Designing a customized clinical practice guideline regarding antibiotic prophylaxis for Iranian general dentists.

BACKGROUND: Clinical practice guidelines produced by developed countries seemed to be not completely feasible for developing countries due to their different local context. In this study, we designed a customized guideline about antibiotic prophylaxis before dental procedures for Iranian general dentists. METHODS: This study was conducted of two parts, including a qualitative part and a cross-sectional analytic part. A multidisciplinary team searched for related guidelines and other documents, selected the most updated and high quality ones, customized their recommendations based on available antibiotics in Iran, prepared a draft adapted guideline and summarized its recommendations in 3 flowcharts. An expert panel (20 specialists of four Iranian dental universities) participated in a consensus process, afterwards to determine the relevance and clarity of the flowcharts and their items. Then the Content Validity Indices (CVIs) were calculated and any items with CVI higher than 0.79 remained. RESULTS: The adapted recommendations were summarized in flowcharts A to C. Two separate groups of patients who need antibiotic prophylaxis were presented in flowchart A; including those with high risk for distant-site infection (infective endocarditis and prosthetic joint infection) and those at risk for poor healing and orofacial infection (due to impaired immunologic function). Flowcharts B and C described antibiotic regimen and also the dental procedures where antibiotic prophylaxis was needed for mentioned groups. The content validity indices and the percentages of agreement between the expert panel members were considerably high. CONCLUSIONS: A localized, clear and straight forward guideline that addresses all groups of dental patients who need antibiotic prophylaxis has been produced for Iranian general dentists

A Systematic Literature Review: Workplace Violence Against Emergency Medical Services Personnel

Context: In spite of the high prevalence and consequences of much workplace violence against emergency medical services personnel, this phenomenon has been given insufficient attention. A systematic review can aid the development of guidelines to reduce violence. Objectives: The research question addressed by this paper is, “What are the characteristics and findings of studies on workplace violence against emergency medical services personnel”? Data Sources: A systematic literature review was conducted using online databases (PubMed, Scopus, Google Scholar, and Magiran) with the help of experienced librarians. Study Selection: Inclusion criteria comprised studies in the English or Persian language and researcher’s access to the full text. There was no limit to the entry of the study design. Exclusion criteria included lack of access to the full text of the article, studies published in unreliable journals or conferences, and studies in which the results were shared with other medical or relief groups and there was no possibility of breaking down the results. Data Extraction: A “Data extraction form” was designed by the researchers based on the goals of the study that included the title and author(s), study method (type, place of study, sample size, sampling method, and data collection/analysis tool), printing location, information related to the frequency of types of violence, characteristics of victims /perpetrators, and related factors. Results: The papers reviewed utilized a variety of locations and environments, methods, and instrument samplings. The majority of the studies were performed using the quantitative method. No intervention study was found. Most studies focused on the prevalence of violence, and their results indicated that exposure to violence was high. The results are presented in six major themes. Conclusions: Workplace violence and injuries incurred from it are extensive throughout the world. The important causes of violence include the shortage of training programs dealing with violence, lack of violence management protocols, and delays in response times. Therefore, afterthought and resolve are more crucial than ever. Workplace violence reduction strategies and suggestions for future studies are also discussed

A Flow Based Horizontal Scan Detection Using Genetic Algorithm Approach

Abstract: An attacker has to "scan" susceptible points of a network before attacking. There are several methods of detection of such behavior which are mostly based on thresholding. As the performance of these methods is highly dependent on the value of threshold, it is crucial to adjust this value appropriately. This adjustment is not always trivial. In this study we proposed a new method to optimize the parameters of the system using genetic algorithms (GA) based on network flows. Subsequently we compared our method with Snort. The results showed a superior performance as measured by the sensitivity index of d"

Generating GHZ state in 2m-qubit spin network

We consider a pure 2m-qubit initial state to evolve under a particular quantum me- chanical spin Hamiltonian, which can be written in terms of the adjacency matrix of the Johnson network J(2m;m). Then, by using some techniques such as spectral dis- tribution and stratification associated with the graphs, employed in [1, 2], a maximally entangled GHZ state is generated between the antipodes of the network. In fact, an explicit formula is given for the suitable coupling strengths of the hamiltonian, so that a maximally entangled state can be generated between antipodes of the network. By using some known multipartite entanglement measures, the amount of the entanglement of the final evolved state is calculated, and finally two examples of four qubit and six qubit states are considered in details.Comment: 22 page

Investigating the trend and severity of withdrawal symptoms in Methamphetamine users amongst homeless addicts

