Health Scope

In Collaboration with Health Promotion Research Center, Zahedan University of Medical Sciences

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Health Scope Journal serves as a multidisciplinary forum for all research areas of public, environmental and occupational health. Original papers, rapid communications, reviews, case reports, technical notes, and editorials are invited and will be accepted for publication following peer review. High priority will be given to articles on public health (i.e. lifestyle, nutrition and physical activity), health promotion, environmental health (environmental pollution, water and wastewater treatment, air and waste management, environmental epidemiology, environmental microbiology), occupational health (risk assessment, environmental toxicology, human factors, occupational accidents, safety) and clinical aspects related to environmental and occupational medicine in an integrated fashion to address critical issues related to environmental quality and public health, health care services administration, health policy, hospital hygiene and other topics relevant to public health.

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Now showing 1 - 20 of 572
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    Work-Related Muscluskeletal Disorders and Work Ability Among Hospital Employees in Southeast of Iran
    (Brieflands, 2024-11-30) Hassan Okati-Aliabad; Raheleh Hashemi Habybabady
    Background: The Work Ability Index (WAI) evaluates how well workers cope with the physical and mental demands of their jobs. Objectives: This study aims to explore how demographic factors and work-related musculoskeletal disorders (WMSDs) influence work ability among employees at the largest specialized hospital in southeast Iran. Methods: This cross-sectional study was conducted at the largest specialized hospital in Zahedan. A sample of 194 clinical staff and support personnel, including nurses, nursing assistants, patient transporters, and cleaning staff, were randomly selected through a stratified random sampling method. Work ability and musculoskeletal discomfort were assessed using the Persian versions of the WAI and Cornell Questionnaires. Quantitative data were presented as mean ± SD, while qualitative data were expressed as numbers and percentages. Pearson correlation, Kruskal-Wallis, Mann-Whitney U, and one- and multi-factor General Linear Models were used for data analysis in SPSS version 19. Results: Work ability decreased with age (P < 0.001). Significant associations were found between work ability and age, job category, education, and Body Mass Index (BMI) (P < 0.05). After adjusting for age, job, education, and BMI, lower back pain (P = 0.002), thigh pain (P = 0.004), and knee pain (P = 0.026) were significantly linked to work ability. There was a notable negative correlation between work ability and discomfort score (r = -0.337, P < 0.001), with nursing assistants reporting higher discomfort scores compared to nurses, cleaning staff, and patient transporters (P < 0.05). Conclusions: Our findings suggest a potential link between musculoskeletal disorders (MSDs) and work ability. Therefore, it is recommended to implement a program focused on identifying and addressing the risk factors associated with MSDs.
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    Prediction of Pralidoxime Dose in Patients with Organophosphate Poisoning Using Machine Learning Techniques
    (Brieflands, 2024-04-24) Babak Mostafazadeh; Shahin Shadnia; Sayed Masoud Hosseini; Mitra Rahimi; Haleh Talaie; Seyed Ali Mohtarami; Peyman Erfan Talab Evini; Joshua King
    Background: Early and appropriate antidotal therapy is crucial for patients with organophosphate poisoning. Objectives: Given the lack of a comprehensive consensus on the optimal dose of pralidoxime for patients with organophosphate poisoning, this study aims to develop a machine learning-based prediction model to determine the individualized pralidoxime dose for these patients. Methods: The dataset was divided into training and test sets with a 70:30 ratio. Feature selection was conducted using Pearson’s correlation coefficient (filter approach) method. Both classification and regression were employed to develop the prediction model using the selected features. The performance of the developed models was evaluated using ten-fold cross-validation and various metrics, including sensitivity, specificity, accuracy, F1-score, and AUC. The models were implemented and assessed using the scikit-learn library in Python. Results: After applying exclusion criteria, data from 325 patients were utilized to train and test the machine-learning models. In the classification approach, the random forest method achieved superior performance with an AUC of 98.6. In the regression approach, the gradient boosting regressor, with an R2 value of 65.4, outperformed other algorithms. Feature selection revealed that muscular weakness, plasma cholinesterase activity, and blood urea nitrogen were the most significant predictors of pralidoxime dose in the classification model. In the regression model, the top predictors were age, HCO3-VBG, and atropine bolus. Many of the selected features coincide with those identified in previous studies, with muscular weakness being particularly significant in both models. Conclusions: The most effective algorithms could be employed to develop a clinical decision support system for personalized pralidoxime dosage prediction in patients with organophosphorus poisoning. However, the study is constrained by its small sample size, retrospective design, and the absence of an external validation cohort. Conducting a prospective multicenter study with a larger sample size is crucial to validate the findings of this study.
