Medical school department chair performance improvement: A qualitative study.

INTRODUCTION: In medical education, department chairs should play a significant role. The present qualitative study was conducted to identify factors that influence the performance improvement of department chairs at medical schools in Iran. METHODS: The study was conducted in Iran in 2022 and used a thematic analysis method. Using a purposeful sampling method, 20 participants were invited to participate, including medical school deans and department chairs. Focus group discussion (FGD) was used for qualitative data gathering. Braun and Clarke's thematic analysis was used to analyze data. RESULTS: There were 18 males and 2 females among the participants. The mean age of the participants was 45±4 years. Five overarching themes were formulated: human resource management, organizational behavior management, performance support system, leadership, and financial resources. Also, nine subthemes emerged, including performance evaluation, job and work design, educational and non-educational support, motivational efforts, organization culture, organizational knowledge management, planning for change, and financing. CONCLUSIONS: In this study, we found factors influencing DC performance improvement. Department chairs' effective performance may have a positive impact on department operations, processes, or outcomes.

Vascular trauma injury evaluation in Khorramabad, Iran: a cross-sectional study.

Background: Vascular trauma injuries are associated significantly with disabilities and mortality where prompt diagnosis and management are of great importance. Objectives: In this study, the authors aim to evaluate the pattern of vascular trauma injuries. Methods: This descriptive retrospective study was performed on patients with vascular injuries due to trauma referred to (Shohada Ashayer Hospital and Shahid Chamran Hospital, Khorramabad). Patients' files were evaluated for the following data: diagnostics, types of treatment and outcome, type of trauma, cause of trauma, anatomy of the injured site, duration of surgery, type of lesion, delayed complication, and requirement of revision surgery. The data obtained were descriptively evaluated using SPSSv22. Results: Of 233 patients studied, 95.3% were males. The mean age of the patients was 29.15±11.8 years. 82.8% of patients presented with penetrating trauma whereas 32.2% of patients had stab wound trauma. The most common sign at the time of referral was a loss of sensation in 54.9% of patients. Direct diagnosis based on clinical presentation was made in 79% of patients. The upper extremity was the most common site of vascular injury in 77.3% of patients with the involvement of radial and ulnar arteries, in 63.1%. 66.9% of patients underwent primary vascular repair, 92 received revision surgery, and 69 required blood transfusion. Conclusion: Epidemiological studies of vascular injury can help clinicians and local healthcare centres to understand the pattern of vascular trauma based on the geographical location and train trauma surgeons and medical staff to provide effective and timely management.

Mapping Global Research in Emergency Medicine; a Bibliometric Analysis of Documents Indexed in the Web of Science Database.

Introduction: Emergency medicine is a relatively new and rapidly growing specialty, and its research monitoring is important for future policies. This study aimed to analyze the published literature related to emergency medicine, to create a documented research perspective for this field. Methods: This research is a bibliometric study that analyzes the research outputs of the subject area of emergency medicine indexed in the Web of Science database from the beginning to 2023. VOSviewer software was used to visualize and predict the trends in research on the topic. Results: The findings showed that the University of California, The Journal of Neurotrauma and Brain Injury, Elsevier, and the USA were the most prolific units in the cycle of scientific productions in the field of emergency medicine. Results showed that most scientific productions in this field fall into 6 clusters: psychological impressions, injuries caused by traumatic events and the effects of traumas on children, pathophysiology and nervous system issues and related diseases, complications of traumatic events and injuries, biomechanics and complications caused by sports injuries, and consciousness. Conclusion: In addition to interventions and clinical complications, research in the field of emergency medicine has also focused on psychological structures. So, based on various measurement indicators, the subjects of this field have been the focus of researchers' attention.

Temporal and spatial pattern of dust storms, their polycyclic aromatic hydrocarbons, and human health risk assessment in the dustiest region of the world.

This study evaluated the concentration and health risks of polycyclic aromatic hydrocarbons (PAHs) in Abadan City under 4 different climatic conditions: normal days, dusty days, dust with northwesterly winds, and dust with southeasterly winds. It also determined the sources of aromatics and discussed the relationship between meteorological parameters and PAH concentrations. The spatiotemporal distribution of dust in the area was determined using the HYSPLIT (hybrid single-particle Lagrangian integrated trajectory) back trajectory model, moderate resolution imaging spectroradiometer (MODIS) images. For this purpose, sampling was performed for 70 days using an Omni device. The concentrations of 16 PAHs (USEPA) ranged from 46.22 to 90.96 ng/m3. The highest concentration of high molecular weight (HMW) PAHs was 4-6 rings, of which 4 rings were predominant in all samples. PAH sources were identified using diagnostic ratios and principal component analysis (PCA), and it was shown that PAHs mainly originate from a mixture of sources, including vehicular emissions, petrol emissions, and traffic. Wind speed was negatively correlated with dust, except on dusty days. This result indicates a decrease in PAH concentrations when wind speed increases. On the other hand, the dust correlation with PAH was positive on normal days, but a negative correlation was observed on dusty days. This result was due to the lower concentration of PAHs from natural resources (such as dust source areas) vs. human resources (such as traffic and industry). PAH health risk assessment in Abadan City showed that the risk of carcinogenesis was higher on normal days and through skin contact. The probability of incremental lifetime cancer risk (ILCR) in all sampling conditions was potential in terms of carcinogenic risk (10-4-10-6). As a critical risk factor, relevant authorities should prevent, control, and reduce it.

Design, development, and evaluation of a surveillance system for suicidal behaviors in Iran.

BACKGROUND: Suicide is a serious cause of morbidity and mortality in Iran and worldwide. Although several organizations gather information on suicide and suicide attempts, there is substantial misperception regarding the description of the phenomenon. This study proposes the minimum data set (MDS) for suicidal behaviors surveillance. METHODS: A literature review was first conducted to achieve a thorough overview of suicide-related items and map the existing evidence supporting the development of the MDS. The data items included in the literature review were then analyzed using a two-round Delphi technique with content validation by an expert panel. The suicidal behaviors surveillance system was then established based on the confirmed MDS, and ultimately, its performance was assessed by involving the end-users. RESULTS: The panel of experts consisted of 50 experts who participated in the Delphi phase and validity content review. Of these, 46% were men, and their mean age and average work experience were (36.4, SD ± 6.4) and (12.32, SD ± 5.2) years, respectively. The final MDS platform of our study contained 108 items classified into eight main categories. A web-based system with a modular and layered architecture was developed based on the derived MDS. CONCLUSION: The developed system provides a framework for recording suicidal behaviors' data. The integration of multiple suicide-related information systems at the regional and national levels makes it possible to assess the long-term outcomes and evolutions of suicide prevention interventions.

Corrigendum to "The relationship between knowledge of leadership and knowledge management practices in the food industry in Kurdistan province, Iran" [Data Brief 15 (2017) 155-159].

[This corrects the article DOI: 10.1016/j.dib.2017.09.031.].

Health Concerns of Various Nanoparticles: A Review of Their in Vitro and in Vivo Toxicity.

Nanoparticles (NPs) are currently used in diagnosis and treatment of many human diseases, including autoimmune diseases and cancer. However, cytotoxic effects of NPs on normal cells and living organs is a severe limiting factor that hinders their use in clinic. In addition, diversity of NPs and their physico-chemical properties, including particle size, shape, surface area, dispersity and protein corona effects are considered as key factors that have a crucial impact on their safe or toxicological behaviors. Current studies on toxic effects of NPs are aimed to identify the targets and mechanisms of their side effects, with a focus on elucidating the patterns of NP transport, accumulation, degradation, and elimination, in both in vitro and in vitro models. NPs can enter the body through inhalation, skin and digestive routes. Consequently, there is a need for reliable information about effects of NPs on various organs in order to reveal their efficacy and impact on health. This review covers the existing knowledge base on the subject that hopefully prepares us better to address these challenges.

Protein-Protein Interaction Analysis of Common Top Genes in Obsessive-Compulsive Disorder (OCD) and Schizophrenia: Towards New Drug Approach Obsessive-Compulsive disorder (OCD) and Schizophrenia Comorbidity Gene Analysis.

Comorbidty is common among psychiatric disorders including obsessive-compulsive disorder and schizophrenia with a high rate. Many studies suggested that the disorders may have same etiological bases. In this regard, shared pathways of glutamate, dopaminergic, and serotonin are the known ones. Here, the common significant genes are examined to understand the possible molecular origin of the disorders in terms of sequence and functional features. Exploring the underling mechanisms of OCD and schizophrenia is important to achieve a better treatment options. Methods of Cytoscape software following R statistical software were applied for this purpose. Needleman-Wunsch global alignment algorithm was used to determine pair-wise similarities followed by clustering methods, AGNES and PAM in R statistical programming software. The results indicate that SLC1A1, DRD2, DRD4, BDNF, ESR1, CDH2, GRIN2B, TNFa, GABBR1, and OLIG2 are significantly common for the two disorders and PPI network analysis showed the important key genes in the interaction profile. ESR1 (estrogen receptor α) as a key hub-bottleneck gene regulates many underling mechanisms of the brain. Application of global alignments indicates some of the genes with sequence similarities also elucidate similar biological terms.

Serum Proteomic Study of Women With Obsessive-Compulsive Disorder, Washing Subtype.

INTRODUCTION: Many genetic studies are conducted on Obsessive-Compulsive Disorder (OCD). however, a high-throughput examination of proteome profile of this severe disease has not been performed yet. METHODS: Here, the proteomic study of OCD patients' serum samples was conducted by the application of Two-Dimensional Electrophoresis (2DE) followed by Mass Spectrometry (MALDI-TOF-TOF). RESULTS: A total of 240 protein spots were detected and among them, five significant differentially expressed protein spots with the fold change of ≥1.5 were considered for further evaluations. These proteins include IGKC, GC, HPX, and two isoforms of HP. While IGKC and HP show down-regulation, GC and HPX indicate up-regulation. Moreover, a validation study of overall HP levels in patients' serum via nephelometric quantification confirmed the lower levels of this protein in the serum of OCD patients. Additionally, enrichment analysis and validation test revealed that inflammation is one of most dominant processes in OCD. CONCLUSION: It is suggested that these candidate proteins and their underlying processes (especially, inflammation) may be linked to OCD pathophysiology and can promise a clinical use after extensive validation studies.

The relationship between knowledge of leadership and knowledge management practices in the food industry in Kurdistan province, Iran.

The aim of this study was to identify the relationship between the knowledge of leadership and knowledge management practices. This research strategy, in terms of quantity, procedure and obtain information, is descriptive and correlational. Statistical population, consist of all employees of a food industry in Kurdistan province of Iran, who were engaged in 2016 and their total number is about 1800 people. 316 employees in the Kurdistan food industry (Kurdistan FI) were selected, using Cochran formula. Non-random method and valid questions (standard) for measurement of the data are used. Reliability and validity were confirmed. Statistical analysis of the data was carried out, using SPSS 16. The statistical analysis of collected data showed the relationship between knowledge-oriented of leadership and knowledge management activities as mediator variables. The results of the data and test hypotheses suggest that knowledge management activities play an important role in the functioning of product innovation and the results showed that the activities of Knowledge Management (knowledge transfer, storage knowledge, application of knowledge, creation of knowledge) on performance of product innovation.

A comparative study of hospital admissions for respiratory diseases during normal and dusty days in Iran.

During the last century, most of people around the world moved from communicable to non-communicable diseases, mainly due to air pollution. Air pollutants and dust storm increase risk of morbidity, for cardiovascular and respiratory diseases, and increase the number of deaths. The city of Ahvaz is considered as the focal point of air pollution and dust storm in Iran. The aim of this study was to determine the number of Hospital Admission Respiratory Disease (HARD) including asthma attacks, acute bronchitis and chronic obstructive pulmonary disease attributed to PM10 by a descriptive study during normal and dust event days in Ahvaz during the time period 2010-2012. The hourly PM10 data was collected from the Iranian Environmental Protection Agency and Razi hospital. The annual PM10 mean concentrations reached 282, 288 and 278 µg/m3 in 2010, 2011 and 2012, respectively. The number of HARD attributed to PM10 was 1438, 1945 and 1393 people, respectively, and the highest number of daily admissions was attributed to the highest daily PM10 concentration in Ahvaz. The average number of daily HARD during dusty days was higher than normal days, and a significant positive correlation, between the number of hospital admissions and dusty days, was found. Dust had significant impact on HARD in Ahvaz.

Metabolomic analysis of human cirrhosis, hepatocellular carcinoma, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis diseases.

Metabolome analysis is used to evaluate the characteristics and interactions of low molecular weight metabolites under a specific set of conditions. In cirrhosis, hepatocellular carcinoma, non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatotic hepatitis (NASH) the liver does not function thoroughly due to long-term damage. Unfortunately the early detection of cirrhosis, HCC, NAFLD and NASH is a clinical problem and determining a sensitive, specific and predictive novel method based on biomarker discovery is an important task. On the other hand, metabolomics has been reported as a new and powerful technology in biomarker discovery and dynamic field that cause global comprehension of system biology. In this review, it has been collected a heterogeneous set of metabolomics published studies to discovery of biomarkers in researches to introduce diagnostic biomarkers for early detection and the choice of patient-specific therapies.

Comparing Intelligence Quotient (IQ)among 3 to 7-year-old strabismic and nonstrabismic children in an Iranian population.

