Examining workload variations among different surgical team roles, specialties, and techniques: a multicenter cross-sectional descriptive study.

BACKGROUND: A high workload may negatively impact the surgical team's performance and jeopardize patient safety. The aim of this study was to measure the workload of the surgical team across different surgical roles, specialties, and techniques in several hospitals. METHODS: This cross-sectional multicenter study was performed in the operating rooms of eight teaching hospitals affiliated with Isfahan University of Medical Sciences, Iran. At the conclusion of each surgical procedure, all members of the surgical team completed the Surgery Task Load Index (SURG-TLX) questionnaire to assess workload levels. Descriptive statistics, analysis of variance (ANOVA), and Pearson correlations, were performed to compare surgical roles, specialties, techniques, and surgical time on workload overall and by subscale. RESULTS: A total of 409 workload questionnaires were obtained from 76 surgical teams or cases, involving 346 surgical team members. The total workload among all participants was 32.41 ± 17.21. Surgical complexity, physical demands, and mental demands were the highest workload subscales and distraction was the lowest workload subscale. Cardiovascular specialty had a higher workload compared to other specialties. Open techniques resulted in a higher workload compared to minimally invasive techniques. Surgical technologists who act in both the role of circulating and scrub nurse (C&Ss) experienced the highest workload, followed by surgical residents and surgeons. CONCLUSIONS: The results of the study showed that the workload for some members of the surgical team is disproportionately high and is influenced by factors such as specialty, technique, role, and surgical duration. By knowing the distribution of workload among the members of the surgical team, efforts can be made to optimize the team members' workload.

One-pot, three-component, iron-catalyzed synthesis of benzimidazoles via domino C-N bond formation.

An efficient one-pot, three-component process for the synthesis of benzimidazole derivatives using a catalytic amount of Fe(iii) porphyrin has been developed. The reaction proceeds via domino C-N bond formation and cyclization reactions of benzo-1,2-quinone, aldehydes and ammonium acetate as a nitrogen source to selectively produce benzimidazole. A number of benzimidazole derivatives have been synthesized using this method in high yields under mild reaction conditions.

Determination of Swelling Behavior and Mechanical and Thermal Resistance of Acrylamide-Acrylic Acid Copolymers under High Pressures and Temperatures.

Unwanted water production is a serious problem accompanying oil extraction especially in oil-fractured reservoirs. An effective approach to tackle this issue is to utilize gels as a blockage agent. In this paper, an effective series of preformed particle gels (PPGs) was synthesized by a free radical copolymerization of acrylamide and acrylic acid [poly(AAm-co-AA)] copolymers. The key factors of synthesis experiments, gelation time, drying behavior, swelling capacity (in CaCl2·2H2O, MgCl2·6H2O, BaCl2·2H2O, KCl, NaCl, and LiCl saline solutions with 200,000 ppm concentration and pH from 3 to 8), and mechanical and thermal resistance of the synthesized PPGs (with a homemade apparatus) were elucidated. Laboratory results revealed that the prepared PPG sample 1 (9.65 mole ratio of AAm/AA and 6 mol % of MBA) would be a good candidate for controlling water in oil and gas reservoirs with a salinity, pressure, and temperature of up to 200,000 ppm, 300 bar, and 170 °C, respectively, and pH values ranging from 3 up to 8.

Identifying the components of spirituality affecting the resilience of nurses.

AIM: To identify the components of spirituality that affect the resilience of nurses in the coronavirus service. BACKGROUND: The nursing profession experiences a great deal of stress at work because of high concentration in the work. This leads to serious physical and psychological consequences that make their resilience challenging. METHODS: The current study is descriptive qualitatively by type and inductive by approach. The study's statistical population consisted of nurses from the Iranian coronavirus service, and a sample of 11 nurses were selected using a teleological sampling method. An interview tool was used to collect qualitative data, and the thematic analysis technique was used to analyse interview data. RESULTS: The main research issue was studied using the thematic analysis technique, and seven main themes were identified as the components of effective spirituality affecting the resilience of nurses in the coronavirus ward in Iran. CONCLUSION: The results of data analysis showed that seven components affecting the resilience of nurses in the Corona ward are religious values, morality, self-awareness, patience and hope, wisdom, voluntary activities and the otherworld belief. IMPLICATIONS FOR NURSING MANAGEMENT: The Nursing Ethics Code, which intended to supplement the guidelines on health ethics for all nurses in education, research, management, health and clinical services, focuses directly on the nurses' performance in patient care.