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    Design and Development of an Ergonomic Chair for Students in Educational Settings
    (Brieflands, 2018-11-30) Samira Ansari; Ahmad Nikpay; Sakineh Varmazyar
    Background: Proper designing of chairs based on ergonomics increases efficiency, promotes quality of education, leads to correct posture in students, and reduces risk of musculoskeletal disorders. Objectives: The aim of this study was to design and develop an ergonomic chair, based on anthropometric data of students in educational settings. Methods: Anthropometric parameters were obtained from a stratified-random sample of 207 students. The data were analyzed using the SPSS 20 software, and the results were extracted as mean, standard deviation, and percentiles. The chair was planned in the CATIA software and developed by a three-dimensional print. Results: In this study, an ergonomic chair was designed based on anthropometric data from students. The seat height, depth, and width of the chair were determined as 44 cm, 42 cm, and 42.15 cm, respectively. The height of the desk was adjustable in 19 to 29 cm, and the depth and length of the desk were considered as 51 cm and 65 cm. The width and height of the backrest were also 54 cm and 44 cm, and the backrest angle was adjustable in 95° to 105°. Conclusions: An ergonomic chair with adjustable parts was designed to achieve a well-match between anthropometric characteristics of students and the furniture. Such chair can reduce musculoskeletal disorders in students. Some ergonomic characteristics of this chair include adjustability of footrest, backrest, armrests, and desk. A chair with such characteristic can be used by many students with different body sizes.
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    The Effect of Family Empowerment Model on Self-care in Hemodialysis Patients of Zahedan, Iran
    (Brieflands, 2021-02-28) Bent Al Hoda Taheri; Alireza Salar
    Background: Self-care is one of the important aspects of treatment in hemodialysis patients. This study was done to determine the effect of the family-centered empowerment model on the self-care of hemodialysis patients. Methods: This study was performed on 100 hemodialysis patients referring to the Zahedan hemodialysis department in 2018. For the intervention group, the family-centered empowerment model was executed in four stages, including understanding the threat, problem-solving, educational participation, and evaluation according to the steps of the model, and the control group received the usual care of the department. The data collection tools were the demographic information questionnaire and self-care questionnaire. Data were analyzed using SPSS V.22 by analysis of variance (ANOVA), independent t-test, repeated measures t-test, and Chi-square test. Results: Based on the independent t-test, the mean self-care score of patients in the intervention and control group was significantly different (P < 0.001). There was a significant difference in the "main caregiver relation" variable (P = 0.006). The results of the "time" and "intervention" effects of this test also showed that these two variables had a significant effect on mean self-care scores (P < 0.001). The results of ANOVA showed that self-care score changed in the two groups there was an increase in the self-care score in the intervention group compared with the control group (P < 0.001). Conclusions: Implementing the family-centered empowerment model in hemodialysis patients by strengthening the ability of the patient and their families to care provides a platform for their promotion and maintenance of their self-care.
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    Identification and Prioritization of Clinical Decision Support Functionalities Built Within A Computerized Provider Order Entry System
    (Brieflands, 2021-02-28) Mehrdad Karajizadeh; Farid Zand; Afsaneh Vazin; Mahdi Nasiri; Roxana Sharifian
    Background: Clinical decision support (CDS) functionalities in Computerized Provider Order Entry system (CPOE) need to be identified by the institutional healthcare providers in developing countries. In this regard, CDS functionalities should be a priority for the execution in CPOE. Objectives: Thus, our study was done to identify and prioritize the CDS functionalities in CPOE. Methods: A Two-round Modified Delphi process was used. Firstly, a systematic search was conducted in electronic databases from the date of database inception to February 2019 for identifying CDS functionalities integrated into CPOE. Studies were retrieved from databases, including PubMed, Embase, ProQuest, Scopus, Web of Science, Cochrane, Science Direct, ACM digital library, and IEEE Xplore Digital Library. Secondly, the Modified Delphi method was carried out in 2019 to provide contextual priorities regarding CDS functionalities in CPOE in two iterative rounds. A total of 12 experts working in the three Intensive Care Units (ICUs) with more than three years of experience with homegrown CPOE in Shiraz Nemazee Teaching Hospital, including two clinical pharmacists, two health information management faculty member, four cases with critical care fellowship, and four critical care experts participated in the study. The ≥ 66.6% agreement was considered as the consensus level. SPSS software version 24 was used for statistical analysis. Results: Totally, 327 studies, which met eligibility criteria were found. A number of 60 potential CDS functionalities in CPOE were identified from eligible studies. Also, 13 out of 60 CDS functionalities reached high priority consensus after 2 iterative Delphi rounds, including drug-allergy checking (83.3%), basic dosing guidance (75%), single dosing checking (66.7%), duplicate therapy checking (66.7%), drug-pregnancy alerts (75%), time-based alerts (66.7%), alert for deep vein thrombosis prophylaxis (66.7%), alerts for duplicate medication order checking (66.7%), drug-drug interaction checking (75%), intelligent dosing guidance based on the patients’ characteristics (66.7%), renal-drug problems checking (83.3%), drug-disease interaction checking (66.7%), and displaying medication/test cost (75%). Conclusions: Our study identified high-priority CDS functionalities to be considered in the CPOE system from the viewpoint of multidisciplinary experts, especially in Iran. Results of this study may be beneficial to plan, design, and implement CDS functionalities in CPOE in the ICU.
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    Comparing Anticonvulsive Effect of Melissa Officinalis` Hydro-Alcoholic Extract and Phenytoin in Rat
    (Brieflands, 2012-05-31) Elaheh Gorgich; Zahra Zakeri; Soheila Ebrahimi; Gholamreza Komeili
    : Background: Epilepsy originates from brain function disorders that might appear in the forms of overt disorders or fainting (losing consciousness), abnormal motional activities, behavioral abnormalities and sensational impairment and/or disorders in autonomic performance; all these symptoms are observable in early sleeping stages.Objectives: Epilepsy is one of the most common neural disorders in human beings and with regard to the conducted studies , the Melissa officinalis plant has been used to treat epilepsy disease. Therefore, in this empirical work the effect of pretreatment with hydro-alcoholic extract of this plant compared to Phenytoin in the prevention of the epileptic convulsions caused by Pentylenetetrazole was studied.Material and Methods: In this research the following groups receive the following drug doses intraperitoneal : four groups received different concentrations of extract (25, 50 , 100 , 200 mg/kg body weight), the positive control group was tested by Phenytoin (5 mg/kg) and the negative control group was tested by normal saline. Data were analyzed by kruskal – Wallis test and Tukey test.Results: Injection of 50 and 100mg of the extract per kilogram of the body weight during the30 minutes interval before the systemic injection of Pentylenetetrazole, resulted in delay in the average onset time of the clonic convulsion Seizures with respect to the control group (P = 0.001) and also delay in the average onset time of the tonic – clonic Seizures with respect to the control group (P = 0.02) and besides the rates of mortality in that group of animals which were pretreated with 50 and 100 mg concentrations of the extract per kg of body weight indicated a significant difference with respect to the control group (P = 0.004) . Mortality rate was 100 % in the negative control group,37.5 % in the50 mg/kg weight group and 12.5 % in the 100 mg/kg weight group and 12.5 % in the group treated by Phenytoin.Conclusions: This study indicated that the hydro-alcoholic extract of the Melissa officinalis plant can cause helpful effects on Seizures induced by Pentylenetetrazole in rats. Therefore, further studies are needed to understand the extent and mechanism of these effects. Implication for health policy/practice/research/medical education:The results of this article may be used by other investigators for future study about precise mechanism of anticonvulsive effects of this plant. If these results approved by other research, can be used with clinicians for prevention of seizure in human trails. These results can be used with other investigators for analysis of this extract for effective components. Please cite this paper as:Gorgich E, Komeili Gh, Zakeri Z, Ebrahimi S. Comparing Anticonvulsive Effect of Melissa officinalis` Hydro-Alcoholic Extract and Phenytoin in Rat. Health Scope. 2012; 1(1):44-8. DOI: 10.5812/JHS.4816 Copyright© 2012 Kowsar Corp. All rights reserved.  
