Protective effects of anti-CfaB-EtpA-LTB IgY antibody against adherence and toxicity of enterotoxigenic Escherichia coli (ETEC).

AIM: Production of IgY antibodies against CfaB-EtpA-LTB (CEL) chimeric protein and evaluation of its protective effects against enterotoxigenic Escherichia coli (ETEC) by in vivo and in vitro investigation. METHODS AND RESULTS: Indirect ELISA and immunoblotting methods were applied to assess the immunogenicity and specificity of IgYs and also to evaluate the efficacy of IgYs in binding prevention and neutralizing the heat-labile (LT) toxin of ETEC bacteria. The results indicated that the anti-CEL IgY at a concentration of 2 mg ml-1 could decrease the bacterial adhesion to HT-29 cells by 74% compared to the control group.At a concentration of 750 µg ml-1, the IgY antibody managed to neutralize the disruptive LT toxin effect on the Y1 cell line. At a concentration of 2 mg ml-1, 81% reduction was observed in the fluid accumulation in the ileal loop assay. CONCLUSION: According to our findings, passive immunotherapy with anti-CEL IgY can prevent bacterial colonization and toxicity, thus facilitating in controlling the enteric diseases caused by ETEC infection.

Effect of Acupressure on Dynamic Balance in Elderly Women: A Randomized Controlled Trial.

BACKGROUND: Balance disorders are common in the elderly and are a major cause of falls. This study aimed to determine the effect of acupressure on dynamic balance in elderly women. METHODS: This randomized controlled clinical trial was conducted on 72 elderly women in Qazvin, Iran. The intervention group received rotary massage using the thumb at the pressure points for 4 weeks, 3 times a week for 20 minutes each session. Dynamic balance in both groups was measured before, 2 and 4 weeks after the intervention using timed up and go test and the step test. Data were analyzed using two way repeated measures ANOVA. RESULTS: The mean age of participants was 67.34 ± 6.30 with a range of 60 to 80 years old. The results showed statistically significant improvement in the dynamic balance quantified by timed up and go test (%Δ = 26.53) and step test for the right (%Δ = 35.22) and left (Δ% = 32.62) legs (p < .001). However, in the control group, no significant change was observed in the dynamic balance after completion of the program. CONCLUSION: The results support that acupressure therapy can be an effective, safe, and inexpensive method to improve the dynamic balance and maintain maximum autonomy of the elderly.

Effects of Benson's relaxation technique on occupational stress in midwives.

PURPOSE: To examine the effect of Benson's relaxation technique on occupational stress in midwives working in a Labor and Delivery (L&D) unit. METHODS: This pre- and post-quasi-experimental study involved 65 midwives with a minimum 1 year of experience using convenience sampling. After training, the participants performed Benson's relaxation technique twice a day for 4 weeks. RESULTS: Occupational stress was measured using standard questionnaires of occupational stress. Data were analyzed using the Statistical Package for Social Sciences software. Statistical analysis was performed using the Kolmogorov-Smirnov goodness-of-fit test, Student's t-test, and Wilcoxon signed rank test. CONCLUSION: This study demonstrated that Benson's relaxation technique may be effective in reducing occupational stress among midwives in L&D units.

Systematic solution for multi-model control approaches in nonlinear dynamic systems based on the s-gap metric.

This paper proposes a systematic approach for optimizing the distribution of local models in multi-model control systems (MMCS) to enhance overall robustness. While existing literature discusses this method for linear parameter varying (LPV) and uncertain linear time-invariant (LTI) systems, significant limitations persist in addressing nonlinear dynamic systems. Robust control tools like the gap metric and generalized stability margin (GSM) have limited effectiveness in analyzing the robustness of nonlinear feedback systems. To address these challenges, novel concepts of the gap metric and GSM are introduced to determine central operating points (COPs) within local operating areas (LOAs) across the total operating area (TOA). These COPs guide the extraction of affine disturbance local models (ADLMs). Additionally, an optimization problem based on the s-gap metric and GSM is presented to optimize COPs placement and LOAs boundaries. Challenges such as non-monotonic behavior of the cost function and complexity arising from the s-gap metric formulation necessitate novel solution methods. To address these, constraints are applied to the cost function, and a novel discrete optimization approach is introduced. Finally, theoretical findings are applied to the Duffing system, pH neutralization process, and continuous stirred tank reactor (CSTR) plant to evaluate the proposed method's effectiveness. This comprehensive validation across different systems underscores the versatility and practical utility of the proposed approach.

