COVID-19 vaccines breakthrough infection and adverse reactions in medical students: a nationwide survey in Iran.

Introduction: There are different types of COVID-19 vaccines approved worldwide. Since no national studies focus on vaccine-related adverse reactions and breakthrough cases, this study aimed to investigate the rate of adverse events and COVID-19 infection in medical students in Iran. Methods: This retrospective cohort study included Iranian medical students who received two doses of COVID-19 vaccines. The medical team gathered the demographic characteristics, comorbidities, type of vaccine, adverse events following vaccination, and history of COVID-19 infection data through a phone interview. The frequency of adverse events and breakthrough infection was stratified by vaccine type (ChAdOx1-S, Gam-COVID-Vac, and BIBP-CorV). Results: A total of 3,591 medical students enrolled in this study, of which 57.02% were females, with a mean age of 23.31 + 4.87. A PCR-confirmed and suspicious-for-COVID-19 breakthrough infection rate of 4.51 and 7.02% was detected, respectively. There was no significant relation between breakthrough infection and gender, BMI, blood groups, and comorbidities. However, there was a significant difference in breakthrough infection rate among different types of vaccines (p = 0.001) and history of COVID-19 infection (p = 0.001). A total of 16 participants were hospitalized due to COVID-19 infection after vaccination for reasons such as dyspnea, abnormal imaging, or decreased oxygen saturation. No severe infection or death was observed in the studied population. Conclusion: Vaccination prevented severe COVID-19 infection, although a high breakthrough infection rate was evident among Iranian medical students during the Delta variant's peak. Vaccine effectiveness may be fragile during emerging new variants and in high-exposure settings. Moreover, adverse events are rare, and the benefits of vaccination outweigh the side effects. However, many limitations challenged this study, and the results should be cautious.

Developing a Support Vector Regression (SVR) Model for Prediction of Main and Lateral Bending Angles in Laser Tube Bending Process.

The laser tube bending process (LTBP) is a new and powerful manufacturing method for bending tubes more accurately and economically by eliminating the bending die. The irradiated laser beam creates a local plastic deformation area, and the bending of the tube occurs depending on the magnitude of the heat absorbed by the tube and its material characteristics. The main bending angle and lateral bending angle are the output variables of the LTBP. In this study, the output variables are predicted by support vector regression (SVR) modeling, which is an effective methodology in machine learning. The SVR input data is provided by performing 92 experimental tests determined by the design of the experimental techniques. The measurement results are divided into two sub-datasets: 70% for the training dataset, and 30% for the testing dataset. The inputs of the SVR model are process parameters, which can be listed as the laser power, laser beam diameter, scanning speed, irradiation length, irradiation scheme, and the number of irradiations. Two SVR models are developed for the prediction of the output variables separately. The SVR predictor achieved a mean absolute error of 0.021/0.003, a mean absolute percentage error of 1.485/1.849, a root mean square error of 0.039/0.005, and a determination factor of 93.5/90.8% for the main/lateral bending angle. Accordingly, the SVR models prove the possibility of applying SVR to the prediction of the main bending angle and lateral bending angle in LTBP with quite an acceptable accuracy.

Prevalence of postpartum depression in women amid the COVID-19 pandemic: A systematic review and meta-analysis.

COVID-19 outbreaks appear to be related to exacerbation of psychological problems such as depression and anxiety in high-risk population such as pregnant women and the postpartum period due to stress and life-threatening illnesses. The aim of this study was to evaluate the prevalence of postpartum depression (PPD) during COVID-19. This study protocol is registered in PROSPERO with CRD42021278425 code. Data sources including Google Scholar, ISC, Magiran, Scopus, PubMed, Embase, and Web of Science and reference list of included articles were used to identify related studies. Observational studies that reported the prevalence of PPD in both Persian and English during COVID-19 between January 20, 2020 and August 31, 2021 were included. Data were collected and analyzed with a random effects model for meta-analysis. In this study, 671 initial articles were identified and after removing duplicates, 454 studies were screened and finally 24 studies entered the meta-analysis stage. According to this study results PPD based on Edinburgh Postnatal Depression Scale (EPDS) ≥9, EPDS ≥10, EPDS ≥11, EPDS ≥12, EPDS ≥13, Postpartum Depression Screening Scale-Short Form (PDSS-SF) ≥17 and total prevalence was reported 12% (95% confidence interval [CI] = 0.07-17, I2  = 97%), 27% (95% CI = 15-39, I2  = 99%), 44% (95% CI = 40-49, I2  = 0.0%), 27% (95% CI = 0.06-49, I2  = 97.4%), 28% (95% CI = 18-39, I2  = 98.5%), 37% (95% CI = 32-42), 28% (95% CI = 23-33, I2  = 98.5%). The findings of this study showed that the prevalence of PPD in women is relatively high during COVID-19. Therefore, considering the psychological consequences of the COVID-19 pandemic and the importance of pregnancy and the postpartum period in terms of the emergence of mental disorders, especially depression, it seems necessary to perform interventions and physical and psychological support.

