Developing the Job Description for Diabetes Nurse Specialists: A Modified Delphi Approach

Background: The first step to establish a new academicmajor is the need assessment and extraction of professional and specialized tasks. Objectives: The current study aimed to identify and describe the duties of diabetes nurse specialists. Methods: This needs assessment study was performed using modified Delphi technique in Isfahan in 2014 - 2015. The study population consisted of patients with diabetes and their families, nurses, endocrinologists, diabetologists and nursing faculty members. The study was conducted in three rounds: first, through qualitative interviews and focus group discussions, the duties and tasks of diabetes nurse specialists were extracted, then a questionnaire was designed and in two consecutive rounds, the experts expressed their opinions about the tasks. Results: The first round of modified Delphi technique resulted in 500 initial codes. According to these codes, 164 duties were classified into seven categories. In the second round of Delphi approach, the experts reached to 100% consensus in 126 tasks. According to the participants, 74 of the 126 duties were similar, overlapping and inappropriate, and thus were eliminated. In the last round of the study according to the opinions of the experts, 15 more tasks were added to the previous list. Finally, job description for diabetes nurse specialist was developed in six tasks on professional responsibilities, 17 tasks on the area of education, 25 tasks regarding caring and treatment, 6 tasks on society and 13 tasks on management. Conclusions: This study led to identification and classification of diabetes nurse specialist duties. The findings can help nursing faculties and other institutes to develop task based educational programs for nurses in diabetes management

Optimal distribution coefficients of energy resources in frequency stability of hybrid microgrids connected to the power system

The continuous stability of hybrid microgrids (MGs) has been recently proposed as a critical topic, due to the ever-increasing growth of renewable energy sources (RESs) in low-inertia power systems. However, the stochastic and intermittent nature of RESs poses serious challenges for the stability and frequency regulation of MGs. In this regard, frequency control ancillary services (FCAS) can be introduced to alleviate the transient effects during substantial variations in the operating point and the separation from main power grids. In this paper, an efficient scheme is introduced to create a coordination among distributed energy resources (DERs), including combined heat and power, diesel engine generator, wind turbine generators, and photovoltaic panels. In this scheme, the frequency regulation signal is assigned to DERs based on several distribution coefficients, which are calculated through conducting a multi-objective optimization problem in the MATLAB environment. A meta-heuristic approach, known as the artificial bee colony algorithm, is deployed to determine optimal solutions. To prove the efficiency of the proposed scheme, the design is implemented on a hybrid MG. Various operational conditions which render the system prone to experience frequency fluctuation, including switching operation, load disturbance, and reduction in the total inertia of hybrid microgrids, are studied in PSCAD software. Simulation results demonstrate that this optimal control scheme can yield a more satisfactory performance in the presence of grid-following and grid-forming resources during different operational conditions

Magnesium-based nanocomposites: A review from mechanical, creep and fatigue properties

The addition of nanoscale additions to magnesium (Mg) based alloys can boost mechanical characteristics without noticeably decreasing ductility. Since Mg is the lightest structural material, the Mg-based nanocomposites (NCs) with improved mechanical properties are appealing materials for lightweight structural applications. In contrast to conventional Mg-based composites, the incorporation of nano-sized reinforcing particles noticeably boosts the strength of Mg-based nanocomposites without significantly reducing the formability. The present article reviews Mg-based metal matrix nanocomposites (MMNCs) with metallic and ceramic additions, fabricated via both solid-based (sintering and powder metallurgy) and liquid-based (disintegrated melt deposition) technologies. It also reviews strengthening models and mechanisms that have been proposed to explain the improved mechanical characteristics of Mg-based alloys and nanocomposites. Further, synergistic strengthening mechanisms in Mg matrix nanocomposites and the dominant equations for quantitatively predicting mechanical properties are provided. Furthermore, this study offers an overview of the creep and fatigue behavior of Mg-based alloys and nanocomposites using both traditional (uniaxial) and depth-sensing indentation techniques. The potential applications of magnesium-based alloys and nanocomposites are also surveyed

Morphology- and size-controlled synthesis of a metal-organic framework under ultrasound irradiation : an efficient carrier for pH responsive release of anti-cancer drugs and their applicability for adsorption of amoxicillin from aqueous solution

Support of this investigation by Tarbiat Modares University is gratefully acknowledged.In this study, we have reported a biocompatible metal-organic framework (MOF) with ultra-high surface area, which we have shown to have uses as both a cancer treatment delivery system and for environmental applications. Using a sonochemical approach, highly flexible organic H3BTCTB and ditopic 4,4́′-BPDC ligands, along with modulators of acetic acid and pyridine were combined to prepare a Zn(II)-based metal-organic framework, DUT-32, [Zn4O(BPDC)(BTCTB)4/3(DEF)39.7(H2O)11.3]. Powder X-ray diffraction (PXRD), field-emission scanning electron microscopy (FE-SEM), and Fourier transform infrared spectroscopy (FTIR) were used to characterize, the particle size, shape, and structure of the DUT-32. To show the effects of shape and size of DUT-32 micro/nano-structures on doxorubicin (DOX) drug release and amoxicillin (AMX) adsorption, time of sonication, initial reagent concentrations, irradiation frequency, and acetic acid to pyridine molar ratios were optimized. The drug-loaded DUT-32 was soaked in simulated body fluid (SBF) and the drug release ratio was monitored through release time to perform in vitro drug release test. A slow and sustained release was observed for DUT-32 micro/nano-structures, having a considerable drug loading capacity. At the pH values 7.4-4.5, various profiles of pH-responsive release were achieved. Also, the prepared DUT-32 micro/nano-structures are found to be biocompatible with PC3 (prostate cancer) and HeLa (cervical cancer) cell lines, when tested by MTT assay. Moreover, DUT-32 micro/nano-structures were studied to show AMX adsorption from aqueous solution. Finally, kinetic studies indicated that AMX adsorption and drug release of DOX via this MOF are of first-order kinetics.PostprintPeer reviewe

