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COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value

Long noncoding RNA MEG3 and NLRC5 genes are both involved in the immune system and the regulation of NLRC5 by MEG3 is documented in rheumatoid arthritis. Therefore, we intended to evaluate the association between the expressions of MEG3 and NLRC5 in multiple sclerosis (MS). Forty relapsing and remitting MS (RRMS) patients (20 in each group) and twenty healthy individuals were enrolled. The expression level of MEG3 and NLRC5 was assessed in peripheral blood mononuclear cells. Sub-group analysis demonstrated that the expression level of MEG3 is reduced in the relapse patient group compared to remission and healthy groups (p < 0.001). The expression level of NLRC5 was higher in whole patients compared with healthy controls (p < 0.05). Moreover, a negative correlation was observed between the expression of these two genes (r = -0.73, p < 0.0001). To conclude, our findings showed the dysregulation of MEG3 and NLRC5 expressions in RRMS patients. Also, the converse association of MEG3 and NLRC5 reflects that the role of MEG3 in MS development is probably mediated by modulation of NLRC5.

This study aimed to assess the maternal features, Vascular Endothelial Growth Factor (VEGF) and Placenta Growth Factor (PLGF) in the Placenta Accreta Spectrum (PAS); then, to determine a predictive value of VEGF and PLGF in the PAS. This prospective case-control study was conducted on 90 pregnant women including 45 PAS, and 45 Normal Placenta (NP). Maternal age, gravidity, C/S, and serum levels of VEGF and PLGF were assessed between NP and PAS, and among NP and PAS sub-groups, including Placenta Accreta (PA), Placenta Increta (PI), and Placenta Percreta (PP). The Multi-gravidity, previous C/S, maternal age, and serum level of PLGF were significantly higher in the PAS group compared to the NP group OR = 42, 8.1, 1.17, and 1.002 (p-value .05). The same differences were seen among NP with PA, PI, and PP sub-groups (p-value .05 for VEGF). Placenta Previa was uniformly distributed across the PAS sub-groups (p-value >.05), also the VEGF and PLGF serum levels did not differ between PAS with Previa and PAS without Previa groups (p-value >.05). A valid cut-off point for PLGF was reported at 63.55. A predictive value of PLGF for the PAS patients is presented enjoying high accuracy and generalisability for the study population.Impact statementWhat is already known on this subject? The Placenta Accreta Spectrum (PAS), in which the placenta grows too deep in the uterine wall, is responsible for maternal-foetal morbidity and mortality worldwide; so, the antenatal diagnosis of PAS is an important key to improve maternal-foetal health. Normal placental implantation requires a fine balance among the levels of angiogenic and anti-angiogenic factors, such as the Placenta Growth Factor (PLGF), the Vascular Endothelial Growth Factor (VEGF), and soluble Fms-like tyrosine kinase-1. However, there is still controversy regarding The PLGF and VEGF level changes in PAS patients.What do the results of this study add? Despite traditional measuring the levels of PLGF and VEGF from the placenta at the time of delivery; in this study including 90 participants (28-34 weeks of gestation) the maternal serum levels of PLGF and VEGF were measured in advance (temporality causation), resulted in presenting a more valid cut-off point for PLGF in PAS group. In addition, the serum level of PLGF was significantly higher in the PAS and PAS sub-groups compared to the Normal Placenta group. Also, the Previa status of PAS patients did not affect the VEGF and PLGF serum levels.What are the implications of these findings for clinical practice and/or further research? PLGF cut-off point derived from the maternal serum level could predict PAS validly and, if used as a screening test in an earlier pregnancy, the maternal-foetal morbidity and mortality would decrease.

Aim: The aim of this study was to explain the causes and attributes of communication skill of the surgical team and patient safety in the operating room.Background: Communication skills and how to work in a team is one of the effective factors on the incidence of error and patient safety in the operating room. However, the quality of this communication and how communication skills increase the patient's safety in the operating room is not entirely clear. The aim of this study was to find out the relationship between communication skills and patient safety in the operating room.Methods: This qualitative study was performed based on grounded theory approach. In this study, data collection was performed by conducting semi-structured interviews. Eight interviews were conducted with members of the surgical team including surgeons, operating room and anesthesia experts, and the samples were selected purposefully. The obtained data were analyzed by Strauss and Corbin’s approach.Results: In data analysis, two main categories were extracted: Factors affecting patient safety before surgery and Factors affecting patient safety during surgery. Consequently, eight sub-themes were classified.Conclusion: The results of the present study show that working in the operating room is a teamwork that requires cooperation and communication. In addition, the formation of proper communication between members of the surgical team has a significant impact on patient safety in the operating room.Relevance to clinical practice: Since the formation of proper communication between members of the surgical team can affect patient safety in the operating room, improving the communication skills of surgical team members can improve patient safety in the operating room.

