The Perception of Cardiac Surgery Patients on Comfortable Resources: A Qualitative Study

Introduction: Comfort is a basic human need throughout life and an outcome of nursing. Therefore, it is necessary to understand the comforting needs of cardiac surgery patients, who experience the complications and problems of this surgery. This study was performed to explain the perception of cardiac surgery patients of comfortable resources. Method: This study was conducted with a qualitative, content analysis approach. The participants were 20 cardiac surgery patients. Data collection was performed through unstructured interview and purposive sampling, and continued until data saturation. Continuous analysis of data was performed concurrently with data collection and through a comparative method. Results: During the content analysis process, 4 themes emerged that indicated the nature and dimensions of the patients’ perception of comfortable resources. These themes included “Feeling a close and humanistic relationship with the nurse”, “Understanding the constant presence and monitoring of the nurse”, “Advocacy of family and peer patients”, and “Being in a safe environment”. Conclusion: The results of the current study showed that patients receive more comfort from human resources than environment and modern equipment. This issue shows the importance of highlighting the role of nurses and humanistic nursing care, despite the need for specialized nursing with modern technical facilities. Therefore, considering nurses and the standardization of human resources in health centers is more important than the physical standardization. This will result in nursing interventions being done with real understanding of the patients’ needs. Keywords: Patient perception, Comfortable resources, Qualitative content analysis, Cardiac surgery

The effect of synbiotic supplementation on body composition and lipid profile in patients with NAFLD: A randomized, double blind, placebo-controlled clinical trial study

Background: Regarding the growing prevalence of non-alcoholic fatty liver disease, concentrating on various strategies for its prevention and management seems necessary. Objectives: This study aimed to assess the effects of synbiotic administration on body composition and lipid profile in patients with NAFLD. Methods: Eighty patients with NAFLD participated in this randomized, double-blind, placebo-controlled clinical trial (from March to July 2014) in Iran. Based on AST and ALT as main variables of the study, 34 patients were required in each group (power 80% and α = 5%). Considering a 20% sample loss, 80 patients were enrolled. Synbiotic supplement in form of a 500 mg capsule (containing 7 species of probiotic bacteria and Fructooligosaccharides) was administrated to patients in the intervention group and those in the placebo group received 1 placebo capsule daily for 8 weeks. At the baseline and the end of the study, body composition and lipid profile were evaluated. Results: A significant reduction was observed in weight (P = 0.001), body fat (P = 0.02), and total cholesterol (P = 0.04) within the synbiotic group. Onthe other hand,WC(P = 0.02), total cholesterol, and LDL-c (P = 0.04 and P = 0.001, respectively) were significantly increased in the placebo group. TG, HDL-c, and FBG levels remained statistically unchanged in both groups. Significance betweengroup differences were seen in total cholesterol (P = 0.01), LDL (P = 0.01), weight, WC, and body fat after adjustment for energy intake (P = 0.05). Conclusions: Synbiotic supplementation may improve lipid profile and body composition in patients with NAFLD and might be useful in prevention of the disease progression

Determining the optimal technique for analyzing catastrophic occupational accidents in Qazvin province in 2017 using Analytic Network Process(ANP)

Background and Aim: In addition to life-threatening consequences, work-related accidents also have financial and social consequences. Therefore, it seems necessary to investigate the accidents. Accidents are investigated for the purposes of "preventing re-occurrence" and "determining the culprit for determining wergilds and paying compensation." At present, a technique for achieving the second goal has not been identified, and labor inspectors and official justice experts generally rely on personal capabilities to find the cause. For this purpose, in this study, an attempt has been made to select the optimal technique for analyzing fatal accidents in Qazvin province by considering the criteria using multi-criteria decision making methods. Materials and Methods: The present study is descriptive and cross-sectional that includes all fatal accidents caused by work in Qazvin province in 1396. Initially, the initial information and incident reports of 29 cases were collected from the labor inspection system and studied. These events were then analyzed using 5 techniques: Tripod-Beta, Why’s5, Fish Bone, FTA and RCA. Investigator software version 3.6 was used for computer analysis of Tripod-Beta and RCA techniques and the analysis of 3 other techniques was done manually. Criteria and sub-criteria were selected from previous studies and the causal relationships between them were identified using expert opinions and DEMATEL technique. Then, 8 main criteria and 20 sub-criteria were divided into two categories: "cause and effect" and "effective and influential". After determining the internal relationships of the criteria, the ANP matrices were adjusted and provided to the same team of experts. At the end, the average opinions of the experts were calculated manually and the values obtained were entered in the SuperDecision software to complete the calculations and results. Results: The criteria of application scope levels, identification of multiple levels of causes and validation with the final weight of 0.311, 0.252 and 0.134, respectively, were ranked first to third in terms of the impact on the selection of the optimal technique. In terms of causal and causal relationships, the criteria of application scope, systematicity and the ability to identify multiple levels of causes with weights of 0.68, 0.45 and 0.32, respectively, are the most influential criteria and criteria for validation, visibility and realism, respectively. Weights of -1.1, -0.58 and -0.21 were identified as the most effective criteria. Discussion and Conclusion: The priority of techniques based on sub-criteria and expert judgment showed that Tripod-Beta with a final weight of 0.3588 compared to other techniques; FTA with a weight of 0.203 and RCA with a weight of 0.202 are preferred. The capabilities of this technique are evident in the criteria of application scope levels, ability to identify causes and sub-criteria for protection, graphical presentation, specialized software and logic tree "both in the opinions of experts and in the features mentioned by the creators of Tripod-Beta technique". It can be concluded that in the absence of educational training criteria and required resources, the difference in score between Tripod-Beta technique and other techniques will definitely be more than the resulting value. Keywords: Accident Analysis Techniques, Criteria for Selection of Optimal Accident Analysis Techniques, Analytic Network Process(ANP) and DEMATEL

