Measurement and Decomposition of Socioeconomic Inequality in Metabolic Syndrome: A Cross-sectional Analysis of the RaNCD Cohort Study in the West of Iran / 예방의학회지

Objectives@#Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran. @*Methods@#This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middle-aged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CIn) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants. @*Results@#The proportion of MetS in the sample was 41.1%. The CIn of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%). @*Conclusions@#Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.

Vaccine-associated complications: a comparative multicenter evaluation among dental practitioners and dental students—which candidate vaccine is more safe in SARS COV II, Gam-COVID-Vac (Sputnik V), ChAdOx1 nCoV-19 (AstraZeneca), BBV152 (Covaxin), or BBIBP-CorV(Sinopharm)? / 대한악안면성형재건외과학회지

Background@#The rapidly developed vaccines against the severe acute respiratory syndrome coronavirus 2 carry a risk of provoking side effects. This study aimed to evaluate current vaccination non-serious/serious side effects. @*Methods@#A multicenter electronic questionnaire via an online platform was conducted over a 1-week period among vaccinated dental staff and dental students inquiring whether they experienced vaccine-related side-effects after vaccine administration. @*Results@#A total of 1205 respondents with a mean age of 39 (SD: 12) were retained for the analyses. The following vaccines were reported; Gam-COVID-Vac (Sputnik V), ChAdOx1 nCoV-19 (AstraZeneca), BBV152 (Covaxin), or BBIBP-CorV (Sinopharm). The majority of respondents received ChAdOx1 nCoV-19 (51.1%) and Gam-COVID-Vac (37.6%). The symptoms most frequently reported after vaccination were fatigue (79%), local pain in the injection site (77.4%), malaise (73%), and body pain (71.1%). Enrollees reported more onset of reactions on 0–12 h (44.1%) and 12–24 h (29.0%) after vaccine administration (p value <0.001). In 75.7%, the side effects last for up to 3 days. Merely 5.5% of cases reported the presence of side effects after the first week. Individuals with a history of SARSCoV-2 and other infections (MERS, influenza, and EBV) were more likely to report a number of unserious systemic side effects. @*Conclusion@#The commonly reported adverse events were in line with similar studies. We have concerns with the frequency of serious adverse effects. This work necessitates the need for further clinical assessments with larger sample sizes.

A Giant Sacrococcygeal Chordoma: A Case Report

Sacrococcygeal chordoma is a rare malignant bone tumor. Although there are tough membranes such as the periosteum and presacral fascia (which resist transgression by the tumors), chordoma usually invades the rectal wall. The serious problem with these tumors is the late diagnosis and its high likelihood to become enlarged. The main treatment options for this tumor is surgical resection, radiotherapy, and chemotherapy. Due to the tumor vicinity to important organs such as bladder and its neurovascular structures, it makes surgical excision extremely challenging. The aim of this study is to describe a 50-year-old man with a giant sacrococcygeal mass. The novelty of this case report is the huge and unique size of the tumor which has not reported previously as well the special surgical approaches performed to remove the tumor.

Effect of taxifolin on methotrexate-induced oxidative and inflammatory oral mucositis in rats: biochemical and histopathological evaluation

Abstract The role of oxidative stress, as well as inflammation in the pathogenesis of methotrexate (MTX)-induced oral mucositis, is a known fact. The anti-inflammatory, antitumor, antimicrobial, and antioxidant properties of taxifolin—the effect we tested against MTX-induced oral mucosal damage—are well known. Objective Evaluating biochemically and histopathologically the effects of taxifolin on methotrexate-induced oral mucosal damage in rats. Methodology In the taxifolin+MTX (TMTX) group, 50 mg/kg taxifolin was orally administered to rats by gavage. In the MTX and healthy (HG) groups, normal saline was applied to rats as solvent by the same method. One hour after administration of taxifolin and solvent, 5 mg/kg MTX was orally administered to rats in the MTX and TMTX groups. Taxifolin and methotrexate were administered once a day for 30 days. Macroscopic, biochemical, and histopathological evaluations were performed on the inner cheek and tongue tissues of rats. These parts were removed after rats were killed with a high-dose anesthesia. Results Taxifolin with MTX prevented the increase in oxidant and pro-inflammatory parameters, such as malondialdehyde (MDA), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), interleukin 6 (IL-6), on the inner cheek and tongue tissues of rats. Moreover, taxifolin antagonized the decrease in total glutathione (tGSH). Taxifolin decreased MTX-induced histopathological damage. Conclusion These findings suggest that taxifolin may be useful to treat MTX-associated oral mucositis.

Effects of climate variables on the incidence of scorpion stings in Iran for five years

Background: Although scorpionism is recorded worldwide, some regions such as Iran present a higher incidence. Due to the great prevalence of scorpion stings in Khuzestan province, southwestern Iran, the present study examined the relationship between different climate parameters and the scorpion sting rate in this area from April 2010 to March 2015. Methods: In this cross-sectional descriptive-analytical study, we considered all scorpion sting cases recorded in the Department of Infectious Diseases, Ahvaz Jundishapur University of Medical Sciences. Data were analyzed using statistics, frequency distribution and Pearson's correlation coefficient. Results: A total of 104,197 cases of scorpion stings was recorded from 2010 to 2015. The cumulative incidence of scorpion sting was 2.23%. The spatial distribution of scorpion stings showed that most cases occurred in the Dehdez district (4,504 scorpion stings/100,000 inhabitants) and the Masjed Soleyman county (4,069 scorpion stings/100,000 inhabitants). A significant association was found between climate factors (temperature, evaporation rate, sunshine duration, humidity, and precipitation) and the scorpion sting rate. An increase in rainfall and humidity coincided with a reduction in scorpion stings whereas an increase in temperature, evaporation, and sunshine duration was accompanied by a growth of scorpion stings. No significant correlation was found between wind velocity/direction and the incidence rate of stings. Moreover, the seasonal peak incidence of scorpion stings was recorded in summer (an average of 8,838 cases) and the lowest incidence was recorded during winter (an average of 1,286 cases). The annual trend of scorpion sting cases decreased during the period from 2010 to 2015. Conclusion: Climate variables can be a good index for predicting the incidence of scorpion stings in endemic regions. Since they occur mostly in the hot season, designing preventive measures in the counties and districts with a high incidence of scorpion stings such as Dehdez and Masjed Soleyman can minimize mortality and other burdens.(AU)

Ivermectin as an adjunct treatment for hospitalized adult COVID-19 patients: A randomized multi-center clinical trial

Objective: To evaluate different doses of ivermectin in adult patients with mild COVID-19 and to evaluate the effect of ivermectin on mortality and clinical consequences. Methods: A randomized, double-blind, placebo-controlled, multicenter clinical trial was performed at five hospitals. A total of 180 mild hospitalized patients with COVID-19 confirmed by PCR or chest image tests were enrolled and allocated to six arms including hydroxychloroquine 200 mg twice per day, placebo plus hydroxychloroquine 200 mg twice per day, single dose ivermectin (200 μg/kg), three low interval doses of ivermectin (200, 200, 200 μg/kg), single dose ivermectin (400 μg/kg), and three high interval doses of ivermectin (400, 200, 200 μg/kg). The primary endpoint of this trial was all-cause of mortality or clinical recovery. The radiographic findings, hospitalization and low O

Immune checkpoints in targeted-immunotherapy of pancreatic cancer: New hope for clinical development

Immunotherapy has been recently considered as a promising alternative for cancer treatment. Indeed, targeting of immune checkpoint (ICP) strategies have shown significant success in human malignancies. However, despite remarkable success of cancer immunotherapy in pancreatic cancer (PCa), many of the developed immunotherapy methods show poor therapeutic outcomes in PCa with no or few effective treatment options thus far. In this process, immunosuppression in the tumor microenvironment (TME) is found to be the main obstacle to the effectiveness of antitumor immune response induced by an immunotherapy method. In this paper, the latest findings on the ICPs, which mediate immunosuppression in the TME have been reviewed. In addition, different approaches for targeting ICPs in the TME of PCa have been discussed. This review has also synopsized the cutting-edge advances in the latest studies to clinical applications of ICP-targeted therapy in PCa.

Integration of Droplet Microfluidic Tools for Single-Cell Functional Metagenomics: An Engineering Head Start / 基因组蛋白质组与生物信息学报·英文版

Droplet microfluidic techniques have shown promising outcome to study single cells at high throughput. However, their adoption in laboratories studying "-omics" sciences is still irrelevant due to the complex and multidisciplinary nature of the field. To facilitate their use, here we provide engineering details and organized protocols for integrating three droplet-based microfluidic technologies into the metagenomic pipeline to enable functional screening of bioproducts at high throughput. First, a device encapsulating single cells in droplets at a rate of ∼250 Hz is described considering droplet size and cell growth. Then, we expand on previously reported fluorescence-activated droplet sorting systems to integrate the use of 4 independent fluorescence-exciting lasers (i.e., 405, 488, 561, and 637 nm) in a single platform to make it compatible with different fluorescence-emitting biosensors. For this sorter, both hardware and software are provided and optimized for effortlessly sorting droplets at 60 Hz. Then, a passive droplet merger is also integrated into our pipeline to enable adding new reagents to already-made droplets at a rate of 200 Hz. Finally, we provide an optimized recipe for manufacturing these chips using silicon dry-etching tools. Because of the overall integration and the technical details presented here, our approach allows biologists to quickly use microfluidic technologies and achieve both single-cell resolution and high-throughput capability (>50,000 cells/day) for mining and bioprospecting metagenomic data.

A possible protective role for Bacillus Calmette-Guérin therapy in urinary bladder cancer in the era of COVID-19: a brief report

Given the systemic immunogenic effects of Bacillus Calmette-Guérin (BCG) therapy in patients with bladder cancer and its non-specific immunogenic effects in viral respiratory diseases, we aimed to study severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in bladder cancer patients with a history of BCG therapy. In the present study, all bladder cancer survivors with a history of BCG therapy were identified and included in the study according to the data recovered from the UORC (Uro-Oncology Research Center) registry database. These patients were followed up in terms of acquiring coronavirus disease 2019 (COVID-19). Among the studied patients, 102 eligible bladder cancer patients with a history of BCG therapy entered the study. The males constituted the majority of the patients (86.3%), and more than half of the study population (55.9%) were above 65 years old. Among the understudy patients, 12.7% were confirmed for COVID-19. The study results did not show a statistically significant association between the time and number of BCG therapy courses and SARS-CoV-2 infection. Although no statistically significant association was observed between receiving BCG therapy and developing COVID-19, the infection rate in patients who had recently received BCG therapy was lower than those who had received therapy more than a year ago.

Evaluation of drought tolerance indices for barley landraces under irrigated and dry conditions / Avaliação de índices de tolerância seca para terraços de cevada em condições irrigadas e secas

Barley cultivation for drought areas requires a reliable assessment of drought tolerance variability among the breeding germplasms. Hence, 121 barley landraces, advanced breeding lines, and varieties were evaluated under both moisture non-stress and stress field conditions using a lattice square (11×11) design with two replications for each set of the trials. Twelve drought tolerance indices (SSI, TOL, MP, GMP, STI, YI, YSI, HM, SDI, DI, RDI, and SSPI) were used based on grain yield under normal (Yp) and drought (Ys) conditions. Analysis of variance showed a significant genetic variation among genotypes for all indices except for TOL and SSPI indices. Yp had a very strong association with Ys (r = 0.92**) that indicates high yield potential under non-stress can predict better yield under stress conditions. Yp and Ys were positively and significantly correlated with MP, GMP, STI, YI, HM, and DI indices, whereas they were negatively correlated with SSI and SDI. In principal component analysis (PCA), the first PC explained 64% of total variation with Yp, Ys, MP, GMP, STI, YI, HM, and DI. The second PC explained 35.6% of the total variation and had a positive correlation with SSI, TOL, SDI, and SSPI. It can be concluded that MP, GMP, STI, YI, HM and DI indices with the most positive and significant correlation with the yield at both non-stress and stress environments would be better indices to screen barley genotypes, although none of the indices could undoubtedly identify high yield genotypes under both conditions.