Regulatory network analysis of Epstein-Barr virus identifies functional modules and hub genes involved in infectious mononucleosis

© 2017, Springer-Verlag Wien.Epstein-Barr virus (EBV) is the most common cause of infectious mononucleosis (IM) and establishes lifetime infection associated with a variety of cancers and autoimmune diseases. The aim of this study was to develop an integrative gene regulatory network (GRN) approach and overlying gene expression data to identify the representative subnetworks for IM and EBV latent infection (LI). After identifying differentially expressed genes (DEGs) in both IM and LI gene expression profiles, functional annotations were applied using gene ontology (GO) and BiNGO tools, and construction of GRNs, topological analysis and identification of modules were carried out using several plugins of Cytoscape. In parallel, a human-EBV GRN was generated using the Hu-Vir database for further analyses. Our analysis revealed that the majority of DEGs in both IM and LI were involved in cell-cycle and DNA repair processes. However, these genes showed a significant negative correlation in the IM and LI states. Furthermore, cyclin-dependent kinase 2 (CDK2) – a hub gene with the highest centrality score – appeared to be the key player in cell cycle regulation in IM disease. The most significant functional modules in the IM and LI states were involved in the regulation of the cell cycle and apoptosis, respectively. Human-EBV network analysis revealed several direct targets of EBV proteins during IM disease. Our study provides an important first report on the response to IM/LI EBV infection in humans. An important aspect of our data was the upregulation of genes associated with cell cycle progression and proliferation

Giant fornix syndrome: a case series.

PURPOSE: To describe the demographics, characteristics, and treatment of giant fornix syndrome, a rare cause of chronic purulent conjunctivitis in the elderly. METHODS: Retrospective chart review of five patients with giant fornix syndrome evaluated by the Cornea Service, Oculoplastics and Orbital Surgery Service and the Department of Pathology at the Wills Eye Institute. RESULTS: The median age of the 5 female patients was 75 years (mean 80, range 70-95). The median duration of eye symptoms before presentation was 2 years (mean 2.4, range 1-4). Before referral, the chronic conjunctivitis was treated with topical antibiotics in all 5 cases and with additional dacryocystorhinostomy in one case. The right eye was affected in 2 cases, and the left eye was affected in the other 3 cases. Floppy eyelids were present in 2 cases. The superior fornix was involved in 4 cases, and the inferior fornix was involved in one case. Pseudomembranes and superficial punctate keratitis (SPK) were seen in 3 cases. Diagnosis of giant fornix syndrome was made in all 5 cases. Conjunctival culture grew methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and S. aureus in singular cases. Case 1 was treated with topical moxifloxacin, Case 2 was treated with topical vancomycin and repair of the upper eyelid, Case 3 was treated with topical besifloxacin, and Case 4 was treated with dacryocystorhinostomy and topical vancomycin. Case 5 was treated with reconstruction of the left upper eyelid. The median duration of follow up was 4 months (mean 21.6, range 1-84). CONCLUSIONS: Giant fornix syndrome can lead to chronic relapsing conjunctivitis in the elderly. Deep conjunctival fornices in affected patients can be a site for prolonged sequestration of bacteria causing recurrent infections. Removing the infected debris from the superior fornix and reconstruction of the upper eyelid may prevent the recurrent chronic persistent infection

Archaeogenetic analysis of Neolithic sheep from Anatolia suggests a complex demographic history since domestication

Sheep were among the first domesticated animals, but their demographic history is little understood. Here we analyzed nuclear polymorphism and mitochondrial data (mtDNA) from ancient central and west Anatolian sheep dating from Epipaleolithic to late Neolithic, comparatively with modern-day breeds and central Asian Neolithic/Bronze Age sheep (OBI). Analyzing ancient nuclear data, we found that Anatolian Neolithic sheep (ANS) are genetically closest to present-day European breeds relative to Asian breeds, a conclusion supported by mtDNA haplogroup frequencies. In contrast, OBI showed higher genetic affinity to present-day Asian breeds. These results suggest that the east-west genetic structure observed in present-day breeds had already emerged by 6000 BCE, hinting at multiple sheep domestication episodes or early wild introgression in southwest Asia. Furthermore, we found that ANS are genetically distinct from all modern breeds. Our results suggest that European and Anatolian domestic sheep gene pools have been strongly remolded since the Neolithic

The work�family conflict and quality of care given by nurses: a cross-sectional questionnaire survey

Aim: This study aimed to assess the work�family conflict among nurses, the quality of nursing care, and the relationship between these two variables. Subjects and methods: Our cross-sectional study was conducted on 200 nurses from two hospitals in the southeast of Iran. Data were collected using the Quality Patient Care Scale (QUALPACS) and Carlson�s Work�Family Conflict Scale. Results: The findings showed that the mean score of nursing care quality was at a high level and the mean score of work�family conflict was at a moderate level. The quality of nursing care had a poor and inverse relationship with work�family conflict. Conclusion: To reduce the work�family conflict, educational courses must be provided for correct planning in both the family and the working lives of nurses. Managers can also contribute to increasing nurses� job satisfaction and ameliorating work�family conflict by reducing workloads, in turn improving the quality of nursing care. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature