Adherence to Antihypertensives in Patients With Comorbid Condition.

BackgroundComorbidity has been noted as a potential barrier to proper adherence to antihypertensive medications.ObjectivesWe decided to investigate whether comorbidity could significantly affect adherence of Iranian patients with hypertension to their medication regimen.Patients and methodsTwo hundred and eighty consecutive hypertensive patients were interviewed in 4 cities of Iran. The 8-item Morisky medication adherence scale (MMAS-8) (validated in Persian) was used to assess medication adherence. This scale determines adherence by scores as lower than 6 (low adherence), 6 or 7 (moderate adherence), and 8 (high adherence). Comorbidity was considered as any concomitant medical condition, which necessitates the patient to take medicine for a minimum of 6 months prior to the interviews.ResultsThe most common comorbid conditions were ischemic heart disease (65 patients, 23.2%), diabetes mellitus (55 patients, 19.6%), and dyslipidemia (51 patients, 18.2%). Mean (± SD) MMAS-8 score in comorbid group was 5.68 (± 1.85) and in non-comorbid hypertensive patients, it was 5.83 (± 1.91) (P = 0.631). Mean (± SD) number of comorbidities was 1.53 (± 0.75) in low adherence group compared to 1.54 (± 0.77) in moderate/high adherers (P = 0.98). With increasing the number of comorbid diseases, the proportion of patients with high adherence decreased successively from 20% in those with no comorbid disease to 14.1% in those with one or two comorbid conditions, and finally 11.1% in those with 3 to 5 comorbid conditions.ConclusionsWith increasing the number of comorbid conditions, the proportion of patients with high adherence decreases. In our opinion, this finding is a useful clinical note for healthcare providers when managing patients with hypertension who have other medical problems at the same time

An evaluation of the effectiveness of a reproductive health education program for nonmedical students in Iran: A quasi-experimental pre-test, post-test research

Background: Young people age 10 - 25 are an important population to evaluate the female youth educational program essential to the prevention of issues related to reproductive health. Objectives: This study evaluated the effectiveness of the education program for improving university student�s reproductive health. Patients and Methods: This quantitative study was conducted in Iran from July 2014 to March 2015. The questionnaire addressed socio-demographic features, knowledge of reproductive problems, and attitudes. Program effectiveness was examined using a quasi-experimental research design with pre-intervention and post-intervention. Data from questionnaires was collected preintervention and post-intervention from 150 female students. Results: In this study, results showed that an intervention and education program had a significant effect on several issues related to reproductive health. Most participants stressed the need to provide reproductive health services for young girls. Conclusions: The results of this study suggest that the reproductive health education program improved the students� knowledge and attitudes about sexuality and decision-making after the program and that these educational programs are important for youths. © 2016, Shiraz University of Medical Sciences

On the rules for aquatic locomotion

We present unifying rules governing the efficient locomotion of swimming fish and marine mammals. Using scaling and dimensional analysis, supported by new experimental data, we show that efficient locomotion occurs when the values of the Strouhal (St) number St(=f A/U) and A∗(=A/L), two nondimensional numbers that relate forward speed U, tail-beat amplitude A, tail-beat frequency f , and the length of the swimmer L are bound to the tight ranges of 0.2–0.4 and 0.1–0.3, respectively. The tight range of 0.2–0.4 for the St number has previously been associated with optimal thrust generation. We show that the St number alone is insufficient to achieve optimal aquatic locomotion, and an additional condition on A∗ is needed. More importantly, we show that when swimming at minimal power consumption, the Strouhal number of a cruising swimmer is predetermined solely by the shape and drag characteristics of the swimmer. We show that diverse species of fish and cetaceans cruise indeed with the St number and A∗ predicted by our theory. Our findings provide a physical explanation as to why fast aquatic swimmers cruise with a relatively constant tail-beat amplitude of approximately 20% of the body length, and their swimming speed is nearly proportional to their tail-beat frequenc

Mems based bridge monitoring supported by image-assisted total station

In this study, the feasibility of Micro-Electro-Mechanical System (MEMS) accelerometers and an image-assisted total station (IATS) for short-and long-term deformation monitoring of bridge structures is investigated. The MEMS sensors of type BNO055 from Bosch as part of a geo-sensor network are mounted at different positions of the bridge structure. In order to degrade the impact of systematic errors on the acceleration measurements, the deterministic calibration parameters are determined for fixed positions using a KUKA youBot in a climate chamber over certain temperature ranges. The measured acceleration data, with a sampling frequency of 100 Hz, yields accurate estimates of the modal parameters over short time intervals but suffer from accuracy degradation for absolute position estimates with time. To overcome this problem, video frames of a passive target, attached in the vicinity of one of the MEMS sensors, are captured from an embedded on-axis telescope camera of the IATS of type Leica Nova MS50 MultiStation with a practical sampling frequency of 10 Hz. To identify the modal parameters such as eigenfrequencies and modal damping for both acceleration and displacement time series, a damped harmonic oscillation model is employed together with an autoregressive (AR) model of coloured measurement noise. The AR model is solved by means of a generalized expectation maximization (GEM) algorithm. Subsequently, the estimated model parameters from the IATS are used for coordinate updates of the MEMS sensor within a Kalman filter approach. The experiment was performed for a synthetic bridge and the analysis shows an accuracy level of sub-millimetre for amplitudes and much better than 0.1 Hz for the frequencies. © 2019 M. Omidalizarandi et al

