Comparison of Perceived Self-efficacy, Benefits, and Barriers of Hypertension Control between Male and Female Patients Referred to Rajaie Cardiovascular Medical and Research Center in Tehran.

Background: Hypertension is a health problem. The purpose of the present study was to compare perceived self-efficacy, benefits, and barriers of hypertension control between male and female patients. Methods: This cross-sectional study was carried out on 400 patients referred to Rajaie Cardiovascular Medical and Research Center in Tehran from August 2020 through March 2021. The convenience sampling method was used. The data collection tools consisted of a digital sphygmomanometer, a demographic form, and a researcher-made questionnaire of perceived benefits, barriers, and self-efficacy of hypertension control, whose validity and reliability were obtained. Results: The mean age of the male and female patients was 54.02±12.93 years and 56.48±12.10 years, respectively. The mean score of perceived barriers in women was lower than that in men, and the mean perceived self-efficacy in women was higher than that in men (P<0.001). According to the regression test, history of smoking in men and family history of hypertension and age in women were predictors of perceived benefits. Further, occupation and history of smoking in men and education level, family history of hypertension, and history of smoking in women were predictors of perceived barriers. Additionally, marital status, education level, and disease duration in men and education level, family history of hypertension, history of smoking, and age in women were predictors of perceived self-efficacy (P<0.050). Conclusion: In men, the mean score of perceived barriers was higher and the mean score of perceived self-efficacy was lower. Additionally, the predictors of each of these perceptions were determined.

Vaccination and isolation based control design of the COVID-19 pandemic based on adaptive neuro fuzzy inference system optimized with the genetic algorithm.

The study of the COVID-19 pandemic is of pivotal importance due to its tremendous global impacts. This paper aims to control this disease using an optimal strategy comprising two methods: isolation and vaccination. In this regard, an optimized Adaptive Neuro-Fuzzy Inference System (ANFIS) is developed using the Genetic Algorithm (GA) to control the dynamic model of the COVID-19 termed SIDARTHE (Susceptible, Infected, Diagnosed, Ailing, Recognized, Threatened, Healed, and Extinct). The number of diagnosed and recognized people is reduced by isolation, and the number of susceptible people is reduced by vaccination. The GA generates optimal control efforts related to the random initial number of each chosen group as the input data for ANFIS to train Takagi-Sugeno (T-S) fuzzy structure coefficients. Also, three theorems are presented to indicate the positivity, boundedness, and existence of the solutions in the presence of the controller. The performance of the proposed system is evaluated through the mean squared error (MSE) and the root-mean-square error (RMSE). The simulation results show a significant decrease in the number of diagnosed, recognized, and susceptible individuals by employing the proposed controller, even with a 70% increase in transmissibility caused by various variants.

Long-term follow-up of intracerebroventricular injection of streptozotocin-inducing pain sensitization.

Age is known to be the major risk factor for both pain sensation and sporadic Alzheimer's disease (sAD). Pain management in AD is a critical health condition. However, assessing pain in sAD patients is challenging. The intracerebroventricularly injected streptozotocin (icv-STZ) rat model of sAD has been brought to the fore as a hopefully suitable model that could mimic some features of sAD. However, the exact mechanism by which this agent may induce AD-like pathology is largely unknown. In some studies, analgesic drugs have been suggested as possible prevention of AD and icv-STZ-induced AD-like pathology. Therefore, this study used formalin and tail-flick tests to investigate whether different doses of icv-STZ injections could affect acute and inflammatory pain sensation and edema volume over time. Behavioral responses were observed at four testing time points (1, 2.5, 3.5, and 6 months postinjection). The results indicate that icv-STZ was able to significantly decrease the animals' formalin pain threshold in both a time- and dose-dependent manner. Formalin-induced acute and chronic pain scores of animals treated with streptozotocin 3 mg/kg (STZ3) increased dramatically 2.5 months after injection and persisted thereafter. The augmentation in pain score induced by streptozotocin 1 mg/kg (STZ1) was observed from 3.5 months after STZ injection. However, the effect of streptozotocin 0.5 mg/kg (STZ0.5) was NS until 6 months after injection. However, formalin-induced paw edema occurred with a longer delay and was not detectable in STZ0.5-treated animals. In addition, only STZ3-treated animals significantly reduced the thermal pain threshold of animals 6 months after injection. These observations indicate that icv-STZ can sensitize central and/or peripheral receptors to pain. The effect of STZ is dose- and time-dependent. AD-like pathology induced by icv-STZ could be partially activated via pain processing pathways. Therefore, anti-inflammatory agents could alleviate AD-like symptoms via pain treatments.

Optimal Allocation of Vaccine and Antiviral Drugs for Influenza Containment over Delayed Multiscale Epidemic Model considering Time-Dependent Transmission Rate.

In this study, two types of epidemiological models called "within host" and "between hosts" have been studied. The within-host model represents the innate immune response, and the between-hosts model signifies the SEIR (susceptible, exposed, infected, and recovered) epidemic model. The major contribution of this paper is to break the chain of infectious disease transmission by reducing the number of susceptible and infected people via transferring them to the recovered people group with vaccination and antiviral treatment, respectively. Both transfers are considered with time delay. In the first step, optimal control theory is applied to calculate the optimal final time to control the disease within a host's body with a cost function. To this end, the vaccination that represents the effort that converts healthy cells into resistant-to-infection cells in the susceptible individual's body is used as the first control input to vaccinate the susceptible individual against the disease. Moreover, the next control input (antiviral treatment) is applied to eradicate the concentrations of the virus and convert healthy cells into resistant-to-infection cells simultaneously in the infected person's body to treat the infected individual. The calculated optimal time in the first step is considered as the delay of vaccination and antiviral treatment in the SEIR dynamic model. Using Pontryagin's maximum principle in the second step, an optimal control strategy is also applied to an SEIR mathematical model with a nonlinear transmission rate and time delay, which is computed as optimal time in the first step. Numerical results are consistent with the analytical ones and corroborate our theoretical results.

Postpartum care promotion based on maternal education needs: A mixed study.

BACKGROUND: The postpartum period can be considered as one of the most sensitive stages of life in different countries; however, it is inadequate in many developed and developing countries. We aimed to determine the educational needs of mothers in the postpartum period in Bojnourd. MATERIALS AND METHODS: This study was conducted in Bojnourd 2019 with two parts: a qualitative part using the content analysis method and a quantitative part using the descriptive cross-sectional method. Data were collected 45 interviews with women, spouses, and key informants. All content was recorded and fully transcribed on paper. MaxQda10software was used for the data management. A simultaneous descriptive cross-sectional study was done including 250 pregnant in the third trimester (25.6%), in the first 48 h after delivery (24.4%), in the first 6 months after delivery (24.4%), and in the second 6 months after childbirth (25.6%) who referred to five health centers in Bojnourd to receive midwifery care. Quota sampling was performed for each center according to the population covered, and convenient sampling was done in each center. RESULTS: In the qualitative study, educational needs were classified into four main categories, including "maintaining and restoring physical health," "sexual health needs," "mental health needs," and "educational barriers." In the quantitative study, according to the findings, the most educational needs among mothers were self-care and breastfeeding and the best time for teaching was during the pregnancy, and the best method was face-to-face training and the best source of information was midwives and gynecologists. CONCLUSION: Attention to the educational needs of each region can be done through various training courses and continuous retraining to promote health provider and should be considered in the planning officials.

A Neonatal Mild Defect in Brain Insulin Signaling Predisposes a Subclinical Model of Sporadic Alzheimer's to Develop the Disease.

Brain insulin system dysfunction has been proposed as a key player in the pathogenesis of sporadic Alzheimer's disease (sAD). Given this fact, an adult rat model for sAD has been developed by intracerebroventricular injection of a subdiabetogenic streptozotocin dosage (icv-STZ). A low dose of icv-STZ in adult rats leads to a subclinical model of Alzheimer's disease. According to the brain developmental origin for sAD occurrence, the present study evaluated the effect of neonatal injection of icv-STZ on the development and progression of Alzheimer's disease later in the adult animals treated with a low dose of icv-STZ. Although no alteration was observed in the rats receiving an adult low dose of icv-STZ, these animals displayed cognitive deficits if they were also treated neonatally with icv-STZ. These impairments were associated with altered gene expression of insulin receptor, tau and choline acetyltransferase, along with increased astrocyte and dark neuron densities in the hippocampus. This study highlights neonatal brain insulin system dysfunction in the programming of brain insulin signaling sensitivity and provides more evidence for the developmental origin of sAD.

Optimal Control Design of Impulsive SQEIAR Epidemic Models with Application to COVID-19.

This paper presents a SEIAR-type model considering quarantined individuals (Q), called SQEIAR model. The dynamic of SQEIAR model is defined by six ordinary differential equations that describe the numbers of Susceptible, Quarantined, Exposed, Infected, Asymptomatic, and Recovered individuals. The goal of this paper is to reduce the size of susceptible, infected, exposed and asymptomatic groups to consequently eradicate the infection by using two actions: the quarantine and the treatment of infected people. To reach this purpose, optimal control theory is presented to control the epidemic model over free terminal optimal time control with an optimal cost. Pontryagin's maximum principle is used to characterize the optimal controls and the optimal final time. Also, an impulsive epidemic model of SQEIAR is considered to deal with the potential suddenly increased in population caused by immigration or travel. Since this model is suitable to describe the COVID-19 pandemic, especial attention is devoted to this case. Thus, numerical simulations are given to prove the accuracy of the theoretical claims and applied to the particular data of this infection. Moreover, numerical computations of the COVID-19 are compared with diseases like Ebola and Influenza. In addition, the controller is evaluated with system parameters identified by using actual data of China. Finally, the controller tuned with the estimated parameters of the Chinese data is applied to the actual data of Spain to compare the quarantine and treatment policies in both countries.

The Effect of Prenatal Self-Care Based on Orem's Theory on Preterm Birth Occurrence in Women at Risk for Preterm Birth.

BACKGROUND: Preterm birth is increasing as a major cause of perinatal complications and mortality in Iran. The present study aimed to investigate the effect of prenatal self-care based on Orem's theory on preterm birth occurrence in women at risk for preterm birth. MATERIALS AND METHODS: The present clinical trial was conducted on 176 pregnant women at 24-26 weeks at risk for preterm birth in Mashhad, Iran, from December 2015 to October 2016. A multistage sampling method was used in this study. The intervention group (88 pregnant women) received individual self-care education but the control group (88 pregnant women) received only common prenatal care. RESULTS: There was a statistically significant difference between intervention and control groups in terms of preterm birth occurrence (6.80% vs 20.50%) (χ2 = 6.90, df = 1,p = 0.008). The incidence of preterm birth in the intervention group was approximately three times higher than that in the control group. CONCLUSIONS: Given that educational interventions could reduce the incidence of preterm birth, it is suggested that the women at risk for preterm birth are trained for prenatal self-care.

Parameter Estimation and Prediction of COVID-19 Epidemic Turning Point and Ending Time of a Case Study on SIR/SQAIR Epidemic Models.

In this paper, the SIR epidemiological model for the COVID-19 with unknown parameters is considered in the first strategy. Three curves (S, I, and R) are fitted to the real data of South Korea, based on a detailed analysis of the actual data of South Korea, taken from the Korea Disease Control and Prevention Agency (KDCA). Using the least square method and minimizing the error between the fitted curve and the actual data, unknown parameters, like the transmission rate, recovery rate, and mortality rate, are estimated. The goodness of fit model is investigated with two criteria (SSE and RMSE), and the uncertainty range of the estimated parameters is also presented. Also, using the obtained determined model, the possible ending time and the turning point of the COVID-19 outbreak in the United States are predicted. Due to the lack of treatment and vaccine, in the next strategy, a new group called quarantined people is added to the proposed model. Also, a hidden state, including asymptomatic individuals, which is very common in COVID-19, is considered to make the model more realistic and closer to the real world. Then, the SIR model is developed into the SQAIR model. The delay in the recovery of the infected person is also considered as an unknown parameter. Like the previous steps, the possible ending time and the turning point in the United States are predicted. The model obtained in each strategy for South Korea is compared with the actual data from KDCA to prove the accuracy of the estimation of the parameters.

Observer-based adaptive PI sliding mode control of developed uncertain SEIAR influenza epidemic model considering dynamic population.

This paper presents a new Susceptible, Exposed, Infected, Asymptomatic, and Recovered individuals (SEIAR) model for influenza considering a dynamic population. In the given model, the possibility of transmission of asymptomatic individuals (infectious with no visible symptoms) to infected individuals (infectious exhibiting symptoms) is considered. The basic reproduction number and the equilibrium points of the new model are given while the stability of the equilibrium points is analyzed by using the Jacobian matrix. Then a multi-controller scheme consisting of a parallel controller defined by two control inputs (vaccination and antiviral treatment) is given where both of them are based on Proportional-Integral (PI) and sliding mode controllers, which are parameterized adaptively to guarantee the convergence of trajectories to the sliding surface with minimum amount of chattering. The proposed control scheme is able to asymptotically stabilize the SEIAR model in the sense of eradication of the infected and susceptible individuals. Moreover, a (reduced-order) observer is designed to estimate the actual state variables that are used in the implementation of the control signals. By using MATLAB® software, a comprehensive simulation and evaluation of treatment and performance are carried out to support the presented theoretical results.

A Highly Selective DNA Sensor Based on Graphene Oxide-Silk Fibroin Composite and AuNPs as a Probe Oligonucleotide Immobilization Platform3667.

In this study, a simple and novel electrochemical biosensor based on a glassy carbon electrode (GCE) modified with a composite of graphene oxide (GO) - silk fibroin nanofibers (SF) and gold nanoparticles (MCH/ssDNA/AuNPs/SF/GO/GCE) was developed for detection of DNA sequences. The fabrication processes of electrochemical biosensor were characterized by scanning electron microscopy (SEM), FT-IR and electrochemical methods. Some experimental conditions such as immobilization time of probe DNA and MCH incubation time, time and temperature of hybridization were optimized. The designed biosensor revealed a wide linear range of 1.0 × 10-16 - 1.0 × 10-8 mol L-1 and a low detection limit (3.3 × 10-17 mol L-1) for detection of BRCA1 5382 mutation by EIS technique. The designed biosensor revealed high selectivity for discrimination of the complementary (P1C) sequences from various non-complementary sequences of (P1nC1, P1nC2 and P1nC3). Also, the biosensor revealed a high reproducibility (RSD of 7.5% (n=4)) and high stability (92% of its initial response after 8 days). So, the fabricated biosensor has a suitable potential to be applied for detection of breast cancer sequences in the initial stages of the cancer.

A transient insulin system dysfunction in newborn rat brain followed by neonatal intracerebroventricular administration of streptozotocin could be accompanied by a labile cognitive impairment.

The early postnatal period is a critical period of hippocampus development, which is highly dependent on insulin receptor (IR) signaling and very important in cognitive function. The present study was conducted in order to present a model of neonatal transient brain insulin system dysfunction through finding an appropriate dose of injection of streptozotocin (STZ) during the neonatal period. Sixty male Wistar rat pups were divided into 4 groups of 15 and received intracerebroventricular saline or STZ (icv-STZ) (15, 20 and 25µg/kg) on postnatal day 7. Gene expression of IR and target genes for IR signaling (choline acetyltransferase (ChAT) and Tau) were measured at the ages of 2 and 7 weeks. Behavioral tests were performed at the ages of 3 and 6 weeks to assess short- and long-term cognitive function. 20µg/kg dose of icv-STZ was estimated as the optimal dose causing transient alteration in gene expression of IR, ChAT and Tau. Additionally, cognitive function of the animals restored to normal level at the age of 6 weeks. Therefore, 20µg/kg dose of icv-STZ is proposed as a new approach to generating transient brain insulin system dysfunction associated with transient cognitive impairments at a critical postnatal period of brain development.