Time Management Behaviors and Emotional Intelligence in Head Nurses in Emergency and Intensive Care Units.

BACKGROUND: Time management is of particular importance in nursing. One of the most effective variables associated with time management is emotional intelligence (EI). This study assessed the relationship between time management and EI and the level of EI and time management skills in head nurses in emergency and intensive care units. METHODS: A cross-sectional study was conducted on all head nurses in the emergency and intensive care units of nine educational hospitals at Isfahan University of Medical Sciences in Iran in 2015 using Bradberry-Greaves' EI and Macan's Time Management Questionnaires. RESULTS: Participants' total time management score was (104.15 ± 6.98); total EI score was (128 ± 15.80). There was no significant relationship between overall EI and time management skills. There was a significant relationship between age and the emotional self-awareness dimension of EI (p = .027) and the mechanics dimension of time management (p = .037), and between work experience and overall time management skills (p = .049) and the mechanics dimension of time management (p = .038). CONCLUSIONS: Specific EI and time management skills may help head nurses to cope with the challenges they face, which may improve the quality of nursing care. Nursing leaders should consider the importance of time management and EI in increasing motivation and satisfaction of nursing staff and improving quality of care.

Complications in Patients with Cardiac Penetrating Trauma.

BACKGROUND: Cardiac penetrating trauma is a medical emergency that mostly affects young people. Based on the type of injury and associated complications, it can present as a surgical challenge and can lead to mortality. OBJECTIVE: The aim of this study is to evaluate the complications of penetrating heart trauma among patients referred to Shahid Madani Hospital. METHODS: In this retrospective descriptive study, the data of penetrating cardiac trauma patients referred to Shahid Madani hospital, Karaj, Tehran, from 2016-2019, were investigated. Information, including age, sex, cause of trauma, traumatized area and complications, was extracted and recorded in a data collection form. The data were evaluated statistically using SPSS v18. RESULTS: A total of 44 patients were included in the study, where the mean age of the patients was 25 years. 73.3% of these patients were men and 26.7% were women. Knife stab wounds were the most prevalent cause of the trauma, present in 93.3% of patients. 73.3% of the patients had cardiac tamponade and 20% had a pneumothorax. The right ventricle was the most common site of the injury in 46.7% of the patients. A mortality rate of 3.4% was reported in this study. CONCLUSION: The results of this study showed that the highest penetrating heart rate trauma occurred among young people, and the most common cause of the trauma was a knife stab. The most common area of the injury was the right ventricular, and cardiac tamponade was the most common complication.

Creep Age Forming of Fiber Metal Laminates: Effects of Process Time and Temperature and Stacking Sequence of Core Material.

Fiber metal laminates (FMLs) are a type of hybrid materials interlacing composites and metals. In the present work, FMLs with aluminum alloy 6061 as the skin and E-glass fiber-reinforced polypropylene (PP) as the core material are fabricated and formed by the creep age forming (CAF) process. The effects of time and temperature as the process parameters and thickness and stacking sequences of composites layers as the FML parameters are evaluated on the springback of glass-reinforced aluminum laminates (GLARE) FMLs. After the CAF process, the springback of creep age-formed FMLs is calculated. The results show that the FMLs can be successfully formed with the CAF process by considering appropriate time and temperature. In addition, the stacking sequence of composite layers can affect the springback behavior of FMLs significantly.

Determining the relationship between emotional intelligence and interpersonal sensitivity with quality of work life in nurses.