The Effect of Sex Counseling Based on (Permission, Limited Information, Specific Suggestions, Intensive Therapy) Model on Sexual Satisfaction in Women with Cyclic Mastalgia: A Randomized Controlled Clinical Trial.

BACKGROUND: More than half of the population of women suffer from cyclic mastalgia which can interfere with women's sexual function and affect their sexual satisfaction. The current study was conducted to determine the effect of sexual counseling on sexual satisfaction in women with cyclic mastalgia. MATERIALS AND METHODS: This randomized controlled trial study was performed on 81 women with cyclic mastalgia. The subjects were randomly divided into two groups of intervention (n = 40) and control (n = 41). Intervention was performed as Permission, Limited information, Specific suggestions, Intensive therapy (PLISSIT) sex counseling in four sessions for a maximum of 90 min in the intervention group. The demographic checklist and Index of Sexual Satisfaction (ISS) were used for data collection. Follow-up was performed 1 and 3 months after the intervention. The obtained data were analyzed using repeated-measures test. RESULTS: The intervention and control groups were in good balance in terms of demographic characteristics and sexual satisfaction scores prior to the intervention and no statistically significant differences were observed. There was a statistically significant increase in the mean (SD) score of female sexual satisfaction in the intervention group: 93 (12.52), 101.15 (7.70),101.37 (5.31), (F (1,39) = 27.4, p < 0.001). We also observed a decrease in the mean (SD) score of sexual satisfaction in the control group: 93.39 (13.12), 90.68 (8.41), 90.85 (6.57), (F (1,40) = 11.9, p < 0.001) 1 and 3 months following the intervention. CONCLUSIONS: This study revealed that individual counseling by PLISSIT sex counseling could lead to improvement in sexual satisfaction index in women with cyclic breast pain.

The effects of musical stimulation on the level of consciousness among patients with head trauma hospitalized in intensive care units: A randomized control trial.

BACKGROUND: Improvement in the level of consciousness (LOC) is considered as an indicator of recovery among patients with head trauma (HT). musical stimulation is a simple noninvasive intervention with potential positive effects on LOC. This study evaluated the effects of musical stimulation on LOC among patients with HT hospitalized in intensive care unit. METHODS: This clinical trial was conducted in 2018-2019. Fifty-four patients with HT were purposively and consecutively recruited from two trauma intensive care units in Qazvin, Iran, and randomly allocated to a control (n = 27) and an intervention (n = 27) group. Participants in the intervention group received fifteen-minute musical stimulation once daily for seven consecutive days using an MP3 player and a headphone for their counterparts, the headphones were silent for 15 min without receiving any musical stimulation once daily for seven consecutive days. A demographic questionnaire, the Glasgow Coma Scale, and the Richmond Agitation-Sedation Scale were used for data collection. LOC was daily assessed before and after each musical stimulation session. The SPSS program (v. 23.0) was used for data analysis at a significance level of less than 0.05. FINDINGS: There were significant between-group differences respecting the posttest mean score of LOC in the third, fourth, fifth, sixth, and seventh days of the study intervention (P < 0.05)., the posttest mean score of LOC in the intervention group significantly increased in the intervention group (P < 0.0001), while it did not significantly change in the control group (P > 0.05). CONCLUSION: musical stimulation is effective in significantly improving LOC among hospitalized patients with HT. Therefore, it can be used as a non-expensive noninvasive intervention to improve treatment outcomes among these patients.

