1. |
- Mahmoudi, H., et al.
(author)
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A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19
- 2021
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In: Brain and Behavior. - : John Wiley & Sons. - 2162-3279 .- 2162-3279.
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Journal article (peer-reviewed)abstract
- Introduction: Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep. Methods: Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables. Results: Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r =.334 to 0.454; p <.01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life. Conclusion: Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.
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2. |
- Ebrahimi-Fakhari, Darius, et al.
(author)
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Defining the clinical, molecular and imaging spectrum of adaptor protein complex 4-associated hereditary spastic paraplegia
- 2020
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In: Brain. - OXFORD ENGLAND : Oxford University Press (OUP). - 0006-8950 .- 1460-2156. ; 143:10, s. 2929-2944
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Journal article (peer-reviewed)abstract
- Bi-allelic loss-of-function variants in genes that encode subunits of the adaptor protein complex 4 (AP-4) lead to prototypical yet poorly understood forms of childhood-onset and complex hereditary spastic paraplegia: SPG47 (AP4B1), SPG50 (AP4M1), SPG51 (AP4E1) and SPG52 (AP4S1). Here, we report a detailed cross-sectional analysis of clinical, imaging and molecular data of 156 patients from 101 families. Enrolled patients were of diverse ethnic backgrounds and covered a wide age range (1.0-49.3 years). While the mean age at symptom onset was 0.8 +/- 0.6 years [standard deviation (SD), range 0.2-5.0], the mean age at diagnosis was 10.2 +/- 8.5 years (SD, range 0.1-46.3). We define a set of core features: early-onset developmental delay with delayed motor milestones and significant speech delay (50% non-verbal); intellectual disability in the moderate to severe range; mild hypotonia in infancy followed by spastic diplegia (mean age: 8.4 +/- 5.1 years, SD) and later tetraplegia (mean age: 16.1 +/- 9.8 years, SD); postnatal microcephaly (83%); foot deformities (69%); and epilepsy (66%) that is intractable in a subset. At last follow-up, 36% ambulated with assistance (mean age: 8.9 +/- 6.4 years, SD) and 54% were wheelchair-dependent (mean age: 13.4 +/- 9.8 years, SD). Episodes of stereotypic laughing, possibly consistent with a pseudobulbar affect, were found in 56% of patients. Key features on neuroimaging include a thin corpus callosum (90%), ventriculomegaly (65%) often with colpocephaly, and periventricular white-matter signal abnormalities (68%). Iron deposition and polymicrogyria were found in a subset of patients. AP4B1-associated SPG47 and AP4M1-associated SPG50 accounted for the majority of cases. About two-thirds of patients were born to consanguineous parents, and 82% carried homozygous variants. Over 70 unique variants were present, the majority of which are frameshift or nonsense mutations. To track disease progression across the age spectrum, we defined the relationship between disease severity as measured by several rating scales and disease duration. We found that the presence of epilepsy, which manifested before the age of 3 years in the majority of patients, was associated with worse motor outcomes. Exploring genotype-phenotype correlations, we found that disease severity and major phenotypes were equally distributed among the four subtypes, establishing that SPG47, SPG50, SPG51 and SPG52 share a common phenotype, an 'AP-4 deficiency syndrome'. By delineating the core clinical, imaging, and molecular features of AP-4-associated hereditary spastic paraplegia across the age spectrum our results will facilitate early diagnosis, enable counselling and anticipatory guidance of affected families and help define endpoints for future interventional trials.
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3. |
- Lin, C. -Y, et al.