Role of Obesity in the Tumorigenesis of Gastric Cancer.

Gastric cancer as a common cancer is a multi-factorial disease that is dependent on parallel effects of environment and genetics. Endogenous and host factors, including gender and several genetic backgrounds are known risk factors also many environmental factors, including smoking, diet, infection and increasing body weight and body mass index (BMI) are associated with the gastric cancer. Epidemiological data have consistently demonstrated a positive relation between obesity and gastric cancer, whereas mechanistic studies have sought to uncover obesity related carcinogenic pathways. Biological mechanisms and the relationship between obesity and cancer are complex and not well understood. Different effective factors include obesity-related hormones and adipokines, growth factors, modulation of energy balance and calorie restriction, inflammatory processes and multiple signaling pathways that affect cancer cell promotion and progression. In this review, we will discuss the recent advances in the understanding of the association of obesity changes in the gastric cancer.

Prognostic value of visfatin in various human malignancies: A systematic review and meta-analysis.

Although numerous studies have shown that visfatin is linked to several cancers, its prognostic value is still unclear. This first comprehensive meta-analysis was performed to evaluate the prognostic effect of visfatin in cancer patients. A systematic search was conducted for relevant studies in health-related electronic databases up to May 2019. The pooled hazard ratios (HRs) and ORs with 95% confidence intervals (CIs) for total and stratified analyses were calculated to demonstrate the prognostic value of visfatin expression level in cancer patients. Heterogeneity and publication bias were also investigated. A total of 14 eligible studies with 1616 patients were included in the current meta-analysis. Pooling results revealed that, high visfatin expression was significantly associated with poorer overall survival (OS) (HR = 2.43, 95% CI 1.64-3.62, P < 0.001). Elevated visfatin level was also correlated with positive lymph node metastasis (OR = 2.45, 95% CI 1.43-4.17, P ≤ 0.001), positive distance metastasis (OR = 2014, 95% CI 1.25-3.69, P ≤ 0.001), advanced tumor stage (OR = 3.01, 95% CI 1.91-7.72, P ≤ 0.001), and larger tumor size (OR = 1.99, 95% CI 1.49-2.69, P ≤ 0.001). Our meta-results indicates that altered visfatin expression is a potential indicator of poor clinical outcomes in tumor patients, suggesting that high visfatin expression may serve as a potential biomarker of poor prognosis and metastasis in cancers.

Targeted Development of Sustainable Green Catalysts for Oxidation of Alcohols via Tungstate-Decorated Multifunctional Amphiphilic Carbon Quantum Dots.

Achieving green and sustainable chemical processes by replacing organic solvents with water has always been one of the green chemistry goals and a challenging topic for chemists. However, the poor solubility of organic materials is a major limitation to achieving this goal, especially in alcohol oxidation. In this contribution, the development and design of amphiphilic catalysts via abundant, safe, cheaper, and more biocompatible sources have received notable attention. To this purpose, herein, our group successfully synthesized a new multifunctional amphiphilic carbon quantum dot (CQD) composed of 1-aminopropyl-3-methyl-imidazolium chloride ([APMim][Cl]), dodecylamine (DDA), and citric acid (CA) (denoted as CQDs@DDA-IL/Cl) using a one-pot hydrothermal route. The CQDs@DDA-IL/Cl was then utilized as an amphiphilic stabilizer for anchoring tungsten ions using an anion-exchange method (marked as CQDs@DDA-IL/W). The CQDs@DDA-IL/W as a reusable catalyst selectivity mediated the oxidation of alcoholic substrates with stoichiometric H2O2 in water solvent. The extraordinary performance of our catalyst was attributable to the coexistence of ionic liquid (IL) and DDA upon the surface of the CQDs@DDA-IL/W, which plays a main duty in the hydrophobic/hydrophilic balance, and significantly increase the catalyst compatibility in the aqueous medium with the purpose of removing organic solvents. As a result, the great mass transfer occurs in the two-phase medium using this amphiphilic nanocatalyst without any phase transfer catalyst (PTC) or other additives. The 100% selectivity, excellent turnover number (TON) and turnover frequency (TOF), high yield, almost complete and fast conversion of alcohol to the desired aldehydes and ketones without more oxidation, and easy and no-trouble isolation of product and catalyst are outstanding features of this catalytic system.

Immobilization of endoglucanase Cel9A on chitosan nanoparticles leads to its stabilization against organic solvents: the use of polyols to improve the stability.

