Exploring internet addiction during Covid-19 pandemic: a comparative study considering psychological, social, familial and individual aspects in University students.

Background: Internet addiction causes a variety of social, interpersonal, psychological, and physical issues. We are confronting a worldwide crisis about internet addiction and its effects. Objectives: Utilizing five questionnaires to survey university students during the COVID-19 epidemic, the current study sought to evaluate internet addiction and associated risk variables. Methods: At the University of Medical Sciences in North Iran, a cross-sectional analytical investigation was carried out. The sample was done among 318 students, selected through the random cluster sampling method. Data collection was done during August and September 2021. Results: Based on our findings, the prevalence of internet addiction was 28.9% (92/318). Our results revealed that women are at twice the twice the risk of internet addiction as men (p = 0.028). Students in the medicinal field (p = 0.043; students with a positive history of mental illness in the family) p = 0.001 (and students with a fear of COVID-19) p = 0.002 (recognized in the risk of Internet addiction, thus depression) p < 0.001 (anxiety) p < 0.001 (somatization) p = 0.001 (and psychological distress) p < 0.001 are risk factors for internet addiction. Age, marital status, place of living, total social support, and use of Alcohol/cigarettes are not risk factors for internet addiction. Conclusions: The findings suggest that university students with a fear of COVID-19, depression, anxiety, somatization, psychological distress and a positive history of mental illness in the family, particularly medicinal field students, are at significant risk for Internet addiction.

Natural biomarocmolecule-based antimicrobial hydrogel for rapid wound healing: A review.

Antibacterial hydrogels are a type of hydrogel that is designed to inhibit the growth of bacteria and prevent infections. These hydrogels typically contain antibacterial agents that are either integrated into the polymer network or coated onto the surface of the hydrogel. The antibacterial agents in these hydrogels can work through a variety of mechanisms, such as disrupting bacterial cell walls or inhibiting bacterial enzyme activity. Some examples of antibacterial agents that are commonly used in hydrogels include silver nanoparticles, chitosan, and quaternary ammonium compounds. Antibacterial hydrogels have a wide range of applications, including wound dressings, catheters, and medical implants. They can help to prevent infections, reduce inflammation, and promote tissue healing. In addition, they can be designed with specific properties to suit different applications, such as high mechanical strength or controlled release of antibacterial agents over time. Hydrogel wound dressings have come a long way in recent years, and the future looks very promising for these innovative wound care products. Overall, the future of hydrogel wound dressings is very promising, and we can expect to see continued innovation and advancement in this field in the years to come.

Comparing the Effects of Virtual Reality and Home Chair-Based Exercises on Balance, Daily Living Activities, and Loneliness Among Older Adults With Balance Disorders.

The current quasi-experimental study aimed to compare the effects of virtual reality (VR) and home chair-based (HCB) exercises on balance, daily living activities, and loneliness among older adults (N = 90) with balance disorders living in nursing homes. Participants were assigned to three groups: (a) VR exercises, (b) HCB exercises, and (c) routine nursing home programs. Findings indicated that VR and HCB exercises significantly increased participants' balance and daily living activities compared to routine programs (p < 0.001). However, there was no clinical difference among groups regarding Berg Balance Scale and Barthel Index scores. Main effect of time regarding loneliness mean score (p = 0.991) was not significant among groups. The minimal detectable change pre-set standard for loneliness also showed no significant clinical difference. Exercise had no significant impact on loneliness; however, it had a positive role in improving balance and daily living activities, with no significant difference between VR and HCB exercises. Further studies are recommended to evaluate adherence to such exercises. [Research in Gerontological Nursing, 16(1), 33-42.].

The effectiveness of a motivational text-messaging program for smoking cessation after coronary angioplasty: a quasi-experimental study.

OBJECTIVE: Smoking is an important risk factor of coronary artery stenosis after angioplasty. Therefore, this investigation aimed to determine the effectiveness of a motivational text-messaging program for smoking cessation after coronary angioplasty. This quasi-experimental study was conducted on 100 patients after angioplasty. The patients were divided randomly into two intervention and control groups. The intervention group received 32 text messages about smoking cessation for 2 months. The control group received only routine training. The primary and secondary outcomes were success and self-efficacy in quitting smoking cigarettes, respectively. Both groups filled out the related questionnaires before and after the intervention. The data were analyzed using SPSS software version 22 and Chi-square tests, independent t-test, and paired t-test. P < 0.05 was considered significant. RESULTS: Success in quitting cigarette smoking was significantly higher in the intervention group (n = 29, 61.7%) compared to the control group (n = 2, 4.3%) (p < 0.001). Moreover, after the intervention, the mean score of self-efficacy in the intervention group (11.01 ± 44.75) was significantly higher than the control group (6.51 ± 3.11) and also higher than before the intervention (5.51 ± 2.44) (P˂0.001). The motivational text-messaging program can improve self-efficacy and success in smoking cessation in patients after coronary angioplasty.

The effect of time management education on critical care nurses' prioritization: a randomized clinical trial.

BACKGROUND: Nurses are at the forefront of patient care, and time management skills can increase their ability to make decisions faster. This study aimed to assess the effect of a time management workshop on prioritization and time management skills among nurses of emergency and intensive care units. METHODS: This randomized clinical trial was performed with 215 nurses. The educational intervention about time management was held in the form of a workshop for the intervention group. The time management questionnaire was completed by both groups before, immediately after, and 3 months after the intervention. RESULTS: Most participants were female (n=191, 88%), with a mean age of 31.82 years (range, 22-63 years). Additionally, the participants' work experience ranged from 1 to 30 years (mean±standard deviation, 8.00±7.15 years). After the intervention, the mean score of time management increased significantly in the intervention group, but no significant difference was observed in this regard in the control group. The results also revealed a significant difference between the intervention and control groups regarding the mean score of time management 3 months after the intervention (P<0.001). CONCLUSIONS: Time management training helped nurses adjust the time required to perform and prioritize various tasks.

Psychosocial Experiences of Older Women in the Management of Urinary Incontinence: A Qualitative Study.

Introduction: Urinary incontinence is a prevalent disorder amongst older women. Identifying the psychosocial experiences of older women in disease management can improve the patient care process. Hence, the present study aimed to determine the psychosocial experiences of older women in the management of urinary incontinence. Methods: This qualitative study was conducted using conventional content analysis. The study data were collected via unstructured in-depth face-to-face interviews with 22 older women suffering from urinary incontinence selected via purposive sampling. Sampling and data analysis were done simultaneously and were continued until data saturation. The interviews were recorded, transcribed, and analyzed using the method proposed by Graneheim and Lundman. Results: The results indicated that the older people with urinary incontinence had various psychosocial experiences while living with and managing this disease. Accordingly, four main themes were extracted from the data as follows: "problem incompatibility with the disease," "mental impasse," "facing social restrictions," and "concealment and social escapism." Conclusion: The findings demonstrated that older people with urinary incontinence experienced significant psychosocial pressures while living with this disorder, which affected their psychosocial well-being. Thus, paying attention to these psychosocial experiences while supporting and taking care of these patients can positively impact their psychosocial health and quality of life.

Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial.

BACKGROUND: Deficient balance and fear of falling in elderly people can lead to disturbed daily activities, falling, and finally reduced quality of life. Therefore, evaluation of low-risk methods that might partially improve balance in this group of people is of utmost importance. The present study aimed to investigate the impact of Virtual Reality (VR) exercises based on Xbox Kinect on balance and fear of falling among elderly people. METHODS: This clinical trial was performed on 60 elderly individuals living in nursing homes divided into two groups of control and Xbox. The participants in the intervention group received VR exercises based on Xbox Kinect in form of two 30-45-min sessions held on a weekly basis for 6 weeks. The individuals in the control group, on the other hand, received routine exercises of the nursing homes. The research tools used in this study included a demographic questionnaire, the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, and the Falling Efficacy Scale (FES). RESULTS: The findings of the current study demonstrated that the scores of BBS and TUG test as the indices of balance among elderly people improved significantly in the Xbox group after the intervention (p < 0.001 for both BBS and TUG test). Moreover, the score of fear of falling diminished significantly in the intervention group compared to the control group (p < 0.001). CONCLUSION: According to the results of the present investigation, 6 weeks of VR balance exercises could enhance balance and fear of falling among elderly people living in nursing homes. TRIAL REGISTRATION: Code: IRCT20190727044347N1 , Date: 17-8-2019.

Online class or flipped-jigsaw learning? Which one promotes academic motivation during the COVID-19 pandemic?

BACKGROUND: Due to the progress in COVID-19, education has undergone a huge change all around the world, leading all universities to move towards distance learning. In this context, the majority of instructors tend to make use of the educational methods that maintain and improve students' motivation and, consequently, promote their academic performance. This study aimed to compare the effects of synchronous online class and the combination of flipped and jigsaw methods on students' academic motivation. METHODS: This quasi-experimental study was conducted on 84 BSc nursing students who had entered Shiraz University of Medical Sciences in two different years. One group was educated in a synchronous online class, while the other group was educated using a combination of flipped and jigsaw methods. Both classes were enrolled in online classes due to the COVID-19 pandemic. The participants' academic motivation was evaluated using Harter's Academic Motivation Scale. RESULTS: The results revealed no significant difference in the intrinsic and extrinsic dimensions of academic motivation in the synchronous online class group before and after the intervention. However, a significant increase was observed in the mean scores of academic motivation (p = 0.002) and its intrinsic (p = 0.003) and extrinsic (p = 0.031) dimensions in the flipped-jigsaw method group after the intervention. Moreover, the mean scores of academic motivation (p = 0.007) and its intrinsic (p = 0.038) and extrinsic (p = 0.010) dimensions were significantly higher in the flipped-jigsaw method group compared to the synchronous online class group after the intervention. CONCLUSIONS: Since the COVID-19 pandemic has led educational institutions to use virtual education methods, the combination of flipped and jigsaw methods may improve students' academic motivation in distance learning.

The characteristics that propel Iranian MS students of nursing into self-directed learning: A qualitative research.

BACKGROUND: Rapid scientific progression in today's world has caused a significant decrease in the half-life of knowledge in different scientific fields. An effective way to be up-to-date in this ever changing world is to be a self-directed learner. PURPOSE: This study aimed to explore the characteristics that propel Iranian MSc students of nursing into self-directed learning. METHODS: A qualitative design using conventional content analysis approach was used in this study. Totally, 20 semi-structured interviews were conducted with fourteen MSc nursing students and three instructors from Shiraz University of Medical Sciences selected using purposive sampling. Data collection and analysis were run concurrently and continued until data saturation. RESULTS: Data analysis indicated that self-directed students had various characteristics that motivated them towards learning. These characteristics were categorized into three main themes, including "openness to experience", "motivation to improve", and "socio-professional commitment", and sixteen subthemes. CONCLUSION: The findings showed that some characteristics facilitated and directed the process of self-directed learning and helped the students to attain their learning goals. Since some of these characteristics can be acquired and improved during education, their recognition can provide a foundation for their development in different levels of academic learning, especially in higher education.

Experiences of Urinary Incontinence Management in Older Women: A Qualitative Study.

INTRODUCTION: Older women have various experiences regarding the management of urinary incontinence depending on the societies they live in and their cultural backgrounds. The present study aimed to determine older women's experiences in urinary incontinence management. METHODS: The present qualitative study employed a conventional content analysis approach and was conducted in Iran from 2019 to 2020. In this research, the data were collected through face-to-face unstructured in-depth interviews with 22 older women suffering from urinary incontinence selected via purposeful sampling. The interviews were continued until reaching the data saturation point. Data analysis was performed simultaneously with data collection. The interviews were recorded, transcribed, and analyzed through Graneheim and Lundman style content analysis, and data management was done using the MAXQDA software. In order to achieve the accuracy and validity of the study, the Four-Dimensions Criteria (FDC) by Lincoln and Guba, namely credibility, dependability, conformability, and transformability, were considered and used. RESULTS: This study was conducted on 22 older women suffering from urinary incontinence with the mean age of 66.54 ± 5.76 years. The acquired data were put in four main categories of "resilience" with three subcategories, "change in lifestyle" with six subcategories, "attempt for treatment of the condition" with three subcategories, and "receiving support" with two subcategories. CONCLUSION: The study results indicated that the older women suffering from urinary incontinence were resilient against the condition, had changed their lifestyles to manage the condition, and sought treatment. In addition, receiving support from the family and the society played a significant role in the follow-up and management of the condition. The present study findings can help healthcare team members focus on urinary incontinence, design care programs for older women with this condition, and improve their quality of life. Furthermore, focusing on young and middle-aged women's health, providing them with the necessary training for taking care of the genitourinary system, and raising their awareness for preventing urinary incontinence during old ages can be helpful. Moreover, increasing the healthcare team's sensitivity and following the patients up can help diagnose, manage, and treat the condition before exerting adverse impacts on their quality of life.

