Mobile phone usage in patients with type II diabetes and their intention to use it for self-management: A cross-sectional study in Iran

Background: Mobile health has potential for promotion of self-management in patients with chronic diseases. This study was conducted to investigate smartphone usage in patients with type II diabetes and their intention to use it for self-management. Methods: This cross-sectional study was conducted in 2018 with 176 patients with type II diabetes visiting a specialized diabetes clinic or one of two endocrinology and metabolism specialists in north of Iran. Data were collected using a validated questionnaire containing items on demographic characteristics, disease information, use of mobile phones, smartphones and the internet, and intention to use mobile phones for diabetes self-management. Results: The majority of the participants had mobile phones (94.9), smartphones (61.1), and daily access to the internet (81.3), and used phones two hours per day on average (80.1). They mostly used mobile phones to contact friends (89.2) and search for information (50.6), and their greatest intention for using smartphones and the internet for self-management was related to dietary planning (96), checking blood glucose (90.9), and contacting specialists (87.5). Younger participants were more interested in using smartphone applications (apps) (P < 0.001). About half of the participants argued that using apps can be interesting (54) and useful (50) for diabetes management, and intended to use apps much more in future (48.3). Conclusions: The majority of patients with type II diabetes are inclined to use mobile phone and the Internet, especially to plan their diet, check blood glucose, and contact their doctors. The present study provides valuable information for designing and implementing interventions based on mHealth to promote self-management in type II diabetes. © 2020 The Author(s)

Patients and Public Involvement in Patient Safety and Treatment Process in Hospitals Affiliated to Kashan University of Medical Sciences, Iran, 2013

Background: In the recent decades, healthcare providers had a perspective of benevolent paternalism. Nowadays, the patients’ role has changed and they have a significant obligation to participate in their caring decisions. Objectives: The current study aimed to investigate the involvement of patients and public in the patient safety and treatment process in hospitals affiliated to Kashan University of Medical Sciences, Kashan, Iran, 2013. Patients and Methods: A cross-sectional study was conducted in the hospitals affiliated to Kashan University of Medical Sciences in 2013. Subjects included all of the 18 chief managers, 10% of nurses in each hospital, and 375 patients. Data collection instruments included a questionnaire and a checklist designed according to the research objectives. Data analysis was performed using the SPSS ver. 13. Descriptive statistics, percentage and frequencies, were calculated for all variables and analyzed by Chi-square test. Results: In the treatment process, 81 patients (21.61%), 50 nurses (80.6%) and 15 chief managers (83.3%) had awareness about Patient Bill of Rights. In patient Safety, 19.73% of the patients stated that hospitals received their feedbacks. Management activities were weak in evaluation. All of the six hospitals (100%) had a defined process to perform satisfaction surveys’ quality improvement and patient authentication policy. Conclusions: Patient and public participation in Kashan hospitals are not adhered well. As the patient has an important role in improving the quality of services, more use of mass media especially local newspapers, hospital websites, and training programs are suggested to inform both the patients and public on their rights and roles in improving the healthcare services

Epitope Mapping of Tetanus Toxin by Monoclonal Antibodies: Implication for Immunotherapy and Vaccine Design

Tetanus as a life-threatening disease is characterized by muscle spasm. The disease is caused by the neurotoxin of Clostridium tetani. Active form of tetanus neurotoxin is composed of the light chain (fragment A) and the heavy chain. Fragment A is a zinc metalloprotease, which cleaves the neuronal soluble N-ethylmaleimide-sensitive attachment receptor (SNARE) protein, leading to the blockade of inhibitory neurotransmitter release and subsequent generalized muscular spasm. Two functional domains of the heavy chain are fragment C, which is required for neuronal cell binding of the toxin and subsequent endocytosis into the vesicles, and fragment B, which is important for fragment A translocation across the vesicular membrane into the neuronal cytosol. Currently, polyclonal immunoglobulins against tetanus neurotoxin obtained from human plasma of hyper-immunized donors are utilized for passive immunotherapy of tetanus; however, these preparations have many disadvantages including high lot-to-lot heterogeneity, possibility of transmitting microbial agents, and the adverse reactions to the other proteins in the plasma. Neutralizing anti-tetanus neurotoxin monoclonal antibodies (MAbs) lack these drawbacks and could be considered as a suitable alternative for passive immunotherapy of tetanus. In this review, we provide an overview of the literature discussing epitope mapping of the published neutralizing MAbs against tetanus toxin. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

Throughput, Risk and Economic Optimality of Runway Landing

Abstract This paper analyzes the optimal level of operations on a single runway used only for arrivals. Two risks associated with landing procedures are the risk of a wake vortex encounter and the risk of simultaneous runway occupancy. We develop optimization models to maximize successful landing operations while mitigating these risk factors. The risks are mitigated by enforcing go-around procedures when separation distances are too small. In our capacity optimization, we assume that the goaround procedures are strictly enforced (making the operations risk-free) and their execution is absolutely safe. We develop two models as decision support tools which mimic the system dynamics and provide new insights into the landing process. One model maximizes the risk-free throughput (number of successful landings per unit of time) with and without wake-vortex effects. The second model accounts for dollar benefits and go-around costs in optimizing the system operations&apos; level. This model maximizes expected net economic outcome (total dollar benefits minus total go-around costs) by adjusting the rate of landing attempts. Through these models, we calculate the maximum (risk-free) achievable throughput in the system. This provides a new definition of the landing capacity of the runway taking into account the probabilistic behavior of operations. Several numerical examples are given

A review of the personal health records in selected countries and Iran

Personal Health Record (PHR) enables patients to access their health information and improves care quality by supporting self-care. The purpose of this study is to provide a comparative analysis of the concept of PHRs in selected countries and Iran in order to investigate the gaps between Iran and more advanced countries in terms of PHRs. The study was carried out in 2008-2009 using a descriptive-comparative method in Australia, the United States, England and Iran. Data was gathered from articles, books, journals and reputed websites in English and Persian published between 1995 and September 2009. After collecting the data, both advantages and disadvantages of each of concepts were analyzed. In the three countries considered in the present study the concepts of PHR, extracted from the literature, are that; a)patient/person be recognized as the owner of PHR; b)information be disclosed only to those authorized by the patient; c) and that PHR is created upon request and consent of the individual involved. Before PHRs can be profitably used in the health administration of a (developing) country, the necessary knowledge, infrastructures, and rules need to be developed. © Springer Science+Business Media, LLC 2010

Usability evaluation of a comprehensive national health information system: A heuristic evaluation

Aim: to evaluate the usability of a comprehensive national health information system by the heuristic method. Introduction: Presently, information systems are widely being used in healthcare settings. Methods: Five independent evaluators assessed the user interface design of this system in terms of its compliance with a set of predetermined standard principles, also known as Jakob Nielsen's 10 general principles. Problems were reassessed in the presence of all evaluators, and similar cases were merged and a single list of unique problems was prepared. After a second assessment, the evaluators determined and categorized problem severity in five domains, including: the absence of a problem (zero point), a cosmetic problem (1 point), a minor problem (2 points), a major problem (3 points) and a catastrophic problem (4 points). Data were then analyzed in a spreadsheet using descriptive statistical tests. Results: The “recognition rather than recall” principle with 13 problems (21.3 of all cases) had the greatest frequency among all problems, while the “match between system and the real world” and “help and documentation” principles with 1 problem (1.6 of all cases) had the least frequency. Moreover, principles such as “help users recognize, diagnose and recover from errors”, “error prevention”, and “help and documentation” had a mean severity of 2.8, 2.8, and 3.4, respectively. Consequently, they were considered as catastrophic and major problems. Conclusions: Based on the viewpoint of evaluation experts, a large portion of problems in this system were classified into major and catastrophic categories, which primarily indicates the poor usability of this system. Therefore, it is highly recommended that authorities be notified of the issues in writing in order to resolve them in a future update. Finally, special consideration should be given to the meticulous evaluation of these systems during preliminary stages of design and development, so as to encounter fewer issues on a national level at the time of implementation. © 2020 The Author

Genetic diversity and population structure of Leishmania infantum from Southeastern France : evaluation using Multi-Locus Microsatellite Typing

In the south of France, Leishmania infantum is responsible for numerous cases of canine leishmaniasis (CanL), sporadic cases of human visceral leishmaniasis (VL) and rare cases of cutaneous and muco-cutaneous leishmaniasis (CL and MCL, respectively). Several endemic areas have been clearly identified in the south of France including the Pyrenees-Orientales, Cevennes (CE), Provence (P), Alpes-Maritimes (AM) and Corsica (CO). Within these endemic areas, the two cities of Nice (AM) and Marseille (P), which are located 150 km apart, and their surroundings, concentrate the greatest number of French autochthonous leishmaniasis cases. In this study, 270 L. infantum isolates from an extended time period (1978-2011) from four endemic areas, AM, P, CE and CO, were assessed using Multi-Locus Microsatellite Typing (MLMT). MLMT revealed a total of 121 different genotypes with 91 unique genotypes and 30 repeated genotypes. Substantial genetic diversity was found with a strong genetic differentiation between the Leishmania populations from AM and P. However, exchanges were observed between these two endemic areas in which it seems that strains spread from AM to P. The genetic differentiations in these areas suggest strong epidemiological structuring. A model-based analysis using STRUCTURE revealed two main populations: population A (consisting of samples primarily from the P and AM endemic areas with MON-1 and non-MON-1 strains) and population B consisting of only MON-1 strains essentially from the AM endemic area. For four patients, we observed several isolates from different biological samples which provided insight into disease relapse and re-infection. These findings shed light on the transmission dynamics of parasites in humans. However, further data are required to confirm this hypothesis based on a limited sample set. This study represents the most extensive population analysis of L. infantum strains using MLMT conducted in France

Effects of Chlamydia trachomatis Infection on Fertility; A Case-Control Study.

BACKGROUND: Nowadays, Chlamydia trachomatis is known as a causative agent of infertility. Because of, asymptomatic nature of infection, many may suffer from its lasting complications such as infertility. This study was performed in Tehran during April 2007 to April 2008 to compare the prevalence of Chlamydia trachomatis infection in fertile and infertile women using ELISA and PCR methods. METHODS: Overall, 234 infertile and 223 pregnant women, as the fertile group, participated in this hospital-based case-control study. After completing an informed consent form and the questionnaire, first catch urine and blood sample were obtained for PCR and ELISA (IgG, IgM) tests, respectively. Logistic regression analysis was used to control possible confounding factors, and determine adjusted odds ratio of infertility due to the infection. RESULTS: PCR results revealed that 29 (12.4%) of the infertile and 19 (8.5%) of the fertile women were positive for C. trachomatis infection (p = 0.440). IgG was positive in 21 (9.0%) of the infertile and 11 (5.0%) in the fertile group (p = 0.093). IgM assays identified that 2 (0.9%) of the infertile and 4 (1.8%) of the fertile women were positive for the micro-organism (p = 0.375). CONCLUSION: We found no significant differences among fertile and infertile women for Chlamydia trachomatis infection. Nevertheless, molecular techniques which are more sensitive, more specific and non-invasive can be used to detect C. trachomatis infection

Epidemic assessment of bacterial agents in osteomyelitis and their antibiotic resistance pattern determination

The aim of the present study was to determine the causative agents of osteomyelitis and specifying their antibiotic resistance pattern in patients referred to pediatrics ward of Imam Khomeini Hospital. This study has been performed in Tehran during January to December 2006. In this study, Synovial fluid was taken from 90 patients who referred to pediatrics ward of Imam Khomeini. Samples were examined by direct test, culture and biochemical tests. In next step, antibiogram by disk diffusion method (Kirby-Bauer Test) was established on each positive sample and finally, the results were analyzed. Of 90 examined samples, 27 bacterial cases were isolated; Staphylococcus aureus with 55.9 was the most epidemic agent and Klebsiella sp., coagulase negative Staphylococci, Streptococcus pneumoniae and Enterobacter sp. were the next common agents, respectively. However, it was revealed that more than 40 Staphylococcus aureus are sensitivity to Vacomycin, Gentamicin, Sulfamethoxazole and Erythromycin and most of gram negative Rods isolated of were sensitivity to Amikacin, Ampicillin and Cephalothin (50-100). The most of bacteria (Staphylococcus aureus, coagulase negative Staphylococci, Streptococcus pneumoniae and Enterobacter sp.) were sensitive to Vancomycin, gentamicin and Cephalothin. Similar to previous results, it was proved either in our study that Staphylococcus aureus is the main agent of osteomyelitis and gram negative bacteria with coagulase negative Staphylococci and Streptococci are other agents. Also, it was observed that the most isolated bacteria had high antibiotic resistance to common drugs. © 2008 Asian Network for Scientific Information

Abandoned Covid-19 personal protective equipment along the Bushehr shores, the Persian Gulf: An emerging source of secondary microplastics in coastlines

During the Covid-19 pandemic, personal protection equipment (PPE) was widely used to control the virus further spared. In this study, the presence of PPE wastes along the coastline of Bushehr port, the Persian Gulf from nine stations was investigated (4 times during 40 days), and their potential for microplastics (MPs) creation was preliminarily assessed. In total, more than 2380 PPE were collected in the study area. No significant differences were found between various beaches regarding their types and common activities. In addition, the estimated disposal rate of PPE per day and year is 350 and 127,750 items, respectively. More than 10% of the collected PPE from Bushehr's coastal areas on each sampling day were damaged. Based on the microscopic analysis, the left surgical masks and torn plastic gloves in the coastal regions are emerging sources of secondary microfibers and MP particles (mostly fragments and films) in the marine environments, respectively