(author)
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Advanced psychometric testing on a clinical screening tool to evaluate insomnia : sleep condition indicator in patients with advanced cancer
- 2020
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In: Sleep and Biological Rhythms. - : Springer. - 1446-9235 .- 1479-8425. ; 18, s. 343-349
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Journal article (peer-reviewed)abstract
- Purpose: To examine the psychometric properties of the Sleep Condition Indicator (SCI) using different psychometric approaches [including classical test theory, Rasch models, and receiver operating characteristics (ROC) curve] among patients with advanced cancer.Methods: Through convenience sampling, patients with cancer at stage III or IV (n = 859; 511 males; mean ± SD age = 67.4 ± 7.5 years) were recruited from several oncology units of university hospitals in Iran. All the participants completed the SCI, Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), General Health Questionnaire (GHQ), and Edmonton Symptom Assessment Scale (ESAS). In addition, 491 participants wore an actigraph device to capture objective sleep.Results: Classical test theory [factor loadings from confirmatory factor analysis = 0.76–0.89; test–retest reliability = 0.80–0.93] and Rasch analysis [infit mean square (MnSq) = 0.63–1.31; outfit MnSq = 0.61–1.23] both support the construct validity of the SCI. The SCI had significant associations with ISI, PSQI, ESS, HADS, GHQ, and ESAS. In addition, the SCI has satisfactory area under ROC curve (0.92) when comparing a gold standard of insomnia diagnosis. Significant differences in the actigraphy measure were found between insomniacs and non-insomniacs based on the SCI score defined by ROC.Conclusion: With the promising psychometric properties shown in the SCI, healthcare providers can use this simple assessment tool to target the patients with advanced cancer who are at risk of insomnia and subsequently provide personalized care efficiently.
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4. |
- Saffari, M., et al.
(author)
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Educational Intervention Based on the Health Belief Model to Modify Risk Factors of Cardiovascular Disease in Police Officers in Iran : A Quasi-experimental Study
- 2020
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In: Journal of Preventive Medicine and Public Health. - : Korean Society for Preventive Medicine. - 1975-8375 .- 2233-4521. ; 53:4, s. 275-284
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Police officers may be at a greater risk for cardiovascular disease (CVD) than the general population due to their highstress occupation. This study evaluated how an educational program based on the health belief model (HBM) may protect police officers from developing CVD. METHODS: In this single-group experimental study, 58 police officers in Iran participated in a 5-week intervention based on HBM principles. Outcomes included changes in scores on an HBM scale, time spent on moderate to vigorous physical activity (International Physical Activity Questionnaire), body mass index (BMI), blood lipid profile, blood glucose, and blood pressure. The intervention consisted of 5 HBM-based educational sessions. Follow-up was conducted at 3 months post-intervention. The paired t-test was used to examine differences between baseline and follow-up scores. RESULTS: All aspects of the HBM scale improved between baseline and follow-up (p<0.05), except the cues to action subscale. Self-efficacy and preventive behaviors improved the most. BMI decreased from 26.7±2.9 kg/m2 at baseline to 25.8±2.4 kg/m2 at follow-up. All components of the lipid profile, including triglycerides, cholesterol, high-density lipoprotein, and low-density lipoprotein, showed significant improvements post-intervention. Blood glucose and blood pressure also decreased, but not significantly. Nearly 25% of participants who were not physically active at baseline increased their physical activity above or beyond the healthy threshold. CONCLUSIONS: A relatively brief educational intervention based on HBM principles led to a significant improvement in CVD risk factors among police officers. Further research is needed to corroborate the effectiveness of this intervention.
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5. |
- Ghalambaz, Mohammad, et al.
(author)
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Study of thermal and hydrodynamic characteristics of water-nano-encapsulated phase change particles suspension in an annulus of a porous eccentric horizontal cylinder
- 2020
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In: International Journal of Heat and Mass Transfer. - : Elsevier BV. - 0017-9310 .- 1879-2189. ; 156
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Journal article (peer-reviewed)abstract
- In this paper, the thermal and hydrodynamic characteristics of a suspension with water-Nano-Encapsulated Phase Change Material (NEPCM) in an annulus of a porous eccentric horizontal cylinder are investigated. The NEPCM particles have a core-shell structure and stability suspended in water. Hence, the particles, along with the liquid, could freely circulate inside the annuli of the horizontal cylinder due to the buoyancy forces. The cores of these particles are made from a Phase Change Material (PCM). Moreover, such cores are in a continuous exchange of heat transfer between the solid and liquid phases. The heat transfer is acting in a combination of absorption, storage, and release mechanisms. The governing equations for the fluid motions and conservation of energy could be written in partial differential forms and by using the appropriate non-dimensional variables converted into non-dimensional ones. Then, the numerical approach is applied by implementing the finite element method (FEM) to solve such equations iteratively. The impact of various non-dimensional parameters including the fusion temperature, Stefan number, Rayleigh number, Darcy number, the volume fraction of nanoparticles, and eccentricity of the inner cylinder is addressed on the flow and heat transfer. It is observed that the most favourable fusion temperature ranges for the maximum heat transfer rate vary as a function of the Rayleigh number. In addition, the heat transfer rate can be enhanced by applying the phase change core of nanoparticles.
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6. |
- Khodabandeh, E., et al.
(author)
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CFD study of non-premixed swirling burners : Effect of turbulence models
- 2020
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In: Chinese Journal of Chemical Engineering. - : Elsevier BV. - 1004-9541 .- 2210-321X. ; 28:4, s. 1029-1038
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Journal article (peer-reviewed)abstract
- This research investigates a numerical simulation of swirling turbulent non-premixed combustion. The effects on the combustion characteristics are examined with three turbulence models: namely as the Reynolds stress model, spectral turbulence analysis and Re-Normalization Group. In addition, the P-1 and discrete ordinate (DO) models are used to simulate the radiative heat transfer in this model. The governing equations associated with the required boundary conditions are solved using the numerical model. The accuracy of this model is validated with the published experimental data and the comparison elucidates that there is a reasonable agreement between the obtained values from this model and the corresponding experimental quantities. Among different models proposed in this research, the Reynolds stress model with the Probability Density Function (PDF) approach is more accurate (nearly up to 50%) than other turbulent models for a swirling flow field. Regarding the effect of radiative heat transfer model, it is observed that the discrete ordinate model is more precise than the P-1 model in anticipating the experimental behavior. This model is able to simulate the subcritical nature of the isothermal flow as well as the size and shape of the internal recirculation induced by the swirl due to combustion.
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7. |
- Sabzpoushan, S., et al.
(author)
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Nonisothermal two-phase modeling of the effect of linear nonuniform catalyst layer on polymer electrolyte membrane fuel cell performance
- 2020
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In: Energy Science & Engineering. - : John Wiley and Sons Ltd. - 2050-0505. ; 8:10, s. 3575-3587
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Journal article (peer-reviewed)abstract
- In this research, it is investigated to numerically evaluate the performance of a polymer electrolyte membrane fuel cell (PEMFC). The performance is investigated through the nonuniformity gradient loading at the catalyst layer (CL) of the considered PEMFC. Computational fluid dynamics is used to simulate a 2D domain in which a steady-state laminar compressible flow in two-phase for the PEMFC has been considered. In this case, a particular nonuniform variation inside the CL along the channel is assumed. The nonuniform gradient is created using a nonisothermal domain to predict the flooding effects on the performance of the PEMFC. The computational domain is considered as the cathode of PEMFC, which is divided into three regions: a gas channel, a gas diffusion layer, and a CL. The loading variation inside the catalyst is defined as a constant slope along the channel. In order to find the optimum slope, different slope angles are analyzed. The results point out that the nonuniform loading distribution of the catalyst (platinum) along the channel could improve the fuel cell performance up to 1.6% and 5% for power density and voltage generation, respectively. It is inferred that it is better to use more catalyst in the final section of the channel if the performance is the main concern.
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8. |
- Saffari, M., et al.
(author)
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Determinants of health-related quality of life in Iranian patients after recovery from COVID-19 : Demographic influences and insomnia
- 2022
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In: International Journal of Public Health Science. - : Intelektual Pustaka Media Utama. - 2252-8806 .- 2620-4126. ; 11:1, s. 220-231
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Journal article (peer-reviewed)abstract
- The current study sought to identify factors that may affect health-related quality of life (HRQoL) in patients recovering from COVID-19 infection in Iran. In a cross-sectional study 258 patients diagnosed with COVID-19, participants completed a questionnaire approximately one month after hospital discharge when demographic and clinical factors (including insomnia) and HRQoL were assessed. A logistic regression was used. Age, gender, marital status, education, having child, early physician visit, early diagnosis, early hospitalization, symptom type, Rhesus factor, and level of insomnia were associated with various components of HRQoL (p<0.05). In multivariate analyses, poorer physical HRQoL was independently associated with female gender (OR=4.53; 95% CI=2.22-2.29), initial symptom of cough (OR=2.73; 95% CI=1.26-5.94), and insomnia (OR=2.74; 95% CI=1.22-6.14). Poorer mental HRQoL was associated with being age 40 years or older (OR=1.90; 95% CI=1.02-3.54), female gender (OR=2.48; 95% CI=1.26-4.88), initial symptom being cough (OR=3.12; 95% CI=1.46-6.68), and insomnia (sub-threshold insomnia, OR=3.19; 95% CI, 1.51-6.74, to severe insomnia, OR=3.86; 95% CI=1.35-11.07). Healthcare professionals should be aware that older people, female gender, those with initial symptom of cough, and insomnia may be at greater risk for poor quality of life following hospital discharge.