Caregiver burden and coping strategies in caregivers of older patients with stroke.

BACKGROUND: Coping strategies play a key role in modulating the physical and psychological burden on caregivers of stroke patients. The present study aimed to determine the relationship between the severity of burden of care and coping strategies amongst a sample of Iranian caregivers of older stroke patients. It also aimed to examine the differences of coping strategies used by male and female caregivers. METHODS: A total of 110 caregivers of older patients who previously had a stroke participated in this descriptive and cross-sectional study. The Zarit Burden Interview and Lazarus coping strategies questionnaires were used for data collection. Questionnaires were completed by the caregivers, who were selected using convenience sampling. The collected data were analyzed using Pearson's correlations and independent t-tests. RESULTS: The mean age of participants was 32.09 ± 8.70 years. The majority of the caregivers sampled reported mild to moderate (n = 74, 67.3%) burden. The most commonly used coping strategies reported were positive reappraisal and seeking social support. Results of the independent t-test showed that male caregivers used the positive reappraisal strategy (t(110) = 2.76; p = 0.007) and accepting responsibility (t(110) = 2.26; p = 0.026) significantly more than female caregivers. Pearson's correlations showed a significant positive correlation between caregiver burden and emotional-focused strategies, including escaping (r = 0.245, p = 0.010) and distancing (r = 0.204, p = 0.032). CONCLUSIONS: Caregivers with higher burden of care used more negative coping strategies, such as escape-avoidance and distancing. In order to encourage caregivers to utilize effective coping skills, appropriate programs should be designed and implemented to support caregivers. Use of effective coping skills to reduce the level of personal burden can improve caregiver physical health and psychological well-being.

The study of the relationship between parenting styles and risk-taking in adolescents in only-child families in Qazvin city.

OBJECTIVES: Risk-taking reasons in adolescents are divided into four cognitive, emotional, socio-environmental, and family factors. Structure, composition, and size of family as well as parenting styles effect on the development of creative abilities, transmitting cultural and social values, and the amount of adolescent risk-taking. The present study aimed to evaluate the tendency toward high-risk behaviors based on ways of interacting with children in only-child families. METHODS: This research is a descriptive analytical study. The research population was only-child adolescents and one of their parents who referred to health centers in Qazvin city to receive healthcare. The sampling has been conducted in census method. The data collection tools were adolescents' risk-taking questionnaires and Baumrind Parenting style Inventory which were completed by adolescents and one parent, respectively. The questionnaires were completed in health centers of Qazvin City, and the sampling was conducted since February to September 2018. The SPSS version 24 was used to analyze the data. RESULTS: One hundred and seventeen adolescents aged between 13 and 19 years together with one of their parents participated in this study. The majority of the mothers were housewives (62.9%) and fathers were either employees or self-employed (76.9%). Authoritative parenting style was the most dominant parenting style amongst parents (93%), and the majority of the samples (78%) had the least amount of risk. The average risk-taking score of adolescents was 23.3 ± 61.29 and the highest risk-taking behavior was dangerous driving (12.83). Risk-taking amount was negatively correlated with authoritative parenting style (r = -0.20, p = 0.28), while having direct and meaningful correlation with the permissive style (r = 0.20, p = 0.02). CONCLUSION: The authoritative parenting style in only-child families has been a dominant trend that justifies the intimate parent-children relationships and decreases the risk-taking amount of adolescents. Therefore, parents are suggested to focus on increasing their relationship with their adolescents, rather than reducing their family size.

Effect of Perineal Massage with Ostrich Oil on the Episiotomy and Lacerations in Nulliparous Women: A Randomized Controlled Clinical Trial.

