The impact of a computerized decision aid on empowering pregnant women for choosing vaginal versus cesarean section delivery: study protocol for a randomized controlled trial

Cesarean delivery on maternal request (CDMR) is one of the main reasons for cesarean delivery in Iran, and women often need help in making a decision about the delivery options available to them. The main objective of this study is to evaluate the effect of a computerized decision aid (CDA) system on empowering pregnant women in choosing an appropriate mode of delivery. This CDA contrasts the advantages and disadvantages of vaginal versus cesarean section delivery in terms of their value to the individual woman. The protocol concerns a randomized trial study that will be performed among Iranian women. Four hundred pregnant women will be recruited from two private and two public prenatal centers in Mashhad, Iran. They will be randomly assigned to either an intervention or a control group. The designed CDA will be provided to the intervention group, whereas the control group will only receive routine care. The CDA provides educational contents as well as some recommendations. The CDA's knowledge base is obtained from the results of studies on predictors of cesarean delivery. The CDA's software will be installed on women's computers for use at home. The two primary outcomes for the study are O'Connor's Decisional Conflict Scale and knowledge as measured by true/false questions. Actual mode of delivery (vaginal versus cesarean) will be compared in the two groups. We investigate the effect of a CDA on empowering pregnant women in terms of reducing their decisional conflict as well as on improving their clinical knowledge pertaining to mode of delivery. This trial is registered with the Iran Trial Registrar under registration number IRCT2015093010777N4 and registration date 26 October 201

Hematological and biochemical evaluation of goats naturally infected with contagious ecthyma

Contagious ecthyma (CE) is a zoonotic skin disease of small ruminants, caused by an epitheliotropic parapoxvirus and has a worldwide distribution with significant economic importance. The objective of this study was to determine clinicopathlogic abnormalities in goats naturally infected with CE. Thirty two goats, 16 affected with CE and 16 normal healthy goats were used in this study. CE was confirmed by histopathology and PCR. Blood samples were collected from jugular veins for hematological and biochemical analysis. The PCV, WBC and neutrophil counts of CE affected goats were significantly higher than those in the unaffected goats (p < 0.05). Serum biochemical analysis revealed significantly higher levels of BUN, glucose, MDA and iron concentrations as well as CK, AST, GGT and catalase activities in CE affected goats than healthy animals (p < 0.05). The serum activity of catalase, SOD and GPx in goats with CE were significantly lower than those in normal goats. Creatinine concentration in serum of goats with CE was significantly lower than that in heathy ones (p < 0.05). There was no significant difference in serum total protein, albumin, total and direct bilirubin, and cholesterol concentrations between CE affected and healthy goats. The alterations observed in hematological and biochemical parameters of CE affected goats could be related to weight loss, subnutrition, oxidative stress and pathological changes including inflammation and secondary bacterial infection. These findings could be useful for the management of cases of sheep and goats with CE

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Engineering and chemistry aspects of the well-known conductive polymers as sensors: Characterization, mechanism, synthesis, scale-up: A review

In this research, the conductive polymers including polypyrrole (PPy), polyaniline (PANI), and polythiophene (PTh) and their hybrids in the role of sensors were studied for the detection of the gas molecules. The synthesis principles, sensing performance, sensing mechanism, characterization of the conductive polymers, and scale-up discussion have been investigated. In addition, the impact of the operating conditions including temperature, humidity, gas concentration, time, recovery, and common additives like tin oxide, iron chloride, and Pd were analyzed. Sensitivity, conductivity, and response were discussed as criteria to evaluate the efficiency of the sensors. The difference of conductive polymers in the gas sensing returns to the level of porosity and morphology in the different conductive polymers. The results reveal that PANI and its composites are the desired choice for sensing toxic gases even in industrial centers or commercial scales

Web-based health Information seeking and eHealth literacy among college students: a self-report study