This study was designed to compare the Intelligence Quotient (IQ) among 3 to 7-year-old strabismic and nonstrabismic children in an Iranian population. In this cross-sectional study, 108 preschool children with equal numbers of strabismic/non-strabismic disorder (age 3-7 years) were randomly selected from exceptional strabismus clinics of Ahvaz and were evaluated with the preschool and primary scale of intelligence versions of Wechsler (WPPSI). In the current study, 108 children were evaluated. In strabismic patients the mean performance, verbal and total IQ were 89.46±19.79, 89.57±21.57 and 91.54±22.08 respectively.These mean scores in normal children  were 91.89±47.53 , 87.56±15.6 and 89.96±17.62 consecuently. The results showed that these three different IQ subscales were not significantly different among 3 to 7 years old strabismic and nonstrabismic children ((P>0.05 for all comparisons). There was no significant difference in IQ between two sexes (P>0.05) while Persian tribe children had greater IQ score compared to other tribes (P<0.05). Also, higher paternal educational status of children related to higher IQ score. IQ score was better in combined deviations and was higher in exotropes than esotropes; however, these differences were not statistically significant.(p>0.05) In this evaluation, we did not found a significant negative interference of strabismus on IQ score of preschool children. It can be concluded that paternal educational level and tribe have a significant effect on intelligent quotient, while this is not the case on sex and ocular deviation.

Cognitive factors related to drug abuse among a sample of Iranian male medical college students.

BACKGROUNDS: Drug abuse is one of the most serious social problems in many countries. College students, particularly at their first year of education, are considered as one of the at risk groups for drug abuse. The present study aimed to determine cognitive factors related to drug abuse among a sample of Iranian male medical college students based on the social cognitive theory (SCT). METHOD: This cross-sectional study was carried out on 425 Iranian male medical college students who were randomly selected to participate voluntarily in the study. The participants filled out a self-administered questionnaire. Data were analyzed by the SPSS software (ver. 21.0) using bivariate correlations, logistic and linear regression at 95% significant level. RESULTS: Attitude, outcome expectation, outcome expectancies, subjective norms, and self-control were cognitive factors that accounted for 49% of the variation in the outcome measure of the intention to abuse drugs.  Logistic regression showed that attitude (OR=1.062), outcome expectancies (OR=1.115), and subjective norms (OR=1.269) were the most influential predictors for drug abuse. CONCLUSIONS: The findings suggest that designing and implementation of educational programs may be useful to increase negative attitude, outcome expectancies, and subjective norms towards drug abuse for college students in order to prevent drug abuse.

Safety and Efficacy of Propranolol in Comparison With Combination of Fentanyl and Ketamine as Premedication in Cataract Surgery Under the Topical Anesthesia.

This study evaluated the safety and effects of propranolol as a premedication before cataract surgery and compared them with the usual combination doses of fentanyl and ketamine. Among all reffered patients to Feiz Hospital of Esfahan for cataract surgery, 122 patients between Mar to Sep 2010 were enrolled in this study and randomly allocated into one of the following equal groups: 40 mg propranolol, 2 hours before surgery and combination of 15 mg ketamine and 50 µg fentanyl l. 5 min before surgery. The ability to control of hemodynamic instabilities caused by stress and to gain patients satisfaction was compared between two groups. Also, the efficacy of each premedication to control of hemodynamic changes during surgery were evaluated and compared. No significant differences were seen in the patients satisfaction and controlling of stress induced hemodynamic changes between two groups (P>0.05). However, patients in ketamine + fentanyl group showed more nausea and less pain during and after surgery. Moreover, no significant adverse effects were reported during and after the surgery. Our results demonstrated that propranolol can be used safely as a premedication in cataract surgery in the comparable efficacy to ketamine plus fentanyl premedication.

Chance Constrained Input Relaxation to Congestion in Stochastic DEA. An Application to Iranian Hospitals.

This article developed an approached model of congestion, based on relaxed combination of inputs, in stochastic data envelopment analysis (SDEA) with chance constrained programming approaches. Classic data envelopment analysis models with deterministic data have been used by many authors to identify congestion and estimate its levels; however, data envelopment analysis with stochastic data were rarely used to identify congestion. This article used chance constrained programming approaches to replace stochastic models with "deterministic equivalents". This substitution leads us to non-linear problems that should be solved. Finally, the proposed method based on relaxed combination of inputs was used to identify congestion input in six Iranian hospital with one input and two outputs in the period of 2009 to 2012.

Association Between Lifestyle and Hypertension in Patients Referred to Health Care Centers of Ilam City in 2014.

