Background: In times of pandemic and quarantine, it is necessary to use new educational methods. The aim of this study was to compare the effectiveness of multimedia and booklet educational methods on knowledge, attitude, and job performance of healthcare providers in community health centers regarding COVID-19 in women during pregnancy, childbirth, and breastfeeding. Objectives: The aim of this study was to compare the effectiveness of multimedia and booklet educational methods on knowledge, attitude, and job performance of healthcare providers in community health centers regarding COVID-19 in women during pregnancy, childbirth, and breastfeeding. Methods: The population of this quasi -experimental study consisted of 90 Iranian health care providers in the community health centers of Gonabad city in eastern Iran) 2021, who were selected using the non-probability, purposive sampling method and randomly divided into three groups using a permuted block randomization design: Control group, Multimedia group and Textbook group. Knowledge, attitude and work performance were measured and compared before, after and four weeks after the intervention. The educational content was based on the Iranian Ministry of Health guidelines for the management of Covid-19 in pregnancy, childbirth and breastfeeding. Results: The results showed a significant difference between the mean score of knowledge, attitude, and work performance of the multimedia group and booklet group before and after the intervention (P<0.001), while there was no statistically significant difference between the mean score of knowledge, attitude, and work performance of the control group before and after the intervention (P<0.05). Conclusion: Multimedia teaching increases the knowledge, attitude and work performance of healthcare providers in community health centers regarding COVID.

Background: The importance of lateral transforaminal endoscopic treatment of thoracic disc herniation lies in the fact that the use of a needle can remove some of the disc contents and cause the disc herniation to disappear. The present study aimed to evaluate the effect of percutaneous endoscopy on the treatment of patients with thoracic disc herniation. Objectives: To investigate the clinical efficacy and feasibility of transforaminal endoscopic discectomy in the treatment of thoracic disc herniation Methods: This retrospective analysis was conducted on patients with thoracic hernias between January 2014 and December 2019. A total of 13 operative cases were selected via census sampling. Lateral endoscopic treatment of thoracic disc herniation was performed on patients, and they were followed up for 6-18 months. All patients were assessed by the visual analog scale Visual Analogue Score (VAS) and Oswestry Disability Index (ODI) before the surgery, as well as one week, three months, and six months after the operation, respectively. Results: The sample included 13 patients with a mean age of 60.3 years. The location of the thoracic disc herniation varied among the patients. The VAS scores before the surgery, as well as one week, three months, and six months after the surgery, were 7±0.8, 3.3±0.6, 2.3±0.8, 1.4±0.3, and 1.3±0.4, respectively, pointing to a significant decrease (P≤0.001). The ODI scores before the surgery, one day after surgery, one week after surgery, three months after surgery, and six months after surgery were 65.2±5.8%, 11.5±5.3%, 8.9±3.3%, 5.3±2.5, and 4.7±3.5, demonstrating a significant decrease (P≤0.001). The score of the Macnab standard, a rating system evaluating the effectiveness of spine surgeries, was also satisfactory. Conclusion: As evidenced by the results of this study, percutaneous endoscopy in the treatment of patients with thoracic disc herniation was able to improve the clinical condition of patients and replace the previous methods of thoracic hernia surgery as an effective, efficient, and safe method.

Background: It is of prime importance to manage trauma patients in the early hours and use easy trauma severity scoring systems to make decisions and evaluate patient prognosis. Objectives: The present study aimed to design a predictive model of the mortality of multi-trauma patients due to traffic accidents. Methods: This cross-sectional analytical study was performed on 600 patients who suffered from multi-trauma caused by traffic accidents from December 2019 to September 2021. Collected data included age, sex, vital signs, trauma mechanism, involved vehicle in the accident, accident location, and hospital outcome. Results: In this study, 600 multi-trauma cases caused by traffic accidents were evaluated. Among the significant variables included in the regression model, age, Mean Arterial Pressure (MAP), Glasgow Coma Scale (GCS), AVPU (Alert, Verbal response, Pain response, Unresponsive), and vehicle versus fixed objects (in Vehicle 2) in the presence of other variables in the model, significantly predicted patient outcomes. Therefore, with the other variables being constant, one unit increase in the age variable increases the probability of death by 1.04 times, one unit increase in the score of the two variables of MAP and GCS, and also the transfer of trauma mechanism from the fixed object to the vehicle reduces death by 0.92, 0.62, and 0.10 times, respectively. In the AVPU variable, the transition from Alert to Verbal, the transition from Verbal to Pain, and the transition from Pain to Unresponsive increases the probability of death by 32, 104, and 567, respectively. Conclusion: In this study, AVPU, age, MAP, primary GCS, and trauma mechanism due to hitting a vehicle with a fixed object had significantly the highest predictive power of hospital mortality in patients with multiple trauma due to traffic accidents, respectively. It is suggested that further studies be performed to replace the AVPU variable with GCS in the newly designed formulas for calculating the severity of trauma to simplify these scores.

Background: Breast cancer (BC) is a malignant tumor that occurs in the epithelial tissue of the breast gland and has become the most common malignancy in women. Various studies have reported the effect of epigenetic changes, including DNA methylation and microRNAs, on breast carcinogenesis. microRNAs play an important role in the post-transcriptional regulation of genes and are important regulators of oncogenic pathways. Studying microRNAs in BC facilitates the development of targeted therapies and early detection of this cancer. Objectives: This study aimed to evaluate the expression level of miR-508-5p and miR-635 in BC tumor tissues compared to healthy marginal tissues. Methods: In silico analysis confirmed microarray datasets (GSE40525, GSE44124 and GSE45666) downloaded from the GEO database. The analysis was defined using the Affy packages in R software to screen remarkably dysregulated miRNAs attended by utilized to predict the potential biological processes and molecular pathways of miR-508-5p and miR-635. Experimental statistical significance of differences in miRNA relative expression results was analyzed by pair-wise fixed reallocation randomization test as a statistical model included in the REST (relative expression software tool). Results: GEO microarray data set, similar to qPCR results, showed that miR-508-5p was downregulated in the sample group by a mean factor of 0.327 (S.E.M range is 0.031-2.000). Moreover, miR-635 was upregulated in the sample group by a mean factor of 2.361 (S.E.M range is 0.250-16.000). Conclusion: miR-508-5p was downregulated, while miR-635 was upregulated in BC tissues. They may be proposed as diagnostic and therapeutic biomarkers for patients with BC.

Background: Poor self-perineal care (SPC) by new mothers due to inadequate knowledge can result in perineal pain and poor wound healing outcome. Objectives: This study aimed to evaluate the effectiveness of self-perineal care education on knowledge and practice among primigravida mothers in Malaysia. Methods: This quasi-experimental study was conducted in two public tertiary care hospitals from September 2019 to March 2020. In total, 125 mothers were recruited using consecutive sampling procedures from two tertiary care hospitals. The intervention group consisted of 62 mothers who received SPC education supplemented by the mobile app, while the other 63 mothers in the control group received only routine hospital care. The knowledge of mothers regarding SPC was assessed at 32 to 33 weeks of gestation and then at 4 h post-delivery. The mothers of both groups reported their perineal care practices on Day 1, Day 3, Day 5, and Day 7 post-childbirth using the SPC education mobile app. Results: There was no significant difference in the SPC knowledge scores between the two groups at baseline (P=0.155). Post-analysis showed a significant increase in the SPC knowledge score in the intervention group (P<0.001) but not in the control group (P=0.133). At all-time points, the mothers in the intervention group performed better SPC practice than those in the control group (P<0.001). There were significant associations between changes in knowledge and practice on all four days (P<0.001). Conclusion: The increased knowledge of SPC was significantly associated with improved SPC practice among the primipara mothers postnatally.