Biomechanical asymmetries persist after ACL reconstruction: results of a 2-year study.

PURPOSE: This study was aimed to examine longitudinal (6, 12, 18, 24 months) asymmetries in double-leg landing kinetics and kinematics of subjects with and without unilateral ACLR. METHODS: Three-dimensional kinematic and kinetic parameters of 40 participants (n = 20 post-ACLR, n = 20 healthy) were collected with a motion analysis system and force plate during a drop-landing task, and asymmetry indices were compared between groups. RESULTS: The asymmetry index (AI) in the ACLR group compared to the healthy group decreased from six to 24 months for vertical ground reaction force (vGRF) from 100% to 6.5% and for anterior posterior ground reaction force (a-pGRF) from 155.5% to 7%. Also, the AI decreased for peak hip flexion moment from 74.5% to 17.1%, peak knee flexion moment from 79.0% to 5.8% and peak ankle dorsiflexion moment from 59.3% to 5.9%. As a further matter, the AI decreased for peak hip abduction moment from 67.8% to 5.1%, peak knee adduction moment from 55.7% to 14.8% and peak knee valgus angle from 48.7% to 23.5%. CONCLUSIONS: Results obtained from this longitudinal study showed that ACLR patients still suffer from limb asymmetries during landing tasks, which appear to normalize by 24-monthspost-surgery. This finding can help us to better understand biomechanics of the limbs after ACLR, and design more efficient post-surgery rehabilitation programs. LEVEL OF EVIDENCE: Level III.

The relationship between spiritual well-being and hope, and adherence to treatment regimen in patients with diabetes.

BACKGROUND: Adherence to treatment regimen is one of the behaviors related to diabetes, which has predicted successful control of the disease and reduced its intensity as well as negative consequences. This study aimed to determine the relationship between spiritual well-being and hope, and adherence to treatment regimen in patients with type II diabetes referred to diabetes clinics. METHODS: In this descriptive-correlational study, 227 diabetic patients referred to healthcare centers and diabetes clinics affiliated to Shiraz University of Medical Sciences were selected via cluster sampling (clinics) followed by convenience sampling (patients). The study data were collected using a demographic information form, spiritual well-being scale developed by Ellison and Paloutzian, Herth hope scale, and adherence to treatment regimen questionnaire. Then, the data were entered into the statistical software and were analyzed using descriptive and inferential statistics. RESULTS: The results indicated that most participants had moderate spiritual well-being, high hope, and low adherence to treatment regimen. Additionally, spiritual well-being was directly associated with hope and reversely related to adherence to treatment. A significant reverse correlation was also observed between hope and adherence to treatment. CONCLUSION: Considering the fact that spiritual well-being and hope were reversely associated with adherence to treatment regimen, further studies should be done in this field. Also patients' image of God and their interpretations of being sick might not be appropriate and need correction.

Pattern of Internet Use by Iranian Nursing Students. Facilitators and Barriers.

OBJECTIVES: To evaluate the pattern of internet use and factors that facilitate or dissuade its use among nursing students from a university in Urmia, Iran. METHODS: A cross-sectional, descriptive study was conducted with 162 nursing students selected through simple random sampling. RESULTS: The findings indicated that 49.1% of the students used the internet from 15 to 60 min per day. The principal use of the internet was to search for scientific content in the Web. Factors that facilitated internet use were "ease of use" and "Access to experts to solve problems and answer questions", while the dissuasive factors were "lack of concentration", "cost of internet services", and preference for information provided by professors or available directly in textbooks. Internet use by the students was related with the use of this tool in classroom activities and with English fluency. CONCLUSIONS: Students have an internet use pattern aimed at self-study that should be strengthened with knowledge of English, assignments online, familiarization with the use of electronic databases, and other strategies to motivate them to use this technology with greater frequency.