O cultivo de cevada para áreas secas exige uma avaliação confiável da variabilidade da tolerância à seca entre os germoplasmas reprodutores. Assim, 121 linhagens crioulas de cevada (linhas de reprodução avançada e variedades) foram avaliadas em campo sob condições sem estresse e com estresse de umidade do solo, utilizando-se para isso um arranjo experimental de malha quadrada (11×11), com duas repetições para cada conjunto de ensaios. Foram utilizados 12 índices de tolerância à seca (SSI, TOL, MP, GMP, STI, YI, YSI, HM, SDI, DI, RDI e SSPI), com base no rendimento de grãos sob condições normais sem estresse (Yp) e com estresse de seca (Ys). A análise de variância mostrou uma variação genética significativa entre os genótipos para todos os índices, com exceção dos índices TOL e SSPI. Yp teve uma associação muito forte com Ys (r = 0,92**), o que indica que o potencial de alto rendimento sob condições sem estresse pode prever melhor rendimento sob condições de estresse. Yp e Ys foram positivamente e significativamente correlacionados com os índices MP, GMP, STI, YI, HM e DI, enquanto, foram correlacionados negativamente com os índices SSI e SDI. Na análise de componentes principais (PCA), o primeiro PC explicou 64% da variação total com Yp, Ys, MP, GMP, STI, YI, HM e DI. O segundo PC explicou 35,6% da variação total e apresentou correlação positiva com SSI, TOL, SDI e SSPI. Pode-se concluir que, os índices MP, GMP, STI, YI, HM e DI com a correlação mais positiva e significativa com a produção nos ambientes sem estresse e com estresse seriam melhores índices para a seleção de genótipos de cevada, embora nenhum dos índices pudesse concretamente identificar genótipos de alto rendimento sob ambas as condições.

The interactive effect of preoperative consultation and operating room admission by a counselor on anxiety level and vital signs in patients undergoing Coronary Artery Bypass Grafting surgery. A clinical trial study

Objective. The purpose of this study was to provide appropriate preoperative supportive conditions to improve anxiety and vital signs for patients undergoing Coronary Artery Bypass Grafting -CABG- surgery. Methods. This clinical trial study was performed on 90 patients undergoing CABG surgery in Farshchian Hospital of Hamadan, Iran in 2019. Sample was selected by convenience and were randomly divided into three groups: control (n=30), intervention1 (n=30), and intervention2 (n=30). The control group received only the routine preoperative counseling of ward and admitted to the operating room as usual; the intervention1 and intervention2 groups in addition received another two counseling sessions, then the intervention1 group was admitted in the operating room as usual, but the intervention2 group was admitted by the counselor in the operating room. Data were collected using a three-part questionnaire including demographic characteristics, vital signs chart, and the Spielberger's State-Trait Anxiety Inventory. Results. The results showed that there was a significant difference in the mean anxiety of the three groups after admission in the operating room (intervention2 was lower than intervention1 and control groups, p<0.001; and intervention 1 group was lower than control group, p<0.001) and also there was a significant difference between the mean systolic blood pressure, heart rate and respiratory rate of the three groups (p<0.001) but the mean of the variables of temperature and diastolic blood pressure in the three groups were not significantly different (p=0.59 and p=0.225, respectively). Conclusion. Our results revealed preoperative consultation and admission in the operating room by the consultant can reduce the level of anxiety and stability of vital signs of patients undergoing CABG

Objetivo. Evaluar si las condiciones de apoyo preoperatorias mejoran la ansiedad y los signos vitales para los pacientes sometidos a cirugía de bypass de arterias coronarias (CABG por sus siglas en inglés). Métodos. Este estudio clínico se realizó en 90 pacientes sometidos a cirugía de revascularización coronaria -CABG- en el Hospital Farshchian de Hamadan en Irán. La muestra se seleccionó por conveniencia y se dividió aleatoriamente en tres grupos: control (n=30), intervención1 (n=30) e intervención2 (n=30). El grupo de control recibió solamente la consejería preoperatoria de rutina cuando ingresó a hospitalización y en el momento de admisión en la sala de cirugía; los grupos de intervención1 e intervención2 además de la consejería rutina recibieron otra sesión adicional; y cuando se admitió el grupo de intervención2 en la sala de operaciones, lo acompañó la misma persona que hizo la consejería. Los datos se recopilaron mediante un cuestionario de tres partes que incluyó características demográficas, un cuadro de signos vitales y los puntajes del State-Trait Anxiety Inventory de Spielberger. Resultados. Los hallazgos mostraron que hubo diferencia significativa en el puntaje de ansiedad de los tres grupos después de la admisión en la sala cirugía (en intervención2 fue menor que en los grupos intervención1 y control, p<0.001; y en el grupo de intervención1 fue menor que en el grupo de control, p<0.001). También se encontraron diferencias estadísticamente significantes para las diferencias en la presión arterial sistólica, la frecuencia cardíaca y la frecuencia respiratoria de los tres grupos, pero no para las variables de temperatura y presión arterial diastólica (p=0.59 y p=0.225, respectivamente). Conclusión. Nuestros resultados revelaron que la consulta preoperatoria y la admisión en el quirófano por parte del consultor pueden reducir el nivel de ansiedad y la estabilidad de los signos vitales de los pacientes sometidos a CABG.

