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Background: Regarding the patients’ critical conditions and various tools and pieces of equipment used in intensive care units (ICUs), the provision of critical care nursing seems complicated. Therefore, nurses’ achievements in making adaptations to critical care nursing are of utmost importance, especially in ICUs. Objectives: The present study aimed to illuminate the facilitators of adaptation to nursing care among ICU nurses. Methods: This qualitative study was conducted using the conventional content analysis approach through semi-structured face-to-face interviews within December 2019 to April 2021. A total of 13 nurses working at a trauma center were selected to participate in this study using purposive sampling in Imam Hossein Hospital in Shahroud, Iran. Results: Based on the results, the facilitators of adaptation to nursing care in ICU nurses consisted of three main categories of psychological capital, professional capital, and social capital. Conclusions: It was concluded that focusing on determining the facilitators of adaptation to critical care nursing and attempting to redouble them can promote the quality of nursing care. Much more attention should be paid to this issue because further adaptation affects society’s health conditions.

Removal of lead from aqueous solutions was studied using nanocomposite absorbent of bentonite/-alumina. The novel absorbent was characterized using XRD, FT-IR and SEM-EDX. Absorption process optimization using response surface methodology (RSM) and experimental design was performed with central composite design technique. The effects of Pb(II) initial concentration, adsorbent dosage, and composite percentage on Pb(II) removal percentage and adsorption capacity were examined. The adsorption capacity of 166.559 mg/g and removal % of 82.9887 with desirability equal to 0.763 were obtained for optimal initial concentration of 200 mg•l-1, adsorbent dosage of 0.5 mg•l-1, and composite percentage of 7.08 % determined using RSM design. The equilibrium adsorption data were investigated by Langmuir, Freundlich and Dubinin-Radushkevich isotherm models. It was found that Freundlich isotherm model fits better compared with other models.

Background: Cytokines as important mediators have a critical role in appropriate immune responses, the irregular production of which can lead to Multiple Sclerosis (MS). Proinflammatory cytokine interleukin-1 (IL-1) triggers inflammatory responses. Function and production of the cytokine are influenced by IL-1 coding gene polymorphism and those antagonists gene polymorphism. Objective: The aim of the present study was to evaluate the possible correlation between MS and IL-1 related alleles in Azeri population of Iran. Methods: Variable number tandem repeats (VNTR) genotypes of 150 MS patients and 220 healthy non-relative controls were determined. Result: n the healthy controls, genotype TT at IL-1A (-889) location was significantly higher than the MS patients (p=0.0001). However, a significant difference was not found between the two groups in genotypic/allelic frequency at IL- 1B+ 3953 location. Evaluation of the IL-1RA gene revealed that genotype 1/2, and genotype 1/3 were significantly higher in the healthy controls and MS patients, respectively. Our findings indicated that the consumption of fast-food in MS patients was significantly higher than controls (p= Conclusion: Polymorphisms of the IL-1B genes and common alleles of IL-1RA were not considered as risk factors for MS disease. However, genotype TT at IL-1A (-889) location and the rare allele of IL-1RA3 can be a potential risk factor for the disease. Furthermore, inappropriate dieting behaviors and consumption of fast-food can increase the risk of MS.

The design and synthesis of natural and synthetic polymer blends have received recent and wide attention. These new biomaterials exhibit progress in properties required in the field of medicine and healthcare. Herein, the aim of present study is to fabricate starch (ST)/polyacrylic acid (PAA) electrospun nanofibrous mat with a smooth and uniform morphology, lowest fiber diameter (below 100 nm) and the highest possible starch content. Starch itself is poor in process-ability, and its electrospinning could be quite a challenging process. To address this, we carried out the response surface methodology (RSM) technique for modelling the electrospinning process. In order to have ST/PAA nanofibers with the finest possible diameter, optimized processing parameters (applied voltage, nozzle‐collector distance and feed rate) obtained from RSM technique were applied. ST/PAA electrospun nanofibers with an average diameter of 74±13 nm were successfully achieved via the electrospinning method for the first time. The structure, preparation and properties of the nanofibrous structure were discussed. Results indicated that drug loaded ST/PAA blend nanofibrous structure has a great potential to be used in controlled drug release systems.

The development of an innovative interfacial wetting strategy known as liquid infused systems offers great promise for the advanced design of superwetting and superantiwetting substrates to overcome the drawbacks of textured surfaces classified under the heading of Cassie/Wenzel states. The potential value of nature-inspired surfaces has significant potential to address scientific and technological challenges within the field of interfacial chemistry. The objective of the current review is to provide insights into a fruitful and young field of research, highlight its historical developments, examine its nature-inspired design principles, gauge recent progress in emerging applications, and offer a fresh perspective for future research.

Nanocellulose fibers bioengineered by bacteria are a high-performance three-dimensional cross-linked network which can confine a dispersed liquid medium such as water. The strong chemical and physical interactions of dispersed water molecules with the entangled cellulosic network allow these materials to be ideal substrates for effective liquid separation. This type of phenomenon can be characterized as green with no equivalent precedent; its performance and sustainability relative to other cellulose-based or synthetic membranes are shown herein to be superior. In this work, we demonstrated that the renewable bacterial nanocellulosic membrane can be used as a stable liquid-infused system for the development of soft surfaces with superwettability and special adhesion properties and thus address intractable issues normally encountered by solid surfaces.

Wettability is one of the most critical interfacial properties of any surface. Surfaces with special wettability such as superwetting or superantiwetting are being intensively explored for their wide-ranging applicability by a biomimetic exploration of unusual wetting phenomena in nature. This study provides a green water-infused superoleophobic composite membrane by boosting bacteria nanocellulose growth on a reinforcement fibrous substrate. It was shown that this versatile antifouling membrane is capable of removing water from surfactant-stabilized oil-in-water micro/nanoemulsions and helps to isolate the oil fraction with very high filtration efficiency. The renewable membrane based on bacteria nanocellulose matrices can vastly improve current technologies by cultivating a naturally occurring soft materials approach with lubricious conformal interfaces to effectively and simply cover suitable surfaces.

Deep vein thrombosis (DVT) is a common and preventable complication in patients with lower extremity trauma. DVT prediction is considered to be necessary.This study aimed to compare the Autar DVT risk assessment scale with modified Wells criteria in predicting DVT by nurses in patients with lower extremity trauma.Patients with lower extremity trauma patients who met the requirements for this study were assessed by both the Autar and Wells tools for DVT risk assessment during the first 24 hours after their admission. Statistical analysis was performed using SPSS 18.There was a significant and direct statistical relationship between the results of risk assessment of these two tools based on Pearson correlation (r= 0.731, P0.0001). Kappa coefficient between the two was 53%. Sensitivity and specificity of the Autar scale were 100% and 68%, respectively, which revealed a higher degree of sensitivity than that of the Wells criteria.Although the results of DVT prediction for the Autar scale and modified Wells criteria were consistent, the Autar DVT risk assessment scale showed higher sensitivity. Therefore, it is recommended that the Autar scale be used to achieve more precise DVT predictions.

Receptor for advanced glycation end-products (RAGE) is involved in the pathogenesis of diabetic nephropathy. FPS-ZM1, a selective RAGE inhibitor, in combination with valsartan were investigated for their protective potentials on the renal markers of tubular injury in streptozotocin-induced diabetic rats. Rats were assigned into groups of receiving FPS-ZM1 (1 mg/kg/day), valsartan (100 mg/kg/day), and FPS-ZM1 plus valsartan (1 mg/kg/day and 100 mg/kg/day, respectively) for one month. Kidney histology, renal inflammation and oxidative stress, and renal and urinary markers of tubular injury were investigated. FPS-ZM1 and valsartan in combination more significantly attenuated renal expressions of tumor necrosis factor-alpha and interleukin-6 genes and reduced urinary levels of interleukin-6. Moreover, the combination elevated renal NAD+/NADH ratios and Sirt1 activities, and mitigated nuclear acetylated NF-κB p65 levels. In addition to alleviating indices of oxidative stress i.e. malondialdehyde, superoxide dismutase and glutathione peroxidase, the combination of FPS-ZM1 and valsartan more effectively upregulated the renal levels of master antioxidant proteins Nrf2, heme oxygenase-1, and NAD(P)H:quinone oxidoreductase-1. Additionally, this dual therapy ameliorated more efficiently the indices of renal tubular injuries as indicated by decreased renal kidney injury molecule-1 levels as well as reduced urinary levels of cystatin C, retinol binding protein, and beta-2-microglobulin. While FPS-ZM1 alone had no appreciable effects on the renal fibrosis, the combination treatment ameliorated fibrosis better than valsartan in the kidneys. Collectively, these findings underline the extra benefits of FPS-ZM1 and valsartan dual administrations in obviating the renal tubular cell injury in streptozotocin-induced diabetic rats partly by suppressing renal inflammation and oxidative stress.

