مجله پیاورد سلامت
سال پانزدهم شماره 2 (خرداد و تیر 1400)

Recent studies indicate that increased body iron stores have been associated with the development of glucose intolerance and type 2 Diabetes. Ferritin is the most important iron storage protein in the body, which is used to evaluate disorders associated with iron metabolism. The aim of this study was to examine the effect of eight weeks of aerobic training on serum ferritin level, glycemic and lipid indices in women with type 2 Diabetes.

Twenty Diabetic women aged 45-55 years were selected voluntarily and divided into experimental (n=10) and control (n=10) groups. The experimental group participated in the aerobic training program for eight weeks, three 60-minutes sessions per week with an intensity of 55-65% of heart rate reserve. The control group did not participate in any activity during the intervention period. Serum ferritin, glycemic and lipid indices were evaluated before and after eight weeks and then data were analyzed by SPSS software.

Ferritin (P=0.012), insulin (P=0.004), fasting glucose (P=0.041), insulin resistance index (P=0.012), total cholesterol (P=0.041), and triglyceride (P=0.005) significantly decreased, while the mean of HDL(P=0.012) significantly increased in the experimental group. Moreover, the results showed that changes in ferritin (P=0.002), insulin (P=0.014), insulin resistance index (P=0.001) and TG (P=0.010) were statistically significant between the experimental and control groups.

Women with type 2 Diabetes can benefit from moderate-intensity aerobic exercise programs to improve their glycemic and lipid profile, as well as iron metabolism abnormalities.

Medical students, as the largest group of health care providers, should be able to combine their technical skills and professional knowledge to diagnose patientschr('39') problems and use it to take a big step towards reducing errors and increase the quality of care. For this reason, a study was conducted to investigate the relationship between health literacy and computer literacy among medical students in Torbat Heydariyeh in 2018.

This cross-sectional study with a descriptive-analytical approach was performed in the middle half of 2018 on 201 students of Torbat Heydariyeh University of Medical Sciences (THUMS), who were selected by multi-stage sampling method. Data were collected using the Iranian Adult Health Literacy Questionnaire (HELIA) and the Computer Literacy Questionnaire. Then, the data were analyzed with SPSS software, using descriptive statistics and Chi-square test.

In this study, 175 subjects (87.1%) were female and the rest were male. The mean and standard deviation of age were 21.52±1.30 and 17.11±0/99, respectively. The results of multivariate linear regression showed that the variable dimensions of computer literacy could predict up to 63% of changes in studentschr('39') health literacy score. The results also showed that the dimensions of basic skills, frequency of computer use and 
self-assessment of working skills with Windows had a significant relationship with studentschr('39') health literacy (P<0.05).

Considering the results, it is suggested that the necessary measures be taken to increase studentschr('39') computer literacy by holding workshops and Update educational content in universities; in this way, a step towards increasing computer literacy and consequently, increasing the health literacy of students can be taken.

Due to the importance and position of the health sector in society and consideration of industry 4.0 during these days, we witness an increase in the spread of state-of-the-art (smart) technologies in various fields, on one hand, and an evolutionary development by integrating healthcare and technology, on the other hand. Thus, the application of smart technologies can help to overcome many of the healthcare sector limitations. This study aimed to propose an appropriate model for deploying smart services in the Iranian healthcare system.

This was a qualitative research study based on thematic analysis in 2020. The required data were extracted by literature review and expert interviews. A sample of 15 experts were selected using purposive sampling. Sampling was continued until full data saturation was reached. The data were collected using semi-structured interviews. The interviews were implemented and analyzed in MAXQDA. Finally, a qualitative method was developed.

Based on the findings of this research, 202 open codes were extracted and 23 basic themes (sub- themes) were identified to design the model of deployment smart services in the Iranian health sector which categorized in seven organizing themes (main themes) consist deployment planning, execution management, task organization frame work, national preparedness, stage-setting, organizational interventions, and resistance management. Then, according to the above themes, the thematic model was provided which has a suitable model fitness (IFI: 0.934, NFI: 0.959, RMSEA: 0.080).

Providing the model for deploying smart health care and use of these technologies help to significantly improve the quality of health services, improve access to these services, reduce costs and thus improve health of society.

Blood malignancies, one of the most common cancers in the world, cause a large number of deaths each year. Many inherited and acquired factors are involved in the development of this disease. Exosomes are a very small model of cells that are secreted by most cells in the body under physiological and pathological conditions. On the other hand, they have found a special place in the treatment of these diseases because of their very small structure and biodegradability. 

This study is a systematic review article. For this study, the electronic databases such as PubMed, Scopus and Web of Science were reviewed and 110 original and review articles were studied from 2000 to 2020. Exosome, blood malignancies and immunotherapy were used as keywords along with a number of other related terms such as tumor microenvironment, acute myeloid leukemia, acute lymphoid leukemia, chronic lymphoid leukemia and multiple myeloma (Exosome AND Leukemia, Leukemia AND Immunotherapy, Exosome AND Cancer, AML AND Exosome) to search in these databases. Finally, 51 sources that related to exosomes and myeloid and lymphoid blood malignancies were used.

The genomic profile of malignant cells and tumor microenvironment changes in the conditions of the disease. The contents of exosomes released by leukemic cells, including anti-apoptotic proteins, various microRNAs, angiogenic agents, heat shock proteins and oncogenes involved in the development of inflammatory phenotype in the target cells, are known as factors involved in the pathogenesis of leukemia. A variety of therapeutic materials such as anti-inflammatory drugs, recombinant proteins, siRNA and the inhibitor of various microRNAs can also be packaged in the exosomes with several ways and used to treat leukemia.

Exosomes derived from malignant cells play the important role in the growth and proliferation, angiogenesis, metastasis, resistance to chemotherapeutic agent, and the escape of cancer cells from the immune system by the modification of tumor microenvironment. The role of exosomes in the creation and development of blood malignancies has been proven. Therefore, using of them will probably be very helpful and promising in the treatment of these disorders with various forms.

Managers’ sufficient awareness about rules and regulations and the legal issues of health system may lead to their optimal performance in organizations. Therefore, this study is conducted to determine senior managers’ level of knowledge about legal rules and regulations related to the health system in Tehran University of Medical Sciences (TUMS).

The present descriptive-analytical cross-sectional study was conducted in 2017. The sample consisted of 75 senior managers. The research tool was a researcher-made questionnaire whose face validity was confirmed using the opinions of 7 specialists and experts in the field of medical law, health care and medical services management; besides, regarding its reliability, Cronbachchr('39')s alpha and test-retest reliability coefficients were 0.89 and 0.79, respectively. With SPSS software, data analysis was performed using descriptive statistics including absolute and relative frequency and inferential statistics including Pearson and Ka-square correlation tests.

The level of knowledge of the studied managers was below average in most legal areas and legal standards related to the health system. There was a significant inverse relationship between the level of knowledge of organizational, financial and transactional areas, and administrative and employment of managers with passing relevant training courses (P=0.01 and P=0.04).

TUMS senior managerschr('39') level of knowledge in the three areas of organizational, financial, and rules and regulations is at medium and lower than medium levels. To raise the awareness of managers, necessary arrangements such as holding training courses with new methods such as simulation, screenwriting, case study and experimentation and using new technologies such as hybrid knowledge management and technology integration are suggested. Also, creating managerschr('39') strategic competency system at the levels of general and specific skills, along with continuous training and monitoring the accountability and feedback provided in management processes, will ensure future reforms.

The overall goal of the medical department is to develop and manage an efficient and effective supply chain. Intrinsic instability and unpredictability of treatment needs to require a flexible supply chain. Agility reflects the hospitalchr('39')s response to environmental changes, and agile hospitals are able to provide appropriate services to the patients. Hospital supply chain management agility needs to find the main aspects affecting the relationship and communication between them and to analyze the dimensions together. The purpose of this study was interpretive-structural modeling and analysis of dimensions of agile hospital supply chain management.

The research design combined descriptive - survey exploratory approach to the future. The population study were doctors, nurses and staff at the University of Medical Sciences. The Delphi technique was used to determine the dimensions of agility and the interpretive-structural modeling approach was used for analysis and modeling. Mick Mac software was used to analyze the dimensions of agility.

The final model of agile hospital supply chain management with 16 dimensions had 8 levels, which was at the highest level of cost reduction and at the lowest level of organizational leadership commitment. The results indicate that leadership commitment is the foundation of supply chain agility in the hospital. Knowledge management variable had low impact and effectiveness and was known as a secondary leverage variable. The results showed that most agile supply chain management aspects of the main causes of complex communication and interaction, and the importance of agility in the hospital of the show. 

The analysis and interpretation of functional from the aspect of Impact and Influence of agility dimensions in hospital environment Showed that, Dimensions of strategic planning, human resource development and staff skills training, human resource management and employee satisfaction, process management, process integration and organizational transformation, flexibility, organizational communication development and information management integration, service quality management and continuous improvement, acceptance of new technology and new ideas, speed of service, patient  understand and satisfaction, monitor, find best responds demand and market sensitivity in the strategic area are located and They cause model instability and With high impact and high influence, They play an important role in the agility of hospital supply chain management.

Breast cancer is one of the most common types of cancer and the second leading cause of cancer death in women. The effect of ligustilide - isolated from the Kelussia on MCF-7 breast cancer cell line compared with human fibroblast cell line (HDF1BOM) was evaluated in the present study.

MCF-7 and HDF1BOM cell lines were treated for 48 and 72 hours with different concentrations (0, 50, 100, 150 and 200 mg/ml) of Z-ligustilide ((ligustilide (Z)-3-butylidene-4,5-dihydrophthalide)). Then, bioavailability was analyzed by ELISA reader using MTT kit and Apoptosis was assessed by flow cytometry using an Annexin V-FITC/PI kit in two times. Statistical analysis was accomplished by ANOVA and Huynh-Feldt tests using SPSS and FlowJo software. 

The results of MTT test showed reduce bioavailability of MCF-7 cell line in all concentrations (from 70.60% in 50 mg/ml to 6.80% in 200 mg/ml  (for 48 h of treatment), from 61.95% in 50 mg/ml  to 5.84% in 200 mg/ml  (for 72 h of treatment)). Also, the results of the Annexin test showed that the induction of apoptosis is not time and concentration dependent manner, and it had increased in most groups. highest percentage of apoptosis were; 98.3% in 50 mg/ml (for 48 h of treatment), and 97.4 % in 100 mg/ml  (for 72 h of treatment). The results of MTT test showed reduce bioavailability of HDF1BOM cell line in both times compared to the control group (from 97.24% in 50 mg/ml  to 5.97% in 200 mg/ml  (for 48 h of treatment), from 90.93% in 50 mg/ml  to 5.26% in 200 mg/ml (for 72 h of treatment)). Also, according to the results of Annexin, early apoptotic cells show a higher percentage (4.21% in 150 mg/ml (for 48 h of treatment), 1.67% in 200 mg/ml  (for 72 h of treatment)). Ligustilide did not show considerable cytotoxicity in HDF1BOM cells.

Due to the fact that ligustilide has an inhibitory effect on the growth, proliferation and invasion of cancer cells by inducting apoptosis, it seems that ligustilide can be used to reduce cell proliferation of breast cancer.

This study aimed to propose a consistent architecture to design integrated and flexible information systems for the Vice-Chancellor for Research and Technology of Ahvaz Jundishapur University of Medical Sciences (AJUMS). 

This applied research employed an integrated design based on business system planning (BSP) and James Martinchr('39')s model for the design of information systems. The statistical population of this study included 27 managers and experts of AJUMS Vice-Chancellorship department for Research and Technology. Data collection was carried out using structured interview, observation, and document analysis. A contrast matrix was then used for data analysis.

In total, 53 processes and 60 data classes were identified. Using a multi-layered architectural model (presentation, process, data and infrastructure), the results were presented in the form of a proposed architecture. In the proposed architecture, 12 subsystems and the relationships among them were identified; such subsystems as library, research activities, sabbatical leave, conference, fellowship, publication, innovation and technology, laboratory information, theses, budget and planning, social subsystem and knowledge-management networks. The results also showed that the level of coverage of the processes, data classes, and objectives by existing information systems were 53%, 50%, and 55%, respectively, and increased to full coverage in proposed or optimal modes.

By identifying the required information systems, it is possible to accurately plan and successfully use these systems in this study. The results of the present study can be used to implement the architecture of information systems of Research and Technology Departments of other universities of medical sciences (UMSs) in Iran, which can have a significant effect on saving cost and time.