. They were evaluated against different antibiotics. The nalC mutant was identified by PCR. Results. The 50 clinical isolates of P. aeruginosa originated from two hospitals in Iran, in which 32 isolates were found in Milad hospital, and 18 isolates were collected in the Ilam Hospital. The results in Milad hospital of nalC revealed that all P. aeruginosa resistant to oxacillin showed the presence of nalC. In Ilam hospital only three (16.6%) isolates were resistant to oxacilin and aztreonam, and among these three isolates only one isolate revealed resistance to ceftazidime and amikacin. The resistant isolates showed the presence of both OXA-10 and nalC. Conclusion. Our results showed that the presence of nalC was observed among P. aeruginosa resistance to oxacilin. Thus, the finding suggested relationship between oxacilin resistance and presence of nalC and consequently overproduction of the MexABOprM efflux system

A comparative study on effectiveness of workshop education versus education via mobile learning (m-learning) in developing medical students’ knowledge and skill about cardiopulmonary resuscitation

INTRODUCTION: A variety of educational approaches are being used today to improve learning in the field of cardiopulmonary resuscitation. Therefore, the present study was conducted to compare workshop education with education via mobile learning (M-learning) in terms of their efficacy in developing medical students’ knowledge and skills about cardiopulmonary resuscitation. MATERIAL AND METHODS: The present study was quasi-experimental performed on 60 interns selected from a university of medical sciences in southwest Iran. Participants were assigned to either the workshop education group (n = 30) or the mobile learning group (n = 30). Before and after the intervention, the knowledge and skills of the participants in terms of basic and advanced cardiopulmonary resuscitation were measured by a questionnaire. The collected data were analyzed using descriptive statistics, Independent-Samples t-Test, Paired-Samples t-Test, and Chi-Square Test in SPSS software v. 22. RESULTS: Education via mobile learning caused a significant increase in the participants’ knowledge about cardiopulmonary resuscitation (p < 0.05). However, this method did not result in a significant difference in the participants’ skill scores, while the workshop education group showed a significant increase in their cardiopulmonary resuscitation skill scores (p < 0.05). CONCLUSIONS: Our results revealed that education via mobile learning was better in enhancing medical students’ knowledge about cardiopulmonary resuscitation. However, workshop education was more effective in developing practical skills in the field of cardiopulmonary resuscitation. Accordingly, educators are recommended to employ a combination of mobile learning and workshop education for achieving better results

Dietary polymer-coated urea enhances the goats lactational performance, excretion of microbial purine derivatives and blood metabolites in the semi-arid zone of Iran

This study aimed to determine the effect of using different sources of nitrogen to supply part of degradable intake protein needs in lactating goat performance and its effect on excretion of microbial purine derivatives and blood metabolites. Thirty-two lactating Saanen goats (body weight 38.85 ± 2.14 kg and 1979 ± 0.25 g day-1 milk yield) were used in a one-way ANOVA completely randomized design. Goats were assigned to the following treatments for a 10-wk experimental period: 1) Control (canola meal as a nitrogen source); 2) Urea (0.5% urea); 3) Optigen (0.55% Optigen- Alltech. Inc., Lexington, KY) and 4) Polymer-Coated Urea (PCU- international patent number: A01K5/00, 0.7% PCU) based on dry mater intake. Non-protein nitrogen groups had a comparative effect (p > 0.05) between control and other treatments on milk composition, microbial protein synthesis and they affected on blood factors including urea, cholesterol, and ALT. Dry matter intake decreased (p > 0.05) in PCU, Optigen, Urea than Control goats. Synthesis of microbial protein in PCU goats was 22.5 g day-1 and it was greater (p > 0.05) than other treatments. Plasma cholesterol was increased in PCU and Optigen, whereas urea concentration was increased in Urea and Control goats. Milk production was higher in PCU than Urea and Control. Feed conversion ratio was improved (p > 0.05) in PCU and Optigen goats versus other treatments. This study demonstrated that polymer-coated urea can be utilized as a nitrogen source and improve goats milk performance

Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study

Introduction Over the past decades prevalence of diabetes has increased in Iran and other countries. This study aimed to update the prevalence of diabetes and prediabetes in Iran and to determine associated sociodemographic risk factors, as well as diabetes awareness and control. Methods This is a nationally representative cross-sectional survey that included 163,770 Iranian adults aged 35-70 years, from different ethnic backgrounds, between 2014 and 2020. Diabetes was diagnosed at fasting blood sugar of >= 6.99 mmol/L (126 mg/dL), or receiving blood glucose-lowering treatment. Multivariable logistic regression was applied to detect determinants associated with prevalence of diabetes and prediabetes, as well as predictors of diabetes awareness and glycemic control. Results Sex- and age-standardized prevalence of diabetes and prediabetes was 15.0% (95% CI 12.6-17.3) and 25.4% (18.6-32.1), respectively. Among patients with diabetes, 79.6% (76.2-82.9) were aware of their diabetes. Glycemic control was achieved in 41.2% (37.5-44.8) of patients who received treatment. Older age, obesity, high waist to hip ratio (WHR), and specific ethnic background were associated with a significant risk of diabetes and prediabetes. Higher awareness of diabetes was observed in older patients, married individuals, those with high WHR, and individuals with high wealth score. Moreover, glycemic control was significantly better in women, obese individuals, those with high physical activity, educational attainment, and specific ethnic background. Conclusions The prevalence of diabetes and prediabetes is increasing at an alarming rate in Iranian adults. High proportion of uncontrolled patients require particular initiatives to be integrated in the health care system

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions