Examining the performance of responding to the Khoy earthquake 2022, challenges, strengths, and lessons learned: thematic analysis.

OBJECTIVE: Disasters in developing countries result in higher human and financial losses compared to global standards, with the death rate being 12 times higher than that of developed countries. Many experts attribute the failures in disaster management to the lack of a system for documenting and analyzing disaster management functions and not leveraging the experiences and lessons learned. This study employed a qualitative data collection approach, utilizing semi-structured interviews with managers, deputies, members of operational teams, and individuals affected by the disaster in the area. This research aims to explore the challenges, strengths, and lessons learned from the response to the Khoy earthquake in Iran. RESULTS: After conducting 40 interviews and achieving data saturation, we extracted experiences and lessons learned to investigate the performance of responsible organizations in the 2022 Khoy earthquake. The obtained data were categorized into 8 categories and 39 sub-categories. These categories encompassed warning and calling forces, disaster assessment, disaster commanding, emergency housing, supply and distribution of items, organization, and guidance of public participation and charities, psychological support, logistics operations, monitoring, evaluation, documentation, information dissemination, and media management. Planners and operational managers can use the findings to review and revise their action and prevention plans.

Refractive surgical approaches to keratoconus: A systematic review and network meta-analysis.

Advancements in diagnostic methods and surgical techniques for keratoconus (KC) have increased non-invasive treatment options. Successful surgical planning for KC involves a combination of clinical science, empirical evidence, and surgical expertise. Assessment of disease progression is crucial, and halting the progression should be the focus if it is progressive. While surgeons used to rely on experience alone to decide the surgical method, comparing the network of primary factors, such as visual acuity, across studies can help them choose the most appropriate treatments for each patient and achieve optimal outcomes. Meticulous tabulation methods facilitate interpretation, highlighting the importance of selecting the correct surgical and rehabilitation approach based on each patient's condition and stage of the disease. We detail the outcomes of a comprehensive network meta-analysis comparing the effectiveness of various combined therapeutic refractive treatments for KC at identical stages of the disease, spanning 4 distinct follow-up intervals. Additionally, the comprehensive analysis suggests that for corneas with optimal best corrected visual acuity (BCVA) preoperatively (classified as regular), combining phakic intraocular lenses with intracorneal ring segments (ICRS) and corneal cross-linking (CXL) could offer the best therapeutic approach provided the disease stage does not exceed stage 3. For irregular corneas, although initial follow-ups show a significant difference in BCVA with surface ablation, longer-term follow-ups recommend combining surface ablation with ICRS and CXL, especially at higher stages.

Investigating health and treatment measures during the Arbaeen procession 2022: A qualitative study.

AIMS: The Arbaeen procession is one of the largest religious gatherings in which tens of millions of people participate every year. The presence of many people in this religious gathering highlights the necessity of planning to reduce incidents related to pilgrims in the field of health and to ensure their timely access to health and treatment services. The current research was conducted with the aim of investigating and analyzing the health field in the Arbaeen procession of 2022. METHODOLOGY: This was a qualitative study, in which in-depth and semistructured interviews were conducted. The target population comprised healthcare policymakers, managers, and providers of the Arbaeen procession in 2022. The interview and data collection guide were developed using the World Health Organization's recommendations. Data collection was continued till data saturation. Directed content analysis was used to analyze the data. Different strategies were applied to increase the validity and reliability of the results of this study. FINDING: Data saturation was reached after 33 interviews. In total, eight main topics were identified, including follow-up of disease and trauma, promotion of public health, education and health system, cooperation and coordination in the field of health, information and communication management, response operations, support and resource management, and security and safety. CONCLUSION: Essential health issues in Arbaeen procession were identified in this research, which may be considered as an evidence-based guide for planners, planners, and executive managers of this religious community. The findings of this research may be used in other marches and public gatherings.

Morpho-molecular study of entomopathogenic fungi associated with citrus orchard pests in Northern Iran.

Entomopathogenic fungi play a significant role in regulating insect populations in nature and have potential applications in pest management strategies in different regions. Citrus spp. are among the important horticultural products in northern Iran, and the orchards are affected by different insect pests, especially mealybugs. This study aimed to isolate and identify entomopathogenic fungi associated with citrus orchard pests in northern Iran, focusing on Akanthomyces and Lecanicillium species on mealybugs. Through the samples collected from different regions within Guilan province, 12 fungal isolates were collected and identified based on the combination of morphological characteristics and molecular data. Akanthomyces lecanii, A. muscarius, Engyodontium rectidentatum, Lecanicillium aphanocladii and Lecanicillium rasoulzarei sp. nov. were identified. Of these, A. muscarius on Lepidosaphes sp., E. rectidentatum on Coccidae, and L. aphanocladii on Tetranychus urticae are reported as new fungal-host records from Iran. Moreover, a new species, Lecanicillium rasoulzarei, is illustrated, described, and compared with closely related species.

Survival of gastric cancer patients in Iran: a systematic review and meta-analysis.

Aim: This study aimed to estimate the survival rates among Iranian gastric cancer patients and to evaluate if the survival has improved during the last three decades. Background: Gastric cancer is one of the most common cancers in Iran with high mortality. Methods: A systematic review and meta-analysis of all published studies addressing gastric cancer survival in Iran was performed. International databases of Scopus, Web of Science, PubMed, and Iranian databases were included in the study. The study included databases from their inception till February 2022. Due to the inherent heterogeneity, we used a random effect model to pool the survivals in three categories of one, three, and five-year survivals. Results: Thirty-three studies with total cases of 17,207 were included in the study. The overall (pooled) one, three, and five-year survivals were estimated as 58.9% (95% CI: 0.52, 0.66), 29.9% (95% CI: 0.25, 0.35), and 18.2% (95% CI: 0.15, 0.23), respectively. Results of subgroup analysis for the calendar years of study showed that the one, three, and five-year survival rates increased during the last three decades but the results were not statistically significant. There was the disparity in survival based on geographic distribution. Conclusion: The results of our study which has pooled many studies for a long period of time clearly indicate that the survival rates of gastric cancer patients have improved. As the improvement of survival may be due to many factors, more studies is needed to understand the dynamic behind this improvement.

Lifestyle assessment in individuals with spinal cord injuries caused by accidents and disasters in qualitative studies published from 1990 to 2020: A meta-synthesis of qualitative study.

Background and Aims: As a debilitating disorder, spinal cord injuries (SCIs) can bring about a range of physical, psychological, and social consequences in individuals and even have effects on their lifestyle indicators. The present study was thus to reflect on lifestyles among people with SCIs developing from accidents and disasters. Methods: Using a meta-synthesis of qualitative research, all articles recruiting qualitative methods to examine patients with SCIs, published from 1990 to 2020, were retrieved by the researchers, good at the Persian and English languages, from the databases of ScienceDirect, MD Consult, Pedro, ProQuest, PubMed, SID, MedLib, Magiran, Scopus, Google Scholar, Iranmedex, the Cochran Library, CINAHL, and Blackwell, tapping the keywords of "spinal cord injury, SCI, manmade disaster, natural disaster, content analysis, concept analysis, thematic analysis, lifestyle, quality of life, QoL, grounded theory, meta-synthesis, mixed-methods research, historical research, ethnography, and phenomenology" in both languages for their inclusion in this study and further analyses. Results: With reference to the inclusion criteria, 18 articles were extracted, and after all 10 studies in line with the research topic were reviewed and analyzed. Ultimately, six main themes, namely, compromise, self-reliance, income-generating activities, mental status, inability, and issues of sexuality were extracted, demonstrating their importance to individuals suffering from SCIs. Conclusion: During the initial stages following SCIs, the abilities to engage in participatory practices and individual's power of decision-making diminish because of physical, social, psychological, and environmental constraints. It was accordingly recommended to have a holistic perspective and respect all aspects of life in individuals with SCIs.

Structural Elements and Requirements in Forming Prehospital Health Response Teams in Response to Chemical, Biological, Radiation, and Nuclear Incidents (CBRN), a Comparative Review Study.

One of the important indicators of increasing the capacity of the health system and the chances of survival of patients and injured immediately after chemical, biological, radiation and nuclear (CBRN) accidents is rapid access to medical services. Establishing prehospital health response teams is one of the main strategies to improve the capacity and ability to respond to unusual events. The aim of this study was to investigate the factors influencing the formation of rapid response teams in the field of health in response to chemical, biological, radiation and nuclear accidents (CBRN EDMRT). In this study, the comparative review method was used. The study period was from November 1, 2021 to March 2022. Forming and deploying rapid health response teams based on an extensive multi-step search and keywords in multiple databases such as PubMed, CINHAL, Blackwell, Iranmedex, SID, Cochrane Database of Systematic Reviews, Google Scholar, Scopus Also, the websites of the Ministry of Health and the responsible organizations in different countries and the proposed structure were done by international institutions and sites. After accessing the resources and documents, the process of analysis and comparison of different team structures was performed. After the initial search, the structure and required elements of their teams were extracted. According to published articles and texts, 10 teams from the International Atomic Energy Agency (IAEA), the US Centers for Disease Control and Prevention (CDC), the US Department of Homeland Security, and the North Atlantic Treaty Organization (NATO), Australia, the British Public Health Organization, and the Japanese Red Cross were compared. Team requirements, population distribution, type of accident, level of team activity and training, equipment required by the team after the accident, according to which, each country/organization should consider the above factors to design and establish the structure of CBRN EDMRT to take. A study should be conducted to design a comprehensive and evidence-based structure.

Effect of motor skills development on psychological and social traits of students of mazandaran province during the covid-19 pandemics.

Nowadays, the covid 19 pandemics are challenging all students. The present study aimed to investigate whether motor skill development affects students' psychological and social traits during the covid 19 pandemics. The present study's population consisted of all students aged 9-17 years in the three grades of the elementary, middle, and high school in Mazandaran province in the academic year 2020-2021, which corresponded to approximately 534 thousand students. We used a simple random sampling to determine the sample size because Iranian schools were closed. In this study, we selected 15 individuals for each of the experimental and control groups. Due to some students dropping out or leaving the practice, the samples comprised 42 girls and 45 boys in the control group and 41 girls and 43 boys in the experimental group. To collect data, we used the Standard Student Social Skills Questionnaire by Garsham and Elliott (1990), Cooper-Smith Self-Esteem Questionnaire, and Children's Depression Scale Short Form (CDS-A). We conducted the experimental group for 36 sessions, i.e., three months and three sessions per week, and each session lasted 30-45 min, depending on the quarantine conditions on the 19th day. To analyze the data, we used a two-way analysis of variance and the Scheffe post hoc test. The results showed that all groups had lower scores in psychological traits than those in the pretest. However, no significant difference was found between groups (P. < 0.05), and this effect was not significant in social traits (05/0 < P.). We also suggest that school principals and health care professionals use this study to design guidelines for creating a healthy environment and developing health-oriented educational programs to improve students' quality of life and health.

The emerging epidemic of inflammatory bowel disease in Asia and Iran by 2035: A modeling study.

BACKGROUND: The projection studies are imperative to satisfy demands for health care systems and proper response to the public health problems such as inflammatory bowel disease (IBD). METHODS: To accomplish this, we established an illness-death model based on available data to project the future prevalence of IBD in Asia, Iran in particular, separately from 2017 to 2035. We applied two deterministic and stochastic approaches. RESULTS: In 2035, as compared to 2020, we expected a 2.5-fold rise in prevalence for Iran with 69 thousand cases, a 2.3-fold increment for North Africa and the Middle East with 220 thousand cases, quadrupling of the prevalence for India with 2.2 million cases, a 1.5-fold increase for East Asia region with 4.5 million cases, and a 1.6-fold elevation in prevalence for high-income Asia-Pacific and Southeast Asia regions with 183 and 199 thousand cases respectively. CONCLUSIONS: Our results showed an emerging epidemic for the prevalence of IBD in Asia regions and/or countries. Hence, we suggest the need for immediate action to control this increasing trend in Asia and Iran. However, we were virtually unable to use information about age groups, gender, and other factors influencing the evolution of IBD in our model due to lack of access to reliable data.

Perception of just culture and its association with work-related psychosocial factors in an Iranian industrial setting: Implications for prevention of errors.

BACKGROUND: A just culture is one in which the reporting of errors and near misses is supported without fear of retribution. The relationship of just culture and psychosocial factors at work has not been explored sufficiently in the literature. OBJECTIVE: To investigate the perception of just culture and its association with socio-demographic and work-related psychosocial factors among 302 employees in an industrial setting in Iran. METHODS: Just culture was assessed using the Just Culture Assessment Tool, and the Copenhagen Psychosocial Questionnaire was used for evaluation of psychosocial work factors (including influence at work, meaning of work, commitment to the workplace, predictability, rewards, quality of leadership, social support from supervisors, trust, and justice and respect). Data were analysed using t test, analysis of variance (ANOVA), and general linear regression analysis. RESULTS: The results indicated that the employees had a fairly positive view on their organisation's just culture, though there were some areas such as trust and balance that needed further attention. The psychosocial issues (particularly commitment to the workplace, meaning of work, social support from supervisors, and rewards) were not adequate from the employees' perspective. Predictability, rewards, and quality of leadership, were the significant psychosocial predictors of just culture in a multivariate regression model. CONCLUSIONS: The findings highlight the areas that need to be considered to improve the experience of organisational just culture, which is important from the point of view of prevention of safety errors and incidents.

Description of the inflammatory bowel disease natural history in Tehran province, Iran: Mixed panel approaches.

AIM: Description of the inflammatory bowel disease natural history in Tehran province. BACKGROUND: Inflammatory bowel disease (IBD) is a non-homogeneous disorder with an unpredictable natural history that impairs a patient's quality of life over the course of their life. As a result, providing evidence for efficient patient management is critical. METHODS: In this case series study, 198 IBD patients who were visited in our clinic at least three times routinely from Oct 2015 to May 2020 were included. Then, two panel-based approaches, the Multi-State Model (MSM) and random-effect ordered logistic, were used to deduce the clinical course of IBD, which included remission, mild, moderate to severe, and surgical states. RESULTS: For ulcerative colitis (UC), women had a slightly poorer condition for remission but better for moderate to severe and a faster transition from moderate to severe to mild (HR=1.490, 95% CI: 1.02-2.16) compared to men. For Crohn's disease (CD), they had a better condition for remission but a slightly poorer condition for the severe state and higher transition from mild to moderate to severe (HR=1.221, 95% CI: 0.471-3.22) than men. Oral 5-ASA had better efficacy in people with remission and/or mild states but not for those with moderate to severe states, especially in CD (mild to moderate to serve, HR=1.526, 95% CI: 0.59-3.89). Immunosuppressive drugs were better for patients with lower disease severity, especially with UC (mild to remission, HR=1.258, 95% CI: 0.75-2.09). CONCLUSION: Panel approaches have the potential efficacy to tackle the unpredictable clinical course of IBD (UC/CD). Hence, we highly recommend that our findings be included into the Iranian routine clinical environment of IBD and/or that related studies be conducted in Iran and other regions to gain a better understanding of the natural history of IBD.

Synthesis and evaluation of in vitro cytotoxic effects of triazol/spiroindolinequinazolinedione, triazol/indolin-3-thiosemicarbazone and triazol/thiazol-indolin-2-one conjugates.

PURPOSE: Cancer as one of the major diseases with high mortality rates threats human life in the world. Subsequently, the design new potent anticancer agents has attracted much attention in the area of synthetic and medicinal chemistry. In this study, new triazol-linked spiroindolinequinazolinone, thiazol-oxindole and oxindole-thiosemicarbazone conjugates were synthesized and evaluated for their in vitro cytotoxic activity toward different cancer lines. METHODS: Some new triazol-linked oxindoles and spirooxindoles conjugates were synthesized. The synthesized compounds were tested for their in vitro cytotoxic activity toward cancer lines including A375, PC3, LNCaP, MDA MB231 and normal cells HDF (human dermal fibroblast). RESULTS: Among all synthesized compounds, the triazol-linked oxindol-thiosemicarbazone conjugate 10b showed the highest cytotoxic activity against different cancer cells. By using quantitative real time PCR (qRT-PCR), it was found that 10b is able to induce apoptosis by alteration of Bax, Bcl2 balance (i.e. by up regulation of Bax and down regulation of Bcl-2 mRNA expression levels). The DAPI staining was used to show the death of cancer cells in the presence of 10b. Interestingly, 10b suppressed the migration of LNCaP cancer cells by up-regulation of epithelial markers (E-cadherin) and down-regulation of mesenchymal markers (vimentin). CONCLUSION: Our findings revealed that the compound 10b may be a new potent candidate with multiple biological activities to design therapeutic agents against different cancers. Synthesis and evaluation of in vitro cytotoxic effects of triazol/spiroindolinequinazolinedione, triazol/indolin-3-thiosemicarbazone and triazol/thiazol-indolin-2-one conjugates.

Seizure Prediction Model in Acute Tramadol Poisoning; a Derivation and Validation study.

