Diabetes-related instrument to assess preventive behaviors among adolescents (DIAPBA): a tool development and psychometric research.

BACKGROUND: Type 2 diabetes is a chronic but preventable disease that is on the rise among adolescents. Evaluating adolescents' behavior and planning to prevent it require a valid and reliable instrument. This study aims at designing a psychometric instrument to measure adolescents' behavior with respect to type-2 diabetes. RESEARCH DESIGN AND METHODS: In this methodological research, 770 students (adolescent boys and girls aged 13-15 years) participated through multistage sampling. The Inclusion criteria were: junior high school students, students' willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by examining the relevant literature and the existing questionnaires as well as considering the research team's comments. The validity of the study was determined through face validity and content validity both quantitatively and qualitatively. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via intraclass consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and Eq. 6.1 were used for data analysis. RESULTS: At first, a list of 47 initial items was designed and compiled, and after by removing similar (10 questions) or inappropriate sentences (12 questions), a draft questionnaire with 25 questions was designed. No items were removed in the face validity phase. Based on exploratory factor analysis, the number of items in the questionnaire was reduced to 20 items and was categorized in five dimensions of stress management, healthy food/healthy diet, unhealthy food/unhealthy diet, high-risk behavior, and self-care. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.70 with ICC = 0.80. CONCLUSION: The questionnaire designed has standard psychometric properties to assess adolescents' behavior with respect to type-2 diabetes prevention. The reliability and the validity of the questionnaire as well as its general structure were confirmed.

Cumulative burden and trajectories of body mass index and blood pressure from childhood and carotid intima-media thickness in young adulthood.

There are significant gaps in understanding of the association between levels and rate of change of body mass index (BMI) and blood pressure (BP) at different ages during childhood and carotid intima-media thickness (CIMT) in adulthood. We investigated the association between trajectories of BMI and BP from childhood to adulthood and adult CIMT among Iranian participants in the Tehran Lipid and Glucose Study (TLGS) cohort. A total of 1334 participants (692 men), from the TLGS cohort (1999-2018) with repeated measurements of BMI and BP (2-6 times) from childhood (3-18 years) to young adulthood (20-40 years) were selected. Trajectory parameters included levels and linear slopes of BMI and BP growth curve models, and cumulative burden defined as the area under those curves (AUC). After adjusting for confounders, AUC of BMI and diastolic blood pressure (DBP) were significantly associated with high CIMT in adulthood, with the standardized odds ratios (OR) and 95% confidence interval (95% CI) of 1.35 (1.12-1.62) and 1.27 (1.01-1.60), respectively. Associations between level-independent slopes of BMI and adult CIMT were significantly positive (ORs: 1.27 to 1.26) during childhood ages (3-18 years). Further, levels of BMI (ORs: 1.23 to 1.29) and DBP (ORs: 1.25 to 1.33) during the ages of 13-18 and 11-17 years, respectively, were significantly associated with CIMT in adulthood (all P < 0.05). The cumulative burden of BMI and DBP was associated with CIMT in adulthood. Adolescence is a crucial period for high CIMT, which has implications for early prevention of atherosclerosis.

Health beliefs on type 2 diabetes: a methodological research for development and psychometric evaluation of "DIABA" (Diabetes-related Instrument to Assess Beliefs of Adolescents) health beliefs on type 2 diabetes.

BACKGROUND: Several reports have shown an increase in the number of type-2 diabetics among adolescents creating an extra burden for this age group. However, there is no instrument assessing adolescents' attitude toward this disease. This study aims at designing a psychometric tool for assessing adolescents' health beliefs regarding type-2 diabetes. RESEARCH DESIGN AND METHODS: In this methodological research, 770 boy and girl adolescents (between 13 and 15) from Tehran participated through multistage sampling. The Inclusion criteria were: junior high school students, students' willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by extensive literature review and the related existing questionnaires, as well as considering the research team's comments. The validity of the questionnaire was determined through face and content validity. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and EQS6.1 were used for data analysis. RESULTS: The pool of questions had 57 items, and by removing similar (23 questions) or inappropriate sentences (8 questions), a draft questionnaire with 26 questions was designed. No items were removed in the face validity phase. Based on the results of CVR and CVI, six items and 4 items in the exploratory factor analysis were removed. Finally, a questionnaire with 16 items in 4 dimensions of perceived self-efficacy, behavioral beliefs, perceived susceptibility and perceived severity was obtained. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.78 and ICC = 0.73. CONCLUSION: The questionnaire designed can be employed as a reliable and valid instrument to assess the psychological perceptions and health beliefs of adolescents with respect to type-2 diabetes.

Assessment of renal function indexes in methamphetamine or tramadol intoxication adults to the emergency departments: a systematic review and meta-analysis.

BACKGROUND: Renal dysfunction is one of the adverse effects observed in methamphetamine (MET) or tramadol abusers. In this study, we aimed to review articles involving intoxication with MET or tramadol to assess the occurrence of renal dysfunction. METHODS: Two researchers systematically searched PubMed, Scopus, Web of Sciences, and Google Scholar databases from 2000 to 2022. All articles that assessed renal function indexes including creatine, Blood Urea Nitrogen (BUN), and Creatine phosphokinase (CPK) in MET and tramadol intoxication at the time of admission in hospitals were included. We applied random effect model with Knapp-Hartung adjustment for meta-analysis using STATA.16 software and reported outcomes with pooled Weighted Mean (WM). RESULTS: Pooled WM for BUN was 29.85 (95% CI, 21.25-38.46) in tramadol intoxication and 31.64(95% CI, 12.71-50.57) in MET intoxication. Pooled WM for creatinine in tramadol and MET intoxication was respectively 1.04 (95% CI, 0.84-1.25) and 1.35 (95% CI, 1.13-1.56). Also, pooled WM for CPK was 397.68(376.42-418.94) in tramadol and 909.87(549.98-1269.76) in MET intoxication. No significance was observed in publication bias and heterogeneity tests. CONCLUSION: Our findings showed that tramadol or MET intoxication is associated with a considerably increased risk of renal dysfunction that may result in organ failure.

Oral Propolis, Nutritional Status and Quality of Life with Chemotherapy for Breast Cancer: A Randomized, Double-Blind Clinical Trial.

Chemotherapy-induced side effects include an impaired nutritional status and reduced quality of life in patients. The contribution of propolis, as a co-adjuvant nutritional supplement in cancer treatment, is suggested due to its functional characteristics and biological activities such as antitumoral activity, DNA protection, free radicals scavenging, and immune stimulation; however, clinical trials to support these effects in cancer patients are necessary. This is a randomized, double-blind, placebo-controlled clinical trial to assess the effect of propolis vs. placebo on the nutritional status and quality of life in patients diagnosed with breast cancer who are receiving chemotherapy (No. IRCT2016062828679N1). A total of 60 patients from the Oncology Clinic at Tohid Hospital, Sanandaj, Iran were randomized to receive propolis (250 mg/two times per day for three months) or a placebo. After three months of intervention, energy intake of patients who received propolis increased significantly compared to placebo group (p = 0.000). The quality of life also showed significant improvements in patients receiving propolis, particularly with regards to emotional functioning (p = 0.03), global QoL functioning (p = 0.04), and financial difficulties (p = 0.01) compared to the control group. Propolis is suggested an adequate and safe therapeutic option to improve the nutritional status and quality of life in patients diagnosed with breast cancer receiving chemotherapy. However, more trials are needed in order to draw robust conclusions with regard to its efficacy in chemotherapy-induced side effects.

Epidemiologic characteristics of orthopedic surgical site infections and under-reporting estimation of registries using capture-recapture analysis.

BACKGROUND: Surgical Site Infections (SSIs) are among the leading causes of the postoperative complications. This study aimed at investigating the epidemiologic characteristics of orthopedic SSIs and estimating the under-reporting of registries using the capture-recapture method. METHODS: This study, which was a registry-based, cross-sectional one, was conducted in six educational hospitals in Tehran during a one-year period, from March, 2017 to March, 2018. The data were collected from two hospital registries (National Nosocomial Infection Surveillance System (NNIS) and Health Information Management database (HIM)). First, all orthopedic SSIs registered in these sources were used to perform capture-recapture (N = 503). Second, 202 samples were randomly selected to assess patients` characteristics. RESULTS: Totally, 76.24% of SSIs were detected post-discharge. Staphylococcus aureus (11.38%) was the most frequently detected bacterium in orthopedic SSIs. The median time between the detection of a SSI and the discharge was 17 days. The results of a study done on 503 SSIs showed that the coverage of NNIS and HIM was 59.95 and 65.17%, respectively. After capture-recapture estimation, it was found that about 221 of orthopedic SSIs were not detected by two sources among six hospitals and the real number of SSIs were estimated to be 623 ± 36.58 (95% CI, 552-695) and under-reporting percentage was 63.32%. CONCLUSION: To recognize the trends of SSIs mortality and morbidity in national level, it is significant to have access to a registry with minimum underestimated data. Therefore, according to the weak coverage of NNIS and HIM among Iranian hospitals, a plan for promoting the national Infection Prevention and Control (IPC) programs and providing updated protocols is recommended.

The effectiveness of intervention based on the transactional model on improving coping efforts and stress moderators in hemodialysis patients in Tehran: a randomized controlled trial.

BACKGROUND: Present study was conducted to determine the effect of training on coping efforts and stress moderators, based on transactional model of Lazarus and Folkman, in hemodialysis patients. METHODS: This is a randomized controlled clinical trial on 116 hemodialysis patients referred to dialysis centers in Tehran from May to August 2018. The patients were assigned to two experimental and control groups using a simple randomization method. The intervention included 6 training sessions in the form of coping efforts and moderators of transactional model. Data were collected before and 3 months after the intervention. Data were analyzed using SPSS 16. RESULTS: After 3 months training intervention, there was significant increase in the intervention group in the mean scores of coping efforts (P < 0.001), moderators and subscales of emotional regulation from 51.18 ± 20.42 to 64.87 ± 13.18 (P < 0.001), dispositional coping style from 45.56 ± 19.45 to 55.84 ± 18.03 and social support from 49.61 ± 20.14 to 55.55 ± 17.35 (P < 0.005). CONCLUSION: The training based on transactional model was successful in the increase of social support, dispositional coping style and emotional regulation in hemodialysis patients. Therefore, Nurses and healthcare providers can use this program to help hemodialysis patients to increase their adaptation to the illness and reduce stress. TRIAL REGISTRATION: IRCT registration number: IRCT20180524039814N1 ; Registration date: 13-08-2018; Registration timing: retrospectively registered: Last update: 13-08-2018.

Development and validation of a knowledge, attitude, and practice questionnaire regarding cardiovascular diseases in an Iranian general population.

BACKGROUND: Studies on knowledge, attitude, and practice (KAP) can be valuable for public health to help to develop targeted educational programs and assess the effectiveness of intervention programs. The purpose of this study was to develop and examine the validity and reliability of a questionnaire on knowledge, attitude, and practice (KAP) regarding cardiovascular diseases (CVDs), their risk factors, and symptoms among an Iranian general population. METHODS: This cross-sectional study was conducted on an Iranian population older than 20 years referred to some of Tehran's healthcare centers. An initial 62-item questionnaire was developed, and the face, content, and construct validities were assessed. RESULTS: In all, 300 adults with a mean age (SD) of 39.79 (12.1) years participated in this study. Based on the results of the content validity, a questionnaire with 30 essential items was designed. Exploratory factor analysis suggested a four-factor subscale with 29 finalized items (CVD-KAP29), and acceptable goodness of fit indices was demonstrated by confirmatory factor analysis. The Cronbach's alpha and McDonald's ω coefficients were higher than 0.60 for all domains except the nutrition and smoking subscales. CONCLUSIONS: Results provided evidence of the validity of the CVD-KAP29 for KAP studies for cardiovascular diseases in the general population.

The national rate of intensive care units-acquired infections, one-year retrospective study in Iran.

BACKGROUND: Hospital-acquired infections (HAIs) in intensive care units (ICUs) are among the avoidable morbidity and mortality causes. This study aimed at investigating the rate of ICU-acquired infections (ICU-AIs) in Iran. METHODS: For the purpose of this multi-center study, the rate of ICU-AIs calculated based on the data collected through Iranian nosocomial infections surveillance system and hospital information system. The data expanded based on 12 months of the year (13,632 records in terms of "hospital-ward-month"), and then, the last observation carried forward method was used to replace the missing data. RESULTS: The mean (standard deviation) age of 52,276 patients with HAIs in the ICUs was 47.37 (30.78) years. The overall rate of ICU-AIs was 96.61 per 1000 patients and 16.82 per 1000 patient-days in Iran's hospitals. The three main HAIs in the general ICUs were ventilator-associated events (VAE), urinary tract infection (UTI), and pneumonia events & lower respiratory tract infection (PNEU & LRI) infections. The three main HAIs in the internal and surgical ICUs were VAE, UTI, and bloodstream infections/surgical site infections (BSI/SSI). The most prevalent HAIs were BSI, PNEU & LRI and eye, ear, nose, throat, or mouth (EENT) infections in the neonatal ICU and PNEU & LRI, VAE, and BSI in the PICU. Device, catheter, and ventilator-associated infections accounted for 60.96, 18.56, and 39.83% of ICU-AIs, respectively. The ventilator-associated infection rate was 26.29 per 1000 ventilator-days. Based on the Pabon Lasso model, the lowest rates of ICU-AIs (66.95 per 1000 patients and 15.19 patient-days) observed in zone III, the efficient area. CONCLUSIONS: HAIs are common in the internal ICU wards. In fact, VAE and ventilator-related infections are more prevalent in Iran. HAIs in the ICUs leads to an increased risk of ICU-related mortality. Therefore, to reduce ICU-AIs, the specific and trained personnel must be responsible for the use of the devices (catheter use and ventilators), avoid over use of catheterization when possible, and remove catheters earlier.

Survival rate in patients with ICU-acquired infections and its related factors in Iran's hospitals.

BACKGROUND: Hospital-acquired infections (HAIs) are a well-known cause of morbidity and mortality in hospitalized patients. This study aimed at investigating the survival rate in patients with ICU-acquired infections (ICU-AIs) and its related factors in Iran's hospitals. METHODS: Data were obtained from the Iranian Nosocomial Infections Surveillance (INIS), which registers all necessary information on the main types of infection from different units of each included hospital. One thousand one hundred thirty-four duplicate cases were removed from the analysis using the variables of name, father's name, age, hospital code, infection code, and bedridden date. From 2016 to 2019, 32,998 patients diagnosed with ICU-AI from about 547 hospitals. All patients were followed up to February 29, 2020. RESULTS: The median age of patients with ICU-AIs was 61 (IQR = 46) years. 45.5, 20.69, 17.63, 12.08, and 4.09% of infections were observed in general, surgical, internal, neonatal and pediatric ICUs, respectively. Acinetobacter (16.52%), E.coli (12.01%), and Klebsiella (9.93%) were the major types of microorganisms. From total, 40.76% of infected patients (13,449 patients) died. The 1, 3, 6-months and overall survival rate was 70, 25.72, 8.21 1.48% in ICU-AI patients, respectively. The overall survival rate was 5.12, 1.34, 0.0, 51.65, and 31.08% for surgical, general, internal, neonatal and pediatric ICU, respectively. Hazard ratio shows a significant relationship between age, hospitalization-infection length, infection type, and microorganism and risk of death in patients with ICU-AI. CONCLUSIONS: Based on the results, it seems that the nosocomial infections surveillance system should be more intelligent. This intelligence should act differently based on related factors such as the age of patients, hospitalization-infection length, infection type, microorganism and type of ward. In other words, this system should be able to dynamically provide the necessary and timely warnings based on the factors affecting the survival rate of infection due to the identification, intervention and measures to prevent the spread of HAIs based on a risk severity system.