Objetivo. O propósito deste estudo foi avaliar se as condições de apoio pré-operatórias melhoram a ansiedade e os signos vitais para os pacientes submetidos a cirurgia de bypass de artérias coronárias (CABG por suas siglas em inglês). Métodos. Este estudo clínico se realizou em 90 pacientes submetidos a cirurgia de revascularização coronária -CABG- no Hospital Farshchian de Hamadan no Irão. A mostra se selecionou por de conveniência e se dividiu aleatoriamente em três grupos: controle (n=30), intervenção1 (n=30) e intervenção2 (n=30). O grupo de controle recebeu somente o aconselhamento pré-operatória de rotina quando ingressou a hospitalização e no momento de admissão na sala de cirurgia; os grupos de intervenção1 e intervenção2 ademais do aconselhamento de rotina receberam outra sessão adicional; e quando o grupo de intervenção2 foi admitido na sala de operações foi acompanhado pela mesma pessoa que fez o aconselhamento. Os dados se recopilaram mediante um questionário de três partes que incluiu características demográficas, um quadro de signos vitais e as pontuações do State-Trait Anxiety Inventory de Spielberger. Resultados. As descobertas mostraram que houve diferença significativa na pontuação de ansiedade dos três grupos depois da admissão na sala cirurgia (em intervenção2 foi menor do que nos grupos intervenção1 e controle, p<0.001; e no grupo de intervenção1 foi menor do que no grupo de controle, p<0.001). Também se encontrou diferenças estatisticamente significantes para as diferenças na pressão arterial sistólica, a frequência cardíaca e a frequência respiratória dos três grupos, mas não para as variáveis de temperatura e pressão arterial diastólica (p=0.59 e p=0.225, respectivamente). Conclusão. Nossos resultados revelaram que a consulta pré-operatória e a admissão na sala de cirurgia por parte do consultor podem reduzir o nível de ansiedade e a estabilidade dos signos vitais dos pacientes submetidos a CABG.

Face masks vs. COVID-19: a systematic review

The coronavirus disease (COVID-19) spread rapidly around the world. Two types of approaches have been applied to use of face masks as a tool to prevent the spread this disease in society. The aim of the systematic review was to assess the effectiveness of face masks against the novel coronavirus. A literature search was performed using different databases until April 30, 2020. Search terms were 'facemasks', 'novel coronavirus', and 'healthcare workers'. Five studies were included in the systematic review. A study stated that no difference between surgical and cotton masks. Also, two studies have emphasized the use of surgical masks or N95 respirators by medical staff, and two other studies emphasized the use of any type of face mask by general public. More studies in controlled contexts and studies of infections in healthcare and community places are needed for better definition of the effectiveness of face masks in preventing coronavirus.

La enfermedad por coronavirus (COVID-19) se propagó rápidamente por todo el mundo. Se han aplicado dos tipos de enfoques al uso de máscaras faciales como herramienta para prevenir la propagación de la enfermedad en la sociedad. El objetivo de la revisión sistemática fue evaluar la efectividad de las máscaras faciales contra el nuevo coronavirus. Se realizó una búsqueda bibliográfica utilizando diferentes bases de datos hasta el 30 de abril de 2020. Los términos de búsqueda fueron: 'máscaras faciales', 'nuevo coronavirus' y 'trabajadores de la salud'. Se incluyeron cinco estudios en la revisión sistemática. Un estudio indicó que no hay diferencia entre las máscaras quirúrgicas y las de algodón. Además, dos estudios han enfatizado el uso de máscaras quirúrgicas o respiradores N95 por parte del personal médico, y otros dos estudios enfatizaron el uso de cualquier tipo de mascarilla por parte del público en general. Se necesitan más estudios en contextos controlados y estudios de infecciones en el cuidado de la salud y en lugares comunitarios para una mejor aclaración de la efectividad de las mascarillas para prevenir el coronavirus.

A doença de coronavírus (COVID-19) se espalhou rapidamente por todo o mundo. Dois tipos de abordagens foram aplicados ao uso de máscaras faciais como uma ferramenta para impedir a propagação da doença na sociedade. O objetivo da revisão sistemática foi avaliar a eficácia das máscaras faciais contra o novo coronavírus. Uma pesquisa bibliográfica foi realizada usando diferentes bancos de dados até 30 de abril de 2020. Os termos de pesquisa foram: máscaras faciais ',' novo coronavírus 'e' profissionais de saúde '. Cinco estudos foram incluídos na revisão sistemática. Um estudo indicou que não há diferença entre máscaras cirúrgicas e máscaras de algodão. Além disso, dois estudos enfatizaram o uso de máscaras cirúrgicas ou respiradores N95 pelo pessoal médico e dois outros estudos enfatizaram o uso de qualquer tipo de máscara pelo público em geral. É necessário mais estudos em ambientes controlados e estudos de infecções nos serviços de saúde e na comunidade para esclarecer melhor a eficácia das máscaras na prevenção do coronavírus

Spatial distribution of cutaneous anthrax in western Iran from 2009 to 2016: Geographic information system mapping for predicting risk of anthrax outbreaks

To explore the spatial accumulation of diseases and their aggravating factors are essential in all public health. This study attempts to use geographic information system (GIS) to provide more information about the incidence and future of anthrax. Methods: Patients were diagnosed with anthrax in Kurdistan Province from 2009 to 2016. Data was then exported into ArcGIS software version 9 and the required layers for years and areas were added.Final map for each year was drawn up, pointing out the hot spots and predicting its future pattern. Results: Most cases were reported in females (57 cases, 54.80 %), and the lower body limbs were most affected (63 cases, 60.57%). The highest numbers of incidences were related to the cities of Marivan, Saqez and Divandareh, with more concentration in the central parts of the province, rather than borderline areas. The highest percentage of the probable incidence of the disease was in Sanandaj (57.74%) with a potential susceptible area of 1 729.12 km

Impact of simulated cigarette excise tax increase on its consumption in Iran / 한국역학회지

OBJECTIVES@#To assess the impact of a simulated tax-induced cigarette price increase on its consumption by different expenditure clusters in Iran. @*METHODS@#Employing consecutive cross sections for cigarette consumption, a two-part model was applied for different expenditure groups. @*RESULTS@#A 75% price increase in cigarettes noticeably— as is common in some countries with strong tobacco control policies—reduces current consumption in all five social classes, causing nearly 8% of current male smokers to quit or not to start. @*CONCLUSIONS@#Findings of the current study suggest that Iranian policy makers go through to implement tobacco taxation policies to control smoking prevalence, which in turn might lead to a reduction in national healthcare expenditures as well as enhance the global community’s capacity to meet Sustainable Development Goals.

The Effects of Implementing an Occupational Health and Safety Management System on Functional Indices: A Five-year Study in Casting Industry

@#Introduction: Assessment of the performance of management systems is one of the main concerns of managers. The measure of success of an occupational health and safety management system is the ex-tent of its effectiveness. The effects of implementing an OHSMS on health and safety perfor-mance indices in a casting site located in Iran between 2015 and 2019 were examined. Methods: A retrospective descriptive-analytical study was conducted over five years on 21 depart-ments of a casting site. All the functional indices one year before the implementation of OHSAS 18001:2007 in 2015 until a year after the implementation (2019) were monitored and the data were analyzed using SPSS (v.19). Results: There was a significant decrease in occupational accidents after the implementation of OHSAS 18001:2007. Mechanical and ergonomic factors demonstrated significant improvements. There were improvements in the indices of opening health files for the personnel, personal protective equipment, education, instructions, legal requirements, commitment, and leadership. There was no significant change in chemical and physical factors. Conclusion: Implementation of the occupational health and safety manage-ment system was effective in the indices that needed managerial control with no or low expenses. However, it was not effective in indices in engineering and technical areas that needed more expenses.

Correlation between Health Literacy and Quality of Life in Iranian Menopausal Women

Objectives@#Understanding the factors that promote quality of life (QOL) in menopausal women is essential for establishing educational strategies and health policies. Studies on the relationship between health literacy and QOL in menopausal women in Iran are rare. Therefore, we aimed to determine health literacy in menopausal women and its relationship with QOL. @*Methods@#The present cross-sectional study was performed on 177 menopausal women referred to comprehensive health services in Hamadan City, Iran. Health Literacy for Iranian Adults and Menopause-Specific QOL questionnaires were used to collect information. Pearson correlation coefficient was used to assess the correlation between health literacy and QOL. @*Results@#The majority of menopausal women included in this study were married housewives, and 44.6% of them were 50–55 years old; furthermore, only 6.2% had adequate or good health literacy. Health literacy was significantly correlated with total QOL score and vasomotor, psychology, and physical domains (P < 0.05). @*Conclusions@#Health literacy was associated with various domains of QOL. Therefore, health providers should pay more attention on improving health literacy by holding educational promotional programs for menopausal women to enhance their QOL.

