Mouth Care in Patients Receiving Mechanical Ventilation: A Systematic Review

Context: Studies show that despite the role of mouth care in preventing ventilator-associated pneumonia, there is no high quality evidences for it. This study reviewed the literature related to mouth care in patients receiving mechanical ventilation. Evidence Acquisition: PubMed, Ovide, Elsevier, ProQuest, IranMedex, SID, and Magiran databases were searched using key terms such as oral care, mouth care, critical care, and intensive care. Fifty-seven full-text articles in total were retrieved and included in the study. Results: Totally, 15 review articles and 42 research articles were reviewed. Only 13 articles introduced or evaluated the validity of instruments or caring guidelines in the area of mouth care. Only one study discussed about designing and validating the psychometric properties of a mouth assessment scale. Most of the articles emphasized on brushing the teeth as the best method for mouth care, but there was no consensus on the frequency of washing and the best washing solution. Conclusions: Despite the importance of mouth care, few original studies are conducted in this area and there is no approved clinical guideline for this procedure

Effect of Using Eye Mask on Sleep Quality in Cardiac Patients: A Randomized Controlled Trial

Background: Patients in coronary care unit are at risk of sleep deprivation. Sleep deprivation can be associated with increased blood pressure and heart rate, raising the risk of developing cardiovascular problems among patients hospitalized in coronary care unit. Objectives: This study was carried out to examine the effect of eye mask on sleep quality in cardiac patients. Patients and Methods: In this randomized controlled trial, 60 patients who met the inclusion criteria were selected using a convenient sampling method and randomly allocated into the experimental and control groups. Patients in the control group received routine care. However, in the experimental group, patients received routine care and eye mask for three subsequent nights. In the both groups, the sleep quality was assessed using the Pittsburgh sleep quality index. Data were analyzed by the chi-square test, independent samples t-test, Mann-Whitney U, and Wilcoxon signed-rank tests. Results: After the study, the median scores of the subjective sleep quality, the sleep latency, the sleep duration, the habitual sleep efficiency, and the sleep disturbances domains, as well as the median score of overall Pittsburgh sleep quality index in the experimental group were significantly lower than those in the control group (P 0.05). Conclusions: Using eye mask can significantly improve the sleep quality in cardiac patients. Therefore, nurses are recommended to use eye mask in combination with current treatments for improving patients’ sleep quality

Undetected leprosy in an endemic area: A case report

Leprosy is an infectious disease causing irreversible disability if unnoticed. A 69-year-old man with undetected leprosy from 30 years ago referred to us with claw hand and Madrosis (Milphosis). The patient complained of non-healing and painless ulcers on the extremities as well as numbness in the right leg. He told the medical team that he could not feel his feet in his shoes. The patient had blurred vision and lacrimation two weeks before admission. He had a history of recurrent foot ulcers from 25 years ago although he referred to medical staff about 5 years ago with infected wound on the hands and multiple scars of pervious ulcers. The disabilities were mainly in consequence of late visit to healthcare centers, misdiagnosis, difficult access to medical centers and patient's unawareness. The case showed the significance of medical education and public awareness for signs and symptoms of leprosy to be recognized and treated on time. In conclusion detecting leprosy should not be delayed just because of a decrease in the number of cases especially in an endemic area like Kurdistan, Iran

Size Control in the Nanoprecipitation Process of Stable Iodine (127I) Using Microchannel Reactor—Optimization by Artificial Neural Networks

In this study, nanosuspension of stable iodine (127I) was prepared by nanoprecipitation process in microfluidic devices. Then, size of particles was optimized using artificial neural networks (ANNs) modeling. The size of prepared particles was evaluated by dynamic light scattering. The response surfaces obtained from ANNs model illustrated the determining effect of input variables (solvent and antisolvent flow rate, surfactant concentration, and solvent temperature) on the output variable (nanoparticle size). Comparing the 3D graphs revealed that solvent and antisolvent flow rate had reverse relation with size of nanoparticles. Also, those graphs indicated that the solvent temperature at low values had an indirect relation with size of stable iodine (127I) nanoparticles, while at the high values, a direct relation was observed. In addition, it was found that the effect of surfactant concentration on particle size in the nanosuspension of stable iodine (127I) was depended on the solvent temperature. © 2015, American Association of Pharmaceutical Scientists