Background: Determining the trend and severity of withdrawal symptoms is considered as the first stage of addiction treatment. Objectives: Therefore, The purpose of this study was to investigate the trend and severity of withdrawal symptoms in methamphetamine (meth) addicts. Patients and Methods: This cross-sectional study was conducted on all the clients admitted to quit methamphetamine abuse in a residential treatment center for homeless addicts in Alborz province. According to the average daily intake, the clients were divided into two groups: mild and severe. To collect the data for this study; methamphetamine withdrawal symptoms assessment scale, Beck Depression Inventory (BDI) and a demographic information questionnaire were used. The analysis of variance (ANOVA) was done for repeated measures through the SPSS software version 16 and at a significance level of 0.05. Results: The findings showed that methamphetamine withdrawal symptoms including anxiety, abuse craving, and fatigue in the first 24 hours and the first, the second, and the third weeks as well as the symptoms of depression within three weeks after the withdrawal began to decline significantly (P < 0.0001). Following the analysis of variance (ANOVA) for repeated data and taking addiction severity index into account, it was observed that the difference between the two groups of mild and severe addicts was significant in terms of the trend and severity of methamphetamine withdrawal symptoms (P < 0.0001). Conclusions: The hardest stage to quit methamphetamine addiction was the first 24 hours after withdrawal with a downward trend; however, abuse craving especially in severe addicted group persisted even after the third week of withdrawal which could be a risk factor for recurrence and re-abuse. Thus, it was suggested that therapists were required to pay more attention to this issue in the treatment of this group of addicted individuals. © 2018, International Journal of High Risk Behaviors and Addiction

Techniques, perspectives, and challenges of bioactive peptide generation: A comprehensive systematic review

Due to the digestible refractory and absorbable structures of bioactive peptides (BPs), they could induce notable biological impacts on the living organism. In this regard, the current study was devoted to providing an overview regarding the available methods for BPs generation by the aid of a systematic review conducted on the published articles up to April 2019. In this context, the PubMed and Scopus databases were screened to retrieve the related publications. According to the results, although the characterization of BPs mainly has been performed using enzymatic and microbial in-vitro methods, they cannot be considered as suitable techniques for further stimulation of digestion in the gastrointestinal tract. Therefore, new approaches for both in-vivo and in-silico methods for BPs identification should be developed to overcome the obstacles that belonged to the current methods. The purpose of this review was to compile the recent analytical methods applied for studying various aspects of food-derived biopeptides, and emphasizing generation at in vitro, in vivo, and in silico. © 2020 Institute of Food TechnologistsÂ

Association between IGF-1 levels ranges and all-cause mortality: A meta-analysis

The association between IGF-1 levels and mortality in humans is complex with low levels being associated with both low and high mortality. The present meta-analysis investigates this complex relationship between IGF-1 and all-cause mortality in prospective cohort studies. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, and Cochrane Library up to September 2019. Published studies were eligible for the meta-analysis if they had a prospective cohort design, a hazard ratio (HR) and 95% confidence interval (CI) for two or more categories of IGF-1 and were conducted among adults. A random-effects model with a restricted maximum likelihood heterogeneity variance estimator was used to find combined HRs for all-cause mortality. Nineteen studies involving 30,876 participants were included. Meta-analysis of the 19 eligible studies showed that with respect to the low IGF-1 category, higher IGF-1 was not associated with increased risk of all-cause mortality (HR&nbsp;=&nbsp;0.84, 95% CI&nbsp;=&nbsp;0.68–1.05). Dose–response analysis revealed a U-shaped relation between IGF-1 and mortality HR. Pooled results comparing low vs. middle IGF-1&nbsp;showed a significant increase of all-cause mortality (HR&nbsp;=&nbsp;1.33, 95% CI&nbsp;=&nbsp;1.14–1.57), as well as comparing high vs. middle IGF-1 categories (HR&nbsp;=&nbsp;1.23, 95% CI&nbsp;=&nbsp;1.06–1.44). Finally, we provide data on the association between IGF-1&nbsp;levels and the intake of proteins, carbohydrates, certain vitamins/minerals, and specific foods. Both high and low levels of IGF-1 increase mortality risk, with a specific 120–160&nbsp;ng/ml range being associated with the lowest mortality. These findings can explain the apparent controversy related to the association between IGF-1&nbsp;levels and mortality

