Investigating the Effect of a Multicomponent Exercise Program on Adropin, Endothelial Function, Insulin Resistance, and Sleep Quality in Overweight Older Adults (a Link With Physiological Indexes and Sleep Quality): Results of a Randomized Controlled Study.

The aim of the present study was to investigate the effects of multicomponent training on adropin, endothelial function, insulin resistance, and sleep quality in overweight older adults. In this randomized controlled study, 40 overweight older adults were randomly divided into training and control groups. The multicomponent training program including aerobic, resistance, and balance exercise was followed for 8 weeks, 3 days a week. Study variables were measured 48 hr before and after the intervention. After 8 weeks of multicomponent training, adropin (p = .01), nitric oxide (p = .01), and maximal oxygen uptake (VO2max; p = .002) increased, and glucose (p = .001), insulin (p = .001), insulin resistance (p = .01), systolic blood pressure (p = .01), and sleep disorders (p = .01) decreased significantly. Also, Pearson's test results showed a significant inverse relationship between adropin level (p = .01 and r = -.55) and glucose (p = .01 and r = -.51) with sleep disorders. It seems that multicomponent training increases adropin and improves insulin resistance, endothelial function, and sleep quality in older adults.

Peer interventions to improve HIV testing uptake among immigrants: A realist review.

Background: As a vulnerable group in HIV control programs, immigrants face various obstacles to HIV testing. Despite the effectiveness of peer interventions on health promotion in HIV testing, relatively little is known about how these interventions work. This realist review aims to understand why, how, and under what conditions peer interventions can improve immigrants' HIV testing uptake. Methods: We followed the steps suggested by Pawson and colleagues for conducting the realist review. To test a initial program theory, we first systematically searched databases of PubMed, Web of Science, Scopus, Embase, and Cochrane, as well as the websites of UNAIDS, World Bank, Global Fund, WHO, and IOM. After data extraction and quality appraisal, data synthesis was conducted to explain the intervention pathways corresponding to context-mechanism-outcome configurations. Results: Seventeen studies were included in the review. Peer interventions for improving immigrants' HIV testing uptake worked through four pathways: Following the improvement of communications (as a proximal mechanism): 1) increasing awareness, 2) reduced stigma, 3) improved support, and 4) increased access to services could lead to improved HIV testing uptake among immigrants. The identified mechanisms were influenced by three groups of individual/ interpersonal, service delivery, and structural factors. Conclusion: Peer interventions with multiple strategies to be designed and implemented considering the barriers to HIV testing and also moving beyond one-size-fits-all approaches can successfully improve the immigrants' HIV testing uptake. The refined program theory in this study can help the healthcare providers and policy-makers promote the immigrants' HIV testing uptake and reduce the risk of disease transmission.

Strategies to improve hidden curriculum in nursing and medical education: a scoping review.

BACKGROUND: The importance of hidden curriculum cannot be neglected in education. Despite much research in the field, there have been limited studies on HC improvement in nursing and medical education. This scoping review aimed to determine the scope of strategies to improve HC in nursing and medical education. METHOD: PubMed, EBSCO/Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, Web of Science, Proquest and Persian-language databases of Magiran and SID were searched in January 2023 without a time filter. According to the PRISMA flow diagram, two independent reviewers selected the records that fit the inclusion and exclusion criteria via title and abstract screening. Next, the reviewers studied the full texts of the related articles. The data extracted from the selected articles were tabulated and ultimately synthesized. FINDINGS: Out of the eight examined studies, published from 2017 to 2022, only one was in the field of nursing and seven were in medicine. The central strategies were implementing new curricula to replace the previous ones, utilizing team-based clinical clerkship, proposing a HC improvement model, implementation a case-based faculty development workshop, implementation longitudinal and comprehensive educational courses, and incorporating an educational activity into a small group program. CONCLUSION: Students and faculty members familiarization on the topic of HC, implementing new curricula, utilizing team-based clerkship, and using comprehensive models were among the HC improvement strategies. Focusing on upgrading the learning environment, particularly the clinical settings, can also be helpful in HC improvement.

Intermittent vs. continuous swimming training on adipokines and pro-inflammatory cytokines in metabolic syndrome experimental model.