Interactive toxicity effect of combined exposure to hematite and amorphous silicon dioxide nanoparticles in human A549 cell line.

The study on the health effects of combined exposure to various contaminants has been recommended by many authors. The objective of the present study was to examine the effects of the co-exposure to hematite and amorphous silicon dioxide (A-SiO2) nanoparticles on the human lung A549 cell line. The A549 cell line was exposed to 10, 50, 100, and 250 µg/ml concentrations of hematite and A-SiO2 nanoparticles both independently and in combination. Their toxicity in both circumstances was investigated by MTT, intracellular reactive oxygen species, cell glutathione content, and mitochondrial membrane potential tests, and the type of interaction was investigated by statistical analysis using Statistical Package for Social Sciences (SPSS, v. 21). Results showed that the independent exposure to either hematite or A-SiO2 compared with the control group produced more toxic effects on the A549 cell line. The toxicity of combined exposure of the nanoparticles was lower compared with independent exposure, and antagonistic interactive effects were detected. The findings of this study could be useful in clarifying the present debate on the health effects of combined exposure of hematite and A-SiO2 nanoparticles. Because of the complexities of combined exposures, further studies of this kind are recommended.

Response to Fluvoxamine in the Obsessive-Compulsive Disorder Patients: Bayesian Ordinal Quantile Regression.

BACKGROUND: Obsessive-Compulsive Disorder (OCD) is a chronic neuropsychiatric disorder associated with unpleasant thoughts or mental images, making the patient repeat physical or mental behaviors to relieve discomfort. 40-60% of patients do not respond to Serotonin Reuptake Inhibitors, including fluvoxamine therapy. INTRODUCTION: The aim of the study is to identify the predictors of fluvoxamine therapy in OCD patients by Bayesian Ordinal Quantile Regression Model. METHODS: This study was performed on 109 patients with OCD. Three methods, including Bayesian ordinal quantile, probit, and logistic regression models, were applied to identify predictors of response to fluvoxamine. The accuracy and weighted kappa were used to evaluate these models. RESULTS: Our result showed that rs3780413 (mean=-0.69, sd=0.39) and cleaning dimension (mean=-0.61, sd=0.20) had reverse effects on response to fluvoxamine therapy in Bayesian ordinal probit and logistic regression models. In the 75th quantile regression model, marital status (mean=1.62, sd=0.47) and family history (mean=1.33, sd=0.61) had a direct effect, and cleaning (mean=-1.10, sd=0.37) and somatic (mean=-0.58, sd=0.27) dimensions had reverse effects on response to fluvoxamine therapy. CONCLUSION: Response to fluvoxamine is a multifactorial problem and can be different in the levels of socio-demographic, genetic, and clinical predictors. Marital status, familial history, cleaning, and somatic dimensions are associated with response to fluvoxamine therapy.

Survival of very preterm infants in the Islamic Republic of Iran: A population-based retrospective cohort study.

