Effectiveness of a comprehensive tele-empowerment programme on self-care behaviours, uncertainty and readmission of patients with heart failure: protocol for a randomised controlled trial.

INTRODUCTION: Heart failure (HF) as a long-term clinical syndrome is associated with inadequate self-care behaviours, a feeling of uncertainty and frequent hospitalisation. In recent years, empowerment has evolved for improving chronic disease management. Nevertheless, there is a lack of studies investigating remote care interventions such as a tele-empowerment programme in patients with HF. Therefore, this protocol proposes a randomised controlled trial which aims to evaluate the effectiveness of a comprehensive tele-empowerment programme on self-care behaviours, uncertainty and readmission in patients with HF. METHODS AND ANALYSIS: The study is a double-arm and parallel-group randomised controlled trial in which a 10-week intervention, including 6 weeks of a comprehensive tele-empowerment programme and 4 weeks of follow-up, will be compared with usual care. A total of 96 eligible patients with HF will be recruited and randomly assigned to the intervention or control group. The patients in the intervention group will join virtual groups and receive the five-step tele-empowerment programme through the internet. The primary outcomes include self-care behaviours and uncertainty which will be measured with valid instruments at baseline and 10th week. The secondary outcome is the number of patients' hospital readmissions and will be assessed at the end of the study. Descriptive statistics will be used to describe variables. According to the types of variables, appropriate statistical tests including two-sample t-tests, Χ2, analysis of covariance or linear regression will be performed. In addition, standardised intervention effect sizes will be calculated for each outcome. ETHICS AND DISSEMINATION: The trial has been approved by the Research Ethics Committee of School of Nursing and Midwifery & Rehabilitation at Tehran University of Medical Sciences. In this study, written consent will be obtained from all participants. The results will be presented to representative groups and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: Iranian Registry of Clinical Trials (IRCT20100725004443N30).

Introducing a procedure for predicting and reducing tire/road noise using a fast-computing hybrid model.

Prediction and reduction of tire noise are some of the main concerns of tire designers nowadays. Due to tire noise's sophisticated nature, low-noise tire design is like a maze path improbable to achieve without a scientific understanding of the underlying causes. This paper develops a knowledge-based hybrid model, incoherent summation of sounds generated and amplified by texture impact, tread impact, air-pumping, Helmholtz resonance, pipe resonance, horn effect, and air cavity resonance. The required data have been carried out by measuring C1 radial tires' noise levels in a semi-anechoic chamber. The developed model [with about a 1.7 dB(A) error on total noise prediction] presents mechanisms' contributions to the overall sound. The model is substituted with a fast-computing statistical model employing data generated based on Taguchi design. Machine learning methods are implemented for this aim, and the support vector machine provides the most accurate model. The proposed fast-computing hybrid model, developed based on a scientific description of underlying mechanisms, is applicable for noise reduction. The model's sensitivity to 21 tire parameters is analyzed, leading to valuable tips on lower tire noise. The results show the critical role of tread pattern characteristics, especially groove angle, in tire noise.

Prognostic significance of lung diffusion capacity and spirometric parameters in relation to hemodynamic status in heart transplant candidates.

INTRODUCTION: Investigations have described a correlation between the severity of heart failure and the severity of pulmonary function abnormalities. In this study, we investigated the association of resting spirometric parameters, lung diffusion for carbon monoxide (DLCO), and the transfer coefficient (KCO) with hemodynamic variables and outcomes in a cohort of heart transplant candidates. MATERIAL AND METHODS: Between January 2018 and January 2020, a total of 100 patients with advanced heart failure who were scheduled for right heart catheterization (RHC) as a pre-transplant evaluation measure were enrolled. Spirometry and DLCO were performed in all patients within 24 hours of their RHC. All selected patients were followed for a median (IQR) time of 6 (2-12) months. The end points of interest were heart failure-related mortality and a combined event involving HF-related mortality, heart transplantation (HTX), and need for the placement of a left ventricular assist device (LVAD). RESULTS: Among 846 patients scheduled for RHC, a total of 100 patients (25% female) with a mean (SD) age of 38.5 (12.8) were enrolled. There was a significant correlation between FEV1/FVC and CVP (r = -0.22, p = 0.02), PCWP (r = -0.4, p < 0.001), mPAP (r = -0.45, p < 0.001), and PVR (r = -0.32, p = 0.001). The cardiac output correlated with DLCO (r = 0.3, p = 0.008). Spirometry parameters, DLCO parameters, and hemodynamic parameters did not correlate with the combined event. Among the several variables, only PVR had an independent association with the combined event. CONCLUSION: Both mechanical and gas diffusion parameters of the lung were not associated with outcomes in the homogeneous group of heart transplant candidates.

Synthesis of Novel bis-spirooxindoles Catalyzed by Magnetic Cobalt Ferrite Encapsulated MCM-41@MgO as a Solid Base.