The Prevalence of Nosocomial Infections in Iranian Hospitals

BACKGROUND AND OBJECTIVE: Nosocomial infections are one of the major health problems. As the length of stay in the hospital increases, the risk of mortality and morbidity increases, which ultimately increases the cost of treatment. Therefore, the present study was performed as a systematic review and meta-analysis to evaluate the prevalence of nosocomial infections in Iran. METHODS: This systematic review and meta-analysis was performed in the range of the years 2001 – 2017. Articles related to the topic were assessed using Persian keywords “nosocomial infections”, “hospital”, and “Iran”, and their English equivalent in descriptive and cross sectional studies by searching online databases of SID & Magiran, PubMed and Scopus, ScienceDirect and Google Scholar. Analytical and interventional studies were excluded from the study list. FINDINGS: 578 articles had the preliminary inclusion criteria, and with the removal of 568 unrelated or low quality articles during secondary analyses, 10 articles were finally included in the process of meta-analysis. The overall prevalence of nosocomial infections in Iranian hospitals was 4.6% (CI-95%: 2.6 – 8.1). The highest prevalence of nosocomial infections was in Sanandaj with 15.6% (CI-95%: 10.22–82.1) and the lowest prevalence was in Urmia with 0.4% (CI-95%: 0.1–1.01). CONCLUSION: The results of the study showed that nosocomial infection has a low prevalence in Iran, but more attention and control over nosocomial infections in Iranian hospitals is necessary to reach standard levels

The influence of combined low-strength ultrasonics and micro-aerobic pretreatment process on methane generation and sludge digestion: Lipase enzyme, microbial activation, and energy yield

Low-frequency ultrasonics is a potential technology to reduce the hydrolysis phase period in anaerobic digestion process. In this study, the influence of combined low frequency ultrasonics and micro-aerobic (MA) pretreatment on sewage sludge solubilization, enzyme activity and anaerobic digestion were assessed. Initially, the effect of ultrasonic density (0.012, 0.014, 0.016, 0.018, 0.1, 0.12 and 0.14 W/mL) and irradiation time (1, 3, 5, 8, 9, 10 and 12 min) of 20 kHz frequency waves were investigated. Accordingly, the effect of micro-aerobic pretreatment (Air flow rate (AFR) = 0.1, 0.2, 0.3 and 0.5 VVM) within 20, 30, 40.48 and 60 h were examined. In addition, the effect of combined pretreatment on COD solubilization, lipase enzyme activation, ATP, percentage of live bacteria and methane gas production during the anaerobic process were examined. The results showed that the highest lipase activity (14.9 Umol/mL) was obtained under the effect of ultrasonic density of 0.1 W/ml within 9 min. The highest solubilization (65) was observed under optimal micro-aerobic conditions: AFR = 0.2 (VVM) and micro-aerobic time: 40 h. Combined ultrasonic and micro-aerobic (US + MA) pretreatment increases the solubilization (70), microbial activity (2080) and lipase enzymatic activity (129) compared to individual pretreatment. The Biogas production during anaerobic digestion pretreated with combined methods increased by 193 compared to the control, while the elevated values of biogas production in reactors pretreated by ultrasonic and micro-aerobic pretreatment alone were observed to be 101 and 165, respectively. The net energy in reactor with the combined pre-treatment methods was calculated to be 1.26 kWh, while this value for control, pretreated ultrasonic and micro-aerobic reactors were obtained to be 0.56, 0.67 and 1.2 kWh, respectively. © 2021 The Author

Assessment of left ventricular mechanical dyssynchrony by phase analysis of gated-SPECT myocardial perfusion imaging and tissue Doppler imaging: Comparison between QGS and ECTb software packages

Background: Recently, the phase analysis of gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has become feasible via several software packages for the evaluation of left ventricular mechanical dyssynchrony. We compared two quantitative software packages, quantitative gated SPECT (QGS) and Emory cardiac toolbox (ECTb), with tissue Doppler imaging (TDI) as the conventional method for the evaluation of left ventricular mechanical dyssynchrony. Methods and Results: Thirty-one patients with severe heart failure (ejection fraction ≤35%) and regular heart rhythm, who referred for gated-SPECT MPI, were enrolled. TDI was performed within 3 days after MPI. Dyssynchrony parameters derived from gated-SPECT MPI were analyzed by QGS and ECTb and were compared with the Yu index and septal-lateral wall delay measured by TDI. QGS and ECTb showed a good correlation for assessment of phase histogram bandwidth (PHB) and phase standard deviation (PSD) (r = 0.664 and r = 0.731, P < .001, respectively). However, the mean value of PHB and PSD by ECTb was significantly higher than that of QGS. No significant correlation was found between ECTb and QGS and the Yu index. Nevertheless, PHB, PSD, and entropy derived from QGS revealed a significant (r = 0.424, r = 0.478, r = 0.543, respectively; P < .02) correlation with septal-lateral wall delay. Conclusion: Despite a good correlation between QGS and ECTb software packages, different normal cut-off values of PSD and PHB should be defined for each software package. There was only a modest correlation between phase analysis of gated-SPECT MPI and TDI data, especially in the population of heart failure patients with both narrow and wide QRS complex. © 2014, American Society of Nuclear Cardiology