BACKGROUND: Emotional intelligence and interpersonal sensitivity are known as important nursing skills. They have significant role in the promotion of nurses working life and the health care which they provide. The goal of this study was the determination of the relationship between emotional intelligence and interpersonal sensitivity with quality of work life in nurses working in governmental hospitals of Tehran city in 2019. MATERIALS AND METHODS: This investigation was a descriptive-analytical and correlation study which was conducted among 256 nurses working in five governmental hospitals in Tehran. The studied nurses were selected through in access sampling method. The instruments of research included demographic, emotional intelligence, interpersonal sensitivity, and work life quality questionnaires. The analysis of data was done by descriptive and deductive statistics (t-test and Pearson correlation coefficient) and also SPSS. RESULTS: The conditions of emotional intelligence, interpersonal sensitivity, and work life quality of nurses were, in turn, in average, severe, and weak levels. The correlation between emotional intelligence and work life quality of nurses was significant (P ≤ 0.05) and they were positively correlated with each other (r = 0.311). The relationship between interpersonal sensitivity and work life quality of nurses was significant (P ≤ 0.05) and they were negatively correlated with each other (r = -0.43). CONCLUSION: The development of emotional intelligence and sensitivity in reciprocally interpersonal relations of nurses lead to fundamental changes in nurses' attitude toward themselves, their colleagues, patients and their profession and can promote their work life quality. Therefore, these two skills are necessary for nurses and they should be taken into consideration by nursing schools, faculty members, instructors, and nursing managers.

Evaluation of social accountability in hospital managers.

BACKGROUND: Today, hospitals need managers who, in addition to having the necessary skills for management and leadership, are accountable to stakeholders, especially the community. Accordingly, the purpose of this study was to evaluate the social accountability of managers of public and private hospitals in Tehran. MATERIALS AND METHODS: The present study is descriptive-analytical and cross-sectional and was performed on 155 managers of selected public and private hospitals in Tehran. The research tools included a demographic characteristic questionnaire and a researcher-made social accountability questionnaire for managers. Data analysis was performed using descriptive and inferential statistics in SPSS 22 software. RESULTS: The situation of social accountability in the managers of public hospitals was at a weak level and in the managers of private hospitals in Tehran was at a good level. In comparing the status of social accountability and its dimensions in the managers of public hospitals with the managers of private hospitals, the status of social accountability in the dimensions of human resource management, quality improvement, executive management, and overall social accountability were significantly different from each other (P ≤ 0.05). However, in terms of governance, the status of social accountability of public hospital managers was not significantly different from private hospitals (P ≥ 0.05). Overall, the results of social accountability in private hospitals were better than in public hospitals. CONCLUSION: The social response status of managers in private hospitals was better than public ones. Lack of attention of managers to social accountability affects the quality of other educational, health, and medical services. This fact raises the need for managers to pay more attention to the issue of social accountability.

An Analytical Comparison of Knowledge, Attitudes, and Practices Regarding HIV/AIDS Among Medical and Non-Medical Students in Iran.

BACKGROUND AND OBJECTIVES: Young people are the main group at risk of HIV/AIDS due to factors such as curiosity, peer pressure, lack of knowledge and skills, unsafe sexual behaviors, and drug abuse. The present study was conducted to compare the knowledge, attitudes, and practices regarding HIV/AIDS among medical and non-medical students in Iran. METHODS: This cross-sectional descriptive-analytical study was conducted on a population consisting of the students of Shahid Beheshti University (SBU) and Shahid Beheshti University of Medical Sciences (SBMU). A total of 303 students were randomly selected from the two universities. Data were collected using a researcher-made HIV/AIDS knowledge, attitude, and practice questionnaire. Data were then analyzed using the independent t-test, Mann-Whitney's U-test, the ANOVA, and the Kruskal-Wallis test in SPSS-18. P<0.05 was set as the level of significance for all the tests. FINDINGS: The frequencies of marital status, education, smoking, alcohol and psychotropic substance use, employment status, and source of information differed significantly between the medical and non-medical students. There was a significant difference between the two groups regarding knowledge (P<0.001) and practice (P=0.019) regarding HIV/AIDS. Meanwhile, there was no significant difference between the two groups in terms of their attitude toward HIV/AIDS (P=0.503). The results of the ANOVA revealed a significant correlation between marital status and practice (P=0.022), education and attitude (P=0.004), and smoking and knowledge (P=0.008) among the medical students. Meanwhile, there was no significant difference between the demographic variables and knowledge, attitudes and practices regarding HIV/AIDS among the non-medical students (P>0.005). CONCLUSION: The present findings showed that designing and developing appropriate educational programs, offered through group media, scientific seminars, courses, lectures, and group discussions, can be effective in enhancing the students' knowledge and changing their attitudes and should be incorporated into healthcare programs.

