A community based intervention to modify preventive behaviors of cutaneous leishmaniasis in children: a randomized controlled trial based on PRECEDE PROCEED model.

OBJECTIVES: Iran ranks among the top six countries globally with a significant incidence of Cutaneous Leishmaniasis (CL). Using planning models is one community-based intervention to promote preventive behaviors. The purpose of our study was to evaluate the effectiveness of the PRECEDE-PROCEED model (PPM) in modifying preventive behaviors related to CL in children through mother training in a community intervention. METHODS: A randomized controlled trial based on the PPM model was conducted on 168 mothers (intervention (n = 84) and control group (n = 84) with 10 years old children in the rural areas of Iran. Mothers from 7 village areas were randomly allocated to the intervention (2 village) and control groups (5 village). The intervention group received a program comprising eight 90-minute training sessions and environmental interventions. In this study, we utilized the PPM as a framework to design the questionnaires on Leishmaniosis prevention behavior. Participants in both groups completed the questionnaires at baseline (before the intervention), immediately after the intervention, and at the 2-month follow-up. Analysis of the data was conducted utilizing SPSS20, with statistical significance set at p < 0.05. RESULTS: Compared to the control group, the intervention group showed significant increases in knowledge, enabling factors, reinforcing factors, attitude, and preventive behaviors related to Cutaneous Leishmaniasis over time from baseline to follow-up (P < 0.001). No significant differences (P > 0.05) were observed in the alterations of the PPM construct, knowledge, and preventive behaviors within the control group from pre-intervention to follow-up. CONCLUSIONS: Community (education and environmental) intervention based on PPM is feasible and acceptable to modify preventive behaviors of Cutaneous Leishmaniasis in children by increasing a mother's knowledge and attitude as well as changing enabling and reinforcing factors. TRIAL REGISTRATION: IRCT20160619028529N8.

Modeling Defensive Response of Cells to Therapies: Equilibrium Interventions for Regulatory Networks.

A major objective in genomics is to design interventions that can shift undesirable behaviors of such systems (i.e., those associated with cancers) into desirable ones. Several intervention policies have been developed in recent years, including dynamic and structural interventions. These techniques aim at making targeted changes to cell dynamics upon intervention, without considering the cell's defensive mechanisms to interventions. This simplified assumption often leads to early and short-term success of interventions, followed by partial or full recurrence of diseases. This is due to the fact that cells often have dynamic and intelligent responses to interventions through internal stimuli. This paper models gene regulatory networks (GRNs) using the Boolean network with perturbation. The dynamic and adaptive battle between intervention and the cell is modeled as a two-player zero-sum game, where intervention and the cell fight against each other with fully opposite objectives. An optimal intervention policy is obtained as a Nash equilibrium solution, through which the intervention is stochastic, ensuring the optimal solution to all potential cell responses. We analytically analyze the superiority of the proposed intervention policy against existing intervention techniques. Comprehensive numerical experiments using the p53-MDM2 negative feedback loop regulatory network and melanoma network demonstrate the high performance of the proposed method.

Learning to Fight Against Cell Stimuli: A Game Theoretic Perspective.

Current genomics interventions have limitations in accounting for cell stimuli and the dynamic response to intervention. Although genomic sequencing and analysis have led to significant advances in personalized medicine, the complexity of cellular interactions and the dynamic nature of the cellular response to stimuli pose significant challenges. These limitations can lead to chronic disease recurrence and inefficient genomic interventions. Therefore, it is necessary to capture the full range of cellular responses to develop effective interventions. This paper presents a game-theoretic model of the fight between the cell and intervention, demonstrating analytically and numerically why current interventions become ineffective over time. The performance is analyzed using melanoma regulatory networks, and the role of artificial intelligence in deriving effective solutions is described.

Joint toxicity of cadmium and fenpyroximate on two earthworms: Interspecific differences, subcellular partitioning and biomarker responses.

Cadmium (Cd) and fenpyroximate are common soil contaminants found together in the field, but their combined toxicity to terrestrial invertebrates has not been studied. Therefore, earthworms Aporrectodea jassyensis and Eisenia fetida were exposed into Cd (5, 10, 50 and 100 µg/g) and fenpyroximate (0.1, 0.5, 1, and 1.5 µg/g) and their mixture, and multiple biomarker responses (mortality, catalase (CAT), superoxide dismutase (SOD), total antioxidant activity (TAC), lipid peroxidation (MDA), protein content, weight loss and subcellular partitioning) were determined to estimate health status and mixture effect. MDA, SOD, TAC, and weight loss were significantly correlated with Cd in total internal and debris (p < 0.01). Fenpyroximate altered the subcellular distribution of Cd. It appears that maintaining Cd in a non-toxic form was the earthworms' primary Cd detoxification strategy. CAT activity was inhibited by Cd, fenpyroximate, and their combined presence. BRI values for all treatments indicated a major and severe alteration in earthworm's health. The combined toxicity of Cd and fenpyroximate was greater than the toxicity of either substance alone. According to EAI, all combined treatments exhibited a clear antagonistic effect. In general, the sensitivity of A. jassyensis was greater than that of E. fetida.

Developing an Educational Parenting Skills Package to Parents Undergoing Substance Abuse Treatment for Preventing Addiction among Adolescents: A Study Protocol Based on Social Marketing Approach.

BACKGROUND: Developing an educational parenting skills package for parents with substance abuse may be effective in preventing the same problem in their adolescents. Social marketing is one of the approaches facilitating the preparation of educational content for this purpose. Social marketing is a regular and planned process focusing on customers and their needs for encouraging a target group to exhibit a particular behavior or adopt a specific idea. This study protocol aims to use the social marketing approach to prepare an educational parenting skills package for the parents undergoing substance abuse treatment to prevent addiction in their adolescents. METHODS: An educational parenting skills package will be designed and validated by a combination of qualitative research (descriptive phenomenology), scoping review, and Delphi study based on social marketing approach (4 Ps = product, price, place, promotion). The package will be prepared in four phases including educational need assessment, ranking the identified educational needs, determining the suitable health education constructs, and modeling and developing the educational content based on the identified constructs. The designed educational package will be validated from the perspective of the target group (parents undergoing substance abuse treatment) and experts. CONCLUSION: Developing educational packages based on a scientific health education approach and mainly the Social Marketing Assessment and Response Tool (SMART) model with an emphasis on market analysis or marketing mix (4 Ps = product, price, place, promotion) can prove effective in attracting the audience and promoting the target activities.

The effect of mobile-app-based instruction on the physical function of female patients with knee osteoarthritis: a parallel randomized controlled trial.

BACKGROUND: Osteoarthritis is a common disease and one of the most important causes of disability in the elderly that negatively affect the quality of their life. The purpose of this study was to evaluate the effectiveness of mobile app-based-instruction in improving physical performance of female patients with knee osteoarthritis. METHODS: The present study was a randomized clinical trial. The sample included 64 female patients (40 to 70 years old) with knee osteoarthritis in Bojnurd city in 2018. They were selected from the available patients that were randomly divided into comparison and intervention groups. Before the intervention, demographic information questionnaire, Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire, and 36-item short-form health survey (SF-36) were employed to elicit data on demographic information, arthritis condition and health status of the participants. Intervention lasted for a period of two months for each group. Intervention group received mobile-app-based instruction coupled with routine cares, while comparison group just received the routine cares. After the intervention both groups were evaluated again in terms of arthritis condition and health status using the same scales. RESULTS: After the intervention, significant differences were found between the intervention and comparison groups in terms of overall WOMAC score (p = 0.005), pain aspect of WOMAC (p = 0.005), physical function aspect of WOMAC (p = 0.005), physical function aspect of SF-36 (p ≤ 0.05), and vitality aspect of SF-36 (p > 0.05). CONCLUSION: The use of mobile-app-based instruction can enhance the physical function and quality of life in patients with knee osteoarthritis. Trial registration The research project was registered at Iranian Registry of Clinical Trials (IRCT20161208031300N2).

The Effect of Geographical and Climatic Factors on the Distribution of Phlebotomus papatasi (Diptera: Psychodidae) in Golestan Province, an Endemic Focus of Zoonotic Cutaneous Leishmaniasis in Iran, 2014.

BACKGROUND: Phlebotomus papatasi is known as the main vector of zoonotic cutaneous leishmaniasis. This study aimed to investigate the effect of geographical and bioclimatic factors on the Ph. papatasi distribution. METHODS: A total of 34 villages were selected, and sampling was performed three times using 120 sticky traps in each selected village. All the collected species were mounted and identified their species. The densities of Ph. papatasi were measured in all the villages and entered into ArcMap as a point layer. The required bioclimatic and environmental variables were extracted from the global climate database and The normalized difference vegetation index was obtained from the MODIS satellite imagery, also, all variables entered into ArcMap as raster layers, so The numerical value of each independent variable in the cell where the selected village is located in this, was extracted using spatial analyst tools and the value to point submenu. All the data were finally entered into IBM SPSS, and the relationship was examined between the number of collected Ph. papatasi and the independent variables using Spearman's correlation test. RESULTS: A total of 1773 specimens of Ph. papatasi were collected. The findings of this study showed that max temperature of warmest month, temperature annual range, temperature seasonality, mean diurnal range, precipitation seasonality, mean temperature of driest and warmest quarter were positively associated with the density of Ph. papatasi. CONCLUSION: Air temperature and precipitation were shown as the most significant factors in the distribution of Ph. papatasi.

Modeling and comparing data mining algorithms for prediction of recurrence of breast cancer.

Breast cancer is the most common invasive cancer and the second leading cause of cancer death in women. and regrettably, this rate is increasing every year. One of the aspects of all cancers, including breast cancer, is the recurrence of the disease, which causes painful consequences to the patients. Moreover, the practical application of data mining in the field of breast cancer can help to provide some necessary information and knowledge required by physicians for accurate prediction of breast cancer recurrence and better decision-making. The main objective of this study is to compare different data mining algorithms to select the most accurate model for predicting breast cancer recurrence. This study is cross-sectional and data gathering of this research performed from June 2018 to June 2019 from the official statistics of Ministry of Health and Medical Education and the Iran Cancer Research Center for patients with breast cancer who had been followed for a minimum of 5 years from February 2014 to April 2019, including 5471 independent records. After initial pre-processing in dataset and variables, seven new and conventional data mining algorithms have been applied that each one represents one kind of data mining approach. Results show that the C5.0 algorithm possibly could be a helpful tool for the prediction of breast cancer recurrence at the stage of distant recurrence and nonrecurrence, especially in the first to third years. also, LN involvement rate, Her2 value, Tumor size, free or closed tumor margin were found to be the most important features in our dataset to predict breast cancer recurrence.

Effect of sheep manure-derived biochar on colloidal phosphorus release in soils from various land uses.

Colloidal phosphorus (CP) as an additional route of P mobilization in soil solution has gained much attention. A batch experiment was conducted to investigate the effect of sheep manure-derived biochar (SMB) on CP release from various land uses (paddy, vegetable, tea, and citrus) at a rate of 0% as a control treatment (CK), 1% as a low (L) level, 2% as a middle (M) level, and 4% as a high (H) level of SMB application. The CP and MRPcoll in the solution increased from 30.58 to 88.97% and from 2.45 to 55.54% of total P (TP), respectively. The SMB enhanced CP release in all the soils and all the treatments (except CK and L levels in tea soil; CK, L, and M levels in vegetable soil; and L and M levels in citrus soil). Multiple linear regression revealed a significant correlation between CP and MRPcoll and between colloidal iron, aluminum, calcium, and total organic carbon (Fecoll, Alcoll, Cacoll, and TOCcoll) and pH, which may play an important role as CP carriers that could depend on the pH. This study suggests that the application of SMB in the soil at an appropriate rate of 1 and 2% for tea and vegetable soils, respectively, could be beneficial to avoid the risk of CP release in water bodies.

Comparison of Higher Order Aberrations after Wavefront-guided LASIK and PRK: One Year Follow-Up Results.

PURPOSE: To evaluate the changes and predictability of higher order aberrations (HOAs) after personalized laser in situ keratomileusis (LASIK) and personalized photorefractive keratectomy (PRK) for simple myopia and compound myopic astigmatism. METHODS: In this prospective cross-sectional study, 100 eyes were included. A total of 50 eyes underwent personalized LASIK and 50 eyes underwent personalized PRK. Preoperative and postoperative wavefront data were compared between the two groups. The influential factors and predictability of HOAs were also assessed. RESULT: Total HOA increased in the amount of 0.01 ± 0.14 µm for the 5 mm pupil (P = 0.55) and 0.08 ± 0.22 µm for the 6 mm pupil (P = 0.02) after PRK; however after LASIK the corresponding values for the 5 and 6 mm pupil sizes were 0.05 ± 0.12 and 0.15 ± 0.18 µm, respectively (P < 0. 001). Mean changes were not significantly different between the PRK and LASIK groups for both 5 and 6 mm pupil sizes (P = 0.21 and P = 0.13, respectively). Spherical aberration increased following LASIK more than following PRK (P < 0.001). Changes in the root mean square (RMS) of total HOA had a statistically significant negative correlation (P < 0.001) with its preoperative value. HOA and spherical aberration reduced in majority of eyes when the preoperative spherical equivalent refraction was low. CONCLUSION: For the 6mm pupil size, the total HOA increased following both personalized PRK and LASIK with no significant difference between the two groups. Change of the total HOA RMS was influenced by the preoperative values. The known influencing factors could predict nearly 50% of the changes in total HOA.

Comparison between Topical and Oral Tranexamic Acid in Management of Traumatic Hyphema.

BACKGROUND: We sought to determine the efficacy of topical tranexamic acid (5%) in the management of traumatic hyphema. METHODS: Thirty eyes with gross traumatic hyphema were enrolled in this study. The patients were treated with tranexamic acid (5%) eye drop every 6 hours for 5 days. The main outcome measures were best corrected visual acuity (BCVA), Intra-ocular pressure (IOP), day of clot absorption, and rate of rebleeding. These parameters were evaluated daily for 4 days and thereafter at the 8(th) and 14(th) days after treatment. The patients were also compared with two historical control groups of patients (80 eyes) with traumatic hyphema; the first control group was treated with oral placebo and the other group was treated with oral tranexamic acid at our department. RESULT: Prior to treatment, the mean logarithm of the minimum angle of resolution (logMAR) BCVA was 0.59±0.62. BCVA was increased to 0.08±0.14 at day 14 (P<0.001) and the mean IOP before treatment was 13.7±3.9 mm Hg, which was reduced to 11.4±1.8 mm Hg at day 14 (P=0.004). Rebleeding occurred in one (3.3%) patient on the 4(th) day post treatment. Comparison between the case group and the other two historical control groups with respect to the rebleeding rate demonstrated statistically significant differences between the case group and the first control group (P=0.008) but no statistically significant differences between the case group and the second control group (P=0.25). CONCLUSION: Topical tranexamic acid seems promising in the management of traumatic hyphema. However, the small sample size of the present study precludes the conclusion that topical tranexamic acid can replace the oral tranexamic acid.