Estimate the prevalence of daily caffeine consumption, caffeine use disorder, caffeine withdrawal and perceived harm in Iran: a cross-sectional study.

One of the informal diagnoses in DSM-5 is Caffeine Use Disorder (CUD). CUD and high levels of caffeine consumption could impact mental health conditions. This study aimed to estimate the prevalence of CUD, caffeine consumption, caffeine-related harms, and related psychiatric symptoms in Iran. A cross-sectional survey with a convenience sample of 1228 adults were conducted in Iran. Caffeine consumption was assessed across 20 products in Iran. Caffeine Use Disorder Questionnaire (CUDQ), Caffeine Withdrawal Symptoms Questionnaire (CWSQ), 14-item Caffeine-related Harm Screening (CHS), and Symptom Checklist-25 (SCL-25) were used in the present study. We used SPSS (desktop version 26.0) to analyze the data using descriptive statistics, chi-square, and the least significant difference (LSD) post hoc test. The daily average caffeine consumption was 146.67 mg. The prevalence of CUD and caffeine withdrawal (C.W.) were estimated at 19.5% and 46.62%, respectively. Also, 12.9% of responders received CUD and C.W.s simultaneously. The prevalence of CUD was higher in men than females (25.08% vs. 13.93%). 95% of participants (n = 1166) reported using at least one caffeine product yesterday. Moreover, the most reported caffeine-related harms were the desire for sugar (42.9%), insomnia (39.3%), and caffeine dependence (38.3%). Age significantly correlates with CUD (- 0.07) and daily caffeine intake (0.08). Moreover, all SCL-90 subscales had a significant correlation with daily caffeine intake. Finally, responders at younger ages reported higher levels of CUD and caffeine consumption than older adults(P < 0.05). High rates of C.W. and CUD in the Iranian population suggest that it is necessary to develop evidence-based treatments.

Fabrication and characterization of a Bi2O3-modified chitosan@ZIF-8 nanocomposite for enhanced drug loading-releasing efficacy.

In this study, a simple novel hybrid mesoporous nanomaterial derived from a metal-organic framework (ZIF-8) and chitosan, which were coated on green bismuth oxide, has been successfully synthesized, characterized, and applied to investigate its dapsone loading-releasing capability in the aqueous media. This suggested nanocomposite showed promise for drug loading from water b using hydrogen bonds, pi-pi, and electrostatic interactions. Structural and morphological analyses were performed on the proposed green synthesized nanocomposite through scanning electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, transmission electron microscopy, Brunauer-Emmett-Teller analysis, and thermogravimetric analysis. Various influencing parameters, including pH, nanocomposite dose, and contact time, were investigated to optimize the dapsone loading process. Utilizing the non-linear optimization methodology, the results show that dapsone-loading efficiency was >85 % for 50 mg.L-1 of dapsone drug. The optimum parameters for achieving maximal loading of dapsone drug were pH = 6.8, hybrid mesosphere dose = 2.6 mg.mL-1, and time = 53 min. Based on the release investigations, the dapsone-loaded nanocomposite was put into phosphate buffer saline, at pH = 7.4 and T = 37 °C, with a maximum efficiency of 93.9 after 24 h.

The impact of using P6 acupressure on the nausea, vomiting, and comfort of myocardial infarction patients: A randomized, single-blind, placebo-controlled clinical trial.

Background: Nausea and vomiting are two common symptoms in myocardial infarction patients. This study aims to determine the impact of p6 acupressure on nausea, vomiting, comfort, and the need for anti-vomiting drugs in myocardial infarction (MI) patients. Methods: This research involved 90 patients with acute heart attacks experiencing persistent nausea despite taking anti-vomiting drugs. They were divided into three groups: acupressure, placebo, and control. The acupressure group wore a wristband with a button, the placebo group had a similar wristband without a button, and the control group received no wristband. Data on nausea severity, comfort, frequency of nausea, vomiting, and retching was collected before and after the intervention at different time points. The study also assessed the use of anti-vomiting drugs within 24 h of the intervention. Results: The patients in the acupressure group, compared to those in the placebo and control groups, experienced significantly lower severity of nausea, frequency of vomiting, nausea, and retching and a substantially higher level of comfort level during the two, four, and 6 h after the start of the intervention (P < 0.05). However, no significant difference between the placebo and control groups was observed (P > 0.05). During the 24 h after the start of the intervention, administration of anti-vomiting drugs to the acupressure group was significantly less than that done in the placebo and control groups (P < 0.05). Conclusions: The results illustrated that p6 acupressure reduces nausea, vomiting, and retching and increases the comfort level in myocardial infarction patients.

The prevalence of elder abuse and risk factors: a cross-sectional study of community older adults.

BACKGROUND: The old people population is increasing worldwide. Along with their increasing population, an increase in elder abuse cases is predicted. Elder abuse is a neglected problem, and many cases go unreported. This study was conducted to identify types of elder abuse and examine associated risk factors. METHODS: This cross-sectional analytical study was conducted on 500 older people in Ardabil (northwestern Iran). Data was collected over three months, from June to September 2020. Data was collected using a demographic information form and the Domestic Elder Abuse questionnaire. The data were analyzed using SPSS software (version 22). Logistic regression was used to identify factors related to elder abuse. RESULTS: The results showed that out of the 500 participants, 258 (51.6%) were male, and 242 (48.2%) were female. Among the 500 participants, 377 individuals (75/4%) reported experiencing at least one type of abuse in the past year. The highest rate of elder abuse was observed for emotional neglect (47.2%) and psychological abuse (40.8%), while the lowest rate was measured for rejection (15.4%) and physical abuse (12.4%). The results indicated that elder abuse was significantly associated with chronic illness (OR = 0.601, 95% CI: 0.391-0.922) and having 1-4 children (OR = 1.275, 95% CI: 1.137-1.430). CONCLUSION: Considering the high level of elder abuse and its dangerous effects on the quality of life for older people, it is essential to develop appropriate programs to increase awareness among older people and their families.

Relation between Condyle Horizontal Angle and Intercondylar Angle with Disc Displacement in Patients with Temporomandibular Joint Disorders: An MRI Evaluation.

Background: Internal derangement (ID) is the most common cause of temporomandibular disorders (TMDs) and extensively affects the articular disc function. The anterior disc displacement is among the most important findings in ID. Knowledge about the etiology of this condition is imperative, and the role of structural parameters in the development of TMDs has not been well evaluated. Objectives: This study aimed to assess the relationship between condylar angulation and intercondylar angle with anterior disc displacement in patients with TMD using magnetic resonance imaging (MRI). Materials and Methods: This case-control study evaluated 31 temporomandibular joints with internal derangement and 57 normal joints. The data retrieved from MRI included disc position in the open mouth (normal, anterior disc displacement with a reduction (DDWR) and without reduction (DDWOR), and posterior displacement (PD)), horizontal condylar angle categorized as normal (10 to 30° angle) and abnormal (<10° and >30°), and intercondylar angle. Chi-square test, T-test, and Fisher's exact were done to assess the relationship between horizontal condylar angle and intercondylar angle in patients with TMDs with DDWR and DDWOR compared with the control group. Results: Patients with DDWR and DDWOR had higher odds of abnormal horizontal condylar angle, particularly >30° angle, which was a significant correlation (odds ratio of 0.19 and 8.3, respectively). The intercondylar angle in the patients with disc displacement was significantly smaller compared to the control group. Conclusion: Disc displacement was correlated with abnormal horizontal angle (particularly < 30) and smaller intercondylar angle compared with the control group.

Effect of Cardamom Inhalation Therapy on Intra-and Postoperative Nausea and Vomiting of Mothers Undergoing Spinal Anesthesia for Elective Cesarean Section.

PURPOSE: This study aimed to determine the effect of cardamom inhalation on intra and postoperative nausea and vomiting (IONV/PONV) of mothers undergoing spinal anesthesia for elective cesarean section. DESIGN: A single-blind, randomized, placebo-controlled clinical trial study. METHODS: Seventy eligible participates were equally randomized to the intervention or placebo group. The demographic and clinical characteristics questionnaire, a 100 mm Visual Analogue Scale (VAS) to measure the severity of nausea; and the mothers' emetic episodes checklist were used. Upon the first episode of nausea, participants inhaled through a plastic bag containing distilled gauze pads in normal saline with or without Cardamom essential oil. FINDINGS: Following the intervention, nausea severity in placebo (25.28 ± 32.38) and cardamom (13.14 ± 19.96) groups declined (P < .001), however after controlling the initial severity of nausea, the declining extent was more noticeable in the intervention group than in the placebo group. The episodes of nausea (37.1% vs 65.7%, P = .006), and retching (20% vs 45.7%, P = .028) were significantly lower in the intervention group than in the placebo group. Administration of antiemetic medications was lower in the intervention than the placebo group (37.1% vs 65.7%, P = .009). CONCLUSIONS: Cardamom aromatherapy was effective in alleviating mothers' experience of nausea and retching across the cesarean surgical continuum. As such, it can be considered as a palliative treatment for IONV/PONV in Cesarean section surgeries.