AIMS AND OBJECTIVE: Synthesis of novel bis-spirooxindoles was carried out from isatins, two equivalents of malononitrile, and various derivatives of cyclohexanones. BACKGROUND: A facile one-pot and four-component reaction was investigated for the synthesis of novel bisspirooxindoles from different derivatives of isatins, two equivalents of malononitrile and various derivatives of cyclohexanone in the presence of magnetic CoFe2O4@MCM-41@MgO NPS catalyst under mild conditions. MATERIALS AND METHODS: Firstly, the magnetic CoFe2O4@MCM-41@MgO was prepared in three steps. Afterwards, the CoFe2O4@MCM-41@MgO was used as a base catalyst for the one-pot synthesis of bisspirooxindoles. RESULTS AND DISCUSSION: The procedure exhibited several benefits, an excellent yield of products, short reaction times, reusability, and recyclability of the nanocatalyst. CONCLUSION: The structure of nanocatalyst was recognized by FT-IR, XRD, VSM, SEM, BET, and EDX techniques, and the structure of the organic products was determined by melting point, FT-IR, 1H NMR, 13C NMR, Mass spectra, and C.H.N analyses.

The effects of amplitude and stability of circadian rhythm and occupational stress on burnout syndrome and job dissatisfaction among irregular shift working nurses.

AIM: To investigate the relation between the circadian rhythm amplitude and stability, and occupational stress with burnout syndrome and job dissatisfaction among shift working nurses. BACKGROUND: Irregular shift working nurses are prone to burnout syndrome (BS) and job dissatisfaction (JD). circadian rhythm difference and occupational stress might be effective in causing burnout syndrome and dissatisfaction. DESIGN: In total, 684 nurses who worked in four teaching hospitals were selected by stratified random sampling in a cross-sectional design based on STROBE guidelines. METHODS: The data were collected by the Circadian Type Inventory, Job Content Questionnaire, Minnesota Satisfaction Questionnaire and the Maslach Burnout Inventory. Multiple linear regression, one-way ANOVA and independent t test were used for statistical analysis by SPSS v24. RESULTS: About 15% of the nurses suffered from high levels of burnout syndrome. Psychological demand (ß = 0.022, CI 95% = 0.003-0.047 and ß = 0.016, CI 95% = 0.001-0.032) and workplace support (ß = -0.043, CI 95% = -0.097-0.003 and ß = -0.025, CI 95% = -0.046-0.006) were significant predictors of BS and JD. Male nurses reported lower BS and higher JD compared to female nurses. Irregular shift working schedule was also related to a significantly higher odd of BS (p = 0.009) and JD (p = 0.011). Nurses classified as languid experienced significantly more BS and JD than vigorous nurses. CONCLUSION: This study shows that BS and JD were strongly associated with psychological demand and workplace support; and vigorous nurses were less prone to BS and JD, and were more suitable for irregular shift work. RELEVANCE TO CLINICAL PRACTICE: In order to reduce burnout syndrome and job dissatisfaction among irregular shift working nurses, we need to identify the effect of risk factors such as individual differences on the circadian rhythm and job demand which can affect nurses who work in irregular schedules.

Synthesis Characterization and DNA Interaction Studies of a New Zn(II) Complex Containing Different Dinitrogen Aromatic Ligands.

A mononuclear complex of Zn(II), [Zn(DIP)(2) (DMP)] (NO(3))(2)·2H(2)O in which DIP is 4,7-diphenyl-1,10-phenanthroline and DMP is 4,4'-dimethyl-2,2'-bipyridine has been prepared and characterized by (1)HNMR spectroscopy, FT-IR, UV-Vis and elemental analysis techniques. DNA-binding properties of the complex were studied using UV-vis spectra, circular dichroism (CD) spectra, fluorescence, cyclic voltammetry (CV), and viscosity measurements. The results indicate that this zinc(II) complex can intercalate into the stacked base pairs of DNA and compete with the strong intercalator ethidium bromide for the intercalative binding sites.

DNA Interaction Studies of a New Platinum(II) Complex Containing Different Aromatic Dinitrogen Ligands.

A new mononuclear Pt(II) complex, [Pt(DMP)(DIP)]Cl(2).H(2)O, in which DMP is 4,4-dimethyl-2,2-bipyridine and DIP is 4,7-diphenyl-1,10-phenantroline, has been synthesized and characterized by physicochemical and spectroscopic methods. The binding interaction of this complex with calf thymus DNA (CT-DNA) was investigated using fluorimetry, spectrophotometry, circular dichroism, viscosimetry and cyclic voltametry (CV). UV-VIS spectrum showed 4 nm bathochromic shift of the absorption band at 280 nm along with significant hypochromicity for the absorption band of the complex. The intrnisic binding constant (K(b) = 2 × 10(4) M(-1)) is more in keeping with intercalators and suggests this binding mode. The viscosity measurements showed that the complex-DNA interaction can be hydrophobic and confirm intercalation. Moreover, the complex induced detectable changes in the CD spectrum of CT-DNA. The fluorescence studies revealed that the probable quenching mechanism of fluorescence of the complex by CT-DNA is static quenching. The thermodynamic parameters (ΔH > 0 and ΔS > 0) showed that main interaction with hydrogenic forces occurred that is intercalation mode. Also, CV results confirm this mode because, with increasing the CT-DNA concentration, shift to higher potential was observed.