Anti-histaminic Effects of Resveratrol and Silymarin on Human Gingival Fibroblasts.

Periodontitis as a chronic inflammatory disease leads to the destruction of the supportive tissues of affected teeth. Crosstalk between periodontitis and the host immune system plays a crucial role in the pathogenesis of this disease. Since polyphenol components such as silymarin and resveratrol have anti-bacterial and anti-inflammatory effects on periodontal tissues, the purpose of this study was to investigate the anti-histaminic effects of silymarin and resveratrol on human gingival fibroblasts (HGFs). HGFs were treated with a concentration of silymarin or resveratrol (100 µg/ml) and a combination of these two polyphenols (50/100 or 100/200 µg/ml silymarin/resveratrol). The effect of silymarin and resveratrol on cell viability was assessed by MTT assay. Also, HGFs were treated with silymarin and/or resveratrol and were stimulated by histamine. The levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-α), and tissue plasminogen activator 1 (TPA-1) were assessed by enzyme-linked immunosorbent assay (ELISA). After treatment with silymarin, the viability of fibroblast cells significantly increased, whereas treatment with resveratrol and combinations of these flavonoids (silymarin 50 µg/ml and resveratrol 100 µg/ml) did not have any significant effect on cell viability after 24 h. Treatment with 100/200 µg/ml silymarin/resveratrol significantly decreased the cell viability after 48 h. Resveratrol inhibited histamine-induced IL-6 secretion by HGFs significantly, whereas silymarin showed significant effect on TNF-α. A blend of silymarin and resveratrol displayed more valuable results. In conclusion, combination of resveratrol and silymarin could significantly inhibit inflammatory effects of histamine on cultured HGFs by reduction of IL-6, IL-8, TPA-1, and TNF-α.

Pattern of Internet Use by Iranian Nursing Students. Facilitators and Barriers

Abstract Objective. To evaluate the pattern of internet use and factors that facilitate or dissuade its use among nursing students from a university in Urmia, Iran. Methods. A cross-sectional, descriptive study was conducted with 162 nursing students selected through simple random sampling. Results. The findings indicated that 49.1% of the students used the internet from 15 to 60 min per day. The principal use of the internet was to search for scientific content in the Web. Factors that facilitated internet use were "ease of use" and "Access to experts to solve problems and answer questions", while the dissuasive factors were "lack of concentration", "cost of internet services", and preference for information provided by professors or available directly in textbooks. Internet use by the students was related with the use of this tool in classroom activities and with English fluency. Conclusion. Students have an internet use pattern aimed at self-study that should be strengthened with knowledge of English, assignments online, familiarization with the use of electronic databases, and other strategies to motivate them to use this technology with greater frequency.

Resumen Objetivo. Evaluar el patrón de uso del Internet y los factores que facilitan o disuaden su uso entre los estudiantes de enfermería de una universidad en Urmia, Irán. Métodos. Se realizó un estudio descriptivo de corte transversal en 162 estudiantes de enfermería seleccionados a través de un muestreo aleatorio simple. Resultados. Los hallazgos indicaron que el 49.1 % de los estudiantes usaron Internet de 15 a 60 minutos por día. El principal uso del Internet fue la búsqueda de contenido científico en la Web. Los factores que facilitaron el uso de internet fueron la "facilidad de uso" y el "acceso a expertos para resolver problemas y responder preguntas", mientras que los factores disuasivos fueron la "falta de concentración", el "costo de los servicios de Internet" y la preferencia por la información suministrada por profesores o disponible directamente en los libros. El uso del Internet por los estudiantes estuvo relacionado con empleo de esta herramienta en las actividades del salón de clase y con el dominio del idioma inglés. Conclusión. Los estudiantes tienen un patrón de uso del Internet encaminado al auto-estudio que debe fortalecerse en conocimiento del idioma inglés, asignaturas en línea, familiarización con el uso de bases electrónicas y otras estrategias para motivarlos a usar esta tecnología con mayor frecuencia.