The immobilization of enzymes improves their stability in non-conventional media such as organic solvents. In this work, the effects of solvents (DMSO, methanol, ethanol, and n-propanol) on the endoglucanase Cel9A activity and stability were studied. Then, the enzymes were stabilized by its immobilization on chitosan nanoparticles and also using polyols (sorbitol and glycerol) against organic solvents. The SEM results illustrated that the chitosan nanoparticles had about 40 nm diameter. The results indicated that the organic solvents, especially n-propanol, decreased the activity of the free and immobilized enzymes. The reduced activity of the immobilized enzyme was less than that of the free enzyme. Our studies about the enzymes' stability showed that the free and immobilized enzymes in hydrophobic solvents (with high log P) had the lowest stability compared to other solvents as we observed the half-life of the free enzyme in n-propanol solvent was 2.84 min, and the half-life of the immobilized enzyme was 4.98 min in n-propanol and ethanol solvents 4.50 min. Analysis of the combinatory effects of polyols (sorbitol and glycerol) and the solvents on the stability revealed that sorbitol and glycerol had the most stabilizing effect on the free enzyme in hydrophilic (DMSO) and hydrophobic (n-propanol) solvents, respectively. However, the stabilizing effects of polyols in the immobilized enzyme were independent of the solvents' hydrophobicity (or log P) due to the hydrophilic properties of chitosan nanoparticles. Therefore, one can conclude that the physiochemical properties of nanoparticles (such as hydrophilicity) influence the stabilizing effects of polyols on immobilized enzyme.

Oxidative Stress and Polycystic Ovary Syndrome: A Brief Review.

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders, occurring in 5-10% women in reproductive ages. Despite a long history of studies on PCOS, its etiology is still unknown. Oxidative stress is now recognized to play a central role in the pathophysiology of many different disorders, including PCOS. Although intracellular reactive oxygen species (ROS) production and propagation are controlled by highly complex antioxidant enzymatic and non-enzymatic systems, understanding of mechanisms that oxidative stress is important to develop strategies for prevention and therapy of PCOS. This article reviews the literature data related to the mechanisms of oxidative stress in PCOS.

Circulating visfatin levels and cancers risk: A systematic review and meta-analysis.

Visfatin levels have been reported to be abnormal in many types of cancers. However, epidemiological studies yielded inconsistent results. Therefore, a meta-analysis was performed to assess the association between circulating visfatin levels and cancer risk. A systematic search was conducted for relevant studies in health-related electronic databases up to March 2018. Data related to standard mean difference (SMD) and overall odds ratio (ORS) were collected and analyzed. Summary SMD and pooled OR with 95% CIs were calculated using a random-effect model. Funnel plot and Egger's linear regression test were conducted to examine the risk of publication bias. A total of 27 studies with 2,693 cases and 3,040 healthy controls were included in meta-analysis for pooling SMD analysis. The results of the meta-analysis showed a significant higher visfatin levels in patients with various cancers than in controls, with a pooled SMD of 0.88, 95% CI = 0.56-1.20, p = 0.000. In subgroup, metaregression, Galbraith plot, and sensitivity analysis showed no substantial difference among all the analyzed factors. Data from 14 studies were also used for pooling ORs analysis. Metaresults revealed that high visfatin levels were associated with cancer risk (OR = 1.24, 95% CI: 1.14-1.34, p = 0.000). No evidence of publication bias was observed for pooling ORs and SMD analysis. This meta-analysis indicated a significant association between high circulating visfatin levels and increased risk of various cancers. Visfatin may represent a potential biomarker for early detection of cancers who may benefit from preventive treatment.Note.

Iodine deficiency status in the WHO Eastern Mediterranean Region: a systematic review.

Iodine deficiency is a global public health issue because iodine plays a major role in the thyroid hormone synthesis and is essential for normal neurological development. This review summarizes the publications on iodine status in the WHO Eastern Mediterranean Region (EMR) countries. All related studies available in main national and international databases were systematically searched using some specific keywords to find article published between 1909 and 2015. The prevention of iodine deficiency disorders (IDDs) in the WHO EMR countries is currently under control without significant side effects. Mild to severe IDDs exist in some countries of the Middle East, due to lack of effective iodine supplementation program, but the Islamic Republic of Iran, Jordan, Bahrain and Tunisia have achieved the goal of universal salt iodization. Overall, despite enormous efforts to control IDDs, still IDD remains a serious public health problem in some countries of the region, requiring urgent control and prevention measures.