Exploring the gelation of aqueous cellulose nanocrystals (CNCs)-hydroxyethyl cellulose (HEC) mixtures.

We investigated the gelation and microstructure of cellulose nanocrystals (CNCs) in nonionic hydroxyethyl cellulose (HEC) solutions. Cellulose nanocrystals (CNCs) with a particle length of 90 nm and width of 8 nm currently produced by acid hydrolysis of wood pulp were used in this study. The microstructures of CNCs/polymer suspensions were investigated by performing linear small amplitude oscillatory shear (SAOS) and nonlinear large amplitude oscillatory shear (LAOS), in addition to constructing CNCs phase diagrams and measuring steady-state shear viscosities. Significant viscosity increases at low shear rates coupled with high shear thinning behaviors were observed in CNCs in HEC solutions above the overlapping concentration of HEC. The physical strength of CNCs/HEC solution gels increased with the increase in CNCs concentration and resembled the weakly crosslinked gels according to the scaling of linear dynamic mechanical experiments. According to LAOS analysis, CNCs/HEC mixtures showed type III behavior with intercycle stress softening, while the samples showed stress stiffening in single cycles.

Reproduction of Limnatis paluda (Tennent 1859) in laboratory conditions.

The reproductive functions of Limnatis paluda were studied in laboratory conditions including imposing of two thermal conditions (T1: 18 ± 2 °C and T2: 26 ± 2 °C) and with there being placement of three bedding substrates (tile, moss, and stone) in the containers specimens were confined. Furthermore, values for reproductive variables of cocoons and hatchlings were recorded. With the T2 treatment, gravid adults had cocoon depositions, whereas those when there was imposing of the T1 treatment did not have cocoon depositions. There was cocoon deposition only on the moss bedding, and it is presumed that moss could provide a robust and stable nursing microenvironment for developing embryos. Frequency (%) of cocoon depositions did not vary during the months of the deposition period. Hatching occurred after 26 ± 2 days when there was imposing of the T2 treatment. There was no correlation between the values for size of the ovigerous cocoons and number of offspring. There was a negative correlation between number and mean weight of hatchlings. There was a difference in cocoon weight for the different months and fluctuation in mortality and hatching rate which is assumed to be related to differences in feeding behaviors.

Comparison of Achievement of Clinical Skills in Seventh and Eighth Semester Nursing Students in Hamadan, West of Iran.

BACKGROUND: Identifying the status of clinical education helps to improve the achievement of educational goals. This study aimed to compare the achievement of clinical skills in the final year nursing students. MATERIALS AND METHODS: In this descriptive analytical study, 157 nursing students in the seventh and eighth semesters were selected through a census method, who were compared with each other. Data were collected using a researcher-developed questionnaire that included 111 clinical skills in 7 dimensions of primary nursing care, vital signs control, oxygenation and airway management, medication administration, laboratory samples collection, infection control, and cardiopulmonary resuscitation skills. Students scored each skill on a scale ranging from 0 to 5. The acceptable skills level in this study was the third level, which observes skills performed by the instructor or the nurse. Data were analyzed using the Kolmogorov-Smirnov test, descriptive statistics, and multiple linear regression. RESULTS: In the seventh semester students, except for the vital signs skills, other skills were at lower than expected levels. In the eighth semester students, except for the laboratory samples collection and infection control skills which were at a lower than expected level, other skills were reported at expected levels. Multiple linear regression showed that the eight semester students had more total score than the seventh semester students (t = 3.19, p = 0.002). CONCLUSIONS: The provision of sufficient opportunity to develop clinical skills in the eight semester was observed in this study; therefore, it is recommended that the internship course be increased in the dimensions in which students can independently perform clinical skills.

The potential roles of herpesvirus and cytomegalovirus in the exacerbation of pemphigus vulgaris.

BACKGROUND: Among exogenous etiologies, the critical role of microbial agents such as herpesviruses (HSV1/2) and cytomegalovirus (CMV) in triggering and flaring autoimmune conditions such as pemphigus vulgaris (PV) has been recently discovered. OBJECTIVES: The present study aimed to investigate the plausible role of these viruses in the exacerbation of PV using serological and molecular methods. PATIENTS/METHODS: Sixty patients with PV (30 with relapse type and 30 with remission type) were recruited for the purpose of this case-control study. Skin, mucosal, and throat specimens were obtained and examined for viruses by reverse transcriptase polymerase chain reaction. To determine the immunoglobulin G (IgG) titer, enzyme-linked immunosorbent assay was used. RESULTS: Desmoglein1-specific IgG was positive in 56.7% of patients with the relapse form and in 20.0% of those with the remission form indicating a significant difference across the 2 groups (P = 0.003), but the rate of positivity for desmoglein3-specific IgG in the relapse and remission types was 76.7% and 63.3%, respectively, with no significant difference (P = 0.260). There was no difference in the mean levels of HSV-IgG and CMV-IgG in the relapse and remission groups. HSV and CMV positivity in PV patients was independent of the site of the samples. Using the multivariable linear regression model, the level of CMV-IgG in PV patients was directly affected by female sex and advanced ages. CONCLUSIONS: Our study could not demonstrate the role of HSV1/2 and CMV as triggering factors for PV exacerbation. Further studies are needed to evaluate the potential role of these viruses in PV exacerbation especially considering demographic variables.

A comparison of the efficacy of mechanical, chemical, and microwave radiation methods in disinfecting complete dentures.

BACKGROUND: Poor denture hygiene can be a potential source of pathogens. The aim of this study was to compare the efficacy of microwave radiation with that of chemical and mechanical techniques in disinfecting complete dentures contaminated with Staphylococcus aureus and Pseudomonas aeruginosa. MATERIALS AND METHODS: Seventy-two sterilized mandibular dentures were separately contaminated with S. aureus (n = 32) and P. aeruginosa (n = 32) and then incubated at 37°C for 48 h. The contaminated dentures were disinfected as follows: chemical disinfection with Corega tablets; chemical disinfection with 2% glutaraldehyde; mechanical disinfection by brushing the denture; and physical disinfection by 650-W microwaves irradiation for 3 min with six samples in each subgroup. Six dentures served as negative control group, and six contaminated dentures with no disinfection served as the positive control group. 10-3-10-6 dilutions were cultured in the nutrient agar, and the colonies were counted after incubation at 37°C for 48 h. To evaluate the lasting time of disinfection, the containers with nutrient agar and dentures were stored for 7 days at 37°C to evaluate turbidity. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-test (α = 0.05). RESULTS: There was no evidence of bacterial growth in 48 h and turbidity after 7 days of incubation of dentures disinfected by microwaves, glutaraldehyde, and Corega tablets, which was statistically significant compared to the positive controls (P < 0.001). In mechanically disinfected dentures (brushing), bacterial growth was detected after 48 h which was statistically significant compared to the positive controls (P < 0.001) and turbidity was seen in all the nutrient agar plates. CONCLUSION: Microwave iradiation, 2% glutaraldehyde, and Corega tablets disinfected complete dentures contaminated with S. aureus and P. aeruginosa which lasted for a long and a short terms.

Physical Activity Patterns in the Elderly Kashan Population.

BACKGROUND: Physical activity is an important component of health in old age that provides personal independence, physical ability, and quality of life. OBJECTIVES: The current study aimed to evaluate physical activity and associated factors among the elderly population in Kashan, Iran. PATIENTS AND METHODS: This is a descriptive cross-sectional study. The sample was 400 elderly people (aged more than 60 years) living in Kashan, Iran in 2014. The subjects randomly selected via multi-stage cluster sampling from healthcare centers in three regions of Kashan. The sample size differed by gender and residence type. Each participant's demographic characteristics and level of physical activity were recorded in a questionnaire, and the data were analyzed by SPSS version 16. Descriptive statistics, chi-square tests, Pearson correlations, and ordinal regression were used in the data analysis. The significance level for all the tests was P < 0.05. RESULTS: 237 (59.2%) of the subjects were female. The average age of the study population was 67.6 ± 6.8 years. Their average physical activity energy consumption was 326.21 ± 364.84 according to the metabolic equivalent of hours per week. 20 subjects (5%) reported no physical activity. 320 (80%) and 59 (14.8%) subjects had low and moderate physical activity levels, respectively. Only 1 subject (0.2%) had extreme levels of physical activity. Men (n = 43, 26.4%) were more likely to be moderately or extremely physically active than women were (n = 17, 7.2%). There was a significant relationship between physical activity and sex (P < 0.0001), marital status (P < 0.0001), educational status (P < 0.002), current occupation (P < 0.0001), and personal independence (P < 0.00001). Of course, effective predictive variations included age (P = 0.034), gender (P = 0.001), marital status (P = 0.033), independent status (P = 0), and local environment (P =0.001). CONCLUSIONS: The study revealed low physical activity in the elderly population in Kashan. The pattern of physical activity in the elderly depends on their lifestyle. A promotion of active lifestyles should be a part of health care planning for the elderly.

Survey of the Relationship Between Activity Energy Expenditure Metabolic Equivalents and Barrier Factors of Physical Activity in the Elderly in Kashan.

BACKGROUND: Physical activity in the elderly is influenced by aspects of aging that cause personal, mental, environmental, and social changes. Increases in factors that are barriers to activity cause physical energy expenditure to decrease. OBJECTIVES: The aim of the present study was to survey the relationship between energy expenditure in metabolic equivalent units (MET) and factors that are barriers to physical activity in elderly people in Kashan, Iran. METHODS: This is a descriptive analysis done in 2014. The study population was 400 people above 60 years old in medical facilities in Kashan. Multistage sampling was used in 10 clinics in 5 areas of Kashan. The sample size was varied according to gender and elderly population. Contributors were given questionnaires concerning energy expenditure levels in physical activity and factors that are barriers to being active. RESULTS: The average age among the study population was 67.6 ± 6.8 years median, and the interquartile range (IQR) of barriers to physical activity among Kashan's elderly was (8.75) ± 33. Average energy expenditure was 326.21 ± 364.84 based on metabolic equivalent units (MET). In fact, 340 persons (85%) were practically without any active energy expenditure. The most common barrier was the lack of an appropriate place for doing physical activity; 298 (74%) of the participants cited this barrier. The results show the Spearman rank-order correlation is significant (P = 0.038, r = 0.104) between barriers to physical activity and activity energy expenditure in Kashan's elderly. CONCLUSIONS: Decreasing barriers to physical activity among the elderly causes physical activities to increase; therefore, energy expenditure is increased. Decreasing social and environmental problems for the elderly is effective in increasing physical activity and energy expenditure.

Fluoride concentration of bottled water and tap water in tehran, iran.

BACKGROUND AND AIMS: As a result of poor quality of public water supply in many countries, people have recently turned to bottled water consumption, the fluoride content of which is not generally consistent among different brands. This study sought to measure the fluoride concentration of public water supply in comparison with commercial brands of min-eral bottled water available in Tehran, Iran. MATERIALS AND METHODS: Eight different brands of locally produced bottled mineral water and samples of tap water were evaluated for fluoride content. All samples were collected in five equal containers in two summer and winter seasons. The fluoride content in part per million (ppm) was determined using a fluoride Ion Selective Electrode. The data were ana-lyzed using two-way ANOVA. For comparison of the fluoride content between three different brands of bottled water, one-way ANOVA was employed. Sample t-test was used to compare the label and laboratory values of bottled water. RESULTS: The highest concentration of fluoride in a bottled water brand was found to be 0.409 ppm with a pH of 6.67 in summer. There was a significant difference between the mean fluoride level of tap water (0.229 ± 0.079 ppm) and bottled water (0.111 ± 0.122 ppm) (P < 0.001). The measured fluoride concentrations of bottled water were significantly lower than those printed on the labels (P < 0.001). CONCLUSION: Our findings revealed that the mean fluoride level of both bottled and tap water samples evaluated is con-siderably lower than accepted standards.

The effect of Er,Cr:YSGG laser and air abrasion on shear bond strength of a fissure sealant to enamel.

PURPOSE: The authors conducted an in vitro study to evaluate the shear bond strength of a fissure sealant to enamel pretreated with erbium,chromium:yttrium, scandium,gallium,garnet (Er,Cr:YSGG) laser or air abrasion followed by acid etching. METHODS: The authors sectioned extracted sound premolars mesiodistally and used the buccal and lingual surfaces for experimental analysis. They divided specimens randomly into three groups of 15 each according to the enamel surface pretreatment methods: group A, 37 percent phosphoric acid; group B, air abrasion followed by acid etching with 37 percent phosphoric acid; group C, irradiation with Er,Cr:YSGG laser followed by acid etching with 37 percent phosphoric acid. After applying a bonding system, the authors bonded cylinders of sealant to the enamel surfaces by using transparent gelatin tubes (0.7 millimeter in diameter and 1 mm in height) and then polymerized them. They stored all specimens in distilled water at 37 degrees C for 24 hours. They tested shear bond strength by using a universal testing machine with a crosshead speed of 0.5 mm per second. The authors analyzed the data by means of one-way analysis of variance and Tukey-Kramer post hoc tests (alpha = .05). RESULTS: The bond strength of group B specimens was statistically higher than those of group A and group C specimens (P < .05). The authors found no statistically significant differences in shear bond strength between surfaces treated with Er,Cr:YSGG laser and those treated with acid etching alone (P > .05). CONCLUSION: Pretreatment of enamel surfaces with air abrasion increased the bond strength of fissure sealant, but pretreatment with Er,Cr:YSGG laser did not increase the effectiveness of conventional acid etching of enamel in sealant bonds.