Sexual Quality of Life of Breast Cancer Survivors: A Cross-Sectional Study.

AIM: Sexual quality of life (SQL), one of the essential issues of sexual and reproductive health, negatively affects the overall quality of life. This study aimed to investigate the SQL of breast cancer survivors. METHODS: In this cross-sectional study, 410 breast cancer survivors were recruited in a two-stage sampling process. The quota sampling method was employed in the first stage, and convenience sampling was used in the second stage between December 2020 and September 2021. The data were collected using the sexual Quality of Life-Female, Female Sexual Function Index, Revised Religious Attitude. RESULTS: The mean age of the participants and the time since the disease diagnosis were 42.64 ± 6.02 years and 13.9 ± 4.80 months, respectively. The mean score of SQL was 66.65 ± 10.23 (95% Confidence Interval: 66.63-67.62). Multiple linear regression analysis showed that the SQL of breast cancer survivors was significantly correlated with their occupation (ß=0.12, P<0.008), education (ß=-0.23, P<0.001), their spouse's education (ß=0.16, P<0.001), belief in the sex initiation by the spouse (ß=0.23, P<0.001), fear of being hurt by sexual intercourse (ß=0.21 P < 0.001), receiving training about sexual relations (ß = 0.1, P < 0.049), lumpectomy (ß = 0.11, P < 0.001), sexual function (ß = 0.13 ß = 0.001), and religious attitude (ß = 0.27, P < 0.001). These factors explain 60% of the variance of the SQL score. CONCLUSION: Considering the various factors contributing to the SQL of breast cancer survivors can inform interventions targeted at improving the health status of these women.

Development and Characterization of a Sustainable Bio-Polymer Concrete with a Low Carbon Footprint.

Polymer concrete (PC) has been used to replace cement concrete when harsh service conditions exist. Polymers have a high carbon footprint when considering their life cycle analysis, and with increased climate change concerns and the need to reduce greenhouse gas emission, bio-based polymers could be used as a sustainable alternative binder to produce PC. This paper examines the development and characterization of a novel bio-polymer concrete (BPC) using bio-based polyurethane used as the binder in lieu of cement, modified with benzoic acid and carboxyl-functionalized multi-walled carbon nanotubes (MWCNTs). The mechanical performance, durability, microstructure, and chemical properties of BPC are investigated. Moreover, the effect of the addition of benzoic acid and MWCNTs on the properties of BPC is studied. The new BPC shows relatively low density, appreciable compressive strength between 20-30 MPa, good tensile strength of 4 MPa, and excellent durability resistance against aggressive environments. The new BPC has a low carbon footprint, 50% lower than ordinary Portland cement concrete, and can provide a sustainable concrete alternative in infrastructural applications.

Effect of a social network-based supportive program (WhatsApp) on the sexual self-concept of women with breast cancer: A single-blind-randomized controlled trial.

OBJECTIVES: Sexual self-concept has an influence on the sexual behaviors of women with breast cancer. Supportive programs for these women have demonstrable empirical efficacy; however, their effectiveness has not been examined. The aim of this study was to investigate the effect of a supportive program based on social networks on the sexual self-concept of women with breast cancer. METHODS: In this randomized controlled single-blind trial, 60 women were assigned to the intervention (n = 30) and control (n = 30) groups using permuted block randomization. Overall, eight 45-min intervention sessions were held (twice a week). The primary outcome was sexual self-concept, and the secondary outcomes were women's sexual quality of life and participants' satisfaction. The questionnaires were completed by patients before the intervention and immediately and 1 month after the intervention. RESULTS: The generalized equation estimation test showed that the positive sexual self-concept score of the intervention group versus the control group had increased by 15.67 points (P < 0.001, effect size = 2.00) 1 month after the intervention. The negative sexual self-concept score had decreased by 2.65 points (P < 0.001, effect size = 0.74), and the situational sexual self-concept score had upturned by 6.82 points (P < 0.001, effect size = 2.08) in the intervention group at the same period. Also, the sexual quality of life score in the intervention group compared to the control group generally increased by 13.82 points (P < 0.001, Effect size = 2.08) 1 month following the intervention. SIGNIFICANCE OF THE RESULTS: A social networking support program can be a promising approach to improve the sexual self-concept of women with breast cancer. CLINICAL TRIALS.GOV IDENTIFIER: Iranian Clinical Trial Register, IRCT20150608022609N8. Registered on 2 July 2020.