Staff perspectives on the relationship between knowledge management and social capital with organizational health in selected educational hospitals in Tehran.

INTRODUCTION: Knowledge management enhances efficiency, empowers employees, and enhances organizational health. Social capital provides a good basis for more productive human resources, and training hospitals also play a key role in the health-care system. The purpose of this study was to determine the relationship between knowledge management and social capital with organizational health in selected educational hospitals of Tehran in 2018. METHODS: This analytical cross-sectional study was performed on 310 medical staff of hospitals using proportional sampling method. The data gathering tools consisted of three standard questionnaires of knowledge management, social capital, and organizational health. Data were analyzed using descriptive and inferential statistics using SPSS version 22 software. RESULTS: Most participants in this study were male (8/66%) and in the age group 31-36 years. The mean of knowledge management and organizational health were 3.43 and 3.49, respectively. There is a significant direct relationship between knowledge management components and organizational health. Moreover, there is a significant but weak direct relationship between knowledge management and social capital with organizational health dimensions (P ≤ 0.05). CONCLUSION: Considering the relationship between knowledge management and social capital with organizational health, enhancing the level of organizational health can help to improve the dimensions of knowledge management and social capital. It is suggested that hospital managers, using knowledge management and social capital components, enhance organizational health so that the hospital is more prepared to adapt to the complexities and changes in the market providing services.

Knowledge, Attitude, and Practice of Emergency Medical Services Staff in Bleeding Control of Trauma Patients; a Cross sectional Study.

INTRODUCTION: External hemorrhage is a leading cause of preventable death due to trauma and Emergency Medical Services (EMS) staff members play a vital role in the frontline of trauma management. This study aimed to assess the knowledge, attitude and practice of EMS staff in bleeding control. METHODS: This knowledge, attitude and practice (KAP) study was conducted to assess the educational needs of EMS staff of Hormozgan province, Iran, regarding the bleeding control of trauma patients, during 2019. The participants were randomly selected and then their knowledge, attitude, and practice in management of hemorrhage and hemorrhagic shock were assessed using two researcher-made scenario-based questionnaires and one checklist. RESULTS: The scores for knowledge of the EMS staff regarding actions during complete amputation, status of injured patients, and medical measures during transfer of injured patients were 3.22 ± 0.68, 2.28 ± 0.83, and 2.29 ± 0.62, respectively. The average participants' attitude scores regarding the fear of bleeding, the importance of bleeding control, and confidence in bleeding control were 2.09±0.56, 2.4±0.58, and 1.76±0.55, respectively. The findings indicated that mean practice score was 1.72 ± 0.46 in capillary hemorrhage control, 1.41 ± 0.25 in venous bleeding control, 1.47 ± 0.25 in arterial bleeding control, and 1.56±0.27 in control of bleeding in the amputee limb. CONCLUSION: The knowledge, attitude, and practice of EMS staff regarding bleeding control were moderate, positive and appropriate, and incomplete, respectively. Since bleeding is a life threatening status and EMS staff skills are critical in this issue, it seems that we need to provide continuous education in this regard.

Statistical modeling, Sobol sensitivity analysis and optimization of single-tip tool geometrical parameters in the cortical bone machining process.

Machining and cutting of cortical bones are very common and important in the field of orthopedic surgeries. Considerable advances in bone machining are obtained by using computer numerical control machines and automatic surgery robots but still, researches are needed to investigate the effects of machining parameters in bone machining. In this article, for the first time, the effect of geometrical parameters of the single-tip tool on cortical bone machining is studied. The machining parameters included in the investigation are rake angle, back rake angle and side cutting edge angle and the response surface methodology is used to analyze the obtained surface quality according to a second-order regression model. The sensitivity of surface quality to the input parameters was measured by applying Sobol sensitivity analysis and the results are optimized by the Derringer algorithm. Finally, the optimum tool is determined as 15° rake angle, -5° back rake angle and 30° side cutting edge angle. Furthermore, the sensitivity of the surface quality to the input parameters is determined as 52% for rake angle, 31% for side cutting edge angle and 17% for back rake angle.

Disaster risk governance in Iran: Document analysis.