Long noncoding RNA MEG3 and NLRC5 genes are both involved in the immune system and the regulation of NLRC5 by MEG3 is documented in rheumatoid arthritis. Therefore, we intended to evaluate the association between the expressions of MEG3 and NLRC5 in multiple sclerosis (MS). Forty relapsing and remitting MS (RRMS) patients (20 in each group) and twenty healthy individuals were enrolled. The expression level of MEG3 and NLRC5 was assessed in peripheral blood mononuclear cells. Sub-group analysis demonstrated that the expression level of MEG3 is reduced in the relapse patient group compared to remission and healthy groups (p 0.001). The expression level of NLRC5 was higher in whole patients compared with healthy controls (p 0.05). Moreover, a negative correlation was observed between the expression of these two genes (r = -0.73, p 0.0001). To conclude, our findings showed the dysregulation of MEG3 and NLRC5 expressions in RRMS patients. Also, the converse association of MEG3 and NLRC5 reflects that the role of MEG3 in MS development is probably mediated by modulation of NLRC5.

The most important effect of natural organic materials in water is reacting with disinfectants and creating disinfectant by-products that are mostly carcinogenic. The aim of this study was to determine the optimum conditions for removal of humic acid (HA) by zeolite coated with nZVI nanoparticles (Zeolite/nZVI) from aqueous solutions. In this study, after synthesis of zeolite/nZVI, its structure and morphology were examined using FTIR, BET, XRF, and FESEM techniques. The effects of HA concentration, composite content, pH, and reaction time were evaluated. The experimental data were analyzed by Langmuir and Freundlich isotherm and pseudo-first-order and second-order kinetic models. Finally, the thermodynamic parameters of enthalpy (ΔΗ°), entropy (ΔS°), and Gibbs free energy (ΔG°) were calculated. The results of the analyses confirmed the accuracy of the composite structure. Its specific surface area by using BET method was 203.43 m2/g. The HA removal efficiency was obtained at 92.98% in optimum conditions of 50 mg/L concentration, 2 g/L composite dose, pH = 3, and reaction time of 60 min. The results of the isotherm and kinetic study showed that the HA adsorption process follows the Langmuir isotherm (R2 = 0.9707) and pseudo-second-order kinetic. The maximum adsorption capacity of the composite was determined at 23.36 mg/g by Langmuir model. Thermodynamic parameters indicate that the adsorption of HA endothermic and the reaction cannot be done spontaneously. Zeolite/nZVI composite had good removal efficiency after five times of recycling. The present study showed that zeolite/nZVI can be used as an effective adsorbent for removal of HA from aqueous solutions.

Adsorption techniques are widely used to remove industrial wastewater contaminants, especially non-biodegradable colourants. In this study, Iranian zeolite clinoptilolite was synthesised using magnetic iron oxide as an inexpensive and efficient adsorbent. The results showed that using natural zeolite, the removal efficiency of 26.8.6% at pH = 3 reached 48% at pH = 9. However, the adsorption capacity of the modified clinoptilolite did not change by increasing pH; it ranged from 96.4% to 98.6%. Moreover, increase in the initial concentration of the dye did not have any effects on the removal efficacy of the modified clinoptilolite. Using natural zeolite, on the other hand, the adsorption capacity showed a significant decrease and reached less than 10% at the 200 mg/l dye concentration. At the optimal contact time of 45 min, the dye removal rate by the modified zeolite was more than 98% at the optimal dose of 0.5 g. Indeed, the adsorption isotherm complied with Freundlich equation. Overall, the resul...

Treatment of Ni(II) acetate with picolinic acid (Hpic) and KSCN resulted in the self-assembly generation of a new heterometallic and heteroleptic 3D metal–organic framework (MOF) formulated as [Ni(μ3-pic)2K(μ-SCN)]n (1). The crystal structure of 1 features a very intricate structure with a rare type of rna topology. This compound extends a still limited family of heterometallic picolinate-driven MOFs and represents the first Ni/K-picolinate derivative. Micro- and nanoscale samples of 1 (hereinafter 1s) were also obtained by a sonochemical irradiation method, wherein the effects of sonication power, reaction time, reactant concentration and temperature on the morphology of 1s were studied. Ultrasonically generated samples of 1s were characterized by standard methods and applied as photocatalysts for the photodegradation of bromocresol green (BCG) in aqueous solution under visible-light, leading to 94% degradation efficiency. The response surface methodology (RSM) with central composite design (CCD) was used for modeling and optimization of photodegradation variables such as pH, irradiation time, the initial BCG concentration, and catalyst dosage.

Background The present study aims to determine the predictive value of vascular endothelial growth factor (VEGF) and placenta growth factor (PLGF) for placenta accreta and for the comparison of the serum level of VEGF and PLGF in normal pregnant women and women with placenta accreta spectrum (PAS).Methods This prospective case-control study was conducted during the 2 years in two hospital in Shiraz, Iran from 2017 to 2019. The inclusion of the study was 90 singleton pregnant women: 45 of them in gestational ages of 28-34 weeks with pathological confirmation of placenta accreta spectrum and 45 healthy pregnant women. In the PAS group, according to pathology reports on the placenta, we divided all cases to placenta accreta, percreta, and increta. Maternal serum level of VEGF and PLGF were measured before the termination of pregnancy and diagnostic accuracy of each factor was evaluated.Results In PAS group, 75 percent of patients had placenta previa and unlike the control group, there was a significant difference in the gravidity, number of cesarean section, maternal age, and serum level of PLGF (p< /001); while in VEGF, the difference was not statistically significant.Conclusions The results of the present study revealed that the maternal serum level of PLGF could be considered as an accurate predictive test in patients with PAS.

Introduction: Clinical education is an essential element in the education of medical students. One of the problems students face in clinical education is stress. Students choose a variety of strategies to overcome clinical stresses. The aim of this study was to determine the relationship between stressors of clinical education and coping strategies. Methods: In this descriptive study, the population of the study was Hamedan Paramedical Students in 1396 who were studied by census method. The information was evaluated using the Stress Factor Questionnaires of Clinical Education and coping strategies for stressful endlerparer. Data were analyzed using Chi-square test, correlation analysis and nonparametric equilibrium analysis of variance. Result: In this study, students' stress was higher than average in all stressful areas except educational environment. The problem-oriented strategy had the highest score among the coping strategies. Among the domains of stressors among paramedical students, interpersonal communication had a direct and significant relationship with all three coping strategies (p

Walking gait of patients suffering from lumbar spine problems could lead to mobility restriction or even surgery. Quantified assessment of spatio-temporal characteristics such as gait speed and dimensionless gait speed known as Froude number along with stance phase and duty factor could contribute towards disease identification. Two groups of patients suffering from Lumbar spinal stenosis (LSS) and lumbar intervertebral disc degeneration (LIDD) were studied and Froude number, duty factor, mechanical internal work and stance phases were determined. The results revealed differences between the two groups. In conclusion, the identified differences in spatio-temporal parameters indicate the possibility of distinguishing lumbar spine patients in clinical settings without a need to use or interpret of diagnostic imaging.

In this study, an anaerobic moving bed biofilm reactor (AMBBR) was designed to biodegrade atrazine under mesophilic (32 °C) condition and then it was evaluated for approximately 1 year. After biofilm formation, acclimation, and enrichment of microbial population within the bioreactor, the effect of various operation conditions such as changes in the concentration of influent atrazine and sucrose, hydraulic retention time (HRT), and salinity on the removal of atrazine and chemical oxygen demand (COD) were studied. In optimum conditions, the maximum removal efficiency of atrazine and COD was 60.5% and 97.4%, respectively. Various models were developed to predict the performance of atrazine removal as a function of HRT during continuous digestion. Also, coefficients kinetics was studied and the maximum atrazine removal rate was determined by Stover - Kincannon model (rmax = 0.223 kgATZ/m3d). Increasing salinity up to 20 g/L NaCl in influent flow could inhibit atrazine biodegradation process strongly in the AMBBR reactor; whereas, the reactor could tolerate the concentrations less than 20 g/L easily. Results showed that AMBBR is feasible, easy, affordable, so suitable process for efficiently biodegrading toxic chlorinated organic compounds such as atrazine. There was no accumulation of atrazine in the biofilm and the loss of atrazine in the control reactor was negligible; this shows that atrazine removal mechanism in this system was due to co-metabolism.

In this study employed an anoxic moving bed biofilm reactor (AnMBBR) to evaluate the effects of hydraulic and toxic shocks on performance reactor. The results indicated a relatively good resistance of system against exercised shocks and its ability to return to steady-state conditions. In optimal conditions when there was the maximum rate of atrazine and soluble chemical oxygen demand (COD) removal were 74.82% and 99.29% respectively. Also, atrazine biodegradation rapidly declines in AnMBBR from 74% ± 0.05 in the presence of nitrate to 9.12% only 3 days after the nitrate was eliding from the influent. Coefficients kinetics was studied and the maximum atrazine removal rate was determined by modified Stover & Kincannon model (U max = 9.87 g ATZ /m 3 d). Results showed that AnMBBR is feasible, easy, affordable, so suitable process for efficiently biodegrading toxic chlorinated organic compounds such as atrazine. Also, its removal mechanism in this system is co-metabolism.