Synergistic Effects of Resistin and Visfatin as Adipocyte Derived Hormones on Telomerase Gene Expression in AGS Gastric Cancer Cell Line.

Recently suggested that adipocytokines may play a role in pathogenesis and progression of certain cancers, especially in gastric cancer. The previous study showed Resistin and Visfatin, as adipocyte derived hormones, separately increases telomerase (hTERT) gene, the aim of this study is investigating synergic effects of Resistin and Visfatin on telomerase gene expression, in AGS gastric cancer cell line. In this study, human gastric cancer AGS cell line was selected. After stimulation with increasing concentrations of Resistin and Visfatin recombinant proteins for 24 and 48 hours, cell proliferation was assessed by XTT assay. In order to investigate the telomerase gene expression affected by these proteins, total RNA was extracted, cDNA was synthesized, and expression of hTERT mRNA was carried out by real-time reverse transcription polymerase chain reaction. After Resistin and Visfatin, recombinant proteins treatment was increased the gastric cell line proliferation and expression of Human Telomerase Reverse Transcriptase (hTERT), but co-stimulation with Resistin and Visfatin showed greater inducible effects on cell proliferation and telomerase gene expression in comparison with the stimulatory effect of the individual hormone. This study has shown Resistin, and Visfatin synergistically increased gastric cancer cell proliferation and enhanced the telomerase gene expression. These data showed that these two hormones in gastric cancer tissue could cooperatively accelerate cancer cell growth via enhancing the telomerase expression as a cancer gene.

A Brief Review on The Molecular Basis of Medullary Thyroid Carcinoma.

Approximately 5-10% of all thyroid cancers are medullary thyroid carcinomas (MTC). MTC is mainly sporadic in nature, but 20-30% of cases are hereditary. Genetic testing for hereditary MTC is very important for the patient and his family, but the patients must be receiving appropriate genetic counseling. About 98% of patients with hereditary MTC have germline mutations in exons 10, 11, 13, 14, 15, 16 and intron 16 of the REarrangement during transfection (RET) proto-oncogene, but the etiology of the more frequent sporadic form of MTC (sMTC) is not well understood. Recently, it has been reported that apparently sporadic MTC may involve point mutations in BRAF and RAS genes, with an overall prevalence of almost 10%. Also alteration and abnormal expression of miRNA has been described in MTC. In this review, we attempted to mention some mutations and molecular changes in sporadic and hereditary MTC pathogenesis.

H-point curve isolation method for determination of catechol in complex unknown mixtures.

In this work, the combination of H-point curve isolation method (HPCIM) and H-point standard additions method (HPSAM) was used for determination of catechol in the presence of phenolic interferents. Spectrophotometric multivariate calibration data constructed by successive standard additions of an analyte in an unknown matrix was used by the method. A cumulative spectrum for interferents in sample was extracted by HPCIM and then HPSAM is used for determination of the catechol concentration by obtained cumulative interferents spectrum. The method was tested with simulated data set. The spectrum obtained from applying HPCIM to the simulated data well agrees with the cumulative spectra of the interferents. The method was applied to the determination of catechol in the presence of highly overlapping interferents in synthetic ternary mixtures using spectrophotometric data. Moreover, the proposed method was successfully used for determination of catechol in real complicated matrices of tea and urine samples. Percent recoveries were between 95.4 and 113.6.

Evaluation of humoral and cellular immune responses against HSV-1 using genetic immunization by filamentous phage particles: a comparative approach to conventional DNA vaccine.

Phage display is based on expressing peptides as a fusion to one of the phage coat proteins. To date, many vaccine researches have been conducted to display immunogenic peptides or mimotopes of various pathogens and tumors on the surface of filamentous bacteriophages. In recent years as a new approach to application of phages, recombinant bacteriophage lambda particles were used as DNA delivery vehicles to mammalian cells. In this study, recombinant filamentous phage whole particles were used for vaccination of mice. BALB/c mice were inoculated with filamentous phage particles containing expression cassette of Herpes simplex virus 1 (HSV-1) glycoprotein D that has essential roles in the virus attachment and entry. Both humoral and cellular immune responses were measured in the immunized mice and compared to conventional DNA vaccination. A dose-response relationship was observed in both arms of immune responses induced by recombinant filamentous phage inoculation. The results were similar to those from DNA vaccination. Filamentous phages can be considered as suitable alternative candidate vaccines because of easier and more cost-effective production and purification over plasmid DNA or bacteriophage lambda particles.