Birds flee en mass from New Year’s Eve fireworks

Anthropogenic disturbances of wildlife, such as noise, human presence, hunting activity, and motor vehicles, are becoming an increasing concern in conservation biology. Fireworks are an important part of celebrations worldwide, and although humans often find fireworks spectacular, fireworks are probably perceived quite differently by wild animals. Behavioral responses to fireworks are difficult to study at night, and little is known about the negative effects fireworks may have on wildlife. Every year, thousands of tons of fireworks are lit by civilians on New Year’s Eve in the Netherlands. Using an operational weather radar, we quantified the reaction of birds to fireworks in 3 consecutive years. Thousands of birds took flight shortly after midnight, with high aerial movements lasting at least 45 min and peak densities measured at 500 m altitude. The highest densities were observed over grasslands and wetlands, including nature conservation sites, where thousands of waterfowl rest and feed. The Netherlands is the most important winter staging area for several species of waterfowl in Europe. We estimate that hundreds of thousands of birds in the Netherlands take flight due to fireworks. The spatial and temporal extent of disturbance is substantial, and potential consequences are discussed. Weather radar provides a unique opportunity to study the reaction of birds to fireworks, which has otherwise remained elusive

A Prospective Study on Risk Factors for Acute Kidney Injury and All-Cause Mortality in Hospitalized COVID-19 Patients From Tehran (Iran)

Background: Several reports suggested that acute kidney injury (AKI) is a relatively common occurrence in hospitalized COVID-19 patients, but its prevalence is inconsistently reported across different populations. Moreover, it is unknown whether AKI results from a direct infection of the kidney by SARS-CoV-2 or it is a consequence of the physiologic disturbances and therapies used to treat COVID-19. We aimed to estimate the prevalence of AKI since it varies by geographical settings, time periods, and populations studied and to investigate whether clinical information and laboratory findings collected at hospital admission might influence AKI incidence (and mortality) in a particular point in time during hospitalization for COVID-19. Methods: Herein we conducted a prospective longitudinal study investigating the prevalence of AKI and associated factors in 997 COVID-19 patients admitted to the Baqiyatallah general hospital of Tehran (Iran), collecting both clinical information and several dates (of: birth; hospital admission; AKI onset; ICU admission; hospital discharge; death). In order to examine how the clinical factors influenced AKI incidence and all-cause mortality during hospitalization, survival analysis using the Cox proportional-hazard models was adopted. Two separate multiple Cox regression models were fitted for each outcome (AKI and death). Results: In this group of hospitalized COVID-19 patients, the prevalence of AKI was 28.5% and the mortality rate was 19.3%. AKI incidence was significantly enhanced by diabetes, hyperkalemia, higher levels of WBC count, and blood urea nitrogen (BUN). COVID-19 patients more likely to die over the course of their hospitalization were those presenting a joint association between ICU admission with either severe COVID-19 or even mild/moderate COVID-19, hypokalemia, and higher levels of BUN, WBC, and LDH measured at hospital admission. Diabetes and comorbidities did not increase the mortality risk among these hospitalized COVID-19 patients. Conclusions: Since the majority of patients developed AKI after ICU referral and 40% of them were admitted to ICU within 2 days since hospital admission, these patients may have been already in critical clinical conditions at admission, despite being affected by a mild/moderate form of COVID-19, suggesting the need of early monitoring of these patients for the onset of eventual systemic complications

Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews

Background: Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification. Aims: To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics. Method: Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analyzed. Binomial Generalized Linear Mixed Models were fit. Results: 17,158 participants (2,287 major depression cases) from 57 primary studies were analyzed. Among fully structured interviews, odds of major depression were higher for the MINI compared to the Composite International Diagnostic Interview (CIDI) [OR (95% CI) = 2.10 (1.15–3.87)]. Compared to semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression [OR (95% CI) = 3.13 (0.98–10.00)], similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) [OR (95% CI) = 0.96 (0.56–1.66)], and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) [OR (95% CI) = 0.50 (0.26–0.97)] Conclusions: The MINI may identify more depressed cases than the CIDI, and semi- and fully structured interviews may not be interchangeable methods, but these results should be replicated