INTRODUCTION: Seizure is a common complication of tramadol poisoning and predicting it will help clinicians in preventing seizure and better management of patients. This study aimed to develop and validate a prediction model to assess the risk of seizure in acute tramadol poisoning. METHODS: This retrospective observational study was conducted on 909 patients with acute tramadol poisoning in Baharloo Hospital, Tehran, Iran, (2015-2019). Several available demographic, clinical, and para-clinical characteristics were considered as potential predictors of seizure and extracted from clinical records. The data were split into derivation and validation sets (70/30 split) via random sampling. Derivation set was used to develop a multivariable logistic regression model. The model was tested on the validation set and its performance was assessed with receiver operating characteristic (ROC) curve. RESULTS: The mean (standard deviation (SD)) of patients' age was 23.75 (7.47) years and 683 (75.1%) of them were male. Seizures occurred in 541 (60%) patients.  Univariate analysis indicated that sex, pulse rate (PR), arterial blood Carbone dioxide pressure (PCO2), Glasgow Coma Scale (GCS), blood bicarbonate level, pH, and serum sodium level could predict the chance of seizure in acute tramadol poisoning. The final model in derivation set consisted of sex, PR, GCS, pH, and blood bicarbonate level. The model showed good accuracy on the validation set with an area under the ROC curve of 0.77 (95% CI: 0.67-0.87). CONCLUSION: Representation of this model as a decision tree could help clinicians to identify high-risk patients with tramadol poisoning-induced seizure and in decision-making at triage of emergency departments in hospitals.

Estimating transition probability of different states of type 2 diabetes and its associated factors using Markov model.

AIMS: Type 2 diabetes is a chronic metabolic disorder and one of the most common non-contagious diseases which is on the rise all over the world. The present study aims to assess the trend of change in fasting blood sugar (FBS) and factors associated with the progression and regression of type 2 diabetes. Moreover, this study estimates transition intensities and transition probabilities among various states using the multi-state Markov model. METHODS: In this study Multi-Ethnic Study of Atherosclerosis (MESA) dataset, from a longitudinal study, was used. The study, at the beginning, included 6814 individuals who were followed during the five phases of the study. FBS, serving as the criterion to assess the progression of diabetes, was classified into four states including (a) normal (FBS<100mg/dl), (b) impaired fasting glucose I (IFG I) (100mg/dl126mg/dl). A continuous-time Markov process was used to describe the evaluation of disease changes over the four states. The model estimated the mean sojourn time for each state. RESULTS: Based on the results obtained from fitting the Markov model, the transition probability for a normal individual to remain in the same status over a 10-year period was 0.63, while the probability for a person in the diabetes state was 0.40. The mean sojourn time for the normal and diabetic individuals aged 45-84 years was 6.26 and 5.20 respectively. The covariates of age, race, body mass index (BMI), physical activity, waist-to-hip ratio (WHR) and blood pressure, significantly affected the progression and regression of diabetes. CONCLUSION: An increase in physical activity could be the most important factor in the regression of diabetes, while an increase in WHR and BMI could be the most significant factors in progression of the disease.

Fatal methanol poisoning: features of liver histopathology.

Methanol poisoning has become a considerable problem in Iran. Liver can show some features of poisoning after methanol ingestion. Therefore, our concern was to examine liver tissue histopathology in fatal methanol poisoning cases in Iranian population. In this study, 44 cases of fatal methanol poisoning were identified in a year. The histological changes of the liver were reviewed. The most striking features of liver damage by light microscopy were micro-vesicular steatosis, macro-vesicular steatosis, focal hepatocyte necrosis, mild intra-hepatocyte bile stasis, feathery degeneration and hydropic degeneration. Blood and vitreous humor methanol concentrations were examined to confirm the proposed history of methanol poisoning. The majority of cases were men (86.36%). In conclusion, methanol poisoning can cause histological changes in liver tissues. Most importantly in cases with mean blood and vitreous humor methanol levels greater than 127 ± 38.9 mg/dL more than one pathologic features were detected.

Determination of aliphatic amines in water by gas chromatography using headspace solvent microextraction.

The possibility of applying headspace microextraction into a single drop for the determination of amines in aqueous solutions is demonstrated. A 1mul drop of benzyl alcohol containing 2-butanone as an internal standard was suspended from the tip of a micro syringe needle over the headspace of stirred sample solutions for extraction. The drop was then injected directly into a GC. The total chromatographic determination was less than 10min. Optimization of experimental conditions (sampling time, sampling temperature, stirring rate, ionic strength of the solution, concentration of reagents, time of extraction and organic drop volume) with respect to the extraction efficiency were investigated and the linear range and the precision were also examined. Calibration curves yielded good linearity and concentrations down to 2.5ngml(-1) were detectable with R.S.D. values ranging from 6.0 to 12.0%. Finally, the method was successfully applied to the extraction and determination of amines in tap and river water samples. This system represents an inexpensive, fast, simple and precise sample cleanup and preconcentration method for the determination of volatile organic compounds at trace levels.