Optimization and simulation models to improve access to organ transplantation in the United States.

Organ allocation in the U.S. is administrated by the United Network of Organ Sharing (UNOS). UNOS’s mission is to ensure fair and equitable allocation of organs as stated in the Code of Federal Regulations, which reads neither place of residence nor place of listing shall be a major determinant of access to transplant . Despite the regulations, there has been endless controversy surrounding the disparity in access to organ transplants. In this context, the primary research goal in this dissertation was to reduce geographic disparity in access to transplants in the U.S., with a focus on heart and kidney transplants. To improve access to heart transplants, we first analyzed the status of geographic disparity and organ utilization under current practice. Next, we used survival analysis and statistical analysis to measure heart utilization rate across the country and studied the factors that can improve heart usage. Additionally, we defined a novel optimization model to modify the geographic boundaries in the U.S. heart allocation system. Finally, We developed a clinically detailed discrete event simulation model for the U.S. heart allocation system to evaluate our proposed changes in in the heart allocation policy stemming from the optimization model. To improve access to kidney transplants, first, we proposed a simulation - optimization approach for better utilization of donated kidneys from living donor through a Kidney Paired Donation (KPD) program. Additionally, to reduce geographic disparity in access to kidney transplants, we used an optimization model to redesign geographic boundaries in the kidney allocation system. Our findings indicated that using optimization and simulation models can greatly improve equity in access to organ transplants

Using ultrasound as an accurate method of determining bone age: A safe method specially in young athletes

Introduction: Bone age determination is used in situations such a migration and sports. Radiography, MRI and ultrasound are different methods of determining bone age. This study was designed to evaluate the effectiveness of ultrasound in determining bone age in 14 -18 year olds. Materials and Methods: One hundred male and 100 female students between 14 and 18 years of age were evaluated. The thickness of the epiphysis of the left distal radius in the ventral, dorsal and lateral views, were measured.Results: In the females most of the growth plates were closed and the rest were inconclusive therefore ultrasound cannot be used in females in this age group. In the males, a minimum thickness of 0.7mm in dorsal and 0.8mm in ventral view in 14 and 15 year olds can be used to differentiate them from the 16 and 17 year olds. A maximum thickness of 1.6mm in dorsal and 1.1mm in ventral view can be used to differentiate 16 and 17 year olds from 14 and 15 year olds. Finally a maximum thickness of 0.8mm in the dorsal view can be used to differentiate 17 year olds from 16 year olds and younger. Conclusion: Bone age determination via sonographic evaluation of the distal radius is an easy, fast and radiation free method that if confirmed by future studies can be used to differentiate 15 and younger from 16 and older boys. Ultrasound cannot be used to differentiate 14 to 18 year old girl

The Effect of Participatory Teaching of Positive Thinking Skills on Nurses Communication Skills in the Emergency Department of a Teaching Hospital

Background & Objectives: Correct relationship between nurses and patients will improve the therapeutic outcomes and improve the patient's recovery process. One of the most important items in improving communication skills, as an essential part of providing nursing services, is the attitude and feedback of nurse to various phenomena and to create the necessary internal preparation for making positive changes in cognitive domain. This study aimed to investigate the effect of participatory teaching of positive thinking skills on communication skills of nurses in the emergency department of a selected hospital in Kerman city. Methods: This analytical study was an interventional study and it was conducted on 60 nurses at the selected educational hospital divided into the two groups of experimental and Control. Queendom Communication Skills Questionnaire was used for data collection. The experimental group received positive thinking skills education during 9 sessions. Independent t-test, ANOVA and single-variable covariance analysis test were used for data analysis. Data were entered into SPSS version 22. Results: Mean of total score of communication skills increased in the experimental group. Based on the post-test results, there was a significant improvement in the mean scores of listening skills, the ability to receive and send messages, emotional control, connection with decisiveness and insight into the communication process of nurses based on their group (P <0.05). Conclusion: Considering the effectiveness of teaching positive thinking skills in increasing nurses' communication skills, it is recommended to provide training for these skills from the beginning of nursing students’ education. Key¬words: Participatory Education, Positive Thinking Skills, Communication Skills, Nurses, Emergency Department, Teaching Hospital Citation: Salehi S, Hashemi F, Avaznejad N, Karami Robati F. The Effect of Participatory Teaching of Positive Thinking Skills on Nurses Communication Skills in the Emergency Department of a Teaching Hospital. Journal of Health Based Research 2018; 4(1): 63-76

Frequency and causes of mortality in patients with stroke referred to Zahedan city hospital in 2016

Background: Stroke is the fifth common cause of mortality worldwide. This study was conducted with the aim of Evaluation of mortality rate and its causes in patients with stroke referred to Zahedan city hospital.Methods: This was a cross-sectional study that conducted on 320 patients with stroke. Data collected by a checklist and then analyzed by statistical methods in SPSS.19.Results: Of all patients, 59.7% were male and 40.3% were female. The mean age of patients was 63.18±13.85 years. 76% of the strokes were ischemic and 24% were hemorrhagic. The mortality rate in this study was 16.3% which was not correlated with age, gender and type of stroke. The most common cause of mortality was pneumonia aspiration with 36.5 % and then sepsis with 32.7%.Conclusions: In overall, this study showed that mortality rate was 16.3 % and the most common cause of mortality was pneumonia aspiration and sepsis

New diagnostic criteria for inguinal hernia based on ultrasound examination

Background: According to increasing use of ultrasound in the diagnosis of inguinal herniation, this study was designed to evaluate the cross-sectional area of the inguinal canal in patients with inguinal herniation and its increase with Valsalva maneuver. We also compared the obtained values with those of normal population. Methods: a cross-sectional study, 52 normal persons and 35 cases with inguinal hernia were assessed. The cross-sectional area of the inguinal canal was measured in all subjects and data was analyzed using Student's t-test and Pearson's correlation tests in SPSS. Receiver operator characteristic (ROC) curves were traced to define cut-off points. Findings: Valsalva maneuver caused significantly greater increase in the cross-sectional area of the inguinal canal among patients than in the normal group. The cut-off point of the cross-sectional area of inguinal canal was 63.5 mm2 in neutral state and 72.5 mm2 with Valsalva maneuver (increase rate: 34 mm2). In the absence of Valsalva maneuver, a cross-sectional area of the inguinal canal of greater than 63.5 mm2 is predictive of inguinal hernia (with 91 sensitivity and 98 specificity). Otherwise, values greater than 72.5 mm2 will be predictive of inguinal hernia (with 100 sensitivity and 98 specificity). Inguinal hernia will also be suspected if Valsalva maneuver increases the cross-sectional area of the inguinal canal by more than 34 mm2 (with 91 sensitivity and 100 specificity). Conclusion: The following diagnostic criteria are suggested for diagnosis of inguinal hernia through ultrasound examination: the presence of bowel loop within the inguinal canal, a cross-sectional area of the inguinal canal > 63.5 mm2 without Valsalva maneuver and > 72.5 mm2 with Valsalva maneuver, an increase of > 34 mm2 in the cross-sectional area of the inguinal canal with Valsalva maneuver, and a > 0.5 cm movement of the spermatic cord with Valsalva maneuver

The effects of high-intensity interval training on the expression of interleukin-10 and STAT3 genes in the intestinal tissue of rats affected by hepatic steatosis

Hepatic steatosis is increasingly being recognized as an important pathological feature of disease that commonly reported in patients with inflammatory bowel disease. This study aimed to investigate the effects of High-Intensity Interval Training (HIIT) on the expression of interleukin-10 and Signal transducer and activator of transcription 3 (STAT3) genes in intestinal tissue in an animal model of fatty liver. In this experimental study, 24 rats (weighing 200-250 gr) were selected and randomly divided into 3 groups including healthy control, fatty liver, and fatty liver + HIIT, groups. In order to induce fatty liver, oral tetracycline 140 mg/kg/day in 2 mL of water in form of a solution was given to the rats by gavage for 7 days. HIIT exercise program performed on treadmill five sessions per week for 5 weeks. Data were analyzed by one-way ANOVA and Tukey post hoc tests. P<0.05 was considered significant. The results showed that IL10 gene expression in HIIT groups was significantly lower than in the fatty liver group (p<0.0001). Also, the expression of the STAT3 gene in intestinal tissue was significantly upper in HIIT groups than that in the fatty liver group (p<0.0001). Regulation of IL-10 and STAT3 gene expression in fatty liver-induced adipose tissue can be modulated by HIIT exercise. Therefore, intense interval training can be considered as a non-pharmacological strategy in the treatment of fatty liver

Mortality rate and immune responses of rainbow trout (Oncorhynchus mykiss) infected with Yersinia ruckeri subsequent to feeding on diet supplemented with Ducrosia anethifolia essential oil

Application of the immunostimulant is the most promising method for controlling diseases in aquaculture. In this study, the mortality rate and immune responses of rainbow trout (Oncorhynchus mykiss) fed on diet supplemented with Ducrosia anethifolia essential oil was investigated after challenging with Yersinia ruckeri. The essential oil mixed with sunflower oil at different concentrations (0.001, 0.01 and 0.1%) and the commercial food was coated with this oil. Fish were fed with diets for 8 weeks and infected with Y. ruckeri at the ending of feeding trial. Serum protein, albumin, globulin and lysozyme and bactericidal activity of challenged fish were evaluated one week after injection and mortality were counted till day 10. The results showed that albumin had not differed among treatments. The highest level of the protein and globulin were found in control group. Serum lysozyme activity showed no difference between groups. The highest and lowest serum bactericidal activity was observed in 0.001% and control group, respectively. The mortality rates in infected fish were as 55% in control group, 40% in 0.001%, 70% in 0.01% and 70% in 0.1% treatment. Lowest rate of mortality was observed in group 0.001%, while began two days earlier than other groups