A facile and effective method is described to engineer original bacterial cellulose fibrous networks with tunable porosity. We showed that the pore shape, volume, and size distribution of bacterial nanocellulose membranes can be tailored under appropriate culture conditions specifically carbon sources. Pore characterization techniques such as capillary flow porometry, the bubble point method, and gas adsorption-desorption technique as well as visualization techniques such as scanning electron and atomic force microscopy were utilized to investigate the morphology and shape of the pores within the membranes. Engineering various shape, size and volume characteristics of the pores available in pristine bacterial nanocellulose membranes leads to fabrication and development of eco-friendly materials with required characteristics for a broad range of applications.

Background Diabetes, a disease with increasing prevalence, requires comprehensive support from family members to ensure that sufferers are able to perform daily activities. The chronic nature of diabetes and its potential side effects impose high financial costs on patients and families, reduce their quality of life (QOL), and change the lifestyle of both patients and their families. Purpose The aim of this study was to investigate the effects of a family-based training program on QOL in persons with Type 2 diabetes. Methods A randomized clinical trial was used to assess the effects of an educational program on QOL both before and after 12 weeks of training for the experimental group (40 patients and families) and of standard care for the control group (40 patients) at an endocrinology clinic in a hospital in Iran. A demographic and social questionnaire and the QOL questionnaire for patients with Type 2 diabetes were used for data collection. The study groups were selected using block randomization sampling, and results were analyzed using descriptive and inferential statistics. Results Both the experimental and control groups were homogeneousin terms of demographic characteristics and QOL before the intervention. The results of the mean score of patient QOL after the 12-week training program showed a significant difference between the scores for the two groups of patients in the physical, mental, social, economic, disease, and treatment dimensions. Moreover, the total score and QOL of the experimental group improved significantly after the patients' families had attended the training program. Conclusions/implications for practice Educating the families of patients was shown in this study to improve the QOL of the patient. The design of educational programs for nursing students must emphasize the role of the family in the care of chronic patients.

One of the problems that employees face today in organizations is ethical problems. Many organizations resort to unethical acts due to the intensified competition in achieving efficiency and profitability. This article has been conducted to examine the relationship between the ethical climate and positive organizational behavior at Shahrud University of Medical Sciences. To do this, 224 employees at Shahrud University of Medical Sciences were selected randomly. The research was done based on a survey. The examined questionnaires included standardized questionnaires of ethical climate and positive organizational behavior. SPSS-19 was used to analyze the data in this study. The reliability of the questionnaires was estimated using Cronbach's alpha. Thus, Cronbach's alpha was obtained 0.844 and 0.730 respectively for the ethical climate of the organization and positive organizational behaviors. The results showed that there is a positive and significant relationship between the ethical climate of the organization and positive organizational behaviors of the staff at Shahrud University of Medical Sciences. Additionally, there are significant relationships among the instrumental ethical climate and the ethical climates of independence, caring, organizational rules and regulations, professional ethical rules and regulations and positive organizational behaviors among the staff at Shahrud University of Medical Sciences.