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9. |
- Sanaeinasab, H., et al.
(author)
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Development and Psychometric Assessment of the COVID-19 Health Literacy Scale : Preliminary Testing and Factor Structure
- 2022
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In: Journal of Health Literacy. - : Mashhad University of Medical Sciences. - 2476-4728. ; 6:4, s. 32-46
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Journal article (peer-reviewed)abstract
- Background and Objective: Improving the health literacy in the different populations regarding COVID-19 may be useful in the control of its prevalence. This study examined the psychometric properties of a newly developed disease-specific measure of health literacy related to COVID-19 to be used as a standard measure. Materials and Methods: Relevant literature was reviewed to identify an item pool, and an expert panel was convened to choose items that might be included in the scale. Content validity ratio (CVR) and content validity index (CVI) was determined and face validity was examined by calculating the impact score in a group of social media users. The factor structure of the initial scale was examined in 590 Iranian individuals participating in online social networks in September 2020. Internal consistency of the scale was assessed by Cronbach’s alpha and test-retest reliability of responses was measured by Pearson correlation coefficients. Results: A five-factor solution for the 51-items scale was obtained through exploratory factor analysis. The five main dimensions were understanding, communication, information seeking, analysis, and behavior. The dimensions explained 47% of the variance in scale scores. Participants whose scores fell in the high category (27%) were significantly different compared to those whose scores fell in the low category (27%) on all dimensions (p<0.001). The CVR values for all items were greater than 0.85 and all items also got CVI values higher than 0.79 based on nine-person expert panel. The Cronbach’s alpha for the overall scale was 0.89, and it was ranged from 0.71 to 0.90. Test-retest reliability for the scale was high (r=0.89). Conclusion: Health Literacy Scale for protect against COVID-19is a valid and reliable measure for Iranian population. This measure should be translated, and administered, in other settings to replicate the results obtained here.
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10. |
- Sanaeinasab, H., et al.
(author)
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Effects of a health education program to promote healthy lifestyle and glycemic control in patients with type 2 diabetes : A randomized controlled trial
- 2021
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In: Primary Care Diabetes. - : Elsevier. - 1751-9918 .- 1878-0210. ; 15:2, s. 275-282
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Journal article (peer-reviewed)abstract
- Background: Type 2 diabetes mellitus (T2DM) is a common chronic disease with an increase in prevalence within developing countries. The aim of this study was to determine the efficacy of a structured educational program for improving lifestyle and health-related measures in Iranians with T2DM. Methods: A randomized controlled trial was conducted in 80 participants with T2DM who were randomly assigned to either the intervention or a control group. A demographic questionnaire along with the Health Promoting Lifestyle Profile-II and related laboratory tests were used to assess the efficacy of the program. The intervention consisted of six educational sessions held over 45 days. The control group received routine diabetic care at the clinic. Three months after the intervention, participants completed the measures again. Within-group and between-group comparisons were then made. Results: All subscales of lifestyle measure improved in the intervention group, whereas only the nutrition domain improved in the control group. After adjusting for baseline differences, physical activity and nutrition domains showed the greatest improvement in the intervention group compared to controls. All clinical measures were also significantly improved within intervention group from baseline to follow-up (p < 0.001), whereas HbA1c, fasting blood glucose, HDL, triglyceride, cholesterol, and weight also changed significantly in the control group. The frequency of HbA1c < 7% was increased from 27.5% at baseline to 37.5% at follow-up (10%) in the intervention group compared to only a 5% increase in the control group. Conclusion: This educational health program significantly improved lifestyle changes and health-related clinical characteristics in persons with T2DM, compared to routine diabetic care in Iran. Further research is needed to better understand the usefulness of such programs in diabetics and other medical conditions among those in different cultural settings.
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