Conus Medullaris Teratoma: Case Report and Literature Review

Teratomas are benign germ cell tumors that usually found out of their anatomical origin. Teratomas usually are found in sacrococcygeal area, gonads, mediastinum, cervicofacial region and intracranial fossa. Spinal teratomas are rare. In this study we describe a case of conus medullaris teratoma which was diagnosed based on imaging studies. The patient underwent surgery. We did bilateral laminectomy. The mass lesion had an obvious and rigid attachment to the conus medullaris. The wall of the lesion was resected as much as possible, but total resection of the lesion’s wall could not be done due to changes in neural monitoring. Previous related studies are reviewed.

Effects of l-arginine supplementation on glycemic profile: Evidence from a systematic review and meta-analysis of clinical trials / 中西医结合学报

BACKGROUND@#The effects of l-arginine supplementation on indices of glycemic control and the role of many factors influencing this intervention have been controversial in clinical trials.@*OBJECTIVE@#This meta-analysis was performed to assess the effects of l-arginine supplementation on indices of glycemic control, including fasting blood glucose (FBG), hemoglobin A1c (HbA1c), serum insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels in randomized controlled trials (RCTs).@*SEARCH STRATEGY@#This study conducted a systematic review of RCTs published in PubMed, Scopus, Web of Science, Cochrane Library and Embase, up to 5 May, 2018.@*INCLUSION CRITERIA@#Studies were included in this meta-analysis if they were RCTs with parallel design and reported sufficient data on participants before and after intervention, and outcomes of glycemic profile parameters in both the arginine supplementation and control groups.@*DATA EXTRACTION AND ANALYSIS@#The screening of titles and abstracts was performed independently by two reviewers. Selected articles were considered if they met the study's inclusion criteria. The quality of included studies was assessed by using the Cochrane Collaboration modified tool. From 710 articles retrieved in the initial search, only 10 trials were suitable for pooling the effects of arginine supplementation on serum glucose, insulin, HOMA-IR and HbA1c levels, with effect sizes of nine, eight, five and five, respectively.@*RESULTS@#Pooled random-effect analysis revealed that l-arginine supplementation could significantly decrease FBG level (weighted mean difference [WMD]: 3.35 mg/dL; 95% confidence interval [CI] = [-6.55, -0.16]; P = 0.04) and serum insulin level (WMD: -2.19 μIU/mL; 95% CI = [-3.70, -0.67]; P = 0.005). However, the effects of l-arginine supplementation on HOMA-IR and HbA1c were not significant. Results of subgroup analysis showed that supplementation with l-arginine could significantly decrease serum insulin levels when the dosage of l-arginine is > 6.5 g/d (WMD: -3.49 μIU/mL; 95% CI = [-5.59, -1.38]; P = 0.001), when the duration of supplementation is ≤ 12.8 weeks (WMD: -3.76; 95% CI = [-6.50, -0.98]; P = 0.008), when the participants are not diabetic patients (WMD: -2.54 μIU/mL; 95% CI = [-4.50, -0.50]; P = 0.01) and when the baseline serum level of insulin was > 20 μIU/mL (WMD: -3.98; 95% CI = [-6.31, -1.65]; P = 0.001).@*CONCLUSION@#Although the results of this study confirmed that supplementation with l-arginine could have significant effects on some glycemic profile indices of participants in clinical trials, the clinical importance of this reduction may not be meaningful.

Reopening of dental clinics during SARS-CoV-2 pandemic: an evidence-based review of literature for clinical interventions / 대한악안면성형재건외과학회지

Background@#Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes serious acute respiratory diseases including pneumonia and bronchitis with approximately 2.3% fatality occurrence.Main bodyThis study argues the main concepts that need to be considered for the gradual reopening of dental offices include treatment planning approaches, fundamental elements needed to prevent transmission of SARS-CoV-2 virus in dental healthcare settings, personal protection equipment (PPE) for dental health care providers, environmental measures, adjunctive measures, and rapid point of care tests in dental offices. @*Conclusion@#This article seeks to provide an overview of existing scientific evidence to suggest a guideline for reopening dental offices.