Development of a Mobile App for Self-Care Against COVID-19 Using the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) Model: Methodological Study

Background: Mobile apps have been shown to play an important role in the management, care, and prevention of infectious diseases. Thus, skills for self-care—one of the most effective ways to prevent illness—can be improved through mobile health apps. Objective: This study aimed to design, develop, and evaluate an educational mobile-based self-care app in order to help the self-prevention of COVID-19 in underdeveloped countries. We intended the app to be easy to use, quick, and inexpensive. Methods: In 2020 and 2021, we conducted a methodological study. Using the ADDIE (analysis, design, development, implementation, and evaluation) educational model, we developed a self-care management mobile app. According to the ADDIE model, an effective training and performance support tool is built through the 5 phases that comprise its name. There were 27 participants who conducted 2 evaluations of the mobile app’s usability and impact using the mobile health app usability and self-care inventory scales. The study design included pre- and posttesting. Results: An Android app called MyShield was developed. The results of pre- and posttests showed that on a scale from 0 to 5, MyShield scored a performance average of 4.17 in the physical health dimension and an average of 3.88 in the mental well-being dimension, thereby showing positive effects on self-care skills. MyShield scored highly on the “interface and satisfaction,” “ease of use,” and “usefulness” components. Conclusions: MyShield facilitates learning self-care skills at home, even during quarantine, increasing acquisition of information. Given its low development cost and the ADDIE educational design on which it is based, the app can be helpful in underdeveloped countries. Thus, low-income countries—often lacking other tools—can use the app as an effective tool for fighting COVID-19, if it becomes a standard mobile app recommended by the government

Effects of Nanoparticles (Zinc and Silicon) and Plant Growth Promoting Rhizobacteria on Yield, Photosynthetic Pigments and Grain Filling Components of Triticale under Salinity Stres

IntroductionSalinity stands as a significant environmental stressor that profoundly curtails the growth and yield of crop plants. This adversity also extends to the impairment of pigments and plastids, leading to diminished chlorophyll indices, rates, and grain-filling durations. To counteract the deleterious impact of such stressors on plant growth, a spectrum of strategies has been devised. Prominent among these strategies are plant growth-promoting rhizobacteria, exemplified by azospirillum, and the utilization of nanoparticles like zinc and silicon. These factors play a pivotal role in elevating yield outcomes. Zinc's pivotal involvement spans protein metabolism, photosynthetic activities, and diverse physiological traits within plants. Particularly noteworthy is its contribution to rectifying zinc deficiency, a particularly critical concern in plants cultivated in high-pH soils. Notably, recent research has illuminated the potential of applying minute quantities of micronutrients, notably zinc via foliar spraying, in bolstering plant resilience against salt stress. Likewise, silicon emerges as a supplemental micronutrient that imparts heightened resistance to environmental stresses, fostering increased resilience within biological systems. Therefore, this study aimed to evaluate the effects of application of plant growth-promoting rhizobacteria and nanoparticles (zinc and silicon) on the yield, photosynthetic pigments, and filling components of triticale grain under salt stress.Materials and MethodsThis experiment was conducted as factorial based on a randomized complete block design with three replications in greenhouse research of the Faculty of Agriculture and Natural Resources, University of Mohaghegh Ardabili in 2022. Factors experimental included salinity at three levels (no salinity as control, application of 60, 120 mM salinity) by NaCl, application of PGPR at two levels (no inoculation as control and seed inoculation with Azospirillium), and foliar application of nanoparticles at four levels (foliar application with water as control, foliar application of 0.8 g.L-1 nano zinc oxide, foliar application 50 mg.L-1 nano silicon, foliar application both of nano zinc oxide (0.4 g.L-1) and nano silicon (25 mg.L-1). The strains and cell densities of microorganisms used as PGPR in this experiment were 1×107 bacteria per milliliter (107 cfu.ml−1). A two-part linear model was used to quantify the grain-filling parameters. In this study, grain dry weight and number were used to calculate the average grain weight for each sample. Total duration of grain filling was determined for each treatment combination by fitting a bilinear model:    GW =where GW is the grain dry weight; a, the GW-intercept; b, the slope of grain weight indicating grain filling rate; t, the days after earring; and t0, physiological maturity. The effective grain filling period (EGFD) was calculated from the following equation:EGFD = the highest grain weight (g)/rate of grain filling (g day-1).Results and DiscussionThe results showed that application of Azospirillium and foliar application of nano zinc-silicon oxide under no salinity increased chlorophyll a (38.42%), chlorophyll b (41.76%), total chlorophyll (39.39%), carotenoids (53.99%), root weight (62.61%), grain filling rate (16.37%), grain filling period and effective grain filling period (21.28 and 29.78%) and grain yield (47.23%) in compared to no application of Azospirillium and nanoparticles under 120 mM salinity. Application of Azospirillium and foliar application nano zinc-silicon oxide under 60 mM salinity also increased chlorophyll a (31.4%), chlorophyll b (34.35%), total chlorophyll (32%), carotenoids (45.68%), root weight (57.14%), grain filling rate (15.21%), grain filling period and effective grain filling period (21.29 and 28.16%) and grain yield (35.67%) in compared to the application of Azospirillium and nanoparticles under 120 mM salinity. According to this study, application of Azospirillium and nanoparticles (zinc and silicon) can increase yield of triticale grain under salinity stress such as no salinity due to the improvement of photosynthetic pigments content and grain filling components

Fosfomycin: Mechanisms and the increasing prevalence of resistance

There are challenges regarding increased global rates of microbial resistance and the emergence of new mechanisms that result in microorganisms becoming resistant to antimicrobial drugs. Fosfomycin is a broad-spectrum bactericidal antibiotic effective against Gram-negative and certain Gram-positive bacteria, such as Staphylococci, that interfere with cell wall synthesis. During the last 40 years, fosfomycin has been evaluated in a wide range of applications and fields. Although numerous studies have been done in this area, there remains limited information regarding the prevalence of resistance. Therefore, in this review, we focus on the available data concerning the mechanisms and increasing resistance regarding fosfomycin. © 2019 The Authors

National Spinal Cord Injury Registry of Iran (NSCIR-IR) � a critical appraisal of its strengths and weaknesses

The National Spinal Cord Injury Registry of Iran (NSCIR-IR) is a not-for-profit, hospital-based, and prospective observational registry that appraises the quality of care, long-term outcomes and the personal and psychological burden of traumatic spinal cord injury in Iran. Benchmarking validity in every registry includes rigorous attention to data quality. Data quality assurance is essential for any registry to make sure that correct patients are being enrolled and that the data being collected are valid. We reviewed strengths and weaknesses of the NSCIR-IR while considering the methodological guidelines and recommendations for efficient and rational governance of patient registries. In summary, the steering committee, funded and maintained by the Ministry of Health and Medical Education of Iran, the international collaborations, continued staff training, suitable data quality, and the ethical approval are considered to be the strengths of the registry, while limited human and financial resources, poor interoperability with other health systems, and time-consuming processes are among its main weaknesses. © 2019 Chinese Medical Associatio

Prevalence and antimicrobial susceptibility pattern of toxigenic clostridium difficistrains isolated in iran

Background/aim: Clostridium difficile is a frequent cause of nosocomial infections and has become a major public health concern in developed nations. In the present study, the prevalence and antimicrobial susceptibility pattern of toxigenic C. difficile strains isolated in Iran were investigated. Materials and methods: Between June 2016 and May 2017, 2947 inpatient fecal samples were taken from symptomatic adult hospitalized patients in different units of 32 care facilities in Tehran, Iran. C. difficile strains were identified by microbiological/biochemical methods. Susceptibility to 20 antimicrobials was measured by E-test method. Toxin-specific immunoassays and cytotoxicity assays were used to determine in vitro toxin production. Results: Out of 2947 fecal samples, 538 (18.25) C. difficile isolates were obtained among those with suspected CDI. In E-test method, all C. difficile isolates were susceptible to fidaxomicin, vancomycin, amoxicillin/clavulanate, and meropenem and were resistant to penicillin G. The prevalence of multidrug resistant C. difficile was 69.33 (373/538). Among 538 C. difficile, 147 (27.32), 169 (31.41), and 222 (41.26) isolates were TcdA+/TcdB+, TcdA-/TcdB+, and TcdA-/TcdB-, respectively. Conclusion: The results evidently support the hypothesis of a probable role of toxigenic strains of C. difficile in developing gastrointestinal complaints in patients with diarrhea. © TUBİTAK

The data set development for the National Spinal Cord Injury Registry of Iran (NSCIR-IR): progress toward improving the quality of care