OBJECTIVES: In this study, metabolic syndrome-affected rats were studied to examine how intermittent and continuous swimming training influenced adipokines and pro-inflammatory cytokines. METHODS: Forty-eight male Wistar rats were randomized in this experimental study into four groups (n=8), including normal control (NC), metabolic syndrome (MS), continuous swimming training with metabolic syndrome (CT-MS: load 0-3% body mass, 5 d/wk, for 8 weeks), and intermittent swimming training with metabolic syndrome (IT-MS: load 5-16% body mass, 5 d/wk, for 8 weeks). The serum levels of metrnl, adipolin, irisin, leptin, TNF-α, and IL-6 were measured using the ELISA test. RESULTS: The IT-MS and NC groups exhibited significantly lower leptin concentrations than the CT-MS group (p=0.001). The irisin, meteorin, and adipolin serum levels increased significantly in CT-MS and IT relative to the NC and CT-MS groups (p=0.001), with the changes being more pronounced in the IT group (p=0.05). TNF-α and IL-6 were inclined in the CT-MS group compared with the other three groups (p=0.001), while IL-6 was increased in the IT group (p=0.024). CONCLUSIONS: Intermittent swimming is more effective than continuous swimming training in improving adipokines in rats with metabolic syndrome.

Influence of eight weeks of combined training on adipsin and lipoprotein profile and possible relations with depression, anxiety and stress in women with multiple sclerosis.

OBJECTIVES: Immobility and its physiological and psychological consequences are common problems in patients with multiple sclerosis. The aim of this study was to investigate the effect of 8 weeks of combined training on Adipsin and lipid profile and the possible relationship between these indicators and psychological function in women with multiple sclerosis. METHODS: In this quasi-experimental study, 40 women with multiple sclerosis were selected by purposeful sampling method and randomly divided into two equal control and exercise groups (n=20). Exercise was performed for 8 weeks (two resistance sessions and one endurance session per week). Before and after the intervention, blood samples were taken and the DASS-21 questionnaire was completed to assess anxiety, depression and stress. Data were analyzed using analysis of covariance, t-test, Bonferroni post hoc test and Pearson correlation test at a significance level of p≤0.05. RESULTS: In the exercise group, levels of Adipsin, total cholesterol, LDL, TG, weight, fat percentage, WHR, BMI, depression, anxiety and stress were significantly reduced and HDL levels were significantly increased after 8 weeks of combined exercise (p≤0.05). Also, BMI (p=0.01), fat percentage (p=0.01) and WHR (p=0.01) levels had significant positive correlation with Adipsin. There was a significant positive relationship between Total cholesterol level with depression index (p=0.04). CONCLUSIONS: Performing combination exercises through improving body composition can increase the risk of obesity and cardiovascular risk factors and improve the psychological function of patients with multiple sclerosis. Specialists can use these exercises as an adjunct to drug therapy for MS patients.

Machine learning models effectively distinguish attention-deficit/hyperactivity disorder using event-related potentials.

Accurate diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) is a significant challenge. Misdiagnosis has significant negative medical side effects. Due to the complex nature of this disorder, there is no computational expert system for diagnosis. Recently, automatic diagnosis of ADHD by machine learning analysis of brain signals has received an increased attention. This paper aimed to achieve an accurate model to discriminate between ADHD patients and healthy controls by pattern discovery. Event-Related Potentials (ERP) data were collected from ADHD patients and healthy controls. After pre-processing, ERP signals were decomposed and features were calculated for different frequency bands. The classification was carried out based on each feature using seven machine learning algorithms. Important features were then selected and combined. To find specific patterns for each model, the classification was repeated using the proposed patterns. Results indicated that the combination of complementary features can significantly improve the performance of the predictive models. The newly developed features, defined based on band power, were able to provide the best classification using the Generalized Linear Model, Logistic Regression, and Deep Learning with the average accuracy and Receiver operating characteristic curve > %99.85 and > 0.999, respectively. High and low frequencies (Beta, Delta) performed better than the mid, frequencies in the discrimination of ADHD from control. Altogether, this study developed a machine learning expert system that minimises misdiagnosis of ADHD and is beneficial for the evaluation of treatment efficacy.

"Intention to receive COVID-19 vaccine among healthcare workers: a comparison between two surveys".

BACKGROUND: Considering the importance of intention to receive COVID-19 vaccine among healthcare workers and its role in maintaining their health and inhibiting the epidemic spread of Covid-19, the present study was done to identify the changes in intention to receive COVID-19 vaccine rate in two different time points and it's determinants based on the dimensions of the health belief model among healthcare workers in Iran. METHODS: Two cross-sectional surveys performed to investigate COVID-19 vaccination intent and associated factors based on the health belief model. The first conducted on 1244 participants from August 18 to 23, 2020, and the second on 1514 participants from February 5 to April 29, 2021, both using a questionnaire of intent to accept COVID-19 vaccination. The questionnaire distribution platform in both surveys was similarly, WhatsApp and Telegram social and working virtual groups of HCWs. Data were analyzed with SPSS-16 software for descriptive and analytical statistics. RESULTS: In the first survey, 58.4% (95% CI: 0.55-0.61%) of healthcare workers intended to receive the COVID-19 vaccine, the rate dropped to 45.7% (95% CI: 0.43-0.48%) in the second survey (P < 0.001). The regression analysis indicated six factors that were significantly associated with higher intention to receive COVID-19 vaccine: being a female (OR = 1.84, 95% CI (1.11-3.03)), history of Covid-19 infection (OR = 1.54, 95% CI (1.09-2.18), perceptions of Covid-19 disease (OR = 1.13, 95% CI (1.01-1.28)), perceived benefits of COVID-19 vaccine (OR = 1.34, 95% CI (1.22-1.47)), prosocial norms for COVID-19 vaccination (OR = 1.25, 95% CI (1.21-1.29)), and COVID-19 vaccine safety/cost concerns (OR = 1.25, 95% CI (1.17-1.33)). CONCLUSIONS: Present study showed an undesirable rate of intention to receive COVID-19 vaccine among healthcare workers, especially decreasing over the time, emphasize the need of interventions to promote healthcare workers' intention to receive the vaccine and reduce the spread of COVID-19 disease.

Aspects Influencing Access to HIV/AIDS Services among Afghan Immigrants in Iran: A Qualitative Study.

Background: A successful response to the risk of human immunodefficiency virus (HIV) infection among immigrants requires improved access to HIV prevention, diagnosis, and treatment services. However, most immigrants face significant challenges in accessing HIV/AIDS services. The aim of this study was to explore the aspects influencing access to HIV/AIDS services among Afghan immigrants in Iran. Methods: This was a qualitative study using conventional content analysis that was conducted from June 2018 to April 2020 in Tehran, Iran. Purposeful sampling method was performed. We conducted 25 semi-structured interviews with three groups of stakeholders including Afghan immigrants infected with or at risk of HIV (n=8), service providers (n=8), and policymakers/managers/experts (n=9). Inductive qualitative content analysis was applied according to the Granheim and Lundman method. Data were analyzed using Open Code software version 4.03. Results: Aspects influencing access to HIV/AIDS health services were categorized into 3 themes (that were extracted from 9 categories): 1. Cultural aspects (cultural similarities and differences, values and beliefs); 2. Psychosocial aspects (social support, stigma and discrimination); and 3. Service delivery related aspects (awareness, health services coverage and integrity, health services financing, accessibility, and continuity of care). Conclusion: The findings suggest that efforts to improve Afghan immigrants' access to HIV/AIDS health services in Iran need to consider the cultural aspects, increasing HIV awareness, providing support, reducing stigma and discrimination, and improving health services coverage, integrity, financing, and continuity of accessible services.

HIV, migration, gender, and drug addiction: A qualitative study of intersectional stigma towards Afghan immigrants in Iran.

HIV-related stigma has been identified as a major barrier to the diagnosis, prevention, and treatment of HIV among immigrants. The intersection of HIV with other forms of stigma can lead to greater inequality in health outcomes and access to health services. This study aimed to improve the understanding of HIV stigma towards Afghan immigrants in Iran through an intersectional perspective. The data were collected using 25 semi-structured interviews with the following three groups: Afghan immigrants who were diagnosed with or at risk of HIV infection due to injection drug addiction or having multiple sexual partners (n = 8), HIV service providers (n = 8), and policymakers/managers/experts (n = 9). Thematic analysis was used for data analysis. The participants described different manifestations of stigma (internalized, anticipated, perceived, experienced stigma, and discrimination) associated with HIV and interlocked with other aspects of stigma, including migration, gender, and drug addiction. According to the results, the intersection of different layers of stigma should be taken into account while designing and implementing HIV prevention and treatment programmes. It was also recommended to conduct the necessary interventions such as comprehensive HIV education, social support, as well as peer and outreach services to reduce stigma and discrimination based on the immigrants' needs as well as cultural and social values.

"Applying Intersectionality in designing and implementing health interventions: a scoping review".

BACKGROUND: Given the potential of intersectionality to identify the causes of inequalities, there is a growing tendency toward applying it in the field of health. Nevertheless, the extent of the application of intersectionality in designing and implementing health interventions is unclear. Therefore, this study aimed to determine the extent to which previous studies have applied intersectionality and its principles in designing and implementing health interventions. METHODS: The title and abstract of the articles which were published in different databases e.g. PubMed, Web of Science, Proquest, Embase, Scopus, Cochrane, and PsychInfo were screened. Those articles that met the screening criteria were reviewed in full text. The data about the application of principles of intersectionality, according to the stages heuristic model (problem identification, design & implementation, and evaluation), were extracted through a 38-item researcher-made checklist. RESULTS: Initially, 2677 articles were found through reviewing the target databases. After removing the duplicated ones and screening the titles and abstracts of 1601 studies, 107 articles were selected to be reviewed in detail and 4 articles could meet the criteria. The most frequently considered intersectionality principles were "intersecting categories" and "power", particularly at the stages of 'problem identification' as well as 'design & implementation'. The results showed that "multilevel analysis" principle received less attention; most of the studies conducted the interventions at the micro level and did not aim at bringing about change at structural levels. There was a lack of clarity regarding the attention to some of the main items of principles such as "reflexivity" as well as "social justice and equity". These principles might have been implemented in the selected articles; however, the authors have not explicitly discussed them in their studies. CONCLUSIONS: Given the small number of included studies, there is still insufficient evidence within empirical studies to show the implication of intersectionality in designing and conducting health interventions. To operationalize the intersectionality, there is a need to address the principles at various stages of health policies and interventions. To this end, designing and availability of user-friendly tools may help researchers and health policymakers appropriately apply the intersectionality.

Therapeutic Efficacy of Aerobic Exercise Training along with Oak Husk Hydroalcoholic Extract for Amelioration of Inflammation in Obese Elderly Male Mice.

BACKGROUND: Fibrinogen and interleukin-1ß as a proinflammatory cytokine and interleukin-10 and nesfatin-1 as an anti-inflammatory cytokine have an important role in the development and prevention of systemic inflammation and incidence of obesity-induced diseases. Thus, this study is aimed at the interaction effects of aerobic training and oak husk hydroalcoholic extract consumption on plasma levels of fibrinogen, interleukin-1ß, nesfatin-1, and interleukin-10 in obese elderly male mice. MATERIALS AND METHODS: In this experimental study, 40 fat male mice were fed a high-fat diet for 4 weeks to induce obesity, and subsequently, they were divided randomly into four groups: control, supplement, exercise-placebo, and exercise-supplement. The training groups performed aerobic exercise 5 days a week for 6 weeks (approximately 80-75% VOmax 2). The supplement groups received a solution of oak husk hydroalcoholic extract at a dose of 20 milligram per kilogram of body weight for 6 weeks. Blood samples were taken 48 h after the last training session, and the levels of IL-10, fibrinogen, IL-1ß, and nesfatin-1 were measured. Data were analyzed using one-way ANOVA and LSD post hoc tests. RESULTS: The results showed that six-week training and oak husk hydroalcoholic extract consumption significantly increased the levels of IL-10 and nesfatin-1 in experimental groups (P < 0.001). Also, the levels of fibrinogen and IL-1ß decreased significantly in training groups. Averages between group variations of all indicators were statistically significant, and they were more meaningfully pronounced in the exercise-supplement group than other groups (P ≤ 0.05). CONCLUSIONS: Considering the results of the present study, the use of moderate aerobic exercise and oak husk hydroalcoholic extract is recommended to reduce the risk of obesity; it may also have a positive effect on inflammatory factors.

Stress Granules in the Anti-Cancer Medications Mechanism of Action: A Systematic Scoping Review.

Stress granule (SG) formation is a well-known cellular mechanism for minimizing stress-related damage and increasing cell survival. In addition to playing a critical role in the stress response, SGs have emerged as critical mediators in human health. It seems logical that SGs play a key role in cancer cell formation, development, and metastasis. Recent studies have shown that many SG components contribute to the anti-cancer medications' responses through tumor-associated signaling pathways and other mechanisms. SG proteins are known for their involvement in the translation process, control of mRNA stability, and capacity to function in both the cytoplasm and nucleus. The current systematic review aimed to include all research on the impact of SGs on the mechanism of action of anti-cancer medications and was conducted using a six-stage methodological framework and the PRISMA guideline. Prior to October 2021, a systematic search of seven databases for eligible articles was performed. Following the review of the publications, the collected data were subjected to quantitative and qualitative analysis. Notably, Bortezomib, Sorafenib, Oxaliplatin, 5-fluorouracil, Cisplatin, and Doxorubicin accounted for the majority of the medications examined in the studies. Overall, this systematic scoping review attempts to demonstrate and give a complete overview of the function of SGs in the mechanism of action of anti-cancer medications by evaluating all research.

Anti-inflammatory properties of combined aquatic extract of Ferulago angulata boiss with aerobic exercise on pro-inflammatory indices in obese males.

BACKGROUND: The application of supplements, herbal extracts, and exercise training for treatment of diseases and reducing chronic inflammation has been increased progressively among people. Thus, the aim of this investigation was to study the combined aquatic extract of Ferulago angulata boiss with aerobic exercise on pro-inflammatory indices in obese males. MATERIALS AND METHODS: In this semi-experimental study, forty young obese men (mean and standard deviation of age 34.59 ± 2.24 years, body mass index (BMI) 33.14 ± 2.75 kg/m2) were selected by purposed sampling and were randomly divided into four equal groups (n = 10), training, training-supplementation, supplementation, and control. Participants in the supplementary groups received 50 mg/ml F. angulata extracts daily for 12 weeks. Aerobic training program included 12 weeks of training, 3 sessions/week, and each session was 20 min at 60%-%-70% of maximal oxygen consumption. Blood samples were taken from the participants 48 h before and after the intervention in fasting state. Data were analyzed using dependent t-test, one-way analysis of variance, and post hoc Tukey test at a significant level of P < 0.05. RESULTS: After 12 weeks of exercise and supplementation, levels of interleukin (IL)-6 (P = 0.001), IL-18 (P = 0.03), IL-1 ß (P = 0.001), tumor necrosis factor alpha (P = 0.001), weight (P = 0.001), BMI (P = 0.001), body fat percent (P = 0.001), and waist-hip ratio (P = 0.001) decreased significantly and the mean changes of these indicators in training + supplementation group were significantly augmented as compared to the other three groups. CONCLUSION: It appears that aerobic training plus F. angulata extract consumption have better effect on improvement of serum inflammatory factors in obese young men.

Combined high-intensity interval training and green tea supplementation enhance metabolic and antioxidant status in response to acute exercise in overweight women.

Thirty sedentary overweight women were randomly assigned to three groups (n = 10), including HIIT + green tea, HIIT + placebo and green tea. The training program included 3 sessions/week HIIT while the supplement consuming groups took 3 * 500 mg of green tea tablets/day for 10 weeks. Results indicated that 10 weeks of HIIT and green tea meaningfully pronounced baseline serum levels of SIRT1 (P ≤ 0.0001), PGC-1α (P ≤ 0.0001) and CAT (P ≤ 0.0001). In addition, significant increase was observed in three indicators in HIIT + green tea group in comparison with two other research groups. Further, the responses of SIRT1 (P ≤ 0.01) and CAT (P ≤ 0.002) increased significantly to second acute exercise in all three groups. The combination of HIIT and green tea consumption may induce increasing SIRT1 and CAT in response to acute exercise and can improve antioxidant system, body composition and VO2 max results rather than green tea and training alone, in young sedentary overweight women.

Measurements of Activity Coefficients at Infinite Dilution for Organic Solutes in the Ionic Liquids N-Ethyl- and N-Octyl-N-methylmorpholinium Bis(trifluoromethanesulfonyl)imide. A Useful Tool for Solvent Selection.

In recent years, many papers describing ionic liquids (IL) as promising solvents in separation techniques have been published. The conscious choice of appropriate ionic liquid as absorption media in effective extraction of selected types of analytes requires deeper understanding of the analyte-IL interactions. Therefore, intensive research is conducted to determine the values of activity coefficient at infinite dilution, which allows us to characterize the nature of these interactions. Based on the inverse gas chromatography retention data, activity coefficients at infinite dilution γ 13 ∞ of 48 different organic compounds in the ionic liquids N-ethyl-N-methylmorpholinium bis(trifluoromethanesulfonyl)imide [C2C1Mor][TFSI] and N-octyl-N-methylmorpholinium bis(trifluoromethanesulfonyl)imide [C8C1Mor][TFSI] were determined. The measurements covered a broad range of volatile organic compounds, including n-alkanes, n-alkenes, n-alkynes, alcohols, aldehydes, ketones, aromatic compounds and common polar solvents, representing different types of interactions. Activity coefficients at infinite dilution were measured in the temperature range from 313.15 to 363.15 K. The excess partial molar enthalpies and entropies at infinite dilution were determined. Selectivity at infinite dilution was also calculated for exemplary separation processes in the hexane/benzene system. The obtained results were analyzed and compared with literature data for ionic liquids containing the same anion [TFSI]¯ and different cations. The study results indicate that some potential applications of the investigated ionic liquids in separation problems exist.

Benefits of 10 weeks of high-intensity interval training and green tea supplementation on cardiovascular risk factors and VO2max in overweight women.

BACKGROUND: Considered the increasing rate of cardiovascular diseases (CVDs) and a positive relationship between prevalence of CVDs and obesity, the goal of the present study was to investigate the effects of green tea supplement and high-intensity interval training (HIIT) on lipid panel, fibrinogen, and maximal oxygen consumption (VO2max) in overweight women. MATERIALS AND METHODS: In this randomized placebo-controlled clinical trial, 30 overweight women (age range, 20-30 years), were chosen purposefully and randomly divided into three equal groups (green tea, HIIT + green tea, and HIIT + placebo), and they trained HIIT workouts for 10 weeks (40-m maximal shuttle run) and used 500 mg/daily green tea or placebo tablets. Serum levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and plasma level of fibrinogen were assessed before and after the intervention in fasting state. To test the hypothesis of the research, Paired t-test, Wilcoxon signed-rank test, analysis of covariance, and Tukey's post hoc tests were used at the significance level of P ≤ 0.05. RESULTS: After 10 weeks, TG, LDL, weight, fibrinogen, and body fat percentage decreased in all groups (P ≤ 0.05). Further, HDL (P = 0.012) and VO2max (P = 0.007) significantly increased in HIIT + green tea and HIIT + placebo groups; while in the green tea group, HDL (P = 0.06) and VO2max (P = 0.06) showed no significant difference for within group differences. Average between-group variations of all indicators were statistically significant, and they were more meaningfully pronounced in HIIT + green tea group than the other two groups (P ≤ 0.05). CONCLUSION: Based on the findings, the combination of HIIT and green tea consumption significantly leads to a reduction in weight, body fat percentage, fibrinogen, TG, and LDL while improves VO2max and HDL levels rather than green tea consumption or performing training alone, in overweight women. However, it seems that exercise training has a vital role in the improvement of mentioned variables according to percentage changes.

Moral distress in Iranian pediatric nurses.