Infective Endocarditis: Clinical Characteristics and Echocardiographic Findings.

Purpose: Infective endocarditis (IE) remains a disease with high morbidity and mortality. The aim of this study was to determine the clinical characteristics and echocardiographic features of patients with IE. Methods: We analyzed patients with either definitive or probable diagnosis of IE who were hospitalized in a teaching hospital in Mashhad, Iran between June 2011 and January 2020. Patients who survived were followed up by echocardiography for at least 6-month after hospital discharge. Results: A total of 82 cases with IE were included of which 62 (75.6%) received definitive diagnosis. The mean age was 39.7 ± 18.7 years and 52 (63.4%) were male. The most common preexisting structural cardiac abnormality that predispose patients to IE were congenital heart diseases (28 %) of which bicuspid aortic valve was more common (n = 12, 14.6%), followed by ventricular septal defect (n = 9, 11%) and Tetralogy of Fallot (TOF) (n = 2, 2.4%). Three (3.6 %) cases had rheumatic heart disease and 12 (14.6 %) were injecting drug users. The most common causative pathogen was Staphylococcus aureus, detected in 7 (19.4%) cases. Follow-up echocardiography revealed right or left ventricular failure in 10 (12.1%) cases. Cardiac complications occurred in 41 (50%) cases and systemic complications in 63 (76.8%). All-cause mortality was 41.5% (n = 34) and 6 (18.1%) patients died due to cardiovascular complications. Conclusions: The short- and long-term prognosis in IE was poor and the predictors for in-hospital and 1-year mortality were defined as heart failure and septic shock. Congenital heart disease and intravenous illicit drug using (IVDU) were the most common predisposing condition which may necessitate a revision in the IE prophylaxis recommendations.

Pulmonary thromboembolism with transthoracic ultrasound and computed tomography angiography.

OBJECTIVE: The detection of pulmonary embolism in emergency department requires an urgent therapeutic and diagnostic attention. This study was performed to determine the accuracy and efficacy of ultrasound in the diagnosis of pulmonary embolism. METHODS: In this study, 110 patients who referred to the emergency department with traumatic embolism symptoms were enrolled. All the patients underwent computed tomography (CT) angiography. Patients were divided into positive and negative outcomes according to the results of transthoracic ultrasonography and CT angiography. RESULTS: In this study, 110 patients were enrolled, of whom 52 (47.3%) were male and 58 (52.7%) were female. Among the patients, 100 (90.9%) patients presented with dyspnea, whereas the frequency of pleural pain was 27% (24.5%). Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasound were 45.67%, 77.41%, 88.09%, and 35.29%, respectively. The positive outcomes from CT scan were significantly associated with gender, p = 0.005. The gender and transthoracic ultrasonography outcomes were also significantly correlated, p = 0.019, and the outcomes of ultrasound were significantly different from those of CT scan, p = 0.008. CONCLUSION: Transthoracic ultrasonography may be used to diagnose pulmonary embolism as a technique in the emergency department, especially in patients who are unable to move due to the severity of the disease. However, further comparative studies are required in this aspect.

Prevalence of the presystolic wave in echocardiography and its association with the extent of coronary artery disease in patients with chronic stable angina.

INTRODUCTION: Since mortality and morbidity of coronary artery disease are high, there is a need for non-invasive diagnostic methods for early diagnosis and prediction of ischemic heart disease (IHD) outcome. This study aimed to assess the relationship between angiographic findings, the Presystolic wave (PSW) and some of the ischemic related parameters in echocardiography of the patients with chronic stable angina. MATERIALS AND METHODS: This cross-sectional study was conducted on the patients with chronic angina pectoris who referred to a tertiary hospital for coronary angiography in Mashhad, Iran. Demographic and medical history of the patients, as well as echocardiography findings, including ejection fraction (EF), regional wall motion abnormalities (RWMA), PSW and diastolic function were recorded. Angiographic findings, including SYNTAX score were also assessed. RESULTS: A total of 220 patients (132 males and 88 females) with the mean age of 62.43 ± 11.40 years old participated in this study. The prevalence of PSW was 49.1%. The absence of the PSW was related to more RWMA (P =.002), and higher stages of left ventricular diastolic dysfunction (LVDD) (P =.029) and higher SYNTAX score (P =.001). There was a significant association between the absence of the PSW and EF categories, especially in severe LV systolic dysfunction (LVEF < 30%) (P =.001). CONCLUSIONS: The findings of this study revealed that PSW is strongly associated with the SYNTAX score. The absence of the PSW may indicate patients at high-risk clinical status (higher SYNTAX score, severe systolic dysfunction, more RWMA, and higher stages of LVDD).

Surveying the Effect of Opioid Abuse on the Extent of Coronary Artery Diseases in Diabetic Patients.

BACKGROUND: Diabetes mellitus is recognized as one of the most common, serious, and costly chronic diseases. Opium addiction is also a common health problem in Iran. Given the high prevalence of opium use in South Khorasan Province and the increasing prevalence of opioid abuse in the community, this study was performed to investigate the effect of opioid abuse on the extent of disease in diabetic patients undergoing coronary angiography in the cardiology department of Vali-e-Asr Hospital in Birjand city, South Khorasan Province, Iran. METHODS: This study recruited a total of 1051 diabetic patients who underwent coronary angiography in the cardiology department of Vali-e-Asr Hospital of Birjand city from 2011 to 2015. The collected data were analyzed using SPSS version 22.0 with the chi-square test and univariate regression analysis. P value <0.05 was considered as statistically significant. RESULTS: Among opiate-addicted diabetics, the risk of coronary artery disease was 0.44 times higher than among nonaddicted diabetics (range 0.24-0.77, P=0.004). The extent of coronary vessel involvement, when present, was not different between the two groups. CONCLUSION: Opiate-addicted diabetics appear to be more susceptible to CAD than their nonaddicted counterparts. The determinants and correlates of this interaction must be the subject of further study.

TiO2-based Photocatalytic Cementitious Composites: Materials, Properties, Influential Parameters, and Assessment Techniques.

Applications of heterogeneous photocatalytic processes based on semiconductor particles in cement-based materials have received great attention in recent years in enhancing the aesthetic durability of buildings and reducing global environmental pollution. Amongst all, titanium dioxide (TiO2) is the most widely used semiconductor particle in structural materials with photocatalytic activity because of its low cost, chemically stable nature, and absence of toxicity. Utilization of TiO2 in combination with cement-based materials would plunge the concentration of urban pollutants such as NOx. In fact, cementitious composites containing TiO2 have already found applications in self-cleaning buildings, antimicrobial surfaces, and air-purifying structures. This paper aims to present a comprehensive review on TiO2-based photocatalysis cement technology, its practical applications, and research gaps for further progression of cementitious materials with photocatalytic activity.

Fire Performance of Heavyweight Self-Compacting Concrete and Heavyweight High Strength Concrete.

In this study, the fresh and hardened state properties of heavyweight self-compacting concrete (HWSCC) and heavyweight high strength concrete (HWHSC) containing heavyweight magnetite aggregate with 50, 75, and 100% replacement ratio, and their performance at elevated temperatures were explored experimentally. For fresh-state properties, the flowability and passing ability of HWSCCs were assessed by using slump flow, T500 mm, and J-ring tests. Hardened-state properties including hardened density, compressive strength, and modulus of elasticity were evaluated after 28 days of mixing. High-temperature tests were also performed to study the mass loss, spalling of HWSCC and HWHSC, and residual mechanical properties at 100, 300, 600 and 900 °C with a heating rate of 5 °C/min. Ultimately, by using the experimental data, rational numerical models were established to predict the compressive strength and modulus of elasticity of HWSCC at elevated temperatures. The results of the flowability and passing ability revealed that the addition of magnetite aggregate would not deteriorate the workability of HWSCCs and they retained their self-compacting characteristics. Based on the hardened densities, only self-compacting concrete (SCC) with 100% magnetite content, and high strength concrete (HSC) with 75 and 100% magnetite aggregate can be considered as HWC. For both the compressive strength and elastic modulus, decreasing trends were observed by introducing magnetite aggregate to SCC and HSC at an ambient temperature. Mass loss and spalling evaluations showed severe crack propagation for SCC without magnetite aggregate while SCCs containing magnetite aggregate preserved up to 900 °C. Nevertheless, the mass loss of SCCs containing 75 and 100% magnetite content were higher than that of SCC without magnetite. Due to the pressure build-up, HSCs with and without magnetite showed explosive spalling at high temperatures. The residual mechanical properties analysis indicated that the highest retention of the compressive strength and modulus of elasticity after exposure to elevated temperatures belonged to HWSCC with 100% magnetite content.

Blood lead levels in pregnant women referring to midwifery clinic in a referral center in Tehran.

BACKGROUND: Lead effects on children and pregnant women are grave, and screening tests would be logical to detect high blood lead levels (BLLs) in early stages. MATERIALS AND METHODS: Blood samples were taken from the pregnant mothers who referred to midwifery clinic with further phone interview postdelivery. RESULTS: In 100 patients evaluated, the mean age was 29 ± 5 years (median interquartile range gestational age of 33 [24, 37] weeks). There was a significant correlation between polluted residential area and median BLL (P = 0.044) and substance exposure (P = 0.02). The median BLL was significantly lower in those without a history of lead toxicity in the family (P = 0.003). The only factor that could predict the BLL levels lower than 3.2 and 5 µg/dL was living in the nonindustrial area. All pregnant women delivered full-term live babies. CONCLUSION: Positive history of lead toxicity in the family and living in polluted areas may pose a higher BLL in pregnant women.

Ultrasound-assisted dispersive magnetic solid phase extraction based on amino-functionalized Fe3O4 adsorbent for recovery of clomipramine from human plasma and its determination by high performance liquid chromatography: Optimization by experimental design.

The applicability of Amino-functionalized Fe3O4 nanoparticles (NPs) as an effective adsorbent was developed for the extraction and determination of clomipramine (CLP) in plasma sample by ultrasound-assisted dispersive magnetic solid phase extraction (UADM-SPE) and high-performance liquid chromatography-ultraviolet (HPLC-UV) detection. Fabrication of the Fe3O4@SiO2-NH2 magnetic nanoparticles confirmed by Fourier transform infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The effect of different extraction parameters (i.e. pH of the sample solution, the amount of magnetic nanoparticles (MNPs), sample volume, temperature and sonication time) on the extraction recovery of CLP were investigated by response surface methodology through central composite design (CCD). The optimum condition is obtained when the affecting parameters are set to: pH of the sample solution=9, the amount of MNPs=37mg, sample volume=23mL, 25°C temperature and sonication time=1min. Under the optimum condition, extraction recovery was 90.6% with relative standard deviation of 3.5%, and enrichment factor of 117. The linear range for determination of CLP was 0.017-0.70mgL-1 with a determination coefficient (R2) of 0.999. Limit of detection (LOD) and limit of quantification (LOQ) were 0.005 and 0.0167mgL-1, respectively. The established UADM-SPE-HPLC-UV method was rapid, simple and efficient for determination of CLP in human plasma samples.