PTPN22 Silencing in Human Acute T-Cell Leukemia Cell Line (Jurkat Cell) and its Effect on the Expression of miR-181a and miR-181b

Purpose: T-cell acute lymphoblastic leukemia (T-ALL) is one of the most common malignancies associated with T-lymphocytes, accounting for 10 to 15 percent of ALL cases in children and 25 percent in adults. Innovative therapeutic approaches that overcome ineffective treatments on tumor cells may be a potential source of improvement in therapeutic approaches. Suppression of gene expression at transfusion level is one of the important strategies in gene therapy. The expression of PTPN22 and miR-181 genes in all types of hematologic malignancies increases and is likely to contribute to the survival and death of cells by affecting a variety of signaling pathways. The purpose of this study was to determine the role of PTPN22 inhibition by siRNA, and alteration in miR-181a and miR-181b in Jurkat cell line. Methods: Jurkat cells were transfected with 80 pmol of siRNA to inhibit PTPN22. After that, expression of PTPN22 mRNA and transcript levels of miR-181a and miR-181b were measured with Real-time PCR after 48hrs. Results: Experiments demonstrated that siRNA transfection resulted in significant downregulation of PTPN22 mRNA after 48 hrs in 80 pmol dose of siRNA. Moreover, transcript levels of both miR-181a and miR-181b was decreased after transfection. Conclusion: PTPN22, miR-181a and miR-181b might be involved in progression of Jurkat cells and targeting these molecules by RNAi might confer promising tool in treatment of T-ALL

The landscape of exosomal non-coding RNAs in breast cancer drug resistance, focusing on underlying molecular mechanisms

Breast cancer (BC) is the most common malignancy among women worldwide. Like many other cancers, BC therapy is challenging and sometimes frustrating. In spite of the various therapeutic modalities applied to treat the cancer, drug resistance, also known as, chemoresistance, is very common in almost all BCs. Undesirably, a breast tumor might be resistant to different curative approaches (e.g., chemo- and immunotherapy) at the same period of time. Exosomes, as double membrane-bound extracellular vesicles 1) secreted from different cell species, can considerably transfer cell products and components through the bloodstream. In this context, non-coding RNAs (ncRNAs), including miRNAs, long ncRNAs (lncRNAs), and circular RNAs (circRNAs), are a chief group of exosomal constituents with amazing abilities to regulate the underlying pathogenic mechanisms of BC, such as cell proliferation, angiogenesis, invasion, metastasis, migration, and particularly drug resistance. Thereby, exosomal ncRNAs can be considered potential mediators of BC progression and drug resistance. Moreover, as the corresponding exosomal ncRNAs circulate in the bloodstream and are found in different body fluids, they can serve as foremost prognostic/diagnostic biomarkers. The current study aims to comprehensively review the most recent findings on BC-related molecular mechanisms and signaling pathways affected by exosomal miRNAs, lncRNAs, and circRNAs, with a focus on drug resistance. Also, the potential of the same exosomal ncRNAs in the diagnosis and prognosis of BC will be discussed in detail

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio

Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019

BACKGROUND: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. METHODS: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. FINDINGS: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. INTERPRETATION: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. FUNDING: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38)

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed