EMPLOYING TELEGRAM APPLICATION: LEARNERS’ ATTITUDE, VOCABULARY LEARNING, AND VOCABULARY DELAYED RETENTION

Using smartphones for learning a language has long been recommended by scholars. However, its effectiveness is still the subject of argument. Moreover, due to the limited time in the conventional language classes, students do not have the chance to practice all vocabulary items which may hinder the learning process. Accordingly, a mixed method only-post-test quasi-experimental study was conducted. Also, for the qualitative phase, data were gathered through a focus group interview with the participants chosen through purposive sampling. It was confirmed that there was a significant effect of online practicing on vocabulary learning of the language learners. Furthermore, it was found out that the participants held a positive attitude for practicing target words through Telegram. In addition, the study results showed that using Telegram application does not have a significant effect on the retention of the vocabulary of the learners. From the results of this study, the researcher proposed some pedagogical implications to EFL teachers, practitioners, material developers, policy makers, and other English education stakeholders.  Article visualizations

Holonic Learning: A Flexible Agent-based Distributed Machine Learning Framework

Ever-increasing ubiquity of data and computational resources in the last decade have propelled a notable transition in the machine learning paradigm towards more distributed approaches. Such a transition seeks to not only tackle the scalability and resource distribution challenges but also to address pressing privacy and security concerns. To contribute to the ongoing discourse, this paper introduces Holonic Learning (HoL), a collaborative and privacy-focused learning framework designed for training deep learning models. By leveraging holonic concepts, the HoL framework establishes a structured self-similar hierarchy in the learning process, enabling more nuanced control over collaborations through the individual model aggregation approach of each holon, along with their intra-holon commitment and communication patterns. HoL, in its general form, provides extensive design and flexibility potentials. For empirical analysis and to demonstrate its effectiveness, this paper implements HoloAvg, a special variant of HoL that employs weighted averaging for model aggregation across all holons. The convergence of the proposed method is validated through experiments on both IID and Non-IID settings of the standard MNISt dataset. Furthermore, the performance behaviors of HoL are investigated under various holarchical designs and data distribution scenarios. The presented results affirm HoL's prowess in delivering competitive performance particularly, in the context of the Non-IID data distribution

Unlocking therapeutic symphonies:Innovations in clinical decision support for drug-disease interactions in kidney transplantation

Introduction: Drug-disease interactions (DDSIs) are associated with increasing morbidity, mortality, and healthcare costs. These interactions are preventable if recognized and managed properly. Medication safety is critical in kidney transplant patients due to polypharmacy, co-morbidities, and susceptibility to adverse events. Clinical decision support systems (CDSSs) can play a key role therein. Therefore, this study aims to report on the process of developing an innovative, patient-centered, context-aware CDSS for managing DDSIs in kidney recipients. Material and Methods: Clinically important DDSIs were identified in the medications of patients at a kidney transplant outpatient clinic. Subsequently, rules for their detection and management were extracted based on pharmacology references and clinical expertise. A CDSS was developed and piloted following recommendations on medication CDSS design principles. Results: The knowledge base for this CDSS was developed with clinical context sensitivity. We defined priority levels for alerts, established associated display rules, and determined necessary actions based on the transplantation clinical workflow. The DDSI-CDSS correctly detected 37 DDSIs and displayed nine warnings and 28 cautionary alerts for the medications of 113 study patients (32.7% DDSI rate). The system fired three warnings for diltiazem in bradyarrhythmia, and two for each of the following medications and underlying diseases: aspirin in asthma, erythropoietin alfa in hypertension, and gemfibrozil in gall bladder disease. The potential consequences of the identified DDSIs were GI complications (17%), deterioration of the existing disease/condition (6.1%), and an increased risk of arrhythmias (2.6%), thrombosis (2.6%), and hypertension (1.7%). Complying with system alerts and recommendations would potentially prevent all these DDSIs. Conclusion: This study delineates the process of developing an evidence-based DDSI-CDSS for kidney transplantation, laying the groundwork for future advancements. Our results underscore the clinical significance of these interactions and emphasize the imperative for their accurate and timely detection, particularly in these vulnerable patients.</p

Effect of Angiography Room Orientation Tour on Anxiety of Patients Awaiting Cerebrovascular Angiography

Abstract Introduction: Cerebrovascular angiography is a method of diagnosing cerebrovascular disorders. Invasive procedures induce anxiety in patients. Poor management of anxiety may be life-threatening for patients. It is the duty of nurses to reduce anxiety. Given the prevalence of anxiety in patients awaiting cerebrovascular angiography and its detrimental complications and also the critical role of nurses in the psychosomatic support of patients and their struggle to reduce anxiety, the use of different methods of patient education such as familiarizing them with diagnostic and therapeutic processes is of utmost significance. This study investigated the effect of orientation tour on anxiety in candidates of cerebrovascular angiography. Methods: In this experimental study, 114 patients awaiting cerebrovascular angiography presenting to Imam Hussein Hospital and Shohadaye Tajrish Hospital in Tehran, capital of Iran, were selected with a convenient sampling method and assigned randomly to either case or control groups. The control group just received routine education in the ward. In contrast, the case group received routine education in the ward and instructions on performing angiography and its pre-, peri-, and post-operative care. Demographics questionnaire and the Depression Anxiety Stress Scale (DASS-21) were used to collect data. Patients' anxiety was measured twice with this instrument at hospitalization and after the intervention. The gleaned data were analyzed with SPSS21 using independent t-test, Chi-square test, and ANOVA. Results: Distribution of age was the same in both groups (P &lt; 0.11). Independent t-test showed a significant difference in the mean score of anxiety before intervention in the control group (9.2) and case group (7.2) (P = 0.02). This test also indicated a significant difference in the mean score of patients' anxiety after intervention in both the control group (9.7) and case group (6.7) (P = 0.001). However, using data collected before the orientation tour as the covariate, repeated measures ANOVA showed a significantly more significant reduction of anxiety in the case group. Conclusions: According to our findings, participation in the angiography room orientation tour leads to reduced anxiety in patients awaiting cerebrovascular angiography. The use of this method is advisable for patients before diagnostic and therapeutic processes

Development and optimization of the new ultrasonic-infrared-vacuum dryer in drying Kelussia odoratissima and its comparison with conventional methods

Among the post-harvest processing of medicinal plants, drying is an important and influential process. Given the numerous applications of medicinal plants, especially Kelussia odoratissima, in the food and pharmaceutical industries, the aim of this study was to compare the effects of the ultrasound-infrared radiation-vacuum method with conventional drying methods on the drying time, the total phenolic content (TPC), total flavonoid content (TFC) and antioxidant activity of K. odoratissima. ANOVA result showed that the effects of drying methods, drying temperature and their interaction effect on phenolic, flavonoid and antioxidant content were significant at 1% probability level. In the ultrasound-IR-vacuum method, by increasing temperature from 40 °C to 80 °C, the TFC increased by 35%. The highest antioxidant capacity was obtained for dry shade treatment, followed by dry sun treatment and three temperatures, i.e., 40 °C, 60 °C and 80 °C, in the combined method. The proposed optimal temperatures for the hot air, IR, and ultrasonic drying, were 63 °C, 66 °C and 71 °C, respectivel

Potentially inappropriate medication prescribing based on 2019 Beers criteria and the impact of pharmacist intervention in elderly patients with kidney diseases:A report from Iran

Background and Aims: A potentially inappropriate medication (PIM) is a pharmaceutical agent that poses a greater risk of harm than potential benefit to elderly patients. This study aimed to detect PIMs and their risk factors in hospitalized elderly patients with kidney disease. Methods: This cross-sectional study assessed medication orders of elderly patients (≥65 years old) with kidney diseases admitted to the hospital. In the first 6 months, we retrospectively evaluated all medications to identify PIMs according to the 2019 Beers criteria. In the second phase, a clinical pharmacist prospectively evaluated all medications and suggested modifications as needed. Data were analyzed to determine risk factors for prescribing PIMs. Results: Based on our evaluation of 258 patients, we observed that the utilization of PIMs was prevalent among the study population. Of the total patients evaluated, 273 instances of PIM use were identified, with only 23.3% of patients not having any PIMs. Notably, proton pump inhibitors and benzodiazepines were the most frequently prescribed PIMs. The risk of experiencing a PIM was significantly amplified by a higher degree of polypharmacy, with odds approximately 2.68 times higher (p &lt; 0.01). Several factors were found to be associated with an increased likelihood of having a PIM, including being male, undergoing hemodialysis, having chronic kidney disease or other comorbidities, and having an extended hospital stay. The second phase of study, in terms of addressing these issues, physicians adhered to 67.5% of the 120 recommendations made by pharmacists regarding the discontinuation of PIM usage. Conclusion: High prevalence of PIMs was detected in our study population. Preventing medication-associated harms in the elderly can reduce the financial burden imposed on healthcare systems. Therefore, routine evaluation of medications with clinical pharmacists and/or implementation of computerized medication decision support systems is recommended to prevent PIMs use.</p

Potentially inappropriate medication prescribing based on 2019 Beers criteria and the impact of pharmacist intervention in elderly patients with kidney diseases:A report from Iran

Background and Aims: A potentially inappropriate medication (PIM) is a pharmaceutical agent that poses a greater risk of harm than potential benefit to elderly patients. This study aimed to detect PIMs and their risk factors in hospitalized elderly patients with kidney disease. Methods: This cross-sectional study assessed medication orders of elderly patients (≥65 years old) with kidney diseases admitted to the hospital. In the first 6 months, we retrospectively evaluated all medications to identify PIMs according to the 2019 Beers criteria. In the second phase, a clinical pharmacist prospectively evaluated all medications and suggested modifications as needed. Data were analyzed to determine risk factors for prescribing PIMs. Results: Based on our evaluation of 258 patients, we observed that the utilization of PIMs was prevalent among the study population. Of the total patients evaluated, 273 instances of PIM use were identified, with only 23.3% of patients not having any PIMs. Notably, proton pump inhibitors and benzodiazepines were the most frequently prescribed PIMs. The risk of experiencing a PIM was significantly amplified by a higher degree of polypharmacy, with odds approximately 2.68 times higher (p &lt; 0.01). Several factors were found to be associated with an increased likelihood of having a PIM, including being male, undergoing hemodialysis, having chronic kidney disease or other comorbidities, and having an extended hospital stay. The second phase of study, in terms of addressing these issues, physicians adhered to 67.5% of the 120 recommendations made by pharmacists regarding the discontinuation of PIM usage. Conclusion: High prevalence of PIMs was detected in our study population. Preventing medication-associated harms in the elderly can reduce the financial burden imposed on healthcare systems. Therefore, routine evaluation of medications with clinical pharmacists and/or implementation of computerized medication decision support systems is recommended to prevent PIMs use.</p

Investigating the Effects of Combined Physical-cognitive Exercises on Executive Functions: A Home-based Exercise Approach

Purpose: Improving brain functions through physical exercises has been the focus of research in recent years. Accordingly, it is important to examine the kind of physical exercises and brain functions that are affected. This study aims to examine the effect of integrated physical cognitive exercises at home on the executive functions of adults. Methods: This was a field trial study, in which 28 people were examined in 2 groups. People in the experimental group participated in combined cognitive and physical exercises for 16 sessions, while the control group did their daily routines. Inhibition components were evaluated by the go/no-go test and working memory through the N-back test at the beginning and end of the training period. The data were analyzed via factorial analysis of variance through the SPSS software, version 19. Results: The findings indicated that the experimental condition, compared to the control condition, caused a significant improvement in the correct inhibition (P=0.002) and total correct response (P=0.047) components in the go/no-go test, along with the commission errors in the N-back test (P=0.003). Conclusion: The results showed that the combined physical and cognitive exercise had a positive effect on the core executive functions (attentional inhibition and working memory) and could prevent the performance decrement caused by quarantine and the reduction of daily activities that people were facing