Evaluating the Health Belief Model Constructs in Adopting the HPV Preventive Behavior.

Objective: Genital warts are a highly contagious sexually transmitted disease. It is caused by the human papillomavirus (HPV), which is transmitted through sexual contact. HPV is the most important cause of cervical cancer. This study aimed to evaluate the health belief model (HBM) constructs in adopting HPV preventive behavior in women referred to comprehensive health centers in Southwestern Iran. Materials and methods: This descriptive-analytical study was performed on 1000 women referring to health centers in Ahvaz during 2019-2020 who were selected via a two-stage stratified random sampling technique. Data were collected using a valid and reliable researcher-made questionnaire based on the HBM. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and regression analysis in SPSS v.18, at a significance level lower than 0.05. Results: Total scale reliability of the tool was very good (α=0.828), as the Intra-cluster correlation coefficient (ICC) was to be 0.86. The mean of preventive behavior using an ANOVA test was significantly different at different levels of education (P <0.05). The mean and standard deviation of knowledge about HPV and preventive behavior was moderate (11.45±3.4). Pearson correlation coefficient showed a significant direct relationship between preventive behavior with awareness, perceived sensitivity, and self-efficacy and inversely related to perceived barriers. Perceived sensitivity (0.01) and self-efficacy (<0.001) were identified as the final predictors of behavior in regression analysis. Conclusion: As the results showed, designing programs to prevent HPV, considering the perceived role of perceived sensitivity and self-efficacy, increases the likelihood of effective interventions.

A supportive randomized clinical trial on Iranian infertile women with the history of infertility treatments dropout following unsuccessful ART cycle/s: A study protocol.

Introduction: Due to high dropout rate of infertility treatments and lack of any intervention for motivating infertile couples to continue treatments, the present study will be conducted with the aim of designing, implementing and determining the effectiveness of the proposed intervention in order to continue infertility treatments. Methods: & Analysis: We will conduct this study in two stages; a review of literature and past studies will be done to identify interventions that have been performed for infertile couples, and then an appropriate intervention with the aim of continuing infertility treatments for infertile women will be designed. After that a Delphi study will be designed in accordance with collected information of previous stages and will be approved by experts. In the second stage we will implement designed intervention of a randomized clinical trial on two groups of infertile women (control and intervention) with the history of infertility treatment dropout following unsuccessful cycle. We will use descriptive statistic in first and second stage. In second stage Chi square test and independent samples T test will be used to compare variables between groups and variables in study questionnaires before and after the intervention between two groups of study. Discussion: The present study will be the first study to be performed as a clinical trial on infertile women who have discontinued the treatments, with the aim of continuing treatments. Thereupon, it seems that the results of this study will be the basis for studies around the world to prevent premature cessation of infertility treatments.

Prevalence of hypertension and its associated factors among professional drivers: a population-based study.

OBJECTIVE: Hypertension is one of the most important causes of cardiovascular disease. It has been found that professional drivers are at high risk of hypertension. This study has been performed to determine the prevalence of hypertension and its associated factors among professional drivers in Shahroud. METHODS AND RESULTS: In this study, the prevalence of hypertension was determined according to the definition by the American Heart Association among 1461 professional drivers participating in the first cross-sectional phase of Shahroud drivers' prospective cohort study. The prevalence of elevated blood pressure and hypertension was examined based on the initial age, and gender presented, along with the factors affecting this disease based on multinomial logistic regression. The prevalence of elevated blood pressure, stage 1 and 2 hypertension was 46.9%, 6%, and 1.3%, respectively. In the multivariate multinomial logistic regression model, having diabetes, Body Mass Index ≥25, and driving years was associated with an increased chance of developing elevated blood pressure and hypertension. CONCLUSIONS: Attention should be paid to high prevalence of elevated blood pressure and hypertension among professional drivers in Iran as a health priority for drivers. Plans should be made to reduce it as well as to prevent its complications.

Comparing the Effect of Local Application of Peppermint and Cold Compresses on the Severity of Pain from Venipuncture in Dialysis Patients: A Parallel Randomized Clinical Trial Study.

Pain at the injection site is one of the most common complaints in the clinic and is the most important symptom affecting the quality of life of hemodialysis (HD) patients. The aim of this study was to determine the effect and compare the topical application of peppermint and cold compresses on the intensity of pain caused by the insertion of a needle into the fistula of HD patients. In this parallel randomized clinical trial, 99 HD patients were assigned to three groups receiving peppermint, a cold compress, or a control using six blocks. For the peppermint group, 20 min before the needle's insertion, a peppermint gel was used; for the cold compress group, an ice pack was used; and for the control group, the usual method was applied. The patients' pain was assessed with the Visual Analog Scale immediately after the needle's insertion. The results showed that after the intervention, the mean and standard deviation of the pain score in the intervention groups receiving peppermint (4.81 ± 1.13) or a cold compress (4.78 ± 1.13) were significantly less than those of the control group (8.42 ± 1.22) (P <0.001), but there was no statistically significant difference between the peppermint group and the cold compress group (P = 0.91). The use of peppermint, which is a cheap and uncomplicated herbal medicine, and a cold compress, which is easy to use and available, is recommended to reduce the severity of pain caused by venipuncture in HD patients.

Risk Factors Associated with Mortality in COVID-19 Patient's: Survival Analysis.

Background: The effect of related factors on recovery or death rates may vary from country to country. Therefore, we aimed to investigate the relationship between demographic, clinical, laboratory factors on the survival rates of confirmed cases of COVID-19 in Shahroud, Iran. Methods: This is an analytical study of the estimation of the survival of patients with COVID-19. Patients who had positive PCR test were considered as COVID-19 cases, and the 2-month survival of these patients was estimated. Among the diseases, heart disease and diabetes were considered as separate variables, and the patients' histories of other diseases were included in the model as comorbidities. Results: Of 396 confirmed patients hospitalized, 109 patients (27.5%) had a history of heart disease, 100 (25.3%) were diabetic, and 80 (20.2%) had a history of other comorbidities. The number of deaths due to the disease was 59 (14.9%). The median age of those who died was 76 years. The multivariate Cox regression analysis shows that heart disease increases hazard ratio more than two times (HR=2.37, 95% CI: 1.33-4.23). The neutrophil-to-lymphocyte ratio (NLR) factor, (HR=1.15, 95% 1.08-1.22), and older age (HR=1.06, 95% CI: 1.03-1.08) increases the risk of death significantly. Conclusion: The heart disease history, NLR factor and older age are associated with death of COVID-19 and may be helpful for the early warning and prediction of disease progression.

Women's Help-Seeking Behaviors for Sexual Health Issues and the Related Factors: A Cross-Sectional Study from Iran.

Delay in help-seeking for sexual health issues may lead to relationship discord and impact the quality of life. The study aimed to explore the factors related to HSBs (help seeking behaviors) for sexual health issues and to determine the role of negative attitudes relating to sexual concerns in the HSBs of Iranian women. This cross-sectional study was performed in 2020. Participants were 390 randomly selected women from Rasht, Iran. The data were collected using a demographic and a sexual history checklist, the Female Sexual Function Index-6-item (FSFI-6), the Attitudes-related Sexual Concern Scale (ASCS), and a help-seeking behavior questionnaire. Formal help-seeking in women with sexual concern was 16.2% and 48.6% engaged informal HSB. Informal HSB was associated with younger age (OR = 0.93; CI = 0.89-0.97), having a university degree (OR = 3.42; CI = 1.89-6.18), sexual abuse in adulthood (OR = 2.59; CI = 1.07-6.26) and lower negative attitudes-related sexual concerns (OR = 0.53; CI = 0.32-0.87). Formal HSB was related to having a university degree (OR = 3.03; CI = 1.32-6.98) and history of a chronic disease (OR = 3.43; CI = 1.68-6.98). Negative attitudes relating to sexual concerns greatly impact informal HSBs of women, so it should be considered in their health care programming.

The Effect of the Web-Based Communication between a Nurse and a Family Member on the Perceived Stress of the Family Member of Patients with Suspected or Confirmed COVID-19: A Parallel Randomized Clinical Trial.

The aim of this study was to identify the effect of web-based communication between a nurse and a family member of a patient with COVID-19 on his/her perceived stress. In this multicenter parallel randomized controlled trial, 67 family members of COVID-19 patients admitted to the Intensive Care Unit (ICU) were investigated. In the intervention group, web-based communication was performed for four consecutive days for 10 to 15 minutes. The Perceived Stress Scale (PSS-14) were completed in both groups before and after the intervention. Mean and standard deviation of perceived stress scores in the two groups were not significantly different (p = 0.26) before the intervention; however, after the intervention, the mean PSS-14 in the intervention group was significantly lower than that of the control group (p < 0.001). Due to the need to follow the physical and social distancing to protect against Coronavirus disease, the use of web-based communication recommended in future studies.

Defluoridationof drinking water by metal impregnated multi-layer green graphene fabricated from trees pruning waste.

A novel adsorbent with excellent adsorptive properties for fluoride was prepared through a green and cheap synthesis route. Populus caspica pruning wastes, a cheap agri-waste material, were reduced to multi-layer green graphene (MLG) and then post-modified to aluminum/iron modified multi-layer green graphene (AMLG and IMLG). Batch experiments revealed the effect of pH (3-11), contact time (0.5-12 h), and initial fluoride concentration (5-40 mg/L). The conversion of raw material to MLG increased the specific surface area about 120 times (from 4 to 475 m2/g). Furthermore, a significant improvement in zero points of charge (pHzpc) was attained for IMLG (7.1) and AMLG (8) compared with pristine MLG (4.3). Fluoride showed superior affinity to AMLG and IMLG compared with MLG. Fluoride removal increased gradually by pH from 3 to 8 and then decreased sharply up to pH 11. The study of process dynamics demonstrated the monolayer fluoride adsorption onto AMLG and IMLG controlled by the chemisorptions. The highest predicted adsorption capacities based on the Langmuir model were 31.52, 47.01, and 53.76 mg/g for MLG, IMLG, and AMLG, respectively. Considering economic and technical feasibility presents AMLG and IMLG as a promising candidate against water contamination by elevated fluoride. Graphical abstract.

Optimization of electro-kinetic process for remediation of soil contaminated with phenanthrene using response surface methodology.

The objective of this work was to investigate the modification of soil contaminated with phenanthrene (PHE) by electro-kinetic remediation (EKR) process using response surface methodology (RSM). The soil sample was obtained from the subgrades (0-30 cm) of an area close to Shahroud City, Northeast of Iran. The effect of variables such as initial pH, voltage, electrolyte concentration, and reaction time on PHE removal was studied. Based on the results obtained from the central composite design (CCD) experiment, the highest and lowest amount of PHE removal was 97 and 20%, respectively. In this study, the variables A, B, C, AB, AC, and C2 with a p value < 0.05 were significant model terms and the parameter of the lack of fit was not significant (p value = 0.0745). Findings indicated that the "predicted R-squared" of 0.9670 was in reasonable agreement with the "adj R-squared" of 0.9857 and the plot of residual followed a normal distribution and approximately linear. Also, the kinetic rates of the removal PHE by the EKR process best fitted with a first-order kinetic model (R2: 0.926). Results of the investigation of the effective variables showed that in values of pH 3, time of 168 h, voltage of 3 V, and electrolyte concentration of 4 mg/L, the removal efficiency of PHE reached 96.6%. Graphical abstract.

Modified wheat straw-derived graphene for the removal of Eriochrome Black T: characterization, isotherm, and kinetic studies.

A cost-effective and environment-benign adsorbent was prepared from an abundant agro-waste material. Wheat straw was reduced to graphene and then modified by crosslinking to epichlorohydrin. During the conversion process of wheat straw to graphene, the specific surface area increased more than 100 times (from 4 to 415 m2 g-1). The adsorption efficiency of raw wheat straw, graphene nanosheets, and modified graphene against Eriochrome Black T (EBT) were 8.0, 34.7, and 74.4%, respectively. The modified graphene was further investigated for the effect of environmental condition, i.e., pH (3 to 11), EBT concentration (25-100 mg L-1), adsorbent dosage (0.25-0.75 g L-1), contact time (5-60 min), and solution temperature (30-60 °C). The dye removal remained at a high level under a wide range of pH from 3 to 9. The EBT removal decreased from 87.3 to 54.5 by increasing dye concentration and increased from 38.2 to 85.4% by increasing adsorbent dose in the studied ranges. Dye removal also increased by mixing time from 5 to 30 min, whereas a slight drop was observed by continuing agitation up to 60 min. Conducting experiments at various temperatures revealed an endothermic process. Pseudo-first-order and pseudo-second-order models were adequate to represent the adsorption kinetics. Isotherm models suggest a multilayer adsorption of EBT molecules on heterogeneous modified graphene surface with a maximum adsorption capacity of 146.2 mg g-1. The present work demonstrated that the modified graphene obtained from available and low-cost agro-wastes could be used effectively as adsorbent against EBT from aqueous media.

Modeling of chromium (VI) removal from aqueous solution using modified green-Graphene: RSM-CCD approach, optimization, isotherm, and kinetic studies.

BACKGROUND: The aim of this study was to investigate the removal of Cr (VI) using Green-Graphene Nanosheets (GGN) synthesized from rice straw. METHODS: Synthesis of the GGN was optimized using response surface methodology and central composite design (CCD). The effect of two independent variables including KOH-to-raw rice ash (KOH/RRA) ratio and temperature on the specific surface area of the GGN was determined. To have better removal of Cr (VI), GGN was modified using the grafting amine group method. In the Cr (VI) removal process, the effects of four independent variables including initial Cr (VI) concentration, adsorbent dosage, contact time, and initial solution pH were studied. RESULTS: The results of this study showed that the optimum values of the KOH/RRA ratio and temperature for the preparation of GGN were 10.85 and 749.61 °C, respectively. The maximum amount of SSA obtained at optimum conditions for GGN was 551.14 ± 3.83 m 2 /g. The optimum conditions for Cr (VI) removal were 48.35 mg/L, 1.46 g/L, 44.30 min, and 6.87 for Cr (VI) concentration, adsorbent dosage, contact time, and pH, respectively. Based on variance analysis, the adsorbent dose was the most sensitive factor for Cr (VI) removal. Langmuir isotherm (R2 = 0.991) and Pseudo-second-order kinetic models (R2 = 0.999) were the best fit for the study results and the Q max was 138.89 mg/g. CONCLUSIONS: It can be concluded that the predicted conditions from the GGN synthesis model and the optimum conditions from the Cr (VI) removal model both agreed with the experimental findings.

Valorization of biomass into amine- functionalized bio graphene for efficient ciprofloxacin adsorption in water-modeling and optimization study.

A green synthesis approach was conducted to prepare amine-functionalized bio-graphene (AFBG) as an efficient and low cost adsorbent that can be obtained from agricultural wastes. In this study, bio-graphene was successfully used to remove Ciprofloxacin (CIP) from synthetic solutions. The efficacy of adsorbent as a function of operating variables (i.e. pH, time, AFBG dose and CIP concentration) was described by a polynomial model. A optimal99.3% experimental removal was achieved by adjusting the mixing time, AFBG dose, pH and CIP concentration to 58.16, 0.99, 7.47, and 52.9, respectively. Kinetic model revealed that CIP diffusion into the internal layers of AFBG controls the rate of the process. Furthermore, the sorption process was in monolayer with a maximum monolayer capacity of 172.6 mg/g. Adsorption also found to be favored under higher CIP concentrations. The thermodynamic parameters (ΔG°<0, ΔH°>0, and ΔS°>0) demonstrated that the process is endothermic and spontaneous in nature. The regeneration study showed that the AFBG could simply regenerated without significant lost in adsorption capacity.

Risk Ratio Estimation in Longitudinal Studies.

Longitudinal studies are very common in medical, behavioral, and interventional sciences. One measure of effect of interest in longitudinal studies is risk ratio, naturally estimated by log-binomial regression which suffers from convergence problem. Odds ratio does not well approximate risk ratio when the outcome is common, so alternative methods have been introduced in cohort studies with one follow-up visit. In this paper, we illustrate 2 simple methods, COPY method and modified log-Poisson regression for risk ratio estimation in longitudinal data setting. Our unpublished simulation study on risk ratio estimation in longitudinal data setting suggests that COPY method performs well in terms of closeness of the risk ratio estimate and true risk ratio (mean square error) and so we suggest this method for risk ratio estimation in longitudinal Longitudinal studies are very common in medical, behavioral, and interventional sciences. One measure of effect of interest in longitudinal studies is risk ratio, naturally estimated by log-binomial regression which suffers from convergence problems. Odds ratio (OR) does not approximate risk ratio (RR) well when the outcome is common, so alternative methods have been introduced in cohort studies with one follow-up visit. In this paper, we illustrate two simple methods: the COPY method and the modified log-Poisson regression for RR estimation in longitudinal data setting. Our unpublished simulation study on RR estimation in longitudinal data setting suggests that the COPY method performs well in terms of closeness of the RR estimate and true RR (mean square error) and so we suggest this method for RR estimation in longitudinal data setting.data setting.

Correlation Study Between IL-28B Gene Polymorphism (rs8099917SNP) and Sustained Virological Response in Iranian Patients with Chronic Hepatitis C.

BACKGROUND: The current standard treatment for hepatitis C is a combination of pegylated interferon alpha and ribavirin (peg-IFNα/RBV). Recent studies have shown that single nucleotide polymorphisms (SNPs) near the interleukin 28B (IL28B) gene coding for IFN-λ3 were associated with the antiviral treatment response. Therefore, in this study, we determined the distribution of the rs8099917 (T/G) polymorphism with sustained virological response (SVR) to chronic hepatitis C virus infection among Iranian patients. METHODS: This cross-sectional study was performed on 150 blood samples based on 93 patients with chronic HCV genotypes 1 and 3 including 71 SVR positive, 22 negative, and 57 healthy individual controls. DNA was extracted from the samples and the frequency of the polymorphism was analyzed the using PCR-RFLP method. Finally, the products were detected on 3.5% agarose gel electrophoresis. RESULTS: The analysis of the data for G/T polymorphism showed that the GG genotype was identified in 6 patients of 71 who achieved SVR, while the GT heterozygous was found in 33 patients and SVR was achieved in 19. Finally, the TT was detected in 53 patients and 7 patients were resistant to treatment. CONCLUSIONS: The results showed significant effects of G allele carriers on susceptibility to HCV infection com-pared to the other allele (T) in our studied population (p = 0.013, OR = 2.23, 95% CI = 1.18-4.21), but we did not find a significant correlation for SVR to therapy in patients with genotype TT (p = 0.055, OR = 0.48, 95% CI = 0.23-1.01). However, further studies with more samples are necessary.