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Abstract Background Maintenance of oral health, prevention, and health promotion stand as primary competencies for dental graduates. Consequently, it is necessary to promote such an approach in dental schools, which are traditionally focused on treatment, to improve the attitude and practice of students in the field of prevention, the final result of which is the reduction of oral and dental diseases in patients. The study aimed to design Integrated Oral Health Care Pathways (IOHCPs) for adults and children referred to Tehran University of Medical Sciences (TUMS), School of Dentistry. Methods The study was carried out in the clinical departments of the School of Dentistry during 2022–2023. The design process involved utilizing the NHS dental care pathway template and developing the initial model for the IOHCPs. Qualitative methods, including semi-structured interviews with adult patients, parents of pediatric patients, and selected members of the interdisciplinary team (including researchers, experts, and policymakers), were employed to assess existing conditions, needs, and available facilities. The Delphi method was utilized to finalize the care pathway. Results Four Integrated Oral Health Care Pathways were formulated, covering dental caries, periodontal diseases, pre-cancerous lesions, and TMJ problems for adults, along with one IOHCP addressing dental caries for children aged 6 years and older, referred to the School of Dentistry. The design of these integrated care pathways was based on the primary prevention of oral diseases. Details, including risk assessment, follow-up times, related home care, and preventive interventions that should be conducted by dental students, were included in the care pathways. Conclusions This study focused on designing care pathways based on primary prevention for child and adult patients in dental settings, aiming to enhance patients' oral health by integrating prevention with treatment. The care pathways, designed according to the needs and facilities of the School of Dentistry of Tehran University of Medical Sciences, allow for continuous monitoring of the patients' oral health status and can be considered as a suitable initial model for other educational centers.

Measuring tractor performance parameters is crucial for validating manufacturer claims and selecting a suitable tractor. Field studies often face high costs and inaccuracies due to external factors and limited parameter measurement. A chassis dynamometer serves as an effective simulator for tractor movement on the ground. This research focused on designing and constructing an in-situ test system (chassis dynamometer) with practical features for measuring parameters at various speeds, loads, and conditions. An accurate data acquisition system records unlimited data based on relations between drawbar traction, speed, vertical load on driving wheels, and the distance to the center of gravity. To evaluate the system, the traction performance of an MF285 tractor was tested at different load and speed levels. The drawbar pull and dynamic axle load of the 2WD tractor were measured, with a maximum traction of about 11 kN. This study successfully designed and implemented an in-situ test system to assess the traction and balance capacities of conventional tractors by applying maximum load on the driving wheels.

Abstract Background Providing care to trauma patients in pre-hospital emergencies is a vital and life-sustaining factor for individuals. This study was conducted to percept of pre-hospital emergency personnel regarding trauma patient care. Methods This qualitative study was done using a conventional content analysis method that employed purposive sampling technique. A total of 12 in-depth semi-structured interviews were conducted with 10 operational staff members of pre-hospital emergency services from May 2021 to September 2022. After recording and transcribing the data, qualitative content analysis, based on Graneheim and Lundman’s approach, was performed on the data. Results From the data analysis, a total of 478 initial codes were extracted, leading to the identification of two main categories, namely “Stress as an Unavoidable Factor” and “Emotional Impasse”. The first category included three sub-categories of work under stress, associating your family in the face of life-threatening conditions, and worrying about the patient’s fate. Three sub-categories of a long-term mental occupation of the technician with the encounter scene, the feeling of guilt despite trying as much as possible, and emotional distress in certain groups emerged from the second category. Conclusions “Stress as an Unavoidable Factor” and “Emotional Impasse” have been introduced as main categories of perceptions of pre-hospital emergency personnel regarding trauma patient care.

Background & Aims: Human lice infestation is considered primordial in origin, and its control dates back several centuries. However, its social stigma and ostracism remain major public health issues, particularly among school children. The main aim of this survey was to determine the relative frequency of head lice and its effective qualitative parameters among primary schoolgirls on Qeshm Island, south of Iran. Materials & Methods: This descriptive analytic study was performed on Qeshm Island. From 38 private and municipal primary schools, six schools, each including at least 60 female students, were randomly selected; a sample size of about 270 was computed. Data were analyzed using SPSS version 22. Results: In this survey, 283 female primary school students with an average age of 9 ± 2.16 years were investigated, of whom 119 (42%) were infested with head lice. Infestation among 6 to 9- year-old students was significantly lower than in the higher age group (p < 0.001). There was also a significant association between the students’ bathing frequency and lack of head lice infestation (p < 0.05). A significant relationship was evident between the mothers’ education level and head lice infestation in students (p < 0.001). Conclusion: Low maternal literacy, inadequate bathing frequency, and 11-year-old girls were at risk of head lice infestation. To reduce this problem, there is an essential need for the implementation of health measures such as employing school nurses, promoting public access to health services, educating tutors, students, and their parents, conducting clinical exams, and periodic screening.

Abstract Background In clinical settings, continuous changes lead to increased professional stress, affecting the quality of life of nurses. Some complementary interventions may influence the improvement of the quality of life. This study aimed to determine the effect of Benson’s relaxation technique on the operating room nurses’ quality of life. Methods In this clinical trial, 180 operating room nurses were randomly allocated to two groups: intervention (Benson’s relaxation technique) and control (routine activity). The study was conducted from December 2021 to March 2022 in hospitals affiliated with Shiraz University of Medical Sciences. Benson’s relaxation technique was performed twice daily by the intervention group for 8 weeks. Quality of life was measured before and after the intervention using the SF-36 questionnaire. Data were analyzed using SPSS version 21 software, with a significance level set at a P

Introduction Emulsion-filled gel is a sort of gel system that traps oil droplets as a filler and contains a wide range of semi-solid to solid food products. It can also be utilized as a dual system to distribute and control the release of both lipophilic and hydrophilic bioactive and micronutrient substances. The main polymers involved in gel formation in food products are proteins and polysaccharides. Using molecular interactions between biopolymers, a wide range of rheological and physicochemical properties of gels can be methodically created. As a result, the interaction between proteins and polysaccharides has received a lot of attention in order to generate novel products. Because of their functional qualities and high nutritional value, whey proteins are frequently used in the food industry. As a result, mixed gels based on whey protein have gained a lot of attention. k-Carrageenan is commonly utilized in the food industry as a gelling and firming agent. Because k-Carrageenan, like whey protein isolate, can form a gel independently, its interaction with whey protein isolate in emulsion gel systems appears appealing. Therefore, in this study, the effect of k-Carrageenan gum (0.0, 0.1, 0.3, 0.5, and 0.7%) on the textural (uniaxial compression test), rheological (steady shear, strain sweep, and frequency sweep tests), and water holding capacity of cold-set emulsion-filled gel based on whey protein isolate was investigated. Materials and Methods Whey protein isolate (WPI) (98.9% protein, dry basis) was given as a gift by Agropur Ingredients Co. (Le Sueur, Minnesota, USA). -Carrageenan and CaCl2 ( : 147.01 gr/mol) were purchased from Sigma Aldrich Co. (USA) and Merck Co. (Darmstadt, Germany), respectively. Sunflower oil was supplied from local supermarket. Stock dispersions of WPI and -Carrageenan were prepared by dissolving sufficient amounts of their powders in deionized water. To prepare uniform oil in water emulsion, sunflower oil was added to the WPI dispersion and the obtained mixture homogenized first using a laboratory rotor-stator homogenizer (15000 rpm, 3 min), then by an ultrasonic homogenizer (20 kHz, 5 min). The prepared emulsion and -Carrageenan dispersions were poured into Schott bottles and heated in a water bath (90 °C, 40 min). WPI emulsion and AG dispersion were mixed in a cylindrical container on a stirring plate at a speed of 600 rpm for 6-8 min to obtain a homogeneous mixture. After decreasing the temperature to 60 °C for the ion-induced gelation, the mixtures were charged with CaCl2 (10 mM). The prepared samples were incubated in a refrigerator overnight to stabilize the 3D network. The final mixed EFG samples contained 5.5% WPI, 20% oil, and 0, 0.1, 0.3, 0.5, and 0.7% (w/w) of k-carrageenan. The tests performed on emulsion-filled gel samples were: 1) steady shear (0.01-10 s-1), 2) strain sweep (strain: 0.1-1000%, frequency: 1 Hz), 3) frequency sweep (frequency: 0.1-100 Hz, strain: 0.5%), 4) uniaxial compression (target strain: 80%, deformation speed:1 mm/s), and 5) water holding capacity (by utilizing a microcentrifuge, 600×g for 10 min). Results and Discussion According to the results of steady shear test, all samples had a shear thinning behavior, and based on the power-law model, this behavior was intensified in the presence of k-Carrageenan; and with increasing the gum concentration from 0 to 0.7%, the consistency coefficient increased from 339.9 to 545.7 Pa.s. In the strain sweep test, with the increase in the gum concentration, the values of the elastic and viscous modulus in the linear region and the modulus at the crossover point increased, and tan dLVE decreased from 0.17 to 0.13, which indicated an increase in the strength of the emulsion gel network structure. Based on the frequency sweep test, with the increase in k-Carrageenan concentration, the parameters and , network strength and network expansion increased from 5311.8 Pa, 939.9 Pa, 1.5380 Pa.s1/z and 10.05 in the control sample to 25080 Pa, 3574.9 Pa, 16097.7 Pa.s1/z and 16.41 in the sample containing 0.7% k-Carrageenan, respectively. Moreover, the frequency dependency of elastic modulus decreased from 0.095 in the control sample to 0.050 in the 0.7% k-Carrageenan contained sample. According to the large deformation test, in general, in the composite emulsion-filled gels, the values of apparent modulus of elasticity and fracture stress were higher and fracture strain and fracture energy were lower than in the control sample. Also, the results showed that different k-Carrageenan concentrations had no significant effect on the water holding capacity. Conclusion The obtained results showed that k-Carrageenan had considerable influence on the rheo-mechanical features of cold-set emulsion-filled gels based on whey protein which can add to the knowledge base for the production of new functional foods.

Abstract Background Intrahepatic lipid accumulation (IHL), a hallmark of metabolic disorders, is closely associated with de novo lipogenesis (DNL). Notably, fructose feeding increased the DNL. Lifestyle modifications resulting from dietary changes and increased physical activity/exercise can decrease the IHL content. We examined the effects of vitamin D3 supplementation (VDS), high-intensity interval training (HIIT), and their combination on the transcription factors and enzymes of the DNL pathway in male Sprague‒Dawley rats fed a high-fructose diet (HFrD). Methods Forty male rats were assigned to 5 groups (n = 8): CS (the control group had a standard diet); CF (the control group had HFrD (10% (w/v) fructose solution in tap water)); and FT (HFrD + HIIT: 10 bouts of 4 min of high-intensity running, corresponding to 85–90% of the maximal speed with 2 min active rest periods of 50% maximal speed, 5 days per week); FD (HFrD + intervention of intraperitoneal injection of 10000 IU/kg/week VDS); FTD (HFrD + HIIT + VDS) that were maintained for 12 weeks. ELISA, the GOD-POD assay, folch, western blotting, and oil red O staining were used to determine insulin, fasting blood glucose (FBG), hepatic triglyceride (TG) and cholesterol levels; SREBP1c, ChREBP-β, ACC1, FASN, p-ACC1, AMPK, p-AMPK, and PKA protein expression; and IHL content, respectively. Results Both HIIT and VDS led to significant increases in the levels of PKA, AMPK, p-AMPK, and p-ACC1, as well as significant decreases in the levels of SREBP1c, ChREBP-β, ACC1, FASN, insulin, FBG, liver TG, liver cholesterol, and IHL. HIIT exhibited superior efficacy over VDS in reducing ChREBP-β, ACC1, insulin, FBG, liver TG and cholesterol, as well as increasing p-ACC1 and PKA. Notably, the combined intervention of HIIT and VDS yielded the most substantial improvements across all the parameters. Conclusions HFrD causes IHL accumulation and the onset of diabetes, whereas VDS and HIIT, along with their combined effects, prevent the consequences of HFrD.

Abstract Background Premenstrual syndrome (PMS) is a prevalent health issue impacting women, significantly impacting their well-being and fostering a negative attitude of femininity and menstruation. We investigated the effect of group counseling based on positive psychology on the severity of PMS symptoms. Methods Participants in the intervention group engaged in six online sessions of group counseling focused on positive psychology via WhatsApp. Data were collected using the Premenstrual Symptoms Screening Questionnaire (PSST) before, immediately, and two months post-intervention. Analytical assessments were performed using SPSS 16 software using Chi-square, independent t-tests, and repeated measures analysis of variance (ANOVA). Comparative analyses were carried out using the Bonferroni post hoc test with a 95% confidence level. Results The mean intensity of PMS symptoms in the intervention group significantly decreased from 21.60 (2.50) to 13.35 (4.727) and 14.750 (5.963) immediately and two months after the intervention; however, the difference was not significant in the control group. The results of repeated measures ANOVA showed that the effect of the intervention over time and the interaction between time and group were significant. The Eta effect size was about 0.20 and 16%, respectively (p = 0.001). According to Bonferroni post hoc test results, the difference in the mean scores of the severity of PMS symptoms before the intervention was statistically significant compared to both follow-up periods (p ≤ 0.007). However, the difference in mean scores immediately after the intervention compared to two months after the intervention was not statistically significant (p = 0.42). Conclusion Using a positive counseling approach demonstrates efficacy in alleviating the severity of PMS symptoms in the short term. While all women can benefit from such interventions, targeting adolescents is particularly strategic, as early interventions can foster positive attitudes toward menstruation. Additionally, social media platforms like WhatsApp provide a feasible and engaging medium for adolescent health interventions. Integrating this approach into adolescent health promotion package appears to be a viable measure worthy of consideration by relevant policymakers. Trial registration Current Controlled Trials IRCT20201113049377N1, Date of Registration 2020, 12, 08.

Background: Fish are an essential source of food worldwide. Most microbial diversity in marine ecosystems remains uncharacterized, with viruses accounting for most of the remaining diversity. This poses a potential major threat to public health, making it critical to understand the variety of viruses in marine ecosystems. Our objective was to assess the virome of ray-finned fishes in terms of diversity and its potential relation to human diseases. Methods: Metagenomic data from a BioProject on ray-finned fishes, with the accession number PRJNA493014 containing eight Sequence Read Archive (SRA) experiments, were retrieved from the SRA. Sequencing data were trimmed and assembled using Unicycler. Reads from each sequencing run were mapped to the reference using Kraken. Unassigned viral reads from the genomes of the eight ray-finned fish species were used to find giant viral fingerprints. Results: We found 2,228,888 sequence reads among ray-finned fishes representing viral kingdom fingerprints. The pooled genome assay of ray-finned fishes revealed a significant abundance of viruses in three clades: the genus Pandoravirus (31%), the order Herpesvirales (23%), and the kingdom Bamfordvirae (10%). Additionally, 432,281 out of 2,031,445 reads (21%) remained unassigned as viruses. According to findings from GiantVirusFinder, 17,931 hits (4.15%) were mapped to the genomes of known giant viruses. Conclusion: Considering that humans regularly consume seafood as a primary part of their diet, it is essential to note that ray-finned fishes serve as hosts to various giant DNA viruses with extensive evolutionary histories. As demonstrated here, there is a need to screen fish for viral infections that may be linked to human illnesses.

Abstract Background Chronic abdominal pain is a potential symptom of lead poisoning, which is often challenging to diagnose. This case–control study aimed to evaluate blood lead levels in pediatric patients with chronic abdominal pain. Methods The case–control study was conducted on 190 pediatrics who presented to the Children's Medical Center Hospital clinics, Tehran between April 2021- 2023. The children were divided into two groups: the case group, consisting of 81 patients with chronic abdominal pain, and the matched control group; 109 children without any gastrointestinal symptoms. The statistical analysis of the data was performed using STATA 16. A multiple logistic regression model was used to assess the association of different independent variables with chronic abdominal pain. Results There was no significant difference between mean (± standard deviation [SD]) of age (8.80(2.7) years vs. control group: 9.23(3.9) years), sex, and BMI (16.55(4.6) vs. 17.32(4.7)) of the patients with chronic abdominal pain (case group) and the control group, whereas the mean weight was remarkably low in patients with chronic abdominal pain: 27.25(± 12.1) kg vs. 31.70(± 14.7) kg (P value = 0.028). Fifty-nine percent of children with chronic abdominal pain had serum lead levels ≥ 10 µg/dL. The mean (SD) of blood lead levels was statistically high in the case group: 11.09 (± 5.35) µg/dL vs. control group: 8.26 (± 5.01) µg/dL) (P value ≤ 0.05). The appetite level was significantly low in the case group: 3.8 (± 2.5) vs. control group 5.4 (± 1.3). Conclusions Lead poisoning could be a possible cause of children's chronic abdominal pain. Regarding the high rate of lead poisoning in children exerting appropriate measures to reduce their exposure to lead is necessary.

Abstract The presence of BTEX (Benzene, Toluene, Ethylbenzene, and Xylene) compounds in beauty salons has raised concerns about potential health risks. This study aimed to measure the levels of BTEX compounds in the air of beauty salons in Lahijan, Iran and assess the associated health risks. Air samples were collected from 15 beauty salons, and the concentrations of BTEX compounds were measured according to 1501 NIOSH standard method. The results showed that the mean concentrations of benzene (20.62 µg/m3), toluene (18.3 µg/m3), ethylbenzene (38.36 µg/m3), and O and P-xylene (27.35, 23.6 µg/m3) were above the recommended levels. The indoor to outdoor ratios for benzene, toluene, ethylbenzene, O and P-xylene were 3.04, 2.36, 3.75, 4.89, and 6.54, respectively. Also, the toluene/benzene (T/B) ratio in indoor and outdoor was 20.9 and 2.68 respectively. Almost half of the technicians (49.12%) reported adverse health effects, including joint pain, itchy eyes and nose, and respiratory allergies. The IARC guideline suggests that there is a potential risk of cancer development for individuals in all salons with LCR values exceeding 10−6, but the HQ index values indicate no non-carcinogenic risk. The findings suggest that beauty salon workers and customers are at risk of developing health problems from exposure to BTEX compounds. Effective risk management strategies, such as proper ventilation, use of personal protective equipment, and substitution of harmful chemicals with safer alternatives, to minimize exposure and protect the health of salon workers and customers recommended.

Since governance has various aspects and dimensions, including economic governance and its subsets,The monetary and financial policy through the central bank of the country's government is considered as monetary governance. With the emergence of new technologies such as blockchain, it seems that this Governance has become relative and has been overshadowed by this technology and has reduced the control of governments over the implementation of monetary policies. Central banks, which see their monetary sovereignty at risk, react based on their understanding of the issue and of course, some governments consider this technology as an opportunity for themselves. Accordingly, this article examines the monetary sovereignty of countries under the influence of cryptocurrencies and blockchain technology, and with a descriptive-analytical method, it seeks to explain the relationship between cryptocurrencies and the monetary and national sovereignty of countries in the field of international law.Banking Law

Abstract Background Improving the professional competency of nursing students during the internship is critical. This study aimed to compare the professional competency and anxiety of nursing students trained based on two internship models. Methods This is a two-group posttest-only quasi-experimental design study. One hundred nursing students who passed internship models A (a previous internship model) and B (an intervention with more educator support and a more planned and programmed process) were randomly enrolled in this study. Internship model groups A and B were conducted for the students in semesters 7 and 8. The outcomes assessed in both groups were “The Competency Inventory for Registered Nurses” and Spielberger “State-Trait Anxiety Inventory”. T-test and MANOVA were used to analyze the data. Results The mean scores of competency were 134.56 (SD = 43.23) and 160.19 (SD = 35.81) for the nursing students in the internship model groups A and B, respectively. The mean scores of nursing students’ anxiety were 92.14 (SD = 15.36) and 80.44 (SD = 18.16) in the internship model groups A and B, respectively. MANOVA test showed a significant difference between the groups regarding professional competency (F = 10.34, p = 0.002) and anxiety (F = 11.31, p = 0.001). Conclusions The internship model group B could improve the professional competency of nursing students to a great extent and they experienced mild anxiety; it is suggested that this intervention should be done for nursing students. Conducting more studies to evaluate the effect of this model on the nursing students’ competency and anxiety after graduation and as a novice nurse is suggested.

Clinical education plays a key role in preparing students for patient care. Laparoscopy is one of the most important minimally invasive surgeries (MISs) wherein surgical technologists are responsible for camera navigation and assistant surgeons are responsible for peg transfer. Therefore, it is necessary to improve the attitude of the operating room students toward these skills during their study period. The present study was conducted to determine the effect of simulating training in the fundamentals of laparoscopic surgery (FLS) on the attitude of the operating room students.

Abstract Wall Shear Stress (WSS) is one of the most important parameters used in cardiovascular fluid mechanics, and it provides a lot of information like the risk level caused by any vascular occlusion. Since WSS cannot be measured directly and other available relevant methods have issues like low resolution, uncertainty and high cost, this study proposes a novel method by combining computational fluid dynamics (CFD), fluid-structure interaction (FSI), conditional generative adversarial network (cGAN) and convolutional neural network (CNN) to predict coronary artery occlusion risk using only noninvasive images accurately and rapidly. First, a cGAN model called WSSGAN was developed to predict the WSS contours on the vessel wall by training and testing the model based on the calculated WSS contours using coupling CFD-FSI simulations. Then, an 11-layer CNN was used to classify the WSS contours into three grades of occlusions, i.e. low risk, medium risk and high risk. To verify the proposed method for predicting the coronary artery occlusion risk in a real case, the patient’s Magnetic Resonance Imaging (MRI) images were converted into a 3D geometry for use in the WASSGAN model. Then, the predicted WSS contours by the WSSGAN were entered into the CNN model to classify the occlusion grade.

Abstract Background Redondoviridae is a newly discovered virus family linked to oral and respiratory conditions in people, while there is still debate about whether it is also coinfected with other respiratory viruses. This study aimed to determine the frequency of Redondovirus (ReDoV) in nasopharyngeal samples and to investigate any possible links to SARS-CoV-2 infections. Methods A polymerase chain reaction (PCR) test was conducted on 731 nasopharyngeal samples from individuals referred to medical centers in Tehran, Iran, for SARS-CoV-2 testing to investigate the prevalence of ReDoV. An oral interview was performed to complete information on dental issues and the individuals’ demographics, symptoms, and vaccination history. Results The prevalence of ReDoV was 25.99%, and 15.26% had a coinfection with SARS-CoV-2. No notable correlation was found regarding ReDoVs and SARS-CoV-2 infections (p > 0.05). Women had a higher ReDoV positivity rate of 18.47% compared to men at 7.52% (p = 0.12), and there was no significant correlation between age groups and ReDoV presence. Nonetheless, a significant association was noted between ReDoVs and dental/gum issues (p

World Health Organization invites the nations to progress towards universal health care coverage. This study evaluated preventive and curative dental services utilization among children aged 12 years and younger in Tehran, Iran, based on the Andersen behavioral model using a generalized structural equation modeling. A phone-based cross-sectional study was conducted in Tehran, Iran, on 886 children in 2023. Information on curative and preventive/consultation dental service utilization and associated factors was collected by a standard questionnaire. We used a generalized structural equation model (GSEM) to build a model based on Andersen's behavioral model. Of 886 children, 22.1% used curative dental services, and 19.9% used preventive/consultation services in the past year. Among children aged 6 years and younger, age (OR = 1.87, p-value

BackgroundObstruction within the left anterior descending coronary artery (LAD) is prevalent, serving as a prominent and independent predictor of mortality. Invasive Fractional flow reserve (FFR) is the gold standard for Coronary Artery Disease risk assessment. Despite advances in computational and imaging techniques, no definitive methodology currently assures clinicians of reliable, non-invasive strategies for future planning.MethodThe present research encompassed a cohort of 150 participants who were admitted to the Rajaie Cardiovascular, Medical, and Research Center. The method includes a three-dimensional geometry reconstruction, computational fluid dynamics simulations, and methodology optimization for the computation time. Four patients are analyzed within this study to showcase the proposed methodology. The invasive FFR results reported by the clinic have validated the optimized model.ResultsThe computational FFR data derived from all methodologies are compared with those reported by the clinic for each case. The chosen methodology has yielded virtual FFR values that exhibit remarkable proximity to the clinically reported patient-specific FFR values, with the MSE of 6.186e-7 and R2 of 0.99 (p = 0.00434).ConclusionThis approach has shown reliable results for all 150 patients. The results are both computationally and clinically user-friendly, with the accumulative pre and post-processing time of 15 min on a desktop computer (Intel i7 processor, 16 GB RAM). The proposed methodology has the potential to significantly assist clinicians with diagnosis.

Due to its global burden, Targeting Hepatitis B virus (HBV) infection in humans is crucial. Herbal medicine has long been significant, with flavonoids demonstrating promising results. Hence, the present study aimed to establish a way of identifying flavonoids with anti-HBV activities. Flavonoid structures with anti-HBV activities were retrieved. A flavonol-based pharmacophore model was established using LigandScout v4.4. Screening was performed using the PharmIt server. A QSAR equation was developed and validated with independent sets of compounds. The applicability domain (AD) was defined using Euclidean distance calculations for model validation. The best model, consisting of 57 features, was generated. High-throughput screening (HTS) using the flavonol-based model resulted in 509 unique hits. The model's accuracy was further validated using a set of FDA-approved chemicals, demonstrating a sensitivity of 71% and a specificity of 100%. Additionally, the QSAR model with two predictors, x4a and qed, exhibited predictive solid performance with an adjusted-R2 value of 0.85 and 0.90 of Q2. PCA showed essential patterns and relationships within the dataset, with the first two components explaining nearly 98% of the total variance. Current HBV therapies tend to fail to provide a complete cure, emphasizing the need for new therapies. This study's importance was to highlight flavonols as potential anti-HBV medicines, presenting a supplementary option for existing therapy. The QSAR model has been validated with two separate chemical sets, guaranteeing its reproducibility and usefulness for other flavonols by utilizing the predictive characteristics of X4A and qed. These results provide new possibilities for discovering future anti-HBV drugs by integrating modeling and experimental research.

Background and aimNeurodegenerative disorders (e.g., Alzheimer’s, Parkinson’s) lead to neuronal loss; neurocognitive disorders (e.g., delirium, dementia) show cognitive decline. Early detection is crucial for effective management. Machine learning aids in more precise disease identification, potentially transforming healthcare. This comprehensive systematic review discusses how machine learning (ML), can enhance early detection of these disorders, surpassing traditional diagnostics’ constraints.MethodsIn this review, databases were examined up to August 15th, 2023, for ML data on neurodegenerative and neurocognitive diseases using PubMed, Scopus, Google Scholar, and Web of Science. Two investigators used the RAYYAN intelligence tool for systematic reviews to conduct the screening. Six blinded reviewers reviewed titles/abstracts. Cochrane risk of bias tool was used for quality assessment.ResultsOur search found 7,069 research studies, of which 1,365 items were duplicates and thus removed. Four thousand three hundred and thirty four studies were screened, and 108 articles met the criteria for inclusion after preprocessing. Twelve ML algorithms were observed for dementia, showing promise in early detection. Eighteen ML algorithms were identified for Parkinson’s, each effective in detection and diagnosis. Studies emphasized that ML algorithms are necessary for Alzheimer’s to be successful. Fourteen ML algorithms were discovered for mild cognitive impairment, with LASSO logistic regression being the only one with unpromising results.ConclusionThis review emphasizes the pressing necessity of integrating verified digital health resources into conventional medical practice. This integration may signify a new era in the early detection of neurodegenerative and neurocognitive illnesses, potentially changing the course of these conditions for millions globally. This study showcases specific and statistically significant findings to illustrate the progress in the area and the prospective influence of these advancements on the global management of neurocognitive and neurodegenerative illnesses.

The curing behavior of an epoxy/phenolic-based system containing graphene oxide (GO), and rubber powder as a toughening agent has been studied using differential scanning calorimetry (DSC) under non-isothermal conditions at a temperature from 0 to 200 °C. So, to better dispersion of GO nanoplates in the resin media, the surface of the GOs was modified by 1,12-diaminododecane and subsequently aforementioned reaction was confirmed by Fourier transform infrared spectroscopy (FT-IR) and thermogravimetric techniques (TGA). DSC results show that rubber powders despite toughening properties prohibited resin-curing reactions. On the other hand, modified GO led to the promotion of curing reactions. The results of differential and integral isoconversional approaches indicated low activation energy for nanocomposite containing modified GO. Furthermore, thermal stability results reveal that the maximum decomposition temperature and char yield values of samples were increased gradually by the addition of GO and rubber powder to the system.

Abstract Objective To assess the effectiveness of a modified Lichtenstein Repair combined with Herniorrhaphy in reducing postoperative chronic pain and enhancing recovery and quality of life in inguinal hernia patients. Methods This retrospective study, conducted at the Taleghani training center between January 2021 and February 2023, retrospectively examined 289 hernia surgeries, of which 130 employed a modified Lichtenstein technique. The investigation encompassed a detailed analysis of patient demographics, employed surgical techniques, operative methods with a focus on minimal dissection, and an evaluation of postoperative outcomes. Results In this study of 289 participants, primarily males aged 60–80 years, the modified technique group demonstrated a notably lower incidence of hernia recurrence (1.5%) compared to the Lichtenstein group (3.1%). Additionally, the modified technique was more effective in reducing postoperative pain, with a significantly lower mean Visual Analogue Scale (VAS) score of 0.15, compared to 0.31 in the Lichtenstein group. This suggests enhanced patient comfort and a potentially quicker recovery in the modified technique group. Conclusion The modified Lichtenstein hernioplasty technique, characterized by minimal tissue trauma and precise mesh placement, emerges as an effective approach in inguinal hernia repair. It offers significant benefits in reducing postoperative discomfort and chronic pain, thereby enhancing patient recovery and overall quality of life. This method aligns with current surgical trends towards patient-centric and minimally invasive procedures.

Abstract Background The technological advancements of the past few decades in various aspects that are directly or indirectly related to health, along with the emphasis on public health in societal development, have improved the quality of life. However, the occurrence of pandemics and crises underscores how various aspects of individual life can be impacted. The financial consequences resulting from the COVID-19 pandemic have particularly affected the field of dentistry and public oral health. This study aims to investigate the financial effects of the COVID-19 virus on dentistry through a scoping review. Methods A comprehensive literature search was conducted across four databases (Medline through PubMed, Embase, Scopus, and Cochrane Central) using keywords such as COVID-19 and its equivalents, dentistry, oral health, dental education, dental services, dental clinics, financial impact, financial opportunities and economic impact. Articles addressing the financial impact of COVID-19 on dentistry and oral health were then screened and reviewed. Results Out of 1015 articles related to COVID-19 and dentistry, 84 were focused on the financial impact of COVID-19 on dentistry. The majority of these articles originated from the United States, Brazil, and Saudi Arabia, with a prevalence of cross-sectional and review articles. The review categorized the articles into two main themes: financial problems and proposed solutions. Moreover, the following themes were extracted: the effects of practice closure on dentists and staff, increased treatment costs and impacts on oral health, personal protective equipment and unforeseen costs, psychological effects of financial issues, and financial challenges within the dental education system. Conclusions While many high-income countries seem able to mitigate COVID-19-induced financial problems, the economic effects on dentistry might persist despite the pandemic's end. These financial challenges have spurred new opportunities and infrastructure development but can pose significant risks to community oral health. This study aimed to highlight these problems and propose solutions, contributing to efforts to improve the oral health of communities globally. Further research is needed to understand long-term impacts.

Abstract Although the relationship between allergies and cancer has been investigated extensively, the role of allergies in head and neck cancer (HNC) appears less consistent. It is unclear whether allergies can independently influence the risk of HNC in the presence of substantial environmental risk factors, including consumption of alcohol, betel quid, and cigarettes. This study aims to find this association. We examined the relationship between allergies and HNC risk in a hospital-based case–control study with 300 cases and 375 matched controls. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals, controlling for age, sex, tobacco smoking and opium usage history, alcohol consumption, and socioeconomic status. Our study showed a significant reduction in the risk of HNC associated with allergy symptoms after adjusting for confounders. The risk of HNC was greatly reduced among those with any type of allergy (OR 0.42, 95% CI 0.28, 0.65). The ORs were considerably reduced by 58–88% for different kinds of allergies. The risk of HNC reduction was higher in allergic women than in allergic men (71% vs. 49%). Allergies play an influential role in the risk of HNC development. Future studies investigating immune biomarkers, including cytokine profiles and genetic polymorphisms, are necessary to further delineate the relationship between allergies and HNC. Understanding the relationship between allergies and HNC may help to devise effective strategies to reduce and treat HNC.

Abstract Vector control of induction motors has provided us with both good performance and acceptable efficiency at rated loads. Using this method at light loads reduces the efficiency due to the adjustment of motor flux at the rated value. Electric motors are normally used even at lower loads than the rated ones and often selected oversized. Enhancing the efficiency of induction motors at light loads will significantly reduce electric energy consumption. A novel method called Flux Angle Control (FAC) of the induction motor is presented to improve efficiency in the steady state at light loads. To increase the accuracy of the induction motor model we consider iron losses. This method controls the angle between the stator flux (stator current) and the d‐axis (rotor flux direction). The primary aim of the flux angle control method is to reduce the flux level and increase the flux angle at light loads. The optimal flux angle is sensitive to some induction motor parameters. The proposed method offers several advantages compared to similar methods, including high efficiency, minimal sensitivity of the optimal flux angle to changes in motor parameters, a reduced number of calculations, and easy implementation. The validity of this method is examined through experiments.

Abstract Coronary artery disease is the leading global cause of mortality and Fractional Flow Reserve (FFR) is widely regarded as the gold standard for assessing coronary artery stenosis severity. However, due to the limitations of invasive FFR measurements, there is a pressing need for a highly accurate virtual FFR calculation framework. Additionally, it’s essential to consider local haemodynamic factors such as time-averaged wall shear stress (TAWSS), which play a critical role in advancement of atherosclerosis. This study introduces an innovative FFR computation method that involves creating five patient-specific geometries from two-dimensional coronary angiography images and conducting numerical simulations using computational fluid dynamics with a three-element Windkessel model boundary condition at the outlet to predict haemodynamic distribution. Furthermore, four distinct boundary condition methodologies are applied to each geometry for comprehensive analysis. Several haemodynamic features, including velocity, pressure, TAWSS, and oscillatory shear index are investigated and compared for each case. Results show that models with average boundary conditions can predict FFR values accurately and observed errors between invasive FFR and virtual FFR are found to be less than 5%.

Abstract Radiotherapy in patients with head and neck cancer fairly leads to xerostomia, profoundly affecting their quality of life. With limited effective preventive and therapeutic methods, attention has turned to exploring alternatives. This article outlines how intraglandular injection of mitochondria-boosting agents can serve as a potential strategy to reduce salivary acinar damage. This method can contribute to the thoughtful development of study protocols or medications to reduce radiation-induced salivary glands damage.

Abstract Introduction Identifying clinical factors that increase the risk of mortality in COVID-19 patients is crucial. This enables targeted screening, optimizing treatment, and prevention of severe complications, ultimately reducing death rates. This study aimed to develop prediction models for the death of patients (i.e., survival or death) during the COVID-19 pandemic in Shiraz, exploring the main influencing factors. Method We conducted a retrospective cohort study using hospital-based records of 1030 individuals diagnosed with COVID-19, who were hospitalized for treatment between March 21, 2021, and March 21, 2022, in Shiraz, Iran. Variables related to the final outcome were selected based on criteria and univariate logistic regression. Hierarchical multiple logistic regression and classification and regression tree (CART) models were utilized to explore the relationships between potential influencing factors and the final outcome. Additionally, methods were employed to identify the high-risk population for increased mortality rates during COVID-19. Finally, accuracy was evaluated the performance of the models, with the area under the receiver operator characteristic curve(AUC), sensitivity, and specificity metrics. Results In this study, 558 (54.2%) individuals infected with COVID-19 died. The final model showed that the type of medicine antiviral (OR: 11.10, p = 0.038) than reference (antiviral and corticosteroid), and discharge oxygen saturation(O2) (OR: 1.10, p

Abstract Purpose objective(s) Manual contouring of the prostate region in planning computed tomography (CT) images is a challenging task due to factors such as low contrast in soft tissues, inter- and intra-observer variability, and variations in organ size and shape. Consequently, the use of automated contouring methods can offer significant advantages. In this study, we aimed to investigate automated male pelvic multi-organ contouring in multi-center planning CT images using a hybrid convolutional neural network-vision transformer (CNN-ViT) that combines convolutional and ViT techniques. Materials/methods We used retrospective data from 104 localized prostate cancer patients, with delineations of the clinical target volume (CTV) and critical organs at risk (OAR) for external beam radiotherapy. We introduced a novel attention-based fusion module that merges detailed features extracted through convolution with the global features obtained through the ViT. Results The average dice similarity coefficients (DSCs) achieved by VGG16-UNet-ViT for the prostate, bladder, rectum, right femoral head (RFH), and left femoral head (LFH) were 91.75%, 95.32%, 87.00%, 96.30%, and 96.34%, respectively. Experiments conducted on multi-center planning CT images indicate that combining the ViT structure with the CNN network resulted in superior performance for all organs compared to pure CNN and transformer architectures. Furthermore, the proposed method achieves more precise contours compared to state-of-the-art techniques. Conclusion Results demonstrate that integrating ViT into CNN architectures significantly improves segmentation performance. These results show promise as a reliable and efficient tool to facilitate prostate radiotherapy treatment planning.

Background: The biomedical and nutraceutical effects of sea lettuce, scientifically known as Ulva lactu-ca, are well known in scientific literature. Considering the nutraceutical effects of this marine organism and the abundance of this algae on Bushehr coasts, one of the objectives of this study was to investigate some phytochemical, nutraceutical, and antioxidant properties and the chemical components of sea let-tuce obtained from the Persian Gulf coasts (Bushehr, Iran). Materials and Methods: After sample collection and preparation, some phytochemical properties, includ-ing the fatty acid profile, amino acid profile, secondary metabolites, and antioxidant activity were respec-tively determined using standard AOAC methods to Cd 86-90 and Cd 3-25, gas chromatography flame ionization detector (GC-FID), high performance liquid chromatography (HPLC), gas chromatography-mass spectrometry (GC-MS) and free radical scavenging (DPPH) methods. Results: The analysis of fatty acids revealed 17 types of fatty acids consisting of significant amounts of Omega 3, 6, and 9, while the amino acid analysis revealed 19 types of amino acids containing significant amounts of essential amino acids (37%). Additionally, the GC-MS results identified 31 secondary metab-olites with different functional groups and nuclei. Sea lettuce showed higher antioxidant activity than the ascorbic acid standard at different concentrations. Conclusion: According to the results, Persian Gulf Sea lettuce contains nutritional compounds and useful primary and secondary metabolites with nutraceutical and biomedical effects for use as a food supple-ment. This marine organism is also a rich source of many bioactive compounds such as phenolics, alka-loids, amino acids, and saturated and unsaturated fatty acids.

Application of nondestructive techniques combined with image processing techniques has been increasing in investigating the internal structure of food products. Magnetic resonance imaging (MRI) is one of these methods. The aim of this research is to investigate the effect of coating formulation on structural properties of turkey nugget samples (turkey nugget with typical batter, tragacanth-containing batter and tragacanth) by MRI. Results revealed that the changes caused by the batter formulation could also be examined using the tomographic images. The results also indicated that the brightness of the MRI images of the nugget core and crust decreased during frying. The core of the nugget with the tragacanth-containing batter was brighter revealing its higher moisture content. Furthermore, the nugget core was less reduced in this sample compared with the other ones. This research aimed to present a valuable knowledge about nugget frying pertaining to quality evaluation.

Porosity plays a crucial role in both natural and man-made materials, serving as a fundamental microstructural characteristic that has a significant impact on their physical properties. Soils and rocks in nature are porous materials that are usually saturated with different fluids such as water, oil and gas. Therefore, it is very important to investigate the properties of porous materials and a better understanding of porous materials properties can lead to progress in oil, mining, and civil industries. In this research, porous samples with different porosity percentages were made and analyzed. The laboratory generation of actual porosity within the rock-like material samples was one of a significant aspect of this research. 5 groups of samples with different percentage of porosities were prepared including: 20%, 15%, 10%, 5%, 2% porosity and classified in 5 groups of A, B, C, D and E, respectively. Various experimental tests were performed with loading rate .5 MPa per second on the samples and the mechanical parameters of the samples were determined. These experiments show that the uniaxial compression and tensile strengths and elastic modulus of the rock-like specimens decrease with increasing their porosity. The mechanical parameters' maximum values were associated with group E samples (with 2-3% porosity). This group demonstrated a strength of approximately 34 MPa, an elastic modulus of 36 GPa, and a tensile strength of 7.3 MPa. The minimum values were observed in group A (with 20% porosity), which exhibited a strength of approximately 13 MPa, an elastic modulus of 16 GPa, and a tensile strength of 2.7 MPa. The study also investigated the Poisson’s ratio. The results indicate that Poisson's ratio increases with increasing porosity. The maximum Poisson's ratio was found in group A, which had 20% porosity and 11% Poisson's ratio, while the minimum value was found in group E, which had 2-3% porosity and 26% Poisson's ratio. the result show that Porosity has the greatest effect on the tensile strength parameter, which can change the tensile strength by 270% with a 20% change.

Background: Aromatherapy is a modality within the realm of alternative medicine to manage pain and alleviate anxiety in high-stress circumstances. The primary objective of this study was to examine the impact of damask rose on the levels of anxiety and pain experienced by patients under endoscopic lithotripsy. Methods: The present double-blind randomized clinical trial was conducted at hospitals in Shiraz, Iran, in 2022, involving 120 patients undergoing endoscopic lithotripsy. These patients were randomly allocated into control and intervention groups using a permuted block design. The data collection was done using the Spielberger and the Visual Analog Scale questionnaires at three stages: the baseline period, the pre-operative holding area, and six hours following the surgical procedure. The intervention group was exposed to a cotton swab infused with three drops of damask rose for a duration of 30 minutes. The data analysis included descriptive statistics, repeated measure analysis of variance, and pairwise comparisons utilizing the Bonferroni post hoc test. Results: The mean levels of overt anxiety in the intervention group during the first and second phases of the intervention were 46.17±7.18 (P

BackgroundBehavioral and Psychological Symptoms of Dementia (BPSD) are common during Alzheimer’s disease and cause severe problems for patients and their caregivers.ObjectivesTo assess the therapeutic efficacy of Pregabalin in comparison with a placebo in treating BPSD in patients with Alzheimer’s disease (AD) visiting the memory and cognition clinic of Roozbeh Psychiatric Hospital in Tehran, Iran.MethodsA 12-week double-blind, randomized comparison of Pregabalin and placebo treatments was conducted in 53 patients with DSM-V diagnosis of dementia of Alzheimer’s type. They were randomly assigned to receive Pregabalin (doses: 50 titrated up to 300 mg/day) or a placebo. Clinical response was evaluated using the Neuropsychiatric Inventory (NPI), and the Behavioral Pathology in AD Rating Scale (BEHAVE-AD) scores compared with baseline. Side effects were also recorded carefully.ResultsPatients receiving Pregabalin had better outcomes in comparison with patients receiving a placebo regarding both NPI and BEHAVE-AD scores after 12 weeks (p-value = 0.009 for NPI and p-value = 0.003 for BEHAVE-AD). There was also a statistically significant decrease in the treatment group depression sub-score regarding NPI and BEHAVE-AD (respectively, p-value =0.000, 0.003). The caregiver burden sub-score of the NPI test was also lower in patients receiving pregabalin (p-value = 0.000). There was no statistically significant difference between the occurrence of adverse effects between the two groups (p-value = 1.00).ConclusionPregabalin at a dose of 300 mg/day was well tolerated and associated with reductions in the severity and frequency of behavioral symptoms in patients with AD. Pregabalin could be considered a favorable choice for treating BPSD in adults with mild to moderate stages of Alzheimer ‘s-type dementia, considering its befitting safety profile.Clinical trial registrationhttps://www.irct.ir/trial/52750, identifier IRCT20201201049553N1

Abstract Our prospective study investigates the 3‐year trajectory of disease‐specific quality of life (QoL) using the PEmb‐QoL questionnaire, functional performance via 6‐min walk tests, and the 5‐year survival following acute pulmonary embolism (PE) and explores their association with patient demographics and clinical characteristics. We highlight that PE‐specific QoL improves over time despite no significant changes in cardiopulmonary performance.

In response to the costly and error-prone manual satellite tracking on the International Space Station (ISS), this paper presents a deep neural network (DNN)-based robotic visual servoing solution to the automated tracking operation. This innovative approach directly addresses the critical issue of motion decoupling, which poses a significant challenge in current image moment-based visual servoing. The proposed method uses DNNs to estimate the manipulator’s pose, resulting in a significant reduction of coupling effects, which enhances control performance and increases tracking precision. Real-time experimental tests are carried out using a 6-DOF Denso manipulator equipped with an RGB camera and an object, mimicking the targeting pin. The test results demonstrate a 32.04% reduction in pose error and a 21.67% improvement in velocity precision compared to conventional methods. These findings demonstrate that the method has the potential to improve efficiency and accuracy significantly in satellite target tracking and capturing.

Background: The radial approach is now recommended as the default strategy in diagnostic coronary angiography and percutaneous coronary intervention. Radial artery occlusion (RAO) is the most common complication that limits subsequent angiographic procedures through this access. Recently, distal radial access (DRA) has been recommended as an alternative access site. Despite lower RAO rates in DRA in some recent clinical trials, concerns remain regarding possible complications and limitations due to the small size of the distal radial artery. Objective: The present study aimed to compare traditional radial access (TRA) and DRA concerning RAO in percutaneous coronary procedures. Methods: In the present prospective cohort study, percutaneous coronary procedures were performed via DRA or TRA in 2 study groups. All consecutive participants underwent DRA from September 2021 to March 2022 and TRA from April 2022 to June 2022. Ultrasonography was performed preprocedurally in the DRA group, and patients with small distal artery diameters (

Abstract Background Repeat‐breeder cows repeatedly fail to conceive after at least three attempts and return to oestrus at apparently normal intervals. Repeat‐breeder cows cause economic losses in dairy farms in different ways. Objective In the present study, we investigated the effect of sustained‐release progesterone injection in two different doses on the expression of interferon‐related genes in repeat‐breeder dairy cows. Methods A total of 96 repeat‐breeder primiparous and multiparous cows were assigned among three groups: control group, inseminated and do not receive progesterone treatment; P400 and P600 groups, inseminated and received a single‐intramuscular injection of 400 and 600 mg slow