BACKGROUND/OBJECTIVES Side effects of current treatments and the need for a safe treatment with higher efficiency necessitate seeking new treatment options for vitiligo. Few studies have investigated the combination of psoralen with narrowband ultraviolet B (NBUVB). In this study, we compared the efficacy and safety of psoralen and NBUVB combination (P-NBUVB) with NBUVB alone in treatment of vitiligo. METHODS This randomised clinical trial was carried out during 2015-2017 in dermatology clinics of Ghaem and Imam Reza hospitals, Mashhad, Iran on 40 vitiligo patients with 5-60% body involvement. The patients were randomly divided into two groups of NBUVB alone and P-NBUVB. Both groups underwent 60 phototherapy sessions (three sessions per week), and the repigmentation rate was measured using vitiligo area severity index (VASI) score. SPSS v. 16 software and appropriate statistical tests were used to analyse the data. P

Events that disable parts of the highway transportation network, ranging from weather conditions to construction closures, may affect freight travel times and ultimately degrade economic productivity. Although previous studies of criticality typically focused on the impacts of natural disasters or terrorist attacks on systemwide travel times, these studies did not quantify the costs associated with disruptions to the economy because of disruptions to the freight transportation system. This paper quantifies the economic criticality of the highway infrastructure in Ontario, Canada, with the use of a new measure of criticality that determines the cost of highway closures (in dollars) on the basis of the value of goods, the time delayed, and the associated value of time. When criticality is measured in this way, it has some correlation with truck volumes, but the correlation differs when the values of shipments and the physical redundancy in the network are considered, and results in new insights into critical freight infrastructure. For example, the highway network within the greater Toronto, Ontario, Canada, area has a high degree of redundancy, but highways farther away from this metropolitan area have less redundancy and are thus more critical. Moreover, sections of Highway 401 located west of the greater Toronto area were found to be more critical—even though it carries lower truck volumes—than those located east of the greater Toronto area because of the lower redundancy in the western portion of the network. This measure has many potential applications in freight transportation planning, operations, and maintenance. Finally, with the cost of these disruptions quantified in dollars, one can then calculate the monetary benefits of potential transportation improvements for comparison (i.e., perform a cost–benefit analysis).

A new class of aerogels based on advanced 1D nanofibers have emerged recently. What makes this class of aerogel, known as “fibrous aerogels,” to stand out from those obtained from traditional sol-gel processed and supercritical drying method is its ease of processability, versatility, and multifunctionality. The fibrous aerogels not only hold intrinsic aerogels properties such as porosity, low density, and high specific surface area but also benefit from the inherent features of electrospun nanofibers, dual micro-/nanoporous structures, and fragmented fibrillar entanglement in the nano-/microscale. Besides, the versatility in the electrospinning and freeze-casting techniques render the process with the possibility of selecting a wide range of materials as the building blocks as well as tunable porosity and different geometrical shapes, which lead to superior mechanical properties and additional functionalities. This review has highlighted the historical developments, design principles, recent breakthroughs in emerging applications, and a fresh perspective for upcoming research in the field of fibrous aerogels.

Empagliflozin, a SGLT-2 inhibitor, improves diabetic nephropathy through its pleiotropic anti-inflammatory effects. The present study aims to evaluate empagliflozin effects on renal and urinary levels of tubular epithelial cell injury markers in streptozotocin-induced diabetic rats. Empagliflozin at 10 mg/kg (p.o.) was administered for 4 weeks, beginning 8 weeks after induction of diabetes. Renal function as well as markers of renal tubular epithelial cell injury were assessed in kidney tissue homogenates and urine. Empagliflozin was able to ameliorate diabetes induced elevations in serum cystatin C levels. It also alleviated renal KIM-1/NGAL levels and urinary albumin, α-GST, and RBP excretions. In addition to decreasing urinary levels of cell cycle arrest indices i.e. TIMP-2 and IGFBP7, empagliflozin mitigated acetylated NF-κB levels in renal tissues of diabetic rats. As a whole, these findings reveal empagliflozin capability in improving diabetic nephropathy via ameliorating indices of renal inflammation, injury, and cell cycle arrest on streptozotocin-induced diabetic rats.