Electrospun nanofibers for efficient adsorption of heavy metals from water and wastewater

Heavy metals (HMs) are persistent and toxic environmental pollutants that pose critical risks toward human health and environmental safety. Their efficient elimination from water and wastewater is essential to protect public health, ensure environmental safety, and enhance sustainability. In the recent decade, nanomaterials have been developed extensively for rapid and effective removal of HMs from water and wastewater and to address the certain economical and operational challenges associated with conventional treatment practices, including chemical precipitation, ion exchange, adsorption, and membrane separation. However, the complicated and expensive manufacturing process of nanoparticles and nanotubes, their reduced adsorption capacity due to the aggregation, and challenging recovery from aqueous solutions limited their widespread applications for HM removal practices. Thus, the nanofibers have emerged as promising adsorbents due to their flexible and facile production process, large surface area, and simple recovery. A growing number of chemical modification methods have been devised to promote the nanofibers\u27 adsorption capacity and stability within the aqueous systems. This paper briefly discusses the challenges regarding the effective and economical application of conventional treatment practices for HM removal. It also identifies the practical challenges for widespread applications of nanomaterials such as nanoparticles and nanotubes as HMs adsorbents. This paper focuses on nanofibers as promising HMs adsorbents and reviews the most recent advances in terms of chemical grafting of nanofibers, using the polymers blend, and producing the composite nanofibers to create highly effective and stable HMs adsorbent materials. Furthermore, the parameters that influence the HM removal by electrospun nanofibers and the reusability of adsorbent nanofibers were discussed. Future research needs to address the gap between laboratory investigations and commercial applications of adsorbent nanofibers for water and wastewater treatment practices are also presented

Evaluation of the Quality of Hospital Services from Patients' Perspective Based on SERVQUAL Model in a Selected Teaching Hospital in Kerman: A Case Study

Background & Objectives: Evaluation of the quality of hospitals services is very valuable. The results of evaluations can be useful to healthcare providers and patients by identifying the gap between the current and the desired status. SERVQUAL model is one of the methods for assessing the quality of health care services. This study aimed to evaluate the quality of services in a selected teaching hospital in Kerman city, from the perspective of patients. Methods: This descriptive-analytic study was conducted in a cross-sectional manner from October to March 2017 in a selected teaching hospital in Kerman. The study population included 83 patients with a history of hospitalization who were selected using convenience sampling. Data were collected using a SERVQUAL model. Data were analyzed using Pearson's correlation, independent t-test, and ANOVA by SPSS version 22. Results: The average age of patients was 43.78±12.43 years. The quality of hospital services was improved compared to previous years. The highest and the lowest mean were related to "Tangibles" (4.04±0.58) and "Empathy" (3.84±0.46), respectively. There was a significant relationship between service quality and gender (P=0.01) and educational level (P<0.001). Conclusion: Healthcare managers should use the results of such studies to plan and allocate optimal hospital resources and increase the quality of their services. Should improve the level of patients' satisfaction by directing resources towards areas affecting patients' perception and experience. Key¬words: Quality of services, Teaching Hospital, Patients, SERVQUAL questionnaire Citation: Hashemi F, Avaznejad N, Mehdipour M, Karami Robati F. Evaluation of the Quality of Hospital Services from Patients' Perspective Based on SERVQUAL Model in a Selected Teaching Hospital in Kerman: A Case Study. Journal of Health Based Research 2018; 4(2): 147-57. [In Persian

Reconfigurable Antennas Based on Plasma Reflectors and Cylindrical Slotted Waveguide

In this chapter, we focus on the application of plasma structures to realize reconfigurable antennas. Several approaches are presented to dynamically control the beamwidth and radiation gain of circularly polarized helical antennas based on plasma reflectors. Ideas and design principles were discussed and confirmed by full-wave simulations and measurements of realized prototypes. It is shown that plasma reflectors can be effectively used to design reconfigurable helicone antennas with controllable gain and beamwidth. The chapter also presents a reconfigurable slotted antenna using a plasma tube inside the metallic waveguide. It is shown that the radiation pattern of the antenna can be readily reconfigured by changing the state of the plasma column. In short, it is shown that in contrast to conventional methods based on electronic or mechanical devices, reconfigurable antennas based on plasma media benefit from simple and relatively low-cost structures as well as high performance