INTRODUCTION: Lifestyle is referred to an individual's healthy and unhealthy behaviors that can affect their health statues. The present study aim was association between lifestyle and hypertension in patients referred to healthcare centers of Ilam city in 2014. MATERIALS & METHODS: This research study was a case-control study. The data were collected through a standard questionnaire of health-promoting lifestyle profile (HPLPII) as well as the researcher's direct visit to the health care centers in the city of Ilam. After the questionnaires were collected and classified, the data were entered into SPSS software and analyzed by descriptive statistics, chi-square tests, T-Tests and logistic regression. RESULTS: The mean and the standard deviation of the age of the main and the control groups were 57.1 (2.22) and 56.5 (2.99) years old, respectively. 10.9%of the control group and 25.5. % of the cases was smoking cigarettes or hookah. The results of the data analysis showed that the mean scores obtained by the main and the control groups on measures of physical activity, psychological growth, stress and total lifestyleare significantly different, so that the obtained score in the dimensions in patients with hypertension was significantly lower than the score obtained among the healthy individuals. CONCLUSIONS: According to the results it seems that educational interventions in the field of healthy lifestyle for individuals with hypertension risk can have an effect on controlling this disease and reducing its incidence.

A case-control study of the factors affecting male infertility.

BACKGROUND/AIM: Infertility is defined as the inability to conceive after at least 1 year of unprotected intercourse. In about one third of infertile couples, a male factor is the primary problem. Thus, the present study aimed to determine the most common risk factors for male infertility in Iranian men. MATERIALS AND METHODS: This case-control study included 268 men attending an infertility clinic in Shiraz, Iran. In this study, 161 fertile men were compared with 108 infertile ones regarding risk factors such as smoking habits, drug consumption, hernia, varicocele, job, and BMI. The data were analyzed using logistic regression analysis and t-test. RESULTS: The mean age of the fertile and infertile participants was 37.5 ± 7 and 36.3 ± 10, respectively. Our findings demonstrated a statistically significant relationship between male infertility and hernia, varicocele, taking ranitidine, job, and BMI. With an increase of 1 cigarette per day, there was a 1% decrease in the motility of the sperm. Moreover, with an increase of 1 year of cigarette smoking, 800,000 sperm are lost. CONCLUSION: The results revealed varicocele and hernia as the most common risk factors in men attending the infertility clinics in Shiraz. In addition, strenuous work could cause testicular injury.

Intention and willingness in understanding Ritalin misuse among Iranian medical college students: a cross-sectional study.

Ritalin misuse can create powerful stimulant effects and serious health risks. The main aim of present study was compared that two cognitive construct (behavioral intention or behavioral willingness) for predicting Ritalin misuse. This cross-sectional study was conducted among 264 Iranian medical college students; participants selected in random sampling, and data were collected by using self-report questionnaire. Data were analyzed by SPSS version 21 at 95% significant level. Our findings showed, the three predictor variables of (1) attitude, (2) subjective norms, and (3) prototype accounted for 29% of the variation in intention and 25% of the variation in willingness to Ritalin misuse. In addition, behavioral intention was a stronger prediction factor compared to willingness for Ritalin misuse, with odds ratio estimate of 1.607 [95% CI: 1.167, 2.213]. There is some support to use the prototype willingness model to design interventions to improve individuals' beliefs that academic goals are achievable without the misuse of Ritalin.

Post traumatic endophthalmitis: incidence and risk factors.

Post traumatic endophthalmitis is an uncommon but severe complication of ocular trauma. We aimed to identify the incidence of post traumatic endophthalmitis and its contributing risk factors in Feiz hospital (Isfahan, Iran) from 2006 until 2010. Medical records of 1042 patients with open globe injury were analyzed and data were collected including age, sex, location of being injured, visual acuity (VA), time from injury to hospitalization and to repair, site of ophthalmic injury and the presence of foreign body. The frequency of post-traumatic endophthalmitis was about 2.1% (N = 22) of all patients. Nine of 22 cases with endophthalmitis were under 8 years. The visual acuity at the time of admission was seen to be contributed to high rate of endophthalmitis. Intraocular foreign body was detected in 139 patients; and the rate of endophthalmitis was 5% among these patients. Statistical analysis showed significant relationship between presence of foreign body and higher rate of endophthalmitis. Also, duration of hospitalization was significantly different between two study groups (P = 0.019). There were no significant differences between two groups in terms of other studied variables. Patients with low age, low visual acuity at admission, presence of intraocular foreign body and long duration of hospital stay had a higher risk of endophthalmitis after the repair of the globe. Compared to the reports of other large institutions, we can attribute the low incidence rate of endophthalmitis in our institution to the early use of systemic antibiotics such as gentamycin and cephalosporins in the first hour of hospitalization until discharge.