STUDY DESIGN: Descriptive study. OBJECTIVES: The aim of this manuscript is to describe the development process of the data set for the National Spinal Cord Injury Registry of Iran (NSCIR-IR). SETTING: SCI community in Iran. METHODS: The NSCIR-IR data set was developed in 8 months, from March 2015 to October 2015. An expert panel of 14 members was formed. After a review of data sets of similar registries in developed countries, the selection and modification of the basic framework were performed over 16 meetings, based on the objectives and feasibility of the registry. RESULTS: The final version of the data set was composed of 376 data elements including sociodemographic, hospital admission, injury incidence, prehospital procedures, emergency department visit, medical history, vertebral injury, spinal cord injury details, interventions, complications, and discharge data. It also includes 163 components of the International Standards for the Neurologic Classification of Spinal Cord Injury (ISNCSCI) and 65 data elements related to quality of life, pressure ulcers, pain, and spasticity. CONCLUSION: The NSCIR-IR data set was developed in order to meet the quality improvement objectives of the registry. The process was centered around choosing the data elements assessing care provided to individuals in the acute and chronic phases of SCI in hospital settings. The International Spinal Cord Injury Data Set was selected as a basic framework, helped by comparison with data from other countries. Expert panel modifications facilitated the implementation of the registry process with the current clinical workflow in hospitals

Iranome: A catalogue of genomic variations in the Iranian population

Considering the application of human genome variation databases in precision medicine, population-specific genome projects are continuously being developed. However, the Middle Eastern population is underrepresented in current databases. Accordingly, we established Iranome database (www.iranome.com) by performing whole exome sequencing on 800 individuals from eight major Iranian ethnic groups representing the second largest population of Middle East. We identified 1,575,702 variants of which 308,311 were novel (19.6%). Also, by presenting higher frequency for 37,384 novel or known rare variants, Iranome database can improve the power of molecular diagnosis. Moreover, attainable clinical information makes this database a good resource for classifying pathogenicity of rare variants. Principal components analysis indicated that, apart from Iranian-Baluchs, Iranian-Turkmen, and Iranian-Persian Gulf Islanders, who form their own clusters, rest of the population were genetically linked, forming a super-population. Furthermore, only 0.6% of novel variants showed counterparts in "Greater Middle East Variome Project", emphasizing the value of Iranome at national level by releasing a comprehensive catalog of Iranian genomic variations and also filling another gap in the catalog of human genome variations at international level. We introduce Iranome as a resource which may also be applicable in other countries located in neighboring regions historically called Greater Iran (Persia)

Low exposure long-baseline neutrino oscillation sensitivity of the DUNE experiment

The Deep Underground Neutrino Experiment (DUNE) will produce world-leading neutrino oscillation measurements over the lifetime of the experiment. In this work, we explore DUNE\u27s sensitivity to observe charge-parity violation (CPV) in the neutrino sector, and to resolve the mass ordering, for exposures of up to 100 kiloton-megawatt-calendar years (kt-MW-CY), where calendar years include an assumption of 57% accelerator uptime based on past accelerator performance at Fermilab. The analysis includes detailed uncertainties on the flux prediction, the neutrino interaction model, and detector effects. We demonstrate that DUNE will be able to unambiguously resolve the neutrino mass ordering at a 4σ (5σ) level with a 66 (100) kt-MW-CY far detector exposure, and has the ability to make strong statements at significantly shorter exposures depending on the true value of other oscillation parameters, with a median sensitivity of 3σ for almost all true δCP values after only 24 kt-MW-CY. We also show that DUNE has the potential to make a robust measurement of CPV at a 3σ level with a 100 kt-MW-CY exposure for the maximally CP-violating values δCP=±π/2. Additionally, the dependence of DUNE\u27s sensitivity on the exposure taken in neutrino-enhanced and antineutrino-enhanced running is discussed. An equal fraction of exposure taken in each beam mode is found to be close to optimal when considered over the entire space of interest

Searching for solar KDAR with DUNE

The observation of 236 MeV muon neutrinos from kaon-decay-at-rest (KDAR) originating in the core of the Sun would provide a unique signature of dark matter annihilation. Since excellent angle and energy reconstruction are necessary to detect this monoenergetic, directional neutrino flux, DUNE with its vast volume and reconstruction capabilities, is a promising candidate for a KDAR neutrino search. In this work, we evaluate the proposed KDAR neutrino search strategies by realistically modeling both neutrino-nucleus interactions and the response of DUNE. We find that, although reconstruction of the neutrino energy and direction is difficult with current techniques in the relevant energy range, the superb energy resolution, angular resolution, and particle identification offered by DUNE can still permit great signal/background discrimination. Moreover, there are non-standard scenarios in which searches at DUNE for KDAR in the Sun can probe dark matter interactions