Critical Thinking Skills in Nursing Students: a Comparison Between Freshmen and Senior Students

Background: Critical thinking is one of the most important concepts in the field of education. Despite studies published on nursing students’ critical thinking skills (CTS), some suggest that there is not enough evidence supporting the relationship between content of nursing education programs and nursing students’ CTS. Objectives: Given the existing discrepancies, this study aimed to compare the critical thinking skills of freshmen and senior nursing students. Patients and Methods: This comparative study was conducted on 150 undergraduate freshmen and senior nursing students in Kashan University of Medical Sciences, during 2012. The students in the first and the last semesters of their study in nursing were entered in the study using the census method. Data were collected using a questionnaire including questions on demographic data and the California Critical Thinking Skills Test, form B. Data analysis was performed using the SPSS v.13 software. Descriptive statistics were calculated. Moreover, independent sample t-test and Spearman and Pearson’s correlation coefficients were used in the data analysis. Results: Both the freshmen and senior nursing students had low CTS. The mean critical thinking scores were 11.79 ± 4.80 and 11.21 ± 3.17 for the freshmen and the senior students, respectively (P = 0.511). Moreover, no significant correlation was found between the students’ score in CTS and their age, gender, high school grade point average (GPA), rank in university entrance examination (RUEE) and interest in the nursing profession. Conclusions: The students were low skilled in critical thinking and their CTS did not significantly change during their nursing degree. Thus it may be concluded that the nursing education program did not affect the CTS of its students. Longitudinal studies are suggested for assessing nursing students’ critical thinking over time. Moreover, revising the curriculum and preparing nursing educators for implementing innovative and active teaching strategies are suggested

Learning Dynamic Network Models for Complex Social Systems

Human societies are inherently complex and highly dynamic, resulting in rapidly changing social networks, containing multiple types of dyadic interactions. Analyzing these time-varying multiplex networks with approaches developed for static, single layer networks often produces poor results. To address this problem, our approach is to explicitly learn the dynamics of these complex networks. This dissertation focuses on five problems: 1) learning link formation rates; 2) predicting changes in community membership; 3) using time series to predict changes in network structure; 4) modeling coevolution patterns across network layers and 5) extracting information from negative layers of a multiplex network. To study these problems, we created a rich dataset extracted from observing social interactions in the massively multiplayer online game Travian. Most online social media platforms are optimized to support a limited range of social interactions, primarily focusing on communication and information sharing. In contrast, relations in massively-multiplayer online games (MMOGs) are often formed during the course of gameplay and evolve as the game progresses. To analyze the players\u27 behavior, we constructed multiplex networks with link types for raid, communication, and trading. The contributions of this dissertation include 1) extensive experiments on the dynamics of networks formed from diverse social processes; 2) new game theoretic models for community detection in dynamic networks; 3) supervised and unsupervised methods for link prediction in multiplex coevolving networks for both positive and negative links. We demonstrate that our holistic approach for modeling network dynamics in coevolving, multiplex networks outperforms factored methods that separately consider temporal and cross-layer patterns

Evaluation of the status of antibiotic prescription in patients admitted to a teaching hospital in west of Iran

BACKGROUND: The aim of this study was to evaluate the status of the appropriate use of antibiotics by type, dosage, and length of treatment and the route of administration in Tohid teaching hospital, Sanandaj, Iran.METHODS: In a retrospective descriptive study, 400 patients were systematically selected from patients receiving antibiotics hospitalized in Tohid hospital from March 2016 to March 2017. Demographic characteristics, hospitalization ward, diagnosis, antibiotic prescribed, dosage, length of treatment, the route of administration, and prescribing physician were recorded. The treatments were compared with standard treatment based on Harrison reference. The data were analyzed using STATA software.RESULTS: Out of total patients, 54% were men and 46% were women with a mean age of 57.87 ± 9.87 years. The mean duration of hospitalization was 6.37 ± 2.69 days. More and less numbers of patients were admitted in the internal medicine ward (23.75%) and intensive care unit (ICU) (1.00%), respectively, The highest antibiotics were administered by internal medicine specialists (40.25%), the most commonly prescribed antibiotic was ceftriaxone (34.59%), and the most common cause of antibiotic therapy was pneumonia (20.50%). Out of 595 antibiotics prescribed, 28.50% of the administrations were inappropriate. In addition, the objective for the prescription of the first and second antibiotic was inappropriate in 27.50% and 33.70% of cases, respectively. Dosage, route of administration, and the length of treatment of the prescribed antibiotic was inappropriate in 9.00%, 0.50%, and 41.00% of cases, respectively. The highest and lowest rate of inappropriate antibiotic prescription was observed in surgical (51.31%) and infectious diseases (12.90%) wards.CONCLUSION: Due to the increase inappropriate administration of antibiotics, it is necessary to train the specialists about the planning, appropriate medical consultations for antibiotic therapy, and limitation of the new antibiotics prescription.

Mmf1p, a novel yeast mitochondrial protein conserved throughout evolution and involved in maintenance of the mitochondrial genome

A novel protein family (p14.5, or YERO57c/YJGFc) highly conserved throughout evolution has recently been identified. The biological role of these proteins is not yet well characterized. Two members of the p14.5 family are present in the yeast Saccharomyces cerevisiae. In this study, we have characterized some of the biological functions of the two yeast proteins. Mmf1p is a mitochondrial matrix factor, and homologous Mmf1p factor (Hmf1p) copurifies with the soluble cytoplasmic fraction. Δmmf1 cells lose mitochondrial DNA (mtDNA) and have a decreased growth rate, while Δhmf1 cells do not display any visible phenotype. Furthermore, we demonstrate by genetic analysis that Mmf1p does not play a direct role in replication and segregation of the mtDNA. rho(+) Δmmf1 haploid cells can be obtained when tetrads are directly dissected on medium containing a nonfermentable carbon source. Our data also indicate that Mmf1p and Hmf1p have similar biological functions in different subcellular compartments. Hmf1p, when fused with the Mmf1p leader peptide, is transported into mitochondria and is able to functionally replace Mmf1p. Moreover, we show that homologous mammalian proteins are functionally related to Mmf1p. Human p14.5 localizes in yeast mitochondria and rescues the Δmmf1-associated phenotypes. In addition, fractionation of rat liver mitochondria showed that rat p14.5, like Mmf1p, is a soluble protein of the matrix. Our study identifies a biological function for Mmf1p and furthermore indicates that this function is conserved between members of the p14.5 family

Is the reduced growth of the halophyte Suaeda maritima under hypoxia due to toxicity of iron or manganese?

For most plants, submergence in water is a rare occurrence, but for plants that grow on salt marshes flooding with seawater may be a twice-daily event. This is the case for plants of the halophyte Suaeda maritima, growing at low elevations on salt marshes. These plants are, however, smaller than those growing at higher elevations, where flooding is less frequent and the soil is better drained. We investigated whether the reduced growth brought about by flooding with saline water was a consequence of toxicity of manganese or iron. Seedlings of S. maritima were grown both in a sold medium (a mixture of salt-marsh mud and sand) that was either submerged twice a day or continuously flooded with half-strength seawater and in a hydroponic solution where the oxygen concentration was adjusted by bubbling with nitrogen or air. Hypoxia, reduced the growth of plants in both solid and liquid media and resuted in increases in manganese and iron in the shoots and roots. Experiments in culture solution showed that elevated levels of manganese were unlikely to be toxic, but that iron did reach toxic concentrations in flooded plants