Background: Although blood is donated rather than purchased, collecting, storing, and testing it for viral markers is expensive. During the Cost of Blood Consensus Conference (COBCON), activity-based costing (ABC) was proposed as a standard way to figure out the cost of preparing a unit of blood. Objectives: The ABC can be used by any organization that pays for blood or blood products. It was used to determine how much each unit of allogeneic blood costs in Iran, considering the limited blood sources and the importance of cost evaluation studies. Methods: This cross-sectional, descriptive-analytical study was conducted at Shiraz Blood Transfusion Organization in 2020-2021 (Shiraz, Iran). We used the ABC method to determine how much each unit of allogeneic blood costs in Iran. In this study, activity centers were divided into high-level, intermediate, and final activity centers. The resources of each activity center were made up of human resources, consumables, buildings, equipment, and energy. Results: Direct and indirect costs of producing blood were separately investigated in the studied sub-units. The final estimated cost of preparing one blood unit was almost 13 million IRR (≈308 USD). According to our findings, indirect costs comprised a significant portion (86.45%) of the cost of producing a unit of blood, while direct costs accounted for only 13.55%. Conclusion: As evidenced by the obtained results, the cost of one blood unit was far more than the national average estimated by the Iran Blood Transfusion Organization. There is a need for additional research on the cost of other blood products and indirect cost reduction strategies.

Background: Vocal cord polyps are common benign lesions that cause voice disorders, particularly hoarseness, which can interfere with daily communication. Objectives: The present study aimed to determine the effect of applying a nursing intervention based on the information-motivation-behavioral (IMB) model on rehabilitation after vocal cord polypectomy. Methods: A total of 76 patients who underwent vocal cord polyp resection in Wuhu Second People's Hospital between January 2019 and September 2021 were selected by convenience sampling as the study participants. A random number table was used to assign the patients to two groups, an intervention group and a control group (n=38 in each group). Patients in the control group were given routine postoperative nursing, whereas those in the intervention group received an IMB-based nursing intervention based on that of the control group. The data collected regarding self-care ability, vocal cord recovery, and voice disorder severity of the two groups after surgery were compared in January and February. Results: The Exercise of Self-Care Agency scale scores of the intervention group were higher than those of the control group both one and two months after surgery, and the difference was statistically significant (97.1±26.1 vs. 84.6±19.8, 103.3±28.4 vs. 85.6±20.0, P< 0.05), indicating the superior self-care ability of the intervention group. The Voice Handicap Index scores of the intervention group were lower than those of the control group both one and two months after the surgery, and the difference was statistically significant (35.8±9.2 vs. 39.8±13.9, 24.6±6.2 vs. 29.7±7.3, P<0.05), indicating that voice disorder severity was lower in the intervention group than in the control group. Moreover, the effective rates (recovery and improvement) of the intervention group were higher than those of the control group one and two months after the surgery. Conclusion: As evidenced by the obtained results, nursing intervention based on the IMB model for patients who undergo vocal cord polyp resection can effectively improve self-care ability, reduce the severity of voice disorders, and promote the recovery of vocal cords.

Background: Nurses who are more self-compassionate may be better able to manage the stress and emotional challenges of working in an emergency hospital during a pandemic. They may be less likely to experience burnout or compassion fatigue and may be more resilient in the face of adversity. They will probably be more patient and understanding with their patients and colleagues, and more able to maintain a positive attitude and provide compassionate care. Objectives: This study aims to determine the relationship between the self-compassion levels and patience levels of the nurses working in an emergency hospital and taking care of patients diagnosed with COVID-19. Methods: This cross-sectional and correlational study was conducted between May and August 2021 on 171 nurses working in an emergency hospital in Istanbul and taking care of patients diagnosed with COVID-19. The data were collected using the researcher-made Nurse Information Form, the Self-Compassion Scale, and Patience Scale. Results: The mean rank was found to be 78.03±12.03 for the Self-Compassion Scale and 37.97±6.34 for the Patience Scale. A weak positive significant correlation was identified between the nurses' mean rank of the Self-Compassion Scale and the mean rank of the Patience Scale (rho=0.393, P=0.000), interpersonal patience (rho=0.395), and short-term patience (rho=0.191) subscales, whereas a moderately positive significant correlation was detected between the mean rank of the Self-Compassion Scale and the mean rank of the long-term patience (rho=0.442) subscale. Conclusion: It can be said that nurses' self-compassion and patience were at moderate levels, and as their self-compassion levels decreased, their patience levels reduced as well. Institutions should develop in-hospital social activities and policies that are supportive of nurses. Supporting nurses' self-compassion levels with evidence-based programs will also increase their patience levels