BACKGROUND: Disaster risk is a product of a combination of hazard, exposure, and vulnerability. Governance in the health system is a multifaceted sphere, with political, economic, and legal dimensions. Disaster risk governance is an analytical framework employed for assessing the capacity of institutional governance. This study has been conducted to investigate the current status of national strategy documents concerned with disaster risk governance in Iran through document analysis. MATERIALS AND METHODS: The investigated documents were collected through requests from the secretariat and the archives. 102 documents were analyzed. Twelve documents in the domain of accountability, 7 in participation, 9 in state and nonstate actor, 14 in knowledge sharing, 21 in sustainable developments, and 19 documents in integrated risk management were analyzed. The process of analysis included selecting documents and evaluating and analyzing them by content analysis method. RESULTS: Documents coded according to the main areas of policymaking in disaster risk governance were analyzed, and sub-component and related topics were deduced in each domain. The acquired themes include unity of command, trustee, commitment, capacity prosperity, align strategy, information synergy, knowledge enhancement, sustainable security, justice clarity, land use planning, climate change adaptation, environment reform, wisdom, environment, diplomacy, capacity and coherence. CONCLUSIONS: Disaster good governance is strengthened by the trustee, commitment, capacity prosperity, align strategy, and organize. Information synergy and knowledge enhancement are effective in the culture of prevention. Collective wisdom, diplomacy, and capacity coherence raise the alignment of public organizations and the government in the risk management process.

Effect of hydrodynamic parameters on nickel removal rate from wastewater by ion flotation.

This study investigated the effect of hydrodynamic parameters on the nickel ion removal in an oscillating grid flotation cell (OGC) with near ideal hydrodynamic environments. Nickel ion was removed in the OGC at various energy inputs (0-2 W/kg), using two bubble sizes (130 and 820 µm) at three surfactant concentrations (SDS/Ni(II) ratio of 1-3) and three air flow rates (1-3 L/min). The results indicated that the energy input has a considerable effect on the ion flotation kinetics and recovery and it is strongly dependent on the cell types (contact environment) and bubble size. Increasing energy input led to an increase in the nickel removal rate due to an increase in the collision rate for bigger bubbles and an optimum flotation rate for smaller bubbles. Nickel removal rate increased around 80% (1.8 times) with an increase in energy input from 0 to 2 W/kg for both bubble sizes. Increasing air flow rate generally led to an increase in the nickel removal rate. A comparison of the effect of energy input on the nickel removal separation efficiency in two different hydrodynamic environments showed that the isotropic and homogeneous contact environment in the OGC is more appropriate than anisotropic and inhomogeneous turbulence in the mechanical cell for ion removal using ion flotation.

Customers' satisfaction about prehospital emergency medical services in Lorestan, Iran.

INTRODUCTION: Patient's satisfaction with health care in ambulance services is an important quality indicator and a helpful tool for managers of prehospital emergency services. This study aimed to measure patient satisfaction with health provided by prehospital emergency medical services (EMS) in Lorestan, Iran. METHODS: This cross-sectional study was conducted on patients (n=450) transferred by EMS to hospitals of Lorestan University of Medical Sciences in a two-year period (2013-2014). Data collection was performed by patient questionnaire, which is a standard LKFR tool. Validity and reliability of the instrument was confirmed by scientific method. Collected data were analyzed by SPSS Version 19. Descriptive and inferential statistics such as Chi-square, paired-samples t-test, independent-samples t-test, ANOVA, Pearson's product-moment correlation coefficient, and Fisher's exact test were used. RESULTS: One hundred ninety-two (42.8%) and 257 (57.2%) patients were female and male, respectively (mean: 41 years, r: 37-83). Patient satisfaction of the dispatcher was good, and satisfaction level in regards to the technicians' performance, physical situation, and facilities inside the ambulance was moderate. The Wilcoxon test did not show any significant difference between pain severity before and after arriving EMS in the cardiac and respiratory patients (p=0.691), but severity of pain in orthopedic patients after arriving EMS was decreased (p=0.001). Cardiac and respiratory patients had low satisfaction of EMS, and the Chi-square test was significant (p=0.001). Orthopedic patients had the most satisfaction of EMS. CONCLUSION: Generally, patients' satisfaction of EMS was low. Satisfaction with pain relief in orthopedic patients was better than pain relief in cardiac and respiratory patients. It is recommended to take necessary actions to improve the level of patient satisfaction of EMS.