BACKGROUND: Moral distress is a very common experience in the nursing profession, and it is one of the main reasons for job dissatisfaction, burnout, and quitting among nurses. For instance, morally difficult situations in taking care of child patients who are severely ill may lead to moral distress for nurses. However, most of the studies about moral distress have been conducted on nurses of special wards and adult medical centers with much focus on developed countries. Subsequently, little has been researched on this topic among nurses in other nations such as Iran, and most certainly, there has been hardly any such research involving Iranian pediatric nurses. AIM/OBJECTIVES: This study was conducted to evaluate moral distress among nurses in selected pediatric hospitals in Tehran, Iran. RESEARCH DESIGN: This cross-sectional study was conducted on eligible nurses who were selected through proportional stratified sampling and who completed demographic characteristics and the pediatric version of Moral Distress Scale-Revised questionnaires. Data were analyzed using descriptive statistics, t test, one-way analysis of variance, and Pearson correlation coefficient. PARTICIPANTS AND RESEARCH CONTEXT: In total, 195 pediatric nurses working at three selected children's specialized university hospitals in Tehran participated in this study. ETHICAL CONSIDERATIONS: This study was evaluated and approved by the institutional review board of Tehran University of Medical Sciences. FINDINGS: The mean and standard deviation of total score of moral distress was 106.41 ± 61.64 within a range of 10-257. Also, the difference between the mean score of moral distress of the group who had not quitted their position and those who have quit in the past was statistically significant (p = 0.043). The situation that was associated with the highest moral distress was "observing medical students performing painful procedures on patients just to gain some skill." Total score of moral distress was significantly higher among male nurses (p = 0.014), while nurses with a master's degree experienced just a higher intensity of moral distress compared to those who had a bachelor's degree (p = 0.006). CONCLUSION: Since many pediatric nurses clearly face moral distress while taking care of children, it is necessary to consider measures for preventing or decreasing situations that would lead to this distress.

Automated and ERP-Based Diagnosis of Attention-Deficit Hyperactivity Disorder in Children.

Event-related potential (ERP) is one of the most informative and dynamic methods of monitoring cognitive processes, which is widely used in clinical research to deal with a variety of psychiatric and neurological disorders such as attention-deficit/hyperactivity disorder (ADHD). In this study, there were 60 participants including 30 patients with ADHD and 30 subjects as a control group. Their ERP signals were recorded by three electrodes in two modalities. After a preprocessing step, several features such as band power, fractal dimension, autoregressive (AR) model coefficients and wavelet coefficients were extracted from recorded signals. The aim of this study is to achieve a high classification rate. The results show that the fractal dimension-wavelet combination features provided a good discriminative capability; it should be noted that this improvement was achieved by combining all sets of features and applying a feature selection algorithm, which resulted in a maximum accuracy rate of 88.77 and 95.39% in support vector machine (SVM) and v_SVM classification algorithms using a 10-fold cross-validation approach, respectively. ERP has been widely used for clinical diagnosis and cognitive processing deficits in children with ADHD. To increase the accuracy of the diagnostic process of ADHD, ERP signals were recorded to extract some specific ERP features related to this disease for classifying the two groups. The results show that the Fra-wave characterization produced the best average accuracy with an efficiency of 99.43% for v_SVM classifier, compared with 97.65% efficiency for the wavelet features and the other features.

Application of response surface methodology for air assisted-dispersive liquid- liquid microextraction of deoxynivalenol in rice samples prior to HPLC-DAD analysis and comparison with solid phase extraction cleanup.

A fast, simple, and easy to operate air assisted-dispersive liquid-liquid microextraction (AA-DLLME) for preconcentration and extraction of deoxynivalenol (DON) from rice samples is proposed and compared with solid phase extraction (SPE) cleanup. DON was determined using a high performance liquid chromatography with diode-array detection (HPLC-DAD). AA-DLLME was performed using a glass syringe and dispersion of extractant in the sample solution was achieved with help of air bubbles. Chloroform was used as the extractant solvent. To find out the optimized condition for the proposed method, response surface methodology (RSM) was applied for multivariate optimization of effecting parameters namely volume of extractant, number of extraction, pH, and rate of centrifugation. Under optimized condition the dynamic range of calibration graph was found to be 50-500µgL-1 with detection limit of 23.6µgL-1. Both methods were applied for extraction of DON from rice.