Resumo Objetivo. Avaliar o padrão de uso da Internet e os fatores que facilitam ou dissuadem seu uso entre os estudantes de enfermagem de uma universidade em Urmia, Irã. Métodos. Se realizou um estudo descritivo de corte transversal em 162 estudantesde enfermagem que foram selecionados através de uma amostra aleatória simples. Resultados. As descobertas indicaram que 49.1% dos estudantes usaram Internet de 15 a 60 minutos por dia. O principal uso da Internet foi a busca de conteúdo científico na Web. Os fatores que facilitaram o uso de internet foram a "facilidade de uso" e o "acesso à especialistas para resolver problemas e responder perguntas", enquanto que os fatores dissuasivos foram a "falta de concentração", o "custo dos serviços de Internet" e a preferência pela informação subministrada por professores ou disponíveis diretamente nos livros. O uso da Internet pelos estudantes esteve relacionado com emprego desta ferramenta nas atividades da aula e com o domínio do idioma inglês. Conclusão. Os estudantes têm um padrão de uso da Internet encaminhado ao auto-estudo que deve fortalecer-se em conhecimento do idioma inglês, matérias em linha, familiarização com o uso de bases eletrônicas, e outras estratégias para motivá-los a usar com maior frequência esta tecnologia

The Relationship Between Critical Thinking Skills and Learning Styles and Academic Achievement of Nursing Students.

BACKGROUND: Academic achievement is one of the most important indicators in evaluating education. Various factors are known to affect the academic achievement of students. PURPOSE: This study was performed to assess the relationship between critical thinking skills and learning styles and the academic achievement of nursing students. METHODS: In this cross-sectional study, 139 sophomores to senior-year nursing students were selected using a simple random sampling method. The data were gathered using a three-part questionnaire that included a demographic questionnaire, the Kolb's Learning Style Standard Questionnaire, and the California Critical Thinking Skills Questionnaire. The previous semester's grade point average of the students was considered as a measure of academic achievement. The data were analyzed using descriptive and analytical statistics in SPSS 20. RESULTS: The mean score for critical thinking skills was 6.75 ± 2.16, and the highest and lowest scores among the critical thinking subscales related to the evaluation and analysis subscales, respectively. No relationship between critical thinking and academic achievement was identified. "Diverging" was the most common learning style. The highest mean level of academic achievement was earned by those students who adopted the "accommodating" style of learning. A significant relationship was found between learning style and academic achievement (p < .001). CONCLUSIONS: According to the findings, the critical thinking skills score of students was unacceptably low. Therefore, it is essential to pay more attention to improving critical thinking in academic lesson planning. As a significant relationship was found between learning style and academic achievement, it is suggested that instructors consider the dominant style of each class in lesson planning and use proper teaching methods that take into consideration the dominant style.

Effects of exercise training and supplementation with selenium nanoparticle on T-helper 1 and 2 and cytokine levels in tumor tissue of mice bearing the 4 T1 mammary carcinoma.

OBJECTIVES: Physical exercise decreases the incidence of breast cancer and also improves survival in breast cancer patients. However, the mechanistic basis of these protective effects of exercise is not well known. Changes in tumor cytokines, such as oncostatin-M (OSM), have been associated with modulation of antitumor immune responses in breast cancer. Exercise and antioxidants such as selenium affect both antitumor immune responses as well as tumor cytokine expression. Thus, the aim of this study was to determine the effects of aerobic exercise training (AET) and selenium nanoparticle (SeNP) administration on T-helper 1 and 2 and tumor tissue cytokines in mice bearing the 4 T1 mammary carcinoma. METHODS: We examined the effects of 6 wk of AET and SeNP administration (100 µg three times/wk) on tumor size, concentration of tumor necrosis factor (TNF)-α, interleukin (IL)-6, interferon (IFN)-γ, IL-4 and OSM in tumor tissue and INF-γ and IL-4 in splenocytes of 64 mice bearing the 4 T1 mammary carcinoma. RESULTS: AET increased OSM levels in tumor tissue. Moreover, AET increased levels of TNF-α in tumor tissue, whereas SeNP supplementation decreased IL-4 levels tumor tissue. Also, the combination of AET and SeNP administration decreased tumor volume and increased T-helper 1 cytokines in the splenocytes of tumor-bearing mice. CONCLUSION: These findings suggest that the combination of AET and SeNP supplementation effects antitumor immune responses in splenocytes, whereas AET induced antitumor cytokines, such as OSM and TNF-α in tumor tissue.