BACKGROUND: Perineal lacerations resulting from vaginal delivery may cause short and long complications, which lead to some problems in women after the delivery. Ostrich oil is safe for use in skincare and beauty products. The aim of this study was to examine the effect of perineal massage with Ostrich oil on the episiotomy and lacerations in nulliparous women. MATERIALS AND METHODS: This single-blind randomized controlled trial was conducted on 77 nulliparous women referred to Razi Hospital in Qazvin (Iran) from May to December 2018. After screening of potential participants, 80 out of 105 pregnant women were selected by convenience sampling and were assigned into the intervention and control groups by block randomization technique. In the intervention group, participants received a perineal massage with Ostrich oil in the active phase and the second stage of labor. The rates of episiotomy and perineal laceration were compared between the two groups. Data were analyzed using Chi-square, t-test and Mann-Whitney. RESULTS: Perineal massage with Ostrich oil in the intervention group significantly decreased the rate of episiotomy compared to the control group (χ2 = 18.32, df = 1, p < 0.001). However, there was no statistically significant difference in perineal lacerations between the two groups. CONCLUSIONS: The results revealed that perineal massage with Ostrich oil could be recommended as an effective, safe, and inexpensive method to improve the rate of episiotomy in vaginal delivery. Perineal massage can be performed by midwives in the first and second stages of labor.

The effect of early change of skin graft dressing on pain and anxiety among burn patients: a two-group randomized controlled clinical trial.

Burn is one of the injuries causing enormous pain among the patients, and the treatment procedure poses great anxiety. This study was designed to determine the effect of early change of skin graft on the pain and anxiety of the patients. MATERIALS AND METHODS: This clinical trial study was accomplished on 64 burn patients at Burn Center of Qazvin University of Medical Sciences in 2018. Convenience sampling was used to select the participants who were then randomly assigned into intervention and control groups. In the intervention group, the graft and donor site dressing was changed one day (early change) after the surgery, while it was done after three days for the control group, both in the same way. The researchers assessed the burn pain anxiety of the patients with BSPAS (Burn Specific Pain Anxiety Scale) and the pain intensity with VAS (Visual Analogue Scale). The data were fed into SPSS 21, and then Chi-square and independent t-test were calculated. RESULTS: The average ages of the patients in the intervention and control groups were respectively 40.4±14.3 and 36.8±13.8. The percentage of burn was 12.1 in the intervention groups and 14.5 in the control group. Statistical analysis using Chi-Square revealed no significant differences between the two groups in the contextual variables (P>0.05). Pain intensity was 4±1.8 in the intervention group and it was 6±1.9 in the control group showing a moderate pain in the former group and severe pain in the control group (P<0.001). Furthermore, it was found that the anxiety level in the control group (46.8±11.2) was significantly greater than that of the intervention group (33.6±11.3) (P<0.001). CONCLUSION: Given that early change of skin graft and donor dressing has a positive effect on decreasing the amount of pain and anxiety, it is recommended to change the dressing in 24 hours after the surgery.

Application of Censored Quantile Regression to Determine Overall Survival Related Factors in Breast Cancer.

BACKGROUND: The occurrence and the mortality related to breast cancer (BC) in Iranian female population has increased over time. Although there are many studies on BC and related risk factors, however, the epidemiological aspects of this melanoma in Iranian females are uncertain. Therefore, the aim of this study was to determine the relationship between demographical and clinical factors on the shape of overall survival (OS) distribution in patients with BC. METHODS: This historical cohort study was carried out using data from 522 participants with BC. Data were gathered from medical records of these patients admitted to Mahdieh Oncology Center of Hamadan Province, western Iran, from January 2000 to August 2011. Kaplan-Meier estimator was used to estimate the survival rates and, censored quantile regression (CQR) to provide in-depth insight in the multivariable association between prognosis factors and survival rates. RESULTS: Patients' follow-up ranged from around 3 to 197 months. One-, three-, and five-year survival rates were 90%, 73% and 62.5%, respectively. Results of CQR model showed that change in the age at diagnosis, number of involved lymph nodes and tumor size could significantly change the median and some other quantiles of OS. CONCLUSIONS: This study, confirm the importance of early detection of BC and usefulness of CQR because of possible changes in distribution family of survival time.