Development and psychometric testing of a new instrument to measure factors influencing women's breast cancer prevention behaviors (ASSISTS)

Background: Breast cancer preventive behaviors have an extreme effect on women's health. Despite the benefits of preventive behaviors regarding breast cancer, they have not been implemented as routine care for healthy women. To assess this health issue, a reliable and valid scale is needed. The aim of the present study is to develop and examine the psychometric properties of a new scale, called the ASSISTS, in order to identify factors that affect women's breast cancer prevention behaviors. Methods: A multi-phase instrument development method was performed to develop the questionnaire from February 2012 to September 2014. The item pool was generated based on secondary analyses of previous qualitative data. Then, content and face validity were applied to provide a pre-final version of the scale. The scale validation was conducted with a sample of women recruited from health centers affiliated with Tehran University of Medical Sciences. The construct validity (both exploratory and confirmatory), convergent validity, discriminate validity, internal consistency reliability and test-retest analysis of the questionnaire were tested. Results: Fifty-eight items were initially extracted from the secondary analysis of previous qualitative data. After content validity, this was reduced to 49 items. The exploratory factor analysis revealed seven factors (Attitude, supportive systems, self-efficacy, information seeking, stress management, stimulant and self-care) containing 33 items that jointly accounted for 60.62 % of the observed variance. The confirmatory factor analysis showed a model with appropriate fitness for the data. The Cronbach's alpha coefficient for the subscales ranged from 0.68 to 0.85, and the Intraclass Correlation Coefficient (ICC) ranged from 0.71 to 0.98; which is well above the acceptable thresholds. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for assessing factors affecting women's breast cancer prevention behaviors that can be used both in practice and in future studies

Effect of Different Heparin Volumes on Blood Gas Analysis

AbstractBackground and Aim: Blood gas analysis is an important laboratory test for diagnosis and treatment of a variety of medical conditions in emergency rooms. Inaccurate sample collection is one of the reasons for errors in blood gas analysis. This study was conducted to evaluate different volumes of heparin in syringes and the effect of sample dilution on blood gas analysis as one of the main factors affecting the results of blood gas analysis.Methods: One hundred children (4 months to 12 years) who presented to Loghman Hakim Hospital, Tehran, Iran, were enrolled in this study. Two samples were taken from each patient. For the first sample, the syringes were filled with heparin sodium and then emptied completely to achieve a very thin layer anticoagulant coating. For the second sample, the syringes were filled with 0.1 mL of liquid heparin sodium 5000 U/mL (5%). The blood gas parameters including pH, PO2, PCO2, HCO3 and BE (base excess) were measured. Data were analyzed using SPSS version 18.Results: All parameter had lower levels in second samples (0.1 mL heparin 5%) except for PO2 compared to the first samples (P < 0.001).Conclusion: This study found that a small amount of heparin in the syringe changed the result of blood gas analysis. Keywords: Blood Gas Analysis; Heparin; pH; PCO2; HCO3

Assessment of COVID-19 among healthcare workers in Non-COVID pediatrics departments, Tehran, Iran: A cross-sectional study

Objective: The severe acute respiratory syndrome coronavirus 2(SARS COV 2) is an important health problem, which is widespread around the world. This study describes the characteristics of COVID-19 infections in healthcare workers (HCWs), related factors and deaths in Non- COVID pediatrics departments from the early phases of COVID-19 pandemic; February 20th, 2020toJanuary19th, 2021 in Tehran-Iran. Materials and Methods: It is a multi-center cross-sectional descriptive study. The standardized questionnaire was designed according Demographics information, Coronavirus disease (COVID-19) history in HCW and Using and access to Personal Protective Equipment (PPE). All data analysis was performed by SPSS software version 21. Results: Of the 82 HCW, 67 (81.7%) was female. The median age was 37.6 ±10.3 years old (rang 24 to 65). 44 (53.6%) were nurses, 14 (17 %) pediatrics residents,13 (15.9%) pediatrics faculty members,8(9.8%) environmental services staff and 3(3.7%) secretaries. Twelve out of our cases (14.6%) have underlying medical diseases. Thirty-six (42.7%) confirmed COVID19. In COVID-19 positive group 28(80%) were female. Among whom 51.4% were identified nurses, 17% faculty member and14.3% pediatrics residents. Secretaries and environmental services staff are more vulnerable job category in this study. Eighty-six percent of them follow protective health protocol and use PPE. COVID-19 cases were infected more on July 2020(25.7%), November 2020 (17.1%) and August 2020(14.2%).   Conclusion: Approximately one half of HCWs in non-Covid-19 pediatrics department infected with corona virus 2 (SARS_COV_2) and most of them thought they were infected in workplac

Lower expression of miR-218 in human breast cancer is associated with lymph node metastases, higher grades, and poorer prognosis.

