Developing national framework of monitoring and evaluation of non-communicable diseases control and prevention: an experience from Iran

Background: Islamic Republic of Iran, as a country has undergone dramatic and rapid demographical and economic transition leading to increase mortality and morbidity of Non-Communicable Diseases (NCDs). Furthermore, the prevalence of risk factors of NCDs is at alarming range for the population. In response to this challenge, a number of different high level policies have been developed dealing with NCDs, directly or indirectly. However, the fragmentation of policies makes monitoring of NCDs control difficult. Therefore, the aim of the present study was to develop a comprehensive framework for monitoring and evaluating of NCDs control and prevention.  Methods: A qualitative approach with content analysis method was conducted. Components of NCDs monitoring and evaluation framework were extracted and adaptation of components based on requirements of Iran’s health system was made.    Results: Based on the proposed framework, the three main components of NCDs surveillance are as follows; 1) monitoring outcomes (morbidity and mortality); 2) monitoring risk factors; and 3) assessing health care system response, which includes national capacity to prevent NCDs.  Conclusion: The developed framework is a political tool to strengthen activities to control and prevention of NCD and making more effective inter-sectorial collaboration

Institutional health promotion standards in school of medicine at Shahid Beheshti University of Medical Sciences according to medical students' opinions in 2020

Background: Health promotion in occupational and educational environments contributes to the improvement and higher efficiency of the people affected by them. The health status of medical students as future providers of health services has great importance. This study aimed to evaluate health promotion standards in the school of medicine at Shahid Beheshti University of Medical Sciences. Methods: This cross-sectional study evaluated health promotion standards of school of medicine using a questionnaire filled out by medical students in 2020. The validity and reliability of the questionnaire were confirmed. The questionnaire measured health promotion standards in the fields of healthy nutrition, facilities for proper physical activity, providing a healthy environment for students, adequate education for health promotion and disease prevention. Analytical and statistical tests were performed using IBM SPSS 23 software. Results: Among 340 medical students participated in the study 31.8 percent were in the basic sciences grade, 26.5 percent were stagers, and 41.8 percent were interns. The mean score of all questions among different grades was 1.11 (SD=0.33), 0.97 (SD=0.43), and 0.93 (SD=0.34), respectively (on a scale of 0-3). A significant difference was reported in the comparison of "basic sciences versus stagers (PV=0.011)" and "basic sciences versus interns (PV<0.01) ". the mean score of questions overall was 1.00 (SD=0.37). Conclusion: Based on findings, health promotion in the school of medicine at Shahid Beheshti University of Medical Sciences was in the medium range, which demonstrates the need for future policies that lead to a more efficient health-promoting environment

Measuring Self-perceived Social Health of Iranians; Finding from Iran Social Health Survey

Background: The novelty of the study is to measure self-perceived social health of Iranians as one of the main dimensions of health.Materials and Methods: This cross-sectional study was conducted in all provinces of Iran in September 2014 with 10500 participants to measure self-perceived social health on a scale from 33 to 165 arranged in three areas; family, friends and relatives, and community. Area of "family" was measure in a range from 6 to 30; area of "friends and relatives" was from 9 to 45; and area of "community" was from 19 to 95. The psychometrics of scale was examined in separate previous study.Results: From a total of 10500 participants, 10244 fulfilled questionnaire (Response rate= 97.6%). 49.2% of participants were male. Mean of the total social health score was 99.91; area of "family" was 22; area of "friends and relatives" was 27.6; and area of "community" was 51.2. The main factors negatively influences on social health were low house size, unemployment, being divorced or widow and being at the age of 18-30. There was no significant relationship between social health score and educational level.Conclusion: It is magnificently attained that standardized social health rate in the present study was 3.9% lower than the rate has been estimated in comparison to similar previously conducted study in three big cities of Iran, two years earlier. Area of "community" is also the main accountant for this drop. To continue monitoring the social health of Iranians, we recommend conducting the next rounds every 3-5 years

A review on Quarantine during COVID-19 Outbreak: Lessons Learned from Previous Epidemics

Background: Since the emergence in December 2019, the novel coronavirus disease 2019 (COVID-19) has caused a global pandemic that has infected so many people all around the world. As there are no vaccination or antiviral treatment available yet, public health measures play a substantial role in the management of this pandemic. Governments of affected countries have imposed different quarantine policies and travel bans. As quarantine can have many controversial aspects, this review intends to clarify its role in disease control and other aspects of human everyday life with due attention to a couple of epidemics in the past (SARS, MERS, and flu) and ongoing COVID-19 outbreak.   Methods: We conducted a thorough search in PubMed, Research Gate, Google Scholar, Excerpta Media Database (EMBASE), and Web of Science databases and collected all relevant articles to Quarantine in the past epidemics (SARS, MERS, and flu) as well as ongoing COVID-19 pandemic.     Results:  A total of 176 articles were extracted in our primary search process. Primarily, 53 articles have been excluded because of duplication. The other 44 articles have been excluded due to different reasons (Lack of useful information and eligibility of data). Finally, 79 articles were selected for more evaluation (published until April 2020).   Conclusion: By having previous epidemics, including SARS, MERS, and flu, in mind, quarantine and isolation seem to be proper choices for this situation. But, as this epidemy is bigger than former ones, stricter public health measurements, such as serious social distancing and community-wide containment, are recommended

Xylo- and cello-oligosaccharide oxidation by gluco-oligosaccharide oxidase from Sarocladium strictum and variants with reduced substrate inhibition

Peer reviewe

Clinical Features and Risk Factors of Relapse and Mortality in Thrombotic Thrombocytopenic Purpura Patients: A Seven-Year Experience

Background: Thrombotic thrombocytopenic purpura (TTP) is associated with microangiopathic hemolytic anemia, thrombocytopenia, and microvascular thrombosis. No comprehensive report exists on clinical characteristics and risk factors of relapse and mortality in Iranian TTP patients. In this study, we aimed to report clinical features of Iranian TTP patients, to evaluate disease relapse and mortality rate and their associated risk factors. Materials and Methods: This study was a cohort study of patients diagnosed with microangiopathic hemolytic anemia admitted to the Shariati Hospital, Tehran, a referral center for TTP patients, from 2010 to 2017. Demographic, clinical, and laboratory data were recorded and patients were followed for 3 years regarding disease relapse and mortality. Results:  114 patients (80 female, 34 male) with a mean age of 39.3 ± 14.99 years were included.  Hematologic and neurologic symptoms were the most common manifestations. Abnormal laboratory findings at the presentation included thrombocytopenia, anemia, and elevated LDH. All patients were treated with plasma exchange, and 75.5% of them had a response to treatment, while the 3-year relapse and mortality rate was 23.6 and 26.3%.  Lower platelet count was a predictor of disease relapse. Age, hematological, or neurological initial presentation were associated with TTP mortality. Conclusion: Based on the largest study of TTP patients ever in Iran, the demographic and clinical characteristics of Iranian TTP patients are similar to other existing reports. Knowledge of the risk factors for TTP relapse and mortality could be useful to alert hematologists for prompt therapeutic actions when necessary

Engineering and Production of Glucooligosaccharide Oxidases for Site-specific Activation of Cellulose and Hemicellulose Substrates