Objective. This study aimed to assess web-based health information seeking and eHealth literacy among Iranian college students. Methods. The study was conducted in five colleges of the Shiraz University of Medical Sciences in Iran during 2018. The data were collected by a researcher-made questionnaire consisting of seven questions on a 4-point Likert-type scale, with scores ranging from 7 to 28. These questions were: ′I know how to use the Internet to answer my questions about health′, ′I think there is enough information about health-related issues on the Internet′, ′I know the vocabulary used in health issues on the Internet′, ′I can tell high-quality health resources from low-quality health resources on the Internet′, ′I know how to use the health information I find on the Internet to help me′, ′I feel confident in using information from the Internet to make health decisions′, and ′Searching for health-related information on the Internet will increase my knowledge in this field′. High eHealth literacy level is defined as above the total mean score and low eHealth literacy level is defined as lower than the total mean score. Results. In all, 386 college students participated in the study. The results showed that the mean score of eHealth literacy was 19.11 out of 28; 205 participants (54.4%) had low eHealth literacy. In addition, the students used the Internet to search for information regarding diseases symptoms (70%), physical illnesses (67.1%), existing treatments (65%), and diagnosis (63.1%). Conclusion. The results showed that participants in this study usually searched for illnesses, symptoms, and treatments after they got sick and paid little attention to other aspects related to integral health.How to cite this article: KHademian F, Roozrokh M, Aslani A. Web-based health Information Seeking and eHealth Literacy among College students. A Self-report study. Invest. Educ. Enferm. 2020. 38(1):e08.Objetivo. Este estudo teve como objetivo avaliar a busca de informações sobre saúde on-line e o nível de alfabetização em eSaúde entre estudantes universitários iranianos. Métodos. O estudo foi realizado em cinco faculdades da Universidade de Ciências Médicas de Shiraz, Irã, durante 2018. Os dados foram coletados com a ajuda de um questionário conduzido pelos pesquisadores, composto por 7 declarações com opções de resposta tipo Likert de 4 pontos, com uma faixa de pontuação de 7-28 pontos. Essas perguntas foram: ‘Eu sei como usar a Internet para responder às minhas perguntas sobre saúde’, ‘Eu acho que há informações suficientes sobre problemas relacionados à saúde na Internet’, ‘Eu conheço o vocabulário usado nas questões de saúde na Internet’, ‘Eu posso distinguir em Recursos de saúde de alta qualidade na Internet que são de baixa qualidade ‘,’ Eu sei como usar as informações de saúde encontradas na Internet para me ajudar ‘,’ Sinto-me seguro ao usar informações da Internet para decisões de saúde ‘e’ A busca de informações relacionadas à saúde na Internet aumentará meu conhecimento neste campo ‘. Foi estabelecido que havia alta alfabetização em eSaúde se a pontuação estivesse acima da média total e baixa literacia em eSaúde se essa pontuação fosse menor que a média. Resultados.386 universitários participaram do estudo. A pontuação média em alfabetização em eSaúde foi 19,11 dos 28 pontos máximos possíveis. 205 participantes (54,4%) tinham baixa alfabetização em eSaúde. Além disso, os estudantes usaram a Internet para buscar informações sobre sintomas da doença (70%), doenças físicas (67,1%), tratamentos existentes (65%) e diagnóstico (63,1%). Conclusão. Os resultados mostraram que os participantes deste estudo geralmente buscavam informações na Internet sobre doenças, sintomas e tratamentos após adoecer e prestavam pouca atenção a outros aspectos relacionados à saúde integral.Objetivo. Evaluar la búsqueda de información de salud en línea y el nivel de alfabetización en eSalud entre los estudiantes universitarios iraníes. Métodos.El estudio se realizó en cinco colegios de la Universidad de Ciencias Médicas de Shiraz, Irán, durante 2018. Los datos se recopilaron con la ayuda de un cuestionario realizado por los investigadores que consta de 7 afirmaciones con opciones de respuesta tipo Likert de 4 puntos, con un rango de puntaje de 7-28 puntos: 1. “Sé cómo usar Internet para responder mis preguntas sobre salud”; 2. “Creo que hay suficiente información sobre problemas relacionados con la salud en Internet”; 3. “Conozco el vocabulario utilizado en temas de salud en Internet”; 4. “Puedo distinguir en Internet los recursos de salud de alta calidad de los que son de baja calidad”; 5. “Sé cómo usar la información de salud que encuentro en Internet para ayudarme”; 6. “Me siento seguro al usar la información de Internet para decisiones de salud”, y 7. “Buscar en Internet información relacionada con la salud aumentará mi conocimiento en este campo”. Se estableció que se tenía alfabetización en eSalud alta si el puntaje estaba por encima de la media total y alfabetización en eSalud baja si este puntaje era inferior a la puntuación media. Resultados. 386 estudiantes universitarios participaron en el estudio. La puntuación media de alfabetización en eSalud fue de 19,11 de los 28 puntos máximos posibles. 205 participantes (54.4%) tenían baja alfabetización en eSalud. Además, los estudiantes utilizaron Internet para buscar información sobre síntomas de enfermedades (70%), enfermedades físicas (67.1%), tratamientos existentes (65%) y diagnóstico (63.1%). Conclusión.Los resultados mostraron que los participantes de este estudio buscaban generalmente información en Internet acerca de enfermedades, síntomas y tratamientos después de enfermarse y prestaban poca atención a otros aspectos relacionados con la salud integral

Improving adsorption performance of l-ascorbic acid from aqueous solution using magnetic rice husk as an adsorbent: experimental and RSM modeling

Abstract In this research, rice husk (RH) was utilized to prepare a magnetic adsorbent for adsorption of ascorbic acid (AA). The magnetic agent is iron(III) chloride (FeCl3). The impact of acid concentration in the range of 400–800 ppm, adsorbent dosage in the range of 0.5–1 g, and contact time in the range of 10–130 min were studied. The Langmuir model had the highest R2 of 0.9982, 0.9996, and 0.9985 at the temperature of 15, 25, and 35 °C, respectively, and the qmax values in these temperatures have been calculated at 19.157, 31.34, and 38.75 mg/g, respectively. The pseudo-second-order kinetic model had the best agreement with the experimental results. In this kinetic model, the values of q have been measured at 36.496, 45.248, and 49.019 mg/g at the acid concentration of 418, 600, and 718 ppm, respectively. The values of ΔHo and ΔSo were measured 31.972 kJ/mol and 120.253 kJ/mol K, respectively, which proves the endothermic and irregularity nature of the adsorption of AA. Besides, the optimum conditions of the design-expert software have been obtained 486.929 ppm of acid concentration, 0.875 g of the adsorbent dosage, and 105.397 min of the contact time, and the adsorption efficiency in these conditions was determined at 92.94%. The surface area of the RH and modified RH was determined of 98.17 and 120.23 m2/g, respectively, which confirms the high surface area of these two adsorbents

Inter-observer and Intra-observer Agreement in Pathological Evaluation of Non-alcoholic Fatty Liver Disease Suspected Liver Biopsies

BACKGROUND: Histopathologic assessment of liver tissue is an essential step in management and follow-up of non-alcoholic fatty liver disease (NAFLD) while inter- and intra-observer variations limit the accuracy of these assessments. OBJECTIVES: The aim of this study was to assess the inter- and intra-observer reproducibility of histopathologic assessment of liver biopsies based on NAFLD activity score (NAS) scoring system. MATERIALS AND METHODS: The anonymous liver biopsy samples of 100 consecutive NAFLD suspected adults were randomly assigned to four pathologists. Then, the samples were randomly reassigned to the pathologists for the second time in a way that each sample would be evaluated by two different pathologists. Biopsies were revisited by their first evaluator after two months. The results were reported based on NAS scoring system. RESULTS: Inter-observer agreement of the pathology scores based on NAS scoring system was acceptable for steatosis, lobular inflammation, and fibrosis, but not for hepatocyte ballooning. The intra-observer agreement was acceptable in all scales, with lowest intra-class correlation observed for lobular inflammation. CONCLUSIONS: NAS scoring system has good overall inter- and intra-observer agreement, but more attention should be given to defining the hepatocyte ballooning and lobular inflammation, and training the pathologists to improve the accuracy of pathology reports