Breast cancer is considered as the most prevalent malignancy in women worldwide. Despite emergence of several prognosticators for better management of patients, there are still limitations for their clinical application due to the complexity of breast tumors, and therefore, new biomarkers for better prognosis of clinical outcomes would be of the great essence. MicroRNAs are highly conserved small non-coding regulatory RNAs involved in post-transcriptional regulating of gene expression during different cellular mechanisms. Accumulating studies suggest that miR-218 plays a multifunctional role in various cancer types and different stages. Here, to address prognostic significance of miR-218 in breast cancer, we investigate the expression profile of miR-218 and B-cell-specific Moloney murine leukemia virus integration site 1 ( BMI1) gene, as one of the putative targets of miR-218, in 33 paired breast tumors and their adjacent normal tissues with respect to the clinicopathological features of patients using quantitative real-time polymerase chain reaction. The correlation of both miR-218 and BMI1 gene expression with overall survival of breast cancer patients was also examined recruiting OncoLNC data portal. Finally, to better understand biological function of miR-218 in breast cancer, we performed in silico Gene Ontology and signaling pathway enrichment analysis on miR-218 targetome. According to our data, significant elevation of the expression of miR-218 and downregulation of BMI1 were observed in clinical breast cancer specimens compared with normal tissues ( p < 0.0001). The lower expression of miR-218 was associated with lymph node metastases, higher grades, and poorer prognosis (logrank p = 0.00988), whereas no significant difference in overall survival was observed between patients with higher and lower expression of BMI1 (logrank p = 0.254). These findings suggest that miR-218 expression profiling might be clinically applicable as a prognostic biomarker in breast cancer. In addition, our in silico enrichment analyses revealed that the association of miR-218 expression with breast cancer prognosis might be through its involvement in endocytosis and gap junction biological pathways

Reference Interval for Fasting Blood Sugar, Triglycerides, Total Cholesterol, Low-Density Lipoprotein, and High-Density Lipoprotein-Cholesterol in Healthy Babolian Individuals

Background and Aim: Sugar and Lipid disorders are the main risk factors for vascular abnormalities. Due to the gender and age, other variables can influence serum Fasting blood sugar and lipid levels, certifying the determination of population-specific reference interval. This study was designed to investigate the age- and gender-specific reference values for serum Fasting blood sugar (FBS), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein-cholesterol (HDL) in healthy Babolian adults. Methods: FBS, TC, TG, and HDL were calculating applying the colorimetric method. The Friedewald equation (LDL=TC−HDL−TG/5) was used to calculate LDL concentrations in individuals. After using the exclusion parameters, 519 participants (199 men and 320 women) aged ≥23 years were included. The Clinical Chemistry guidelines of the International Federation applied for characterizing the reference values for samples. Results: Reference values for serum FBS, TG, TC, LDL, HDL were 77.01-107.69 mg/dL, 35.34-204.38 mg/dL, 117.97-242.81 mg/dL, 47.6-137.16 mg/dL and 33.29-67.13 mg/dL in men. In women, reference values for serum FBS, TG, TC, LDL, HDL were 75.03-107.99, 27.49-192.33 mg/dL, 125.84-244.32 mg/dL, 44.08-139.48 mg/dL and 36.66-81.1 mg/dL. FBS, TG, and LDL parameters were higher in men, and TC and HDL parameters were higher in women. Conclusion: Reference values for serum FBS, TC, TG, LDL, HDL in healthy Babolian adults were specified, and these data could supply a clear pathway for better decision making in both clinical settings and prevention. *Corresponding Author: Negar Yavari; Email: [email protected] Please cite this article as: Gholami Bahnemiri M, Amiri M, Khanicheragh M, Safizadeh F, Mohammadi Tahroodi F, Akbari Javar A, Aram H, Mir SM, Yavari N. Reference Interval for Fasting Blood Sugar, Triglycerides, Total Cholesterol, Low-density Lipoprotein, and High-density Lipoprotein-cholesterol in Healthy Babolian Individuals. Arch Med Lab Sci. 2019;5(4):14-20. https://doi.org/10.22037/amls.v5i4.2992

BIOTECHNOLOGICAL PRODUCTS AND PROCESS ENGINEERING EGFP reporter protein: its immunogenicity in Leishmania-infected BALB/c mice

Abstract Optical reporter genes such as green fluorescent protein (GFP) and luciferase are efficiently and widely used in monitoring and studying the protective/therapeutic potential of candidate agents in leishmaniasis. But several observations and controversial reports have generated a main concern, whether enhanced GFP (EGFP) affects immune response. To address this issue, we studied the immunogenicity of EGFP in vivo by two lines of stably transfected parasites (Leishmania major EGFP or L. major EGFP-LUC ) in BALB/c model and/or as a recombinant protein (rEGFP) produced in vitro by bacteria in parallel. Disease progression was followed by footpad swelling measurements and parasite burden in draining lymph nodes using microtitration assay and real-time PCR, and immune responses were also evaluated in spleen. EGFP-expressing parasites generated larger swellings in comparison with wild-type (L. major) while mice immunized with rEGFP and challenged with wild-type parasite were quite comparable in footpad swelling with control group without significant difference. However, both conventional and molecular approaches revealed no significant difference in parasite load between different groups. More importantly, no significant inflammatory responses were detected in groups with higher swelling size measured by interferon-γ (IFN-γ), interleukin (IL)-10, IL-5, and nitric oxide against frozen and thawed lysate of parasite as stimulator. Altogether, these results clearly revealed that EGFP protein expressed in prokaryotic and eukaryotic hosts is not an immunological reactive molecule and acts as a neutral protein without any side effects in mice. So, EGFP expressing Leishmania could be a safe and reliable substitution for wildtypes that simplifies in situ follow-up and eliminates the animal scarification wherever needed during the study

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed