Pulmonary Manifestations of SARS Co V 2 Infection in Mild/Severe Patients

The coronavirus disease 2019 (COVID-19) caused viral pneumonia in Wuhan City in China in December of 2019. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily targets the lungs with severe hypoxia, which usually results in death. COVID-19 is highly heterogeneous regarding severity, clinical phenotype, and more importantly, global dispersal. The respiratory system in all aspects such as respiratory airways, endothelium of pulmonary vessels, conducting airways, the alveoli, neuromuscular breathing structure, and pulmonary circulation are affected by this virus. A comprehensive concept of the source and dynamic action of the SARS-CoV-2 and the possible causes of heterogeneity in COVID-19 is required for predicting and managing the illness in acute and chronic stages of the pulmonary sign

The Use of Cumulative Disciplinary Score in an Integrated Curriculum to Prevent Deliberate Omission of Course Content

Background & Objective: Student assessment is one of the most challenging issues of an integrated curriculum. While calculating an overall score is in line with the goals of integrated curriculum, it poses the risk that some students will deliberately leave out the content of some disciplines, based on the fact that they have lower credits in each block exam. In the present study, we describe the experience of Tehran University of Medical Sciences, Iran, where an integrated medical curriculum has been launched since September 2011 as part of curriculum reform initiative. Methods: In the first academic year, students passed 4 blocks: Molecule and Cell; Tissue; Development and Function; Cardiovascular Function; Blood circulation; and Blood-Respiratory Function. Each block included anatomy, histology, physiology, and embryology. The overall block score was reported at the end of each block. In addition, a cumulative disciplinary score was calculated at the end of the academic year through the summation of the weighted subscores of each discipline in each block. Results: At the end of the year, the number of students who had failed in histology, anatomy, embryology, and physiology were 15, 17, 44, and 3, respectively. They were required to take a disciplinary examination before the beginning of the next academic year. Conclusion: A comparison of the number of students who failed disciplines with low credits (e.g. histology) with those who failed disciplines with high credits (e.g. physiology) suggests that the former had systematically been ignored by some students. The calculation of a cumulative disciplinary score may reduce the deliberate omission of course content in integrated blocks. Key Words: Integration, Student assessment, Cumulative disciplinary scor

Micromorphology and leaf ecological anatomy of Bassia halophyte species (Amaranthaceae) from Iran

Bassia belongs to the family Chenopodiaceae, which is widely distributed in the world, especially in Irano-Turanian Region. According to the morphological similarities among the species of the genus, ecological implications of structural features were studied. In fact, understanding these relationships is of great importance in natural classification. We have studied the relationships of Bassia species using morphological, anatomical, and micro-morphological methods. The current results indicated that phenotypic plasticity and repetitive patterns were probably due to ecological adaptations, especially in decreasing the leaf surface by changing the inner structure. All species have a Kranz anatomy structure (Kochioid subtype), related to C4 photosynthesis. The changes in cell size increasing the cell membrane thickness, the density of two-vascular systems, the increase of palisade to water storage parenchyma ratio and photosynthetic system. The leaf surface is covered with long highly dense hairs and microechinate ornamentation. Though the adaptation caused some morphological similarities, the variation was seen in other descriptive characteristics such as morphological and anatomical features especially in two synonym species of B. turkestanica and B. pilosa. Information about the similarity species is provided

Temporal response to drought stress in several Prunus rootstocks and wild species

Prunus species are important crops in temperate regions. In these regions, drought periods are predicted to occur more frequently due to climate change. In this sense, to reduce the impact of climate warming, obtaining new tolerant/resistant cultivars and rootstocks is a mandatory goal in Prunus breeding. Therefore, the current study assembled three Prunus species including almond, (P. dulcis Mill D.A. Webb), apricot (P. armeniaca L.) and peach (P. persica L.) to model the temporal effects of drought. A hybrid peach × almond and a wild almond-relative species Prunus webbii were also included in the study. Physiological traits associated with photosynthetic activity, leaf water status, and chlorophyll content were assessed under three watering treatments. Results showed that effects of time, genotype, and treatment interact significantly in all traits. In addition, results confirmed that P. webbii have a greater tolerance to drought than commercial rootstocks. However, “Real Fino” apricot showed the fastest recovery after re-irrigation while being one of the most affected cultivars. In addition, from the better response to these watering treatments by the almond genotypes, two different trends were observed after re-irrigation treatment that clearly differentiate the response of the almond cultivar “Garrigue” from the rest of Prunus genotypes. A better characterization of the short-term drought response in Prunus, an accurate and more efficient evaluation of the genotype effect was obtained from the use of mixed models considering appropriate variance–covariance structures. Although the advantages of these approaches are rarely used in Prunus breeding, these methodologies should be undertaken in the future by breeders to increase efficiency in developing new breeding materials.info:eu-repo/semantics/publishedVersio

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Burden of tracheal, bronchus, and lung cancer in North Africa and Middle East countries, 1990 to 2019: Results from the GBD study 2019

ObjectiveTo provide estimates on the regional and national burden of tracheal, bronchus, and lung (TBL) cancer and its attributable risk factors from 1990 to 2019 in the North Africa and Middle East (NAME) region.Methods and materialsThe Global Burden of Disease (GBD) 2019 data were used. Disability-adjusted life years (DALYs), death, incidence, and prevalence rates were categorized by sex and age groups in the NAME region, in 21 countries, from 1990 to 2019. Decomposition analysis was performed to calculate the proportion of responsible factors in the emergence of new cases. Data are presented as point estimates with their 95% uncertainty intervals (UIs).ResultsIn the NAME region, TBL cancer caused 15,396 and 57,114 deaths in women and men, respectively, in 2019. The age-standardized incidence rate (ASIR) increased by 0.7% (95% UI -20.6 to 24.1) and reached 16.8 per 100,000 (14.9 to 19.0) in 2019. All the age-standardized indices had a decreasing trend in men and an increasing trend in women from 1990 to 2019. Turkey (34.9 per 100,000 [27.6 to 43.5]) and Sudan (8.0 per 100,000 [5.2 to 12.5]) had the highest and lowest age-standardized prevalence rates (ASPRs) in 2019, respectively. The highest and lowest absolute slopes of change in ASPR, from 1990 to 2019, were seen in Bahrain (-50.0% (-63.6 to -31.7)) and the United Arab Emirates (-1.2% (-34.1 to 53.8)), respectively. The number of deaths attributable to risk factors was 58,816 (51,709 to 67,323) in 2019 and increased by 136.5%. Decomposition analysis showed that population growth and age structure change positively contributed to new incident cases. More than 80% of DALYs could be decreased by controlling risk factors, particularly tobacco use.ConclusionThe incidence, prevalence, and DALY rates of TBL cancer increased, and the death rate remained unchanged from 1990 to 2019. All the indices and contribution of risk factors decreased in men but increased in women. Tobacco is still the leading risk factor. Early diagnosis and tobacco cessation policies should be improved

Sequential Objective Structured Clinical Examination based on item response theory in Iran

Purpose In a sequential objective structured clinical examination (OSCE), all students initially take a short screening OSCE. Examinees who pass are excused from further testing, but an additional OSCE is administered to the remaining examinees. Previous investigations of sequential OSCE were based on classical test theory. We aimed to design and evaluate screening OSCEs based on item response theory (IRT). Methods We carried out a retrospective observational study. At each station of a 10-station OSCE, the students’ performance was graded on a Likert-type scale. Since the data were polytomous, the difficulty parameters, discrimination parameters, and students’ ability were calculated using a graded response model. To design several screening OSCEs, we identified the 5 most difficult stations and the 5 most discriminative ones. For each test, 5, 4, or 3 stations were selected. Normal and stringent cut-scores were defined for each test. We compared the results of each of the 12 screening OSCEs to the main OSCE and calculated the positive and negative predictive values (PPV and NPV), as well as the exam cost. Results A total of 253 students (95.1%) passed the main OSCE, while 72.6% to 94.4% of examinees passed the screening tests. The PPV values ranged from 0.98 to 1.00, and the NPV values ranged from 0.18 to 0.59. Two tests effectively predicted the results of the main exam, resulting in financial savings of 34% to 40%. Conclusion If stations with the highest IRT-based discrimination values and stringent cut-scores are utilized in the screening test, sequential OSCE can be an efficient and convenient way to conduct an OSCE

Knowledge and Attitude of Students at Alzahra University about Breast Self-Examination, Iran

Background: Breast cancer is the most common preventable cancer among women. One of the ways of prevention and early detection of breast cancer is breast self-examination (BSE). Thus, we decided to conduct a study about the knowledge and attitude toward BSE among the students of Alzahra University, Iran. Methods: This was a cross-sectional analytical study in which 135 female students aging 18-26 years were enrolled using stratified random sampling. Data was collected by valid and reliable questionnaires. Descriptive statistics and chi-square test were used to analyze the data. Results: While most students (45.9%) had an average level of knowledge about BSE, married students were significantly more knowledgeable (P = 0.007). The majority of students (68.1%), especially older, married students and those with a positive family history of breast cancer, had more positive attitude about BSE. The most popular way of gaining information among students was mass media. Students who gained information from university books had significantly more knowledge than others (P < 0.001). Subjects who obtained information from mass media had more positive attitude than others (P = 0.04). In addition, students with more knowledge had significantly more positive attitude (P < 0.001). Conclusion: The knowledge and attitude about BSE is less than satisfactory even among university students. The values would probably be even less among the general female population in Iran. Proper and more intense educational programs about BSE should be scheduled even in higher education institutions. Keywords: Knowledge, Attitude, Breast self examination, Students

Analyzing the Quality of Objective Structured Clinical Examination in Tehran University of Medical Sciences

Introduction: With the  increasing popularity of performance-based assessments, it is necessary to employ proper indicators to ensure their quality. The present study examines the metrics of Objective Structured Clinical Examination (OSCE). Methods: In this descriptive, cross-sectional research in 10 pre-internship OSCE stations of Tehran University of Medical Sciences in 2012, the cut-off score was determined by borderline regression method and the failure rate was calculated. Root Mean Square Error (RMSE) was used to estimate error rate threshold.  Internal consistency was calculated using Cronbach’s alpha and then, the Standard Error of Measurement (SEM) was determined. Alpha if item deleted, R2 coefficient, intergrade discrimination, difficulty and discrimination indices were calculated for each station. A total of 266 students participated in this exam. Results: A total of 266 students participated in this exam. The OSCE total cut-off score was 52.55 (out of 100). Four students (1.5%) failed the exam and the RMSE equaled 0.45. SEM was 4.84 and Cronbach’s alpha was calculated at 0.70 where the alpha if item deleted scores varied from 0.64 to 0.70. The R2 coefficient ranged from 0.16 to 0.85 and the intergrade discrimination ranged between 0.66 and 1.93. The ranges of difficulty and discrimination indices were 0.71-0.89 and 0.12-0.44 respectively. Conclusion: The internal consistency, SEM and threshold error rate were all acceptable. The alpha if item deleted was in the acceptable range in all stations. In two stations, the R2 value was lower than the desired range. The intergrade discrimination value was appropriate in all stations except one. The stations were not too difficult or highly discriminative which is considered favorable in criterion-referenced exams