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    Nasal and Indoors Fungal Contamination in Healthy Subjects
    (Brieflands, 2016-02-01) Samaneh Eidi; Seyed Amir Kamali; Zahra Hajari; Abdolmajid Fata; Reza Farid Hosseini; Ali Naseri; Mehdi Bakhshaee
    Background: Fungi are regarded as one of causal factors of respiratory allergies and are a serious threat to public health in indoor environments. Before conclusively identifying fungi as the major causative agent of all or some types of rhinitis, we should have a good knowledge of the fungal flora of the nasal cavity and indoor building environments of healthy subjects. Objectives: The aim of this study was to determine the presence and relative abundance of fungal flora in the nasal cavity and bedroom of healthy subjects in Mashhad city, north east of Iran. Patients and Methods: A group of fifty healthy volunteers without a history of respiratory system diseases were selected. Samples from the nasal cavity and different parts of the bedroom including indoor air, pillow, mattress, blanket, dust of the bed, dust of the shelf and dust of the air duct were collected and cultured. The fungi were identified by standard mycological techniques. Results: The most common fungi isolated from all samples were Aspergillus, Penicillium, Yeast, Alternaria and Cladosporium. Stemphylium, Ulocladium, Stachybotrys, Basidiobolus and Exophiala showed the least frequencies among the isolated fungi. Conclusions: The presence of fungi in the nasal cavity and indoors of healthy subjects in this study suggests that fungi should be considered as health hazards. Furthermore, it is important and seems necessary to monitor indoor air quality and raise awareness of existing threats due to microorganisms, including fungi.
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    Hajj Pilgrimage and the New Emerging Cases of Middle East Respiratory Syndrome Outside the Middle East
    (Brieflands, 2016-02-01) Viroj Wiwanitkit
    This article does not have an abstract.
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    Off-Gas Treatment of Ammonia Using a Diffused Air Stripper: A Kinetic Study
    (Brieflands, 2016-02-01) Hooshyar Hossini; Abbas Rezaee; Bita Ayati; Amir Hossein Mahvi
    Background: The presence of excess ammonia nitrogen in aqueous environments has caused various problems such as eutrophication, oxygen depletion and aquatic toxicity. Hence, it is necessary to have special consideration in the discharge of ammonia to environment. Objectives: The aim of this study was to study kinetic of ammonia degasification at a short-time (6 hours) with relatively constant pH and temperature. Materials and Methods: Ammonia degassing was carried out using a diffused air stripper. The unit consisted of 1 L cylindrical column with dimension of 30 × 8 cm. The flow rate was set at 2 L/minute at 6 hours. The operating parameters such as ammonia, nitrate, nitrite, electrical conductivity (EC), the oxidation-reduction potential (ORP), and pH were analyzed according to standard methods. Results: According to obtained results, the maximum removal efficiencies were determined 17%, 35.5%, 31%, 66%, and 85.5%, for 50, 100, 200, 500 and 1000 mg/L ammonia concentrations, respectively. A first-order kinetic model was adopted to represent the ammonia degassing. Conclusions: The ammonia degassing is a simple and suitable technology for ammonia removal at high concentration. Undesirable removal efficiency (17%, 35.5% and 31%) can be occurred in suitable pH 11 in the presence of lower ammonia concentrations (50, 100 and 200 mg/L).
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    Social Determinants of Women's Reproductive Health: A Systematic Review
    (Brieflands, 2024-02-29) Maryam Biglari Abhari; Hamideh Sabetrohani; Samaneh Saghfian Larijani; Ronak Ghafori; Ayoub Nafei
    Context: Health, in all its aspects, is an important human right. There are various factors for the health of individuals with complex relationships with other cultural and social characteristics of a society that lead to inequality in health. Social determinants of health have a critical role in health matters; their impact on women's fertility and childbearing must be viewed as an important field to macrolevel and microlevel health scope decision-making and policy development. Objectives: This study aims to extract and determine the social determinants that affect women's reproductive health based on existing studies and strong evidence. Methods: This study was a systematic review that searched reputable medical databases and sites, including PubMed, Scopus, ISI, IranDoc, and SID, utilizing keywords like "social," "reproductive health/fertility/childbearing," and "women/female/woman". The scope of the study was limited to articles published between 2010 and 2019 due to the large volume of data available, and articles written in languages other than English or Persian were excluded from the review. The segregated articles concerning the abstract content were screened by two independent individuals to match the research objectives and keywords. The relevant abstracts were separated for review in the next step, and the full text of the obtained articles was read separately by two independent individuals to ensure their alignment with the research objectives. The articles were reviewed for quality and accuracy using the CASP tool, and those scoring above 75% entered the final stage of the study. Results: In the initial database search, 1731 articles were found, and after removing duplicates, 1516 remained. Of these, 1313 were removed for not meeting the research objectives, leaving 203 articles for the next stage. After further review, 92 articles were excluded, resulting in 107 articles for further review. Out of these, 84 articles were evaluated for compliance with research objectives, with 26 articles entering the critical evaluation stage. All articles scored above 75% on evaluation tools and entered the final stage of information extraction. Conclusions: The social determinants that impact women's reproductive health and childbearing, based on studies worldwide, include racial, ethnic, and national discrimination (for immigrants and minorities), micro and macroeconomic factors (income, costs of living, and healthcare), socio-cultural factors (education, employment, family norms), and socio-geographical factors (residence and urban status).
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    Researchers in Less Developed Region Should be Able to Communicate and Take Advantages of Other Scientists
    (Brieflands, 2012-05-15) Ramazan Mirzaei
    This article does not have abstract.
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    Leisure-Time Physical Activity Impact on Quality of Life, Anxiety, Depression, and Clinical Intensity of Pemphigus Vulgaris
    (Brieflands, 2024-02-29) Maryam Momtazbakhsh; Yousef Fakour; Ali Zarei; Maryam Daneshpazhooh; Ehsan Aghapour
    Background: Currently, physical activity serves as a preventive approach to reduce the side effects of medical conditions and mental disorders, as well as to enhance public health. Objectives: This study aims to explore the impact of physical activities on depression, anxiety, quality of life (QoL), and the severity of clinical symptoms in patients with pemphigus vulgaris (PV). Methods: This study was conducted as an experimental investigation on patients with PV who were referred to Razi Hospital in Tehran. A total of 76 patients were selected as the statistical sample and were randomly divided into 2 equal groups: An intervention group and a control group. The intervention involved engaging in recreational walking in a park for 60 minutes every other day, for three sessions a week, over a period of 8 weeks. Results: The intervention group showed improved QoL compared to the control group after 8 weeks (P-value = 0.045, 5.2 ± 2.97 vs. 7.5 ± 6.45); (P-value = 0.066, 4.97 ± 1.89 vs. 6.1 ± 4). Additionally, there was a noticeable reduction in anxiety levels in the intervention group compared to the control group after 8 weeks (6.92 ± 4.7 vs. 9.31 ± 4.97, P-value = 0.03). However, there was no significant difference in depression and the severity of symptoms between the 2 groups over the two-month period (4.6 ± 6.03 vs. 4.3 ± 7.78, P-value = 0.067). Nonetheless, significant improvements in anxiety were observed in the intervention group.
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    Noise Pollution in Zahedan and Residents’ Knowledge About Noise Pollution
    (Brieflands, 2012-05-31) Ramazan Mirzaei; Alireza Ansari-Moghaddam; Mahdi Mohammadi; Fatemeh Rakhshani; Maryam Salmanpor
    Context: Noise is considered one of the most pervasive and harmful agents in crowded cities. The aim of this study was to determine the exposure rate to noise pollution of residents on the main streets of Zahedan city in southeastern Iran and the knowledge and attitudes of these residents concerning noise. Evidence Acquisition: Noise was measured for three consecutive weeks in the OctoberNovember areas of the city in 31 test locations, using a CEL-440 Classic sound level meter and analyzer during the noisiest hours of the day (07:00 to 22:00). Using a validated questionnaire, data were collected from 400 subjects to estimate their knowledges and attitudes about noise pollution. Results: The average noise level in the main city streets during the day was 75 ± 2.96 dB. The mean age of participants was 31.9 ± 11 years. Approximately 82.3% of the subjects tested reported that street noise pollution was too high, and 48% suggested that the best way to decrease city noise pollution was to enhance people’s knowledge of the problem. Furthermore, 65.8% of the subjects stated that street noise is a cause of stress. There was a significant association between noise levels and subjects’ sleepiness (P < 0.05). In addition, noise pollution in Zahedan city streets was found to be higher than standard levels. Conclusions: It was concluded that appropriate traffic management and a health promotion program are essential for increasing the residents’ understanding about how to improve the current noise pollution situation.