Despite the effectiveness of renin-angiotensin blockade in retarding diabetic nephropathy progression, a considerable number of patients still develop end-stage renal disease. The present investigation aims to evaluate the protective potential of FPS-ZM1, a selective inhibitor of receptor for advanced glycation end products (RAGE), alone and in combination with valsartan, an angiotensin receptor blocker, against glomerular injury parameters in streptozotocin-induced diabetic rats. FPS-ZM1 at 1 mg/kg (i.p.), valsartan at 100 mg/kg (p.o.), and their combination were administered for 4 weeks, starting 2 months after diabetes induction in rats. Tests for kidney function, glomerular filtration barrier, and podocyte slit diaphragm integrities were performed. Combined FPS-ZM1/valsartan attenuated diabetes-induced elevations in renal levels of RAGE and phosphorylated NF-κB p65 subunit. It ameliorated glomerular injury due to diabetes by increasing glomerular nephrin and synaptopodin expressions, mitigating renal integrin-linked kinase (ILK) levels, and lowering urinary albumin, collagen type IV, and podocin excretions. FPS-ZM1 also improved renal function as demonstrated by decreasing levels of serum cystatin C. Additionally, the combination also alleviated indices of renal inflammation as revealed by decreased renal monocyte chemoattractant protein 1 (MCP-1) and chemokine (C-X-C motif) ligand 12 (CXCL12) expressions, F4/80-positive macrophages, glomerular TUNEL-positive cells, and urinary alpha-1-acid glycoprotein (AGP) levels. These findings underline the benefits of FPS-ZM1 added to valsartan in alleviating renal glomerular injury evoked by diabetes in streptozotocin rats and suggest FPS-ZM1 as a new potential adjunct to the conventional renin-angiotensin blockade.

Background: Most health professions, including nursing, create a lot of stress. To alleviate and cope with stresses and strains of the job, awareness of the causes is essential. Burnout and quality of work life are among factors affecting employees’ performance degradation. Objectives: This study aimed at investigating the relationship between quality of work life and burnout among nurses. Methods: This study had a cross-sectional and was carried out at Imam Hossein hospital of Shahroud, during year 2014. Data was collected using Walton’s quality of work life questionnaire and Maslach burnout inventory. The study applied convenience sampling and the sample size was 134. Data was analyzed using Pearson’s correlation, t-test, one-way analysis of variance (ANOVA), and structural equation modeling (SEM). Results: The majority of nursing staff (n = 118) under study were females (88.1%) and their mean age was 30.48. Results showed that the mean score for quality of work life in the majority of subjects was moderate (90.3%). In terms of frequency and intensity of burnout, the majority of participants showed high scores in personal accomplishment (100%) and depersonalization dimensions (99.3%). In addition, a negative and significant relationship was found between quality of work life and burnout. Conclusions: The results of this study indicate that there was a correlation between the quality of work life and burnout among nurses. Accordingly, interventions to improve the quality of work life, reduce burnout, increase the level of personal accomplishment, and ultimately provide patients with better services are advised.

Background and Purpose: Spiritual health is one of the important aspects of health status that may be influenced by QOL. Researchers have shown the relationship between spiritual well-being & a person's general health, so that religion and spirituality are considered the important resources for coping with stressful life events. This study aims to identify the relationship between spiritual well-being and quality of life in hemodialysis patients. Method: In this descriptive analytical study, 72 hemodialysis patients were selected using convenience sampling method. Information was collected by Paloutzian spiritual health and quality of life questionnaires (SF36). Data were analyzed by using descriptive and analytical statistics (Pearson correlation coefficient, t-test, ANOVA). Results: In line with these findings, the quality of life of the patients (47.8) 88.47 and their spiritual health scores (21.13) 88/91, most were moderate.There was no significant relationship between spiritual well-being and QOL. But there was a significant positive correlation between spiritual existential aspect of well-being and the dimensions of fatigue (P=0.02, r=0.26), emotional health (P=0.003, r=0.34), social functioning (P=0.01, r=0.29) and general health (P=0.01, r=0.29) and social performance (P=0.01, r=0.27). Also social performance had a significant positive correlation with spiritual well-being. Conclusion: According to the results, a significant relationship was observed between some aspects of quality of life and spiritual well-being. In order to understand the factors affecting the quality of life, exploring strategies to improve it and strengthen some aspects of spiritual well-being that affect the quality of life in hemodialysis patients is emphasized.

The selection of a suitable fabric layer is an important aspect in the development of a cooling garment. One of the essential ingredients in selecting fabric for cooling garments is high heat transfer coefficient. In this study five different type of knitting fabrics with similar woven pattern were selected. The fabrics were attached to a vapor-compression system which is one of the most important systems in cooling garments. Heat transfer coefficient was calculated for each fabric for three different refrigerator flow rates. The most efficient fabric for applying in cooling garments was determined from the point of heat transfer coefficient.