Background: There are very few reports on the correlation between the apparent diffusion coefficient (ADC) of magnetic resonance parameters and other laboratory indicators of prostate cancer in China, and there is no unified clinical conclusion at present from the other parts of the world. Therefore, this study analyzed the correlation between ADC and laboratory indicators, such as serum total prostate specific antigen (TPSA), complex prostate specific antigen (CPSA), free prostate specific antigen (FPSA), Gleason score, and left and right diameters of the prostate so as to provide a basis for the diagnosis and treatment of prostate cancer. Methods: A total of 104 patients of all age groups with prostate cancer diagnosed in the General Hospital of Wanbei Coal and Electricity Group, Wanbei, China, from January 2017 to December 2022 were retrospectively analyzed as the experimental group. At the same time, 63 patients with benign prostatic hyperplasia who received health examinations were selected as the control group. TPSA, CPSA, FPSA, CPSA/TPSA, FPSA/TPSA, Gleason score, left and right diameters of the prostate, and magnetic resonance parameter ADC were detected in all patients. At the same time, we analyzed the correlation between ADC and other parameters in prostate cancer patients. Results: The serum levels of TPSA, CPSA, and FPSA in prostate cancer patients were significantly higher (P<0.001) than in those in the control group. The differences between CPSA/TPSA and FPSA/TPSA in the two groups were not statistically significant. Meanwhile, ADC and left and right diameters of the prostate were significantly lower in prostate cancer patients than in subjects in the control group, and the differences were statistically significant (P<0.001). In addition, serum TPSA, CPSA, and FPSA in high-risk prostate cancer patients were found to be significantly higher than in cases in the medium-risk and low-risk groups. The results of our study also revealed that ADC was moderately negatively correlated with FPSA (r=-0.415, P<0.001) and weakly negatively correlated with TPSA (r=-0.222, P=0.024). Conclusion: There is a correlation between ADC, TPSA, and FPSA in patients with prostate cancer, and there were significant differences in TPSA, CPSA, and FPSA between patients with prostate cancer and patients with benign prostatic hyperplasia. The three parameters can be combined for the diagnosis of prostate cancer.

Background: Colorectal Cancer (CRC) is the most common malignant gastrointestinal cancer. Cancer stem cells (CSCs) are the major cause of cancer recurrence and cancer drug resistance. Silibinin, as an herbal compound, has anticancer properties. Objectives: The present study aimed to evaluate the antiproliferative effects of silibinin on HT29 stem-like cells (spheroids). Methods: In this study, antiproliferative and apoptotic properties of Silibinin encapsulated in Polymersome Nanoparticles (SPNs) were evaluated by MTT assay, propidium iodide (PI) /AnnexinV assay, cell cycle analysis, and DAPI (4',6-diamidino-2-phenylindole) staining. The expression of some miRNAs and their potential targets was evaluated by real-time reverse transcription-polymerase chain reaction (qRT-PCR). Results: IC50 of SPNs was determined at 28.13±0.78µg/ml after 24 h. SPNs (28µg/ml) induced apoptosis by 32.36% in HT29 cells after 24 h. DAPI staining indicated a decrease in stained nuclei after SPNs induction. SPNs treatment increased the expression of miR-34a, as well as P53, BAX, CASP9, CASP3, and CASP8. The downregulation of miR-221 and miR-222 was observed in SPNs treated cells. Moreover, SPNs decrease the expression level of CD markers in HT29 spheroids (cancer stem cells) compared to untreated spheroids. Spheroids were completely destroyed after 72 h treatment with SPNs (28µg/ml). Conclusion: As evidenced by the obtained results, SPNs can be used as an effective anticancer agent in multi-layer (cancer stem cells) and mono-layer cancerous cells with the upregulation of tumor suppressive miRs and genes, as well as downregulation of oncomiRs and oncogenes.