Background: Estimation of the survival of very preterm infants is necessary to make decisions and design interventions in order to improve their quality of care. This survey aimed to estimate the survival of very preterm infants born at 23 up to 33 weeks of gestational age (GA) in Iran. Methods: This population-based retrospective cohort study included 8536 infants born before 33 weeks of GA, from March 21st to December 22nd 2013 in Iran. The primary data were extracted from the Iranian national maternal and neonatal registration network (IMAN). All infants who have been discharged alive, followed up by telephone contact up to one year after birth. The Kaplan-Meier and Log-rank tests were performed to estimate survival and to compare survivals, respectively, using SPSS version 26 and R 3.5.2 softwares. Results: The overall survival was estimated at 56.70% (95% C.I: 55.60%-57.80%) at the end of the follow-up period. Total death rate was estimated at 43.30% and was significantly decreased with increasing birth weight (p<0.0001). Survival was increased significantly with increasing GA (p<0.0001), from 5.7% at 23 weeks to 79.6% at 32 weeks. The estimated cumulative proportion of death until the end of the neonatal period had a decreasing trend and then had a steady trend until the end of the follow-up period. The hazard ratio of quadruple or more birth and GA were 1.46 (p=0.021) and 0.83 (p<0.001), respectively. Conclusion: The overall estimated survival of very preterm infants was not high. Even with modern perinatal technology and care, early deaths of very preterm infants were still common.

Additive toxicity of Co-exposure to pristine multi-walled carbon nanotubes and benzo α pyrene in lung cells.

The Mixture exposure to pristine multi-walled carbon nanotubes (P-MWCNTs) and polycyclic aromatic hydrocarbons (PAHs) such as benzo α pyrene (BaP) in the environment is inevitable. Assessment toxicity of P-MWCNTs and BaP individually may not provide sufficient toxicological information. The objective of this work is to investigate the combined toxicity of P-MWCNTs and BaP in human epithelial lung cells (A549). The physico-chemical properties of P-MWCNTs were determined suing analytical instruments. The toxicity of P-MWCNTs and BaP on A549 lung cells individually or combined were assessed. For toxicity assessment, cell viability, ROS generation, oxidative DNA damage, and apoptosis experiments were conducted. The results of this study demonstrated that P-MWCNTs and BaP individually reduced cell viability in A549 lung cells, and oxidative stress was as the possible mechanism of cytotoxicity. The co-exposure to P-MWCNTs and BaP enhanced the cytotoxicity compared to exposure to P-MWCNTs and BaP individually, but not statistically significant. The two-factorial analysis demonstrated an additive toxicity interaction for co-exposure to P-MWCNTs and BaP. The complicated toxicity interaction among BaP with fibers and metal impurities of P-MWCNTS could be probable reasons for additive toxicity interaction. Results of this study could be helpful as the basis for future studies and risk assessment of co-exposure to MWCNTs and PAHs.

Effectiveness of a health intervention based on WHO food safety manual in Iran.

BACKGROUND: Food safety manual was developed by the World Health Organization (WHO) to train professionals to reduce the burden of foodborne diseases as a global strategy. The present pioneering research aimed to explore the effectiveness of an intervention based on the manual of five keys to safer food by WHO in enhancing the knowledge, attitude and behavior of Iranian Female Community Health Volunteers (FCHVs). METHODS: In the present quasi-experimental research, FCHVs (n = 125) were selected and assigned to two groups, an intervention and a control. A modified version of the questionnaire based on WHO manual was used to measure knowledge, attitude and behavior of the sample. The questionnaire was first completed at the outset of the study (pre-test) and then once again in 2 months of the intervention (post-test). Face and content validity of the questionnaire was tested and confirmed. Cronbach's alpha was used to test the reliability of the questionnaire along with the test-retest method of testing reliability. The data entered SPSS16 for statistical analysis. To this aim, Chi-squared test, dependent and independent samples T-test, ANOVA and ANCOVA were run. Partial population attributable risks were calculated and corresponding 95% confidence intervals (95% CIs) were estimated using a bootstrap method. RESULTS: The two groups showed no statistically significant difference in the pretest (p > .05). In the post-test, the mean scores for all variables was higher in the intervention group than the control, and this difference between the two research groups was statistically significant (p < .001). When the volunteers were adjusted for age and experience in healthcare centers, the mean scores were significantly higher in the intervention group than the control (p < .001). CONCLUSION: It was revealed in the present study that the educational intervention based on five keys to food safety manual by WHO managed to improve participants' knowledge, attitude and behavior. Translation of the target guideline in future can be a great help to researchers in prospective research. TRIAL REGISTRATION: Retrospectively registered: Iranian Registry of Clinical Trials IRCT20160822029485N4, at 2020-03-16.

Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties.

BACKGROUND: This article aims to provide a description of conceptual dimensions and psychometric properties of the tools of oral and dental health literacy. METHODS: Two authors in this study conducted electronic searches in the Medline (via PubMed), and Embase databases to find relevant articles from 1990 to present day. Evaluation of the tools was carried out in two parts; general evaluation of the tools using skills introduced by Sørensen et al., and qualitative assessment of psychometric properties using COSMIN checklist. RESULTS: After reviewing 1839 articles on oral and dental health literacy and evaluating 33 full text articles for eligibility, 21 articles entered the study. The sample size varied from 20 to 1405 subjects and the items of each tool ranged from 11 to 99 items. Of the 21 tools examined, 16 tools were evaluated for word recognition. For the studies examined, the evaluation of COSMIN scores was often fair or good. Of the 21 tools examined, 9 tools at least in one dimension were in the category of "poor", 19 tools were in the category of "fair", 20 tools were in the category of "good", and 4 tools were in the category of "excellent" in at least one dimension. CONCLUSION: The findings of this study showed that some aspects of oral and dental health literacy are being ignored in the existing tools. Therefore, the authors of present study emphasize on the necessity to design and develop a comprehensive tool and take into account two characteristics of simplicity and briefness for international use.

Antagonistic effect of co-exposure to short-multiwalled carbon nanotubes and benzo[a]pyrene in human lung cells (A549).

In theenvironment, co-exposure to short-multiwalled carbon nanotubes (S-MWCNTs) and polycyclic aromatic compounds (PAHs) has been reported. In the co-exposure condition, the adsorption of PAHs onto MWCNTs may reduce PAHs toxic effect. The objective of this study was to investigate the cytotoxicity of S-MWCNTs and benzo[a]pyrene (B[a]P) individually, and in combination in human lung cell lines (A549). The adsorption of B[a]P onto MWCNTs was measured spectrometrically. In vitro toxicity was assessed through cell viability, reactive oxygen species (ROS) generation, apoptosis, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) generation experiments. The S-MWCNTs demonstrated cytotoxicity through the generation of ROS, apoptosis, and 8-OHdG in A549 cells. Co-exposure to S-MWCNTs and B[a]P demonstrated a significant reduction in ROS generation and apoptosis compared with the sum of their separate toxic effects at the same concentrations. Decreasing the bioavailability of B[a]P by MWCNT interaction is the probable reason for the antagonistic effects of the co-exposure condition. The findings of this study will contribute to a better understanding of the health effects of co-exposures to air pollutants and could be a starting point for modifying future health risk assessments.

Investigation of the effect of magnetite iron oxide particles size on cytotoxicity in A549 cell line.

INTRODUCTION: Magnetite as iron oxide is widely used in various industries, in the pharmaceutical industry in particular where it is used for its magnetic properties. The environmental and occupational exposure to airborne nanoparticles and microparticles of iron oxide compounds have been reported. Since authors have reported contradictory results, the objective of this study was to investigate the effect of particles' size in their toxicities. METHODS: The human cell line A549 was exposed with magnetite iron oxide in two size categories of micro (≥5 µm) and nano (<100 nm), with four concentrations of 10, 50, 100, and 250 µg/ml at two time periods of 24 and 72 h. The cell viability, reactive oxygen species (ROS), changes in mitochondrial membrane potential, and incidence of apoptosis were studied. RESULTS: Nano and micro magnetite particles demonstrated diverse toxicity effects on the A549 cell line at the 24- and 72-h exposure periods; however, the effects produced were time- and concentration-dependent. Nano magnetite particles produced greater cellular toxicities in forms of decreased viabilities at concentration exposures greater than 50 µg/ml (p < 0.05), along with increased ROS (p < 0.05), decreased cellular membrane potential (p < 0.05), and reduced rate of apoptosis (p < 0.05). DISCUSSION: The results of this study demonstrated that magnetite iron in nano-range sizes had a greater absorbability for the A549 cell line compared to micro sizes, and at the same time, nanoparticles were more toxic than microparticles, demonstrating higher production of ROS and decreased viabilities. Considering the greater toxicity of nanoparticles of magnetite iron in this study, thorough precautionary control measures must be taken before they can be used in various industries.

Is there any difference between the iodine statuses of breast-fed and formula-fed infants and their mothers in an area with iodine sufficiency?

Despite substantial progress in the global elimination of iodine deficiency, lactating mothers and their infants remain susceptible to insufficient iodine intake. This cross-sectional study was conducted to compare iodine statuses of breast-fed and formula-fed infants and their mothers at four randomly selected health care centres in Tehran. Healthy infants <3 months old and their mothers were randomly selected for inclusion in this study. Iodine was measured in urine and breast milk samples from each infant and mother as well as commercially available infant formula. The study included 124 postpartum mothers (29·2 (sd 4·9) years old) and their infants (2·0 (sd 0·23) months old). The iodine concentrations were 50-184 µg/l for infant formula, compared with a median breast milk iodine concentration (BMIC) of 100 µg/l in the exclusive breast-feeding group and 122 µg/l in the partial formula feeding group. The median values for urinary iodine concentration in the exclusive breast-feeding group were 183 µg/l (interquartile range (IQR) 76-285) for infants and 78 µg/l (IQR 42-145) for mothers, compared with 140 µg/l (IQR 68-290) for infants and 87 µg/l (IQR 44-159) for mothers in the formula feeding group. These differences were not statistically significant. After adjustment for BMIC, ANCOVA revealed that feeding type (exclusive breast-feeding v. partial formula feeding) did not significantly affect the infants' or mother's urinary iodine levels. Thus, in an area with iodine sufficiency, there was no difference in the iodine statuses of infants and mothers according to their feeding type.

Can postpartum maternal urinary iodine be used to estimate iodine nutrition status of newborns?

I deficiency can lead to detrimental effects, particularly in neonates and young infants. The aim of this study was to explore whether postpartum maternal urinary I can be used to estimate the I status of newborns. In this cross-sectional study conducted in Tehran, lactating mothers and newborns, within 3-5 d postpartum, were randomly selected. Urine samples were collected from each mother and newborn, and a heel-prick blood sample was obtained from all newborns as part of the routine national newborn screening programme. According to the WHO criteria, median urinary I concentration (UIC) 5 mIU/l was considered as I insufficiency. A total of 147 postpartum women and neonates, aged 27·8 (SD 5·3) years and 4·2 (SD 0·6) d, respectively, completed this study. The median UIC was 68·0 (interquartile range (IQR) 39·4-133·5) and 212·5 (IQR 92·3-307·3) µg/l in postpartum mothers and newborns, respectively. The median neonatal TSH was 1·00 (IQR 0·50-1·70) mIU/l. There was no significant difference in the neonatal UIC and TSH of infants whose mothers had deficient and sufficient urinary I. In the multiple linear regression, neonatal UIC value was associated with maternal urinary I (P=0·048) and parity (P=0·039); a significant association was observed between neonatal TSH and infant sex (P=0·038) and birth weight (P=0·049). The findings of our study demonstrate that, despite postpartum mothers being mildly I deficient, I status of their infants was adequate as assessed by UIC and TSH values. It seems factors other than maternal urinary I may influence the I status in newborns.