The Generation of Hematopoietic Progenitor Cells from Endothelial Cells by Silymarin.

Background: The generation of hematopoietic cells from endothelial cells may determine a novel approach for the production of blood cells. Regenerative functions of Silymarin, a mixture of polyphenolic flavonoids derived from milk thistle, have previously been reported. The purpose of this study was to investigate the direct effect of Silymarin on conversion of endothelial cells to hematopoietic cells. Methods: The effect of Silymarin on CD34, CD45, and vascular endothelial growth factor receptor-2 (VEGFR-2) markers along with all the main hematopoietic lineage markers in human umbilical vein endothelial cells (HUVEC) were investigated by flow cytometry and immunocytochemistry. Results: Treatment of HUVEC cells with Silymarin after 24 hours significantly increased the number of the cells expressing CD34 and CD45 markers. Although the percentage of VEGFR-2 and CD13 was increased, the changes were not statistically significant during 24 hours. No significant expression of the rest of the hematopoietic lineage specific markers was found during this time. Conclusions: Taken together, our preliminary findings demonstrated the potential of Silymarin to switch human umbilical vein endothelial cells into hematopoietic progenitor cells.

The Barriers and Challenges of Applying New Strategies in the Clinical Evaluation of Nursing Students from the Viewpoints of Clinical Teachers.

BACKGROUND: Numerous studies have emphasized the use of new approaches in clinical evaluation. However, there are some challenges and barriers to applying these new approaches. The aim of the present study was to investigate the barriers and challenges of applying new strategies in the clinical evaluation of nursing students from the viewpoints of clinical teachers. MATERIALS AND METHODS: This cross-sectional study was conducted among 151 clinical teachers. A researcher-made questionnaire was used to collect data. The questionnaire was validated using library references and a variety of texts, as well as thorough consulting with 15 clinical teachers. The questionnaire's reliability was approved with a Cronbach's alpha of 78%. Data analysis was conducted using Pearson's correlation coefficient, one-way analysis of variance (ANOVA), and descriptive statistics in SPSS software. RESULTS: The highest score was related to the "students and clinical environment" domain [24.05 (8.10)], and the lowest to the "facilities" domain [13.31 (1.50)]. One-way ANOVA results showed a significant relationship between the mean scores of academic degree and the two domains of "tests" (F = 9.66, p < 0.001) and "facilities" (F = 8.26, p < 0.001). CONCLUSIONS: The implementation of a new approach for evaluating clinical training requires infrastructure and overcoming executive obstacles. Educating students and clinical teachers on new evaluation methods requires their familiarity with the implementation process as well as encouragement and support by their educational institution and administrators.

Lateral Lower Lip Cleft: A Report of a Rare Craniofacial Cleft in a Child.

INTRODUCTION: Craniofacial clefts are unusual. Perioral clefts that are discussed in the literature include cleft lip and cleft palate is more common. Midline mandibular and lower lip clefts are rare. Lateral lower lip cleft with only soft tissue involvement is so rare that it has not been reported until now. CLINICAL REPORT: A 44-month-old girl with a 1-cm-length cleft on the lateral side of the lower lip 8 mm medial to the commissure in lateral one-third of the lower lip referred to the authors' clinic. Repair of the lip consisted of excision of excess mucosa, muscle repair, and 2 z plasties at the level of skin and mucosal layer. CONCLUSION: This is the first report of a new foreseen type of Tessier clefts which may be classified as one of the clefts 15 to 29. Repair of this cleft can be done by soft tissue considerations when there are no underlying hard structure defects.