Canada has an extensive supply of residual biomass, which comprises plant polysaccharides that represent a renewable resource for the production of biochemicals, polymers and fuels. Enzymatic oxidation of plant oligo- and poly-saccharides can alter the characteristics of these compounds, enhancing their application in food products; enzymatic oxidation could also facilitate site-specific chemical derivatizations of carbohydrates, leading to new bio-based polymers. A glucooligosaccharide oxidase from Sarocladium strictum (GOOX) was engineered in this study using a genetic engineering approach to extend the activity of this enzyme on a wider range of plant polysaccharides and oligosaccharides. For the first time, in addition to the previously reported cello- and malto-oligosaccharides, activity of wild type GOOX on xylooligosaccharides was reported. The catalytic efficiency of two mutant enzymes (GOOX-Y300A, GOOX-Y300N) on cellooligosaccharides and xylooligosaccharides was 2-fold higher than the wild-type enzyme. Notably, the binding affinity of these mutants towards oligosaccharides had decreased, which was correlated to reduced substrate inhibition by cellooligosaccharides. As expected, the GOOX-W351F mutant showed enhanced activity and affinity on galactose compared to wild-type GOOX as a result of reduced steric hindrance. Wild type GOOX exhibited low activity on polysaccharides including konjac glucomannan, and barley β-glucan, and weak activities on carboxy-methyl cellulose, regenerated amorphous cellulose, microcrystalline cellulose (Avicel), and xyloglucan. The specific activity was improved by up to 56 %, 55 % and 30 % for crystalline cellulose (Avicel), regenerated amorphous cellulose (RAC) and glucomannan, respectively, by constructing fusions between GOOX and various carbohydrate binding modules (CBMs). Binding capacities of the fusion proteins on crystalline and amorphous cellulose, as well as glucomannan, β-glucan, and xyloglucan also increased by over 10-fold as determined by SDS-polyacrylamide gel electrophoresis and affinity gel electrophoresis. The immobilized fusion enzyme on a solid cellulose surface remained stable and active. This finding is anticipated to broaden applications of GOOX as an immobilized enzyme used in cellulose-based biosensing devices. In addition to enzyme engineering and biochemical characterizations, three applications of GOOX enzymes were briefly evaluated including production of oxidized oligosaccharides as sugar standards, synthesis of plant oligosaccharides and polysaccharides with enhanced nutraceutical value, and substitution of glucose oxidase used in baking applications.Ph.D

Enhanced Polysaccharide Binding and Activity on Linear β-Glucans through Addition of Carbohydrate-Binding Modules to Either Terminus of a Glucooligosaccharide Oxidase

<div><p>The gluco-oligosaccharide oxidase from <i>Sarocladium strictum</i> CBS 346.70 (GOOX) is a single domain flavoenzyme that favourably oxidizes gluco- and xylo- oligosaccharides. In the present study, GOOX was shown to also oxidize plant polysaccharides, including cellulose, glucomannan, β-(1→3,1→4)-glucan, and xyloglucan, albeit to a lesser extent than oligomeric substrates. To improve GOOX activity on polymeric substrates, three carbohydrate binding modules (CBMs) from <i>Clostridium thermocellum</i>, namely <i>Ct</i>CBM3 (type A), <i>Ct</i>CBM11 (type B), and C<i>t</i>CBM44 (type B), were separately appended to the amino and carboxy termini of the enzyme, generating six fusion proteins. With the exception of GOOX-<i>Ct</i>CBM3 and GOOX-<i>Ct</i>CBM44, fusion of the selected CBMs increased the catalytic activity of the enzyme (<i>k</i>cat) on cellotetraose by up to 50%. All CBM fusions selectively enhanced GOOX binding to soluble and insoluble polysaccharides, and the immobilized enzyme on a solid cellulose surface remained stable and active. In addition, the CBM fusions increased the activity of GOOX on soluble glucomannan by up to 30 % and on insoluble crystalline as well as amorphous cellulose by over 50 %.</p></div

The half-life of wild-type GOOX and CBM fusions at 45°C.

<p>Values were obtained by plotting the log (% residual activity) versus incubation time (min). Errors indicate standard deviations; n = 3. Asterisk indicates statistically significant improvements compared to wild-type GOOX as determined using a two-tailed t-test for two samples with unequal variance (p < 0.05)</p><p>The half-life of wild-type GOOX and CBM fusions at 45°C.</p

Affinity gel electrophoresis (AGE) of wild-type GOOX and CBM fusions.

<p>Purified proteins were subjected to AGE using a 7.5% (w/v) polyacrylamide gel containing A: no polysaccharides, B: β-glucan, C: xyloglucan, D: glucomannan, E: carboxymethyl cellulose. The final concentration of each polysaccharide was 0.01%. Bovine serum albumin (BSA) was used as a reference.</p