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    Decision-Making in Australia’s Healthcare System and Insights From Complex Adaptive Systems Theory
    (Brieflands, 2012-05-31) Abdolvahab Baghbanian; Ghazal Torkfar; Yaser Baghbanian
    Background: Identifying the optimal allocation of resources to improve health and evaluating the ever-changing nature of healthcare delivery programs have proved challenging. Little is known about how decision-makers actually identify the optimal allocation of resources to improve health.Objectives: This study seeks to elucidate how decision-makers decide in complex healthcare situations, what tools or methods to employ and why.Patients and Methods: A theoretical sample of 25 Australian healthcare executives was recruited to participate in individual, semi-structured interviews. The participants were managers at each level of organizational structure with responsibilities for healthcare resource allocation. They were interviewed on their perspectives about the weightiest allocation decisions they had made in the past. All interviews were digitally recorded, transcribed and analysed thematically.Results: We found that decision-making in Australia’s healthcare system is never an individual rational choice. Allocation decision-making involved a multifaceted interplay of elements in situations of action. It was not exclusively rational and no single methodological framework is sufficient. Decision-making relates to contextual run-time factors which change while the system is operating. Problems that combine complexity with uncertainty resisted evidence-based decision-making. Our findings revealed that Australia’s healthcare systems exhibits most, if not all, underlying features of complex adaptive systems and confirmed that Cynefin sense-making model can be applied heuristically to analysis of decision-making in healthcare resource allocation.Conclusions: Healthcare decision-making and policy environment is becoming increasingly complex and inter-dependent. The way forward is only understood through contextual knowledge and relativist understanding of the decision contexts, uncertainty, multiplicity and broader stakeholder involvement.
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    Association of EPHA3 Gene Variation with Oral Hygiene in an Iranian Population
    (Brieflands, 2024-05-31) Hoshangh Rafighdoosth; Elaheh Hasanpour; Mohamad Hashemi; Gholamreza Bahari; Mohsen Taheri
    Background: Non-syndromic cleft lip with or without cleft palate (NSCL/P) is the most prevalent congenital birth anomaly. The EPHA3 gene is suggested to play a pivotal role in the development of oral clefts. Objectives: This study aimed to evaluate the influence of EPHA3 gene polymorphisms on the risk of NSCL/P within an Iranian cohort. Methods: We performed genotyping of the EPHA3 gene polymorphisms rs7650466, rs1398197, rs17801309, rs1054750, and rs7632427 in 150 NSCL/P patients and 152 healthy controls using PCR-RFLP, T-ARMS-PCR, and ARMS-PCR methods. Results: The results indicated that the rs1398197 variation significantly reduced the risk of NSCL/P in a heterozygous codominant model (OR = 0.58, 95% CI = 0.36 - 0.94, P = 0.027, G/A vs. G/G), a dominant model (OR = 0.56, 95% CI = 0.35 - 0.89, P = 0.014, G/A + A/A vs. G/G), and at the allele level (OR = 0.62, 95% CI = 0.43 - 0.91, P = 0.014, A vs. G). The rs1054750 polymorphism showed a decreased risk of NSCL/P in codominant (OR = 0.62, 95% CI = 0.39 - 0.99, P = 0.047, T/C vs. T/T) and dominant models (OR = 0.62, 95% CI = 0.39 - 0.98, P = 0.042, T/C + C/C vs. T/T). The rs17801309 polymorphism was not associated with any risk or protection from NSCL/P. rs7650466 and rs7632427 were not polymorphic in the study sample. Conclusions: Our findings suggest that variants of the EPHA3 gene may be linked with a reduced risk of NSCL/P.
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    Assessing Musculoskeletal Disorder Risks in an Automobile Part Manufacturing Factory: A Comparison Study of Biomechanical and Ergonomic Tools
    (Brieflands, 2024-05-31) Abouzar Eynipour; Navid Arjmand; Iman Dianat; Ali Reza Soltanian; Rashid Heidarimoghadam
    Background: Various tools and methods are available to assess the risk of musculoskeletal injuries in occupational settings, each considering different assessment criteria. While these methods have been previously studied, further comparative investigations are still needed. Objectives: This study aimed to assess the risk of musculoskeletal disorders (MSDs) in workers performing various tasks using different ergonomic and biomechanical risk assessment tools and to compare the outcomes of these tools. Methods: This analytical and cross-sectional study was conducted in a sector of the SAIPA Automobile Part Manufacturing Factory in Iran. A total of 33 workers engaged in lifting, grinding, pushing, and lowering activities participated. Lifting activities involved handling parts weighing 36, 7.9, and 3.4 kg at three workstations. In total, six tasks were examined, and workers' discomfort levels were evaluated using the Cornell Musculoskeletal Discomfort Questionnaires (CMDQ). Fourteen biomechanical and ergonomic risk assessment tools were utilized and compared. Kendall's tau-b correlation coefficient and Cohen's kappa agreement coefficient were applied to determine relationships between different tools and to match the measurement of risk levels, respectively. Additionally, the mean and standard deviation of the data were calculated. Results: There was a high positive correlation between the outcomes of three biomechanical tools [3D static strength prediction programTM (3DSSPP), hand-calculation back compressive force (HCBCF), and JACK], with 3DSSPP and HCBCF being interchangeable for estimating lumbar spine loads. Ergonomic assessment tools showed a suitable correlation in assessing load-carrying tasks. Manual handling assessment charts (MAC) had perfect agreement with National Institute for Occupational Safety and Health (NIOSH), and SNOOK with Washington Industrial Safety and Health Act (WISHA). Among body posture evaluation methods, rapid upper limb assessment (RULA) and rapid entire body assessment (REBA) had the highest correlation. Lifting fatigue failure tool (LiFFT) correlated well with manual handling methods, and survival chance correlated better with body posture evaluation methods. Lowering activities were identified as the most hazardous. Conclusions: Ease of use and accuracy are key considerations when selecting biomechanical risk assessment tools. Experienced assessors can effectively utilize JACK, 3DSSPP, and HCBCF. The MAC and NIOSH, as well as RULA and REBA tools, are interchangeable. Selecting appropriate tools requires consideration of their limitations and advantages.
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    Misclassification Bias of Poisoning-Related Mortality in Iran
    (Brieflands, 2024-05-31) Mehran Rostami; Mohammad Jalilian
    This article does not have an abstract.
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    Prediction of Pralidoxime Dose in Patients with Organophosphate Poisoning Using Machine Learning Techniques
    (Brieflands, 2024-05-31) Babak Mostafazadeh; Shahin Shadnia; Sayed Masoud Hosseini; Mitra Rahimi; Haleh Talaie; Seyed Ali Mohtarami; Peyman Erfan Talab Evini; Joshua King
    Background: Early and appropriate antidotal therapy is crucial for patients with organophosphate poisoning. Objectives: Given the lack of a comprehensive consensus on the optimal dose of pralidoxime for patients with organophosphate poisoning, this study aims to develop a machine learning-based prediction model to determine the individualized pralidoxime dose for these patients. Methods: The dataset was divided into training and test sets with a 70:30 ratio. Feature selection was conducted using Pearson’s correlation coefficient (filter approach) method. Both classification and regression were employed to develop the prediction model using the selected features. The performance of the developed models was evaluated using ten-fold cross-validation and various metrics, including sensitivity, specificity, accuracy, F1-score, and AUC. The models were implemented and assessed using the scikit-learn library in Python. Results: After applying exclusion criteria, data from 325 patients were utilized to train and test the machine-learning models. In the classification approach, the random forest method achieved superior performance with an AUC of 98.6. In the regression approach, the gradient boosting regressor, with an R2 value of 65.4, outperformed other algorithms. Feature selection revealed that muscular weakness, plasma cholinesterase activity, and blood urea nitrogen were the most significant predictors of pralidoxime dose in the classification model. In the regression model, the top predictors were age, HCO3-VBG, and atropine bolus. Many of the selected features coincide with those identified in previous studies, with muscular weakness being particularly significant in both models. Conclusions: The most effective algorithms could be employed to develop a clinical decision support system for personalized pralidoxime dosage prediction in patients with organophosphorus poisoning. However, the study is constrained by its small sample size, retrospective design, and the absence of an external validation cohort. Conducting a prospective multicenter study with a larger sample size is crucial to validate the findings of this study.
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    Removal of Pyrocatechol from Aqueous Solution Using Activated Carbon Coated with Aluminum Nanoparticles by a Green Method
    (Brieflands, 2024-05-31) Bahram Kamarehie; Ali Jafari; Faramarz Azimi; Marzieh Rashidipour; Arefeh Sepahvand
    Background: Pyrocatechol, a phenol derivative, is commonly found in industrial effluents at various concentrations due to its extensive use in multiple industries. These toxic compounds are resistant to biological degradation and pose significant threats to environmental and human health when they enter aquatic environments. Objectives: This study explores the removal of pyrocatechol from aqueous solutions using activated carbon coated with aluminum nanoparticles. Methods: Laboratory materials included oak wood (collected from the mountains around Lorestan province, Iran), pyrocatechol, H3PO4, HCl, Al2O3, NaCl, NaOH, graphite oxide, and NH3. This experimental study was conducted on a laboratory scale. Oak wood was used to synthesize activated carbon, while aluminum oxide and oak moss were employed to produce aluminum nanoparticles using a green method. The characteristics of the adsorbents were examined using XRD, FESEM, FTIR, and BET analyses. Parameters such as contact time (5 - 40 min), pH (3 - 11), initial concentration of pyrocatechol (20 - 200 mg/L), adsorbent dose (50 - 250 mg), and ionic strength were investigated. The residual concentration of pyrocatechol was measured using a spectrophotometer at a wavelength of 275 nm. Results: The results indicated that maximum adsorption efficiency was achieved with a pyrocatechol concentration of 100 mg/L, a pH of 7, a contact time of 20 minutes, and an adsorbent dose of 250 mg. Isotherm and kinetic analyses showed that the adsorption data correlated well with the Langmuir model and the pseudo-second-order kinetic model, respectively. Conclusions: Activated carbon derived from oak wood and coated with aluminum nanoparticles using a green method is highly efficient in removing pyrocatechol from aqueous solutions. This method is recommended as an effective, rapid, cost-effective, and environmentally friendly approach for the removal of pyrocatechol from aqueous environments.
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    Factors Affecting the Pharmaceutical Supply Chain: A Systematic Review
    (Brieflands, 2024-05-31) Mohammadkarim Bahadori; Ehsan Teymourzadeh; Sajjad Bahariniya; Ali Tahernezhad; Gholamreza Poorheidari
    Background: Medicine plays a crucial role in societal health, and even minor disruptions in the supply chain can lead to crises. An organized supply chain ensures that patients receive their medications in the best possible conditions. Objectives: This study aims to identify and categorize key variables associated with the pharmaceutical supply chain. Methods: We conducted a systematic review of all studies on drug supply chain management, adhering to the PRISMA guidelines. The search was carried out in both international and national databases from January 30, 2000, to March 30, 2023. We used specific keywords related to the drug supply chain for this search. We excluded articles, letters to the editor, and editorials from the review and ultimately qualitatively examined 34 studies. The quality of these articles was assessed using the CASP checklist. Results: We identified key variables and classified them into five categories: Monitoring and control (16 variables), information technology and intelligence (4 variables), human capital (10 variables), physical and financial resources (16 variables), and suppliers (4 variables). Conclusions: It is imperative for health policymakers to develop effective strategies in monitoring and control, information technology and intelligence, human capital, physical and financial resources, and management of drug suppliers. These strategies are essential for the efficient supply and distribution of drugs within the supply chain.