Nonsurgical Treatment of Type II Dens Invaginatus in a Maxillary Lateral Incisor Using Cone-Beam Computed Tomography

This is a clinical report of a case of Oehlers type II dens invagination in left maxillary lateral incisor. A 12-year-old female patient was referred to endodontic department of Islamic Azad University. She reported history of pain and swelling on left anterior maxilla. Due to the insufficient information from conventional radiography, cone-beam computed tomography (CBCT) was ordered. CBCT revealed apical lucency and two separate canals. Conventional root canal therapy was done using warm vertical technique for invaginated canal. One year follow-up radiographies showed periapical repair and absence of symptoms.Key Words: Cone-Beam Computed Tomography; Dens Invaginatus; Maxillary Lateral Inciso

Geometry optimization of double wishbone suspension system via genetic algorithm for handling improvement

Motion control, stability maintenance and ride comfort improvement are fundamental issues in design of suspension systems in off-road vehicles. In this paper, a double wishbone (DW) suspension system, mostly used in off-road vehicles, is modeled using ADAMS software. Geometric parameters of suspension system are optimized using genetic algorithm (GA) in a way that ride comfort, handling and stability of vehicle are improved. Simulation results of suspension system and variations of geometric parameters due to road roughness and different steering angles are presented in ADAMS and effects of optimization of suspension system during various driving maneuvers in both optimized and non-optimized conditions are compared. Simulation results indicate that the type of suspension system and geometric parameters have significant effect on vehicle performance

Stress and dynamic analysis of optimized trailer chassis

Članak se bavi dinamičkom i analizom naprezanja lančane sheme šasije kamiona. Najprije se, kako bi se konstruirala šasija najmanje težine, odabiru vrsta materijala i profili poprečnog presjeka šasije u skladu s maksimalnim normalnim naprezanjem i teorijama maksimalne deformacije. Zatim je provedena analiza naprezanja šasije kamiona primjenom ABAQUS softvera u svrhu određivanja maksimalnog poprečnog progiba i raspodjele naprezanja. Rezultati pokazuju da su U-profili dovoljni za smanjenje težine koja može izdržati opterećenja. U sljedećem su koraku razmatrana vibracijska svojstva šasije, što je od velike važnosti za određivanje prirodnih frekvencija konstrukcije. U tu se svrhu provela modalna analiza metodom konačnih elemenata pomoću ANSYS softvera te su određene prirodne frekvencije i oblici vibriranja. U završnom se stupnju dinamički model vozila iskoristio za usporedbu dinamičkih parametara vozila i voznih karakteristika kod optimalizirane i neoptimalizirane šasije. Rezultati simulacije su pokazali da optimalizirana šasija povećava stabilnost kod ljuljanja i poboljšava uvjete u vožnji. Također, da bi se izbjeglo poklapanje frekvencije pobude (ekscitacije) s prirodnom frekvencijom šasije, prirodne frekvencije i oblici vibriranja analizirali su se uz promjene uvjeta opterećenja.This paper discusses the stress and dynamic analysis of truck ladder chassis. At the first stage, in order to design a chassis for self-weight reduction, material type and cross section profiles of chassis are selected according to a maximum normal stress and maximum strain theories. Then, the stress analysis of truck chassis has been carried out by ABAQUS software to determine maximum transverse deflection and stress distribution. Results show that open U-shaped profiles are sufficient for weight reduction which can endure loads. In the next stage, the prediction of the vibrational properties of the chassis which is of great significance in determining the natural frequencies of the structure, are considered. For this purpose, the modal analysis has been accomplished by the finite element packaged ANSYS software, and natural frequencies and mode shapes have been determined. In the final stage, vehicle dynamic model is used to compare vehicle dynamic parameters and ride response in optimized and not optimized chassis conditions. Simulation results clarified that the optimized chassis increases the roll stability and improves ride conditions. Also, in order to avoid matching the natural frequency of the chassis with the excitation frequency, natural frequencies and vibration modes have been analysed during the loading conditions

Psychometric evaluation of the health-seeking behavior scale based on Kroeger’s model for elective cardiac interventions

Background: Coronary artery bypass graft surgery (CABG) is one of the two most commonly used interventions for Myocardial Reperfusion. Studies suggest that the existence and direction of the effect of the factors affecting health-seeking behavior depend on the context of each society. Thus, this study aimed to introduce and validate a tool for investigating the factors affecting the health-seeking behavior of patients requiring a cardiovascular intervention as a prerequisite for planning and policymaking.   Methods: By reviewing the literature and questionnaires previously used in the field of health-seeking behavior and the patient's decision-making process, a set of related questions was collected based on Kroeger’s model variables. Ten content experts were requested to evaluate each item and then content validity ratio (CVR) and content validity index (CVI) were calculated and used for instrument modification. Participants were included through a convenience sampling procedure. Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) was used to assess construct validity. Cronbach's alpha coefficient was used to measure instrument reliability.   Results: Of the 142 participants, 79 (55.5%) were male. Through the validation process, a hierarchical model with four factors and 20 items with three error covariance (accounting for 63.06 present of outcome variable variation) was confirmed. Also, an examination of the four constructs obtained with Cronbach's alpha coefficient was more than 0.8 indicating acceptable reliability.   Conclusion: Findings suggest that the designed scale of health-seeking behavior based on Kroeger’s model is a reliable and valid scale among the Iranian population

Intersectoral collaboration in the management of non-communicable disease’s risk factors in Iran: stakeholders and social network analysis

Introduction As the major cause of premature death worldwide, noncommunicable diseases (NCDs) are complex and multidimensional, prevention and control of which need global, national, local, and multisectoral collaboration. Governmental stakeholder analysis and social network analysis (SNA) are among the recognized techniques to understand and improve collaboration. Through stakeholder analysis, social network analysis, and identifying the leverage points, we investigated the intersectoral collaboration (ISC) in preventing and controlling NCDs-related risk factors in Iran. Methods This is a mixed-methods study based on semi-structured interviews and reviewing of the legal documents and acts to identify and assess the interest, position, and power of collective decision-making centers on NCDs, followed by the social network analysis of related councils and the risk factors of NCDs. We used Gephi software version 0.9.2 to facilitate SNA. We determined the supreme councils' interest, position, power, and influence on NCDs and related risk factors. The Intervention Level Framework (ILF) and expert opinion were utilized to identify interventions to enhance inter-sectoral collaboration. Results We identified 113 national collective decision-making centers. Five councils had the highest evaluation score for the four criteria (Interest, Position, Power, and Influence), including the Supreme Council for Health and Food Security (SCHFS), Supreme Council for Standards (SCS), Supreme Council for Environmental Protection (SCIP), Supreme Council for Health Insurance (SCHI) and Supreme Council of the Centers of Excellence for Medical Sciences. We calculated degree, in degree, out-degree, weighted out-degree, closeness centrality, betweenness centrality, and Eigenvector centrality for all councils. Supreme Council for Standards and SCHFS have the highest betweenness centrality, showing Node's higher importance in information flow. Interventions to facilitate inter-sectoral collaboration were identified and reported based on Intervention Level Framework's five levels (ILF). ConclusionA variety of stakeholders influences the risk factors of non-communicable diseases. Through an investigation of stakeholders and their social networks, we determined the primary actors for each risk factor. Through the different (levels and types) of interventions identified in this study, the MoHME can leverage the ability of identified stakeholders to improve risk factors management. The proposed interventions for identified stakeholders could facilitate intersectoral collaboration, which is critical for more effective prevention and control of modifiable risk factors for NCDs in Iran. Supreme councils and their members could serve as key hubs for implementing targeted inter-sectoral approaches to address NCDs' risk factors

Timely referral to health centers for the prevention of cardiovascular diseases: IraPEN national program

IntroductionThe IraPEN program is an adapted version of the WHO-PEN program designed to prevent four major non-communicable diseases in Iran. This study aimed to determine the rate of compliance and related factors among individuals participating in the IraPEN program for the prevention of cardiovascular disease.MethodIn this study, compliance was defined as timely referral to the health center as scheduled, and the researchers approached four pilot sites of IraPEN from March 2016 to March 2018. Sex-stratified logistic regressions were applied to investigate factors related to compliance. However, it is important to note that in this study, compliance was defined as compliance to revisit, not compliance to taking prescribed medications or behavioral lifestyle changes.ResultsThe total compliance rate, including timely compliance and early and late compliance, was 16.5% in men and 23.3% in women. The study found that cardiovascular risk factors such as diabetes, hypertension, hypercholesterolemia, and being underweight were associated with lower compliance. The higher calculated risk of CVD was associated with higher compliance, but after adjusting for cardiovascular risk factors, high-risk individuals showed lower compliance. There was negligible interaction between sex and other factors for compliance.ConclusionThe compliance rate with scheduled programs for cardiovascular preventive strategies was very low, and high-risk individuals were less compliant, regardless of their high level of risk factors. The study recommends further training to increase awareness and knowledge regarding the IraPEN program and the prevention of non-communicable diseases among high-risk populations

A study of blood pressure prevalence and some of its effective factors in different ethnicities in the rural population

&nbsp;&nbsp; BACKGROUND: High blood pressure is considered as one of the main problems in developed and developing countries. Undoubtedly, controlling blood pressure is a significant factor in the declining of case of fatal non-contagious diseases, and plays an important role in reducing the rate of mortality caused by these diseases. The purpose of this research is to investigate blood pressure prevalence and its effective factors in the population older than 30 years of age in Shaft, Iran, around 2007-2008. &nbsp;&nbsp; METHODS: This is a descriptive, cross-sectional, and applied research, which is dedicated to surveying the relationship between family history of blood pressure, diabetes, and fatness with high blood pressure prevalence in 27,057 people older than 30 years of age. Data was collected via a questionnaire along with observation, and was analyzed by SPSS software. &nbsp;&nbsp; RESULTS: Results showed that from the 27,057 screened people, 47.4% were male and 52.6% female. 49.6% of screened people were at risk of high blood pressure 56% of at risk individuals had BMI factor of more than 25 and 13.6% had family history of diabetes. From the total population under survey, 1.9% were suspected of having high blood pressure, 0.47% of whom were diagnosed by physicians for the first time. The highest frequency of prevalence (including old and new sick people) was observed in 22% of people of 70 years of age and older that implied the risk of high blood pressure will be raised by increasing of age. The prevalence of high blood pressure in women (12.6%) was higher than men (4.58%). &nbsp;&nbsp; CONCLUSION: Overweight people, people that had family history of blood pressure and diabetes, and smokers were more at risk of high blood pressure compared to healthy people. Therefore, paying sufficient attention to risky cardiovascular factors in the treatment of high blood pressure, changing the patients&rsquo; lifestyle, amending their diet and preventing them from immobility can be some of the effective ways of controlling risky factors. &nbsp; &nbsp; &nbsp; Keywords: Blood pressure, Fatness, Diabetes, Family Background, Lifestyle</p

Study on the Serum Titer of Anti-Hbs Antibody of the Vaccinated Staffs of A Hospital in Three Consecutive Years

Hepatitis B virus is one of the main factors causing acute and chronic hepatitis and hepatocellular carcinoma. Among others, healthcare workers are at the highest risk for exposure to hepatitis B virus. Vaccination against hepatitis B virus is one of the protective strategies but anti-HBs titer will be reduced in the sera of vaccinated people after some time. The aim of this study was to determine the titer of anti-HBs in the sera of vaccinated medical staffs in three consecutive years since administration of the last dose of hepatitis B vaccine.Materials and Methods : This study was carried out on 90 Omidvar Hospital (Lar, Iran) medical staffs that had passed 3-4 months since the administration of the last dose of hepatitis B vaccine. All sera samples were tested for anti-HBs in an ELISA method. Finally, statistical analysis was performed using SPSS-16 software.Results : This study was conducted in duration of 3 consecutive years on 90 medical staffs including 14.44% lab technicians, 10% obstetricians, 43.35% nurses, 6.665% specialists, 5.55% general practitioners and 20% maid staffs. While HBs Ab titer was measured as 87.7% (>100 mIU/ml) in the first year elapsed since the last dose of hepatitis B vaccination, it had been decreased to 55.4% after 3 years.Conclusion : The results showed that re-vaccination of the medical staffs is quite necessary as anti-HBs titer had been decreased after 3 years and the desired immune response was seen only in 55.4% of the medical staffs

Table_1_Timely referral to health centers for the prevention of cardiovascular diseases: IraPEN national program.docx

IntroductionThe IraPEN program is an adapted version of the WHO-PEN program designed to prevent four major non-communicable diseases in Iran. This study aimed to determine the rate of compliance and related factors among individuals participating in the IraPEN program for the prevention of cardiovascular disease.MethodIn this study, compliance was defined as timely referral to the health center as scheduled, and the researchers approached four pilot sites of IraPEN from March 2016 to March 2018. Sex-stratified logistic regressions were applied to investigate factors related to compliance. However, it is important to note that in this study, compliance was defined as compliance to revisit, not compliance to taking prescribed medications or behavioral lifestyle changes.ResultsThe total compliance rate, including timely compliance and early and late compliance, was 16.5% in men and 23.3% in women. The study found that cardiovascular risk factors such as diabetes, hypertension, hypercholesterolemia, and being underweight were associated with lower compliance. The higher calculated risk of CVD was associated with higher compliance, but after adjusting for cardiovascular risk factors, high-risk individuals showed lower compliance. There was negligible interaction between sex and other factors for compliance.ConclusionThe compliance rate with scheduled programs for cardiovascular preventive strategies was very low, and high-risk individuals were less compliant, regardless of their high level of risk factors. The study recommends further training to increase awareness and knowledge regarding the IraPEN program and the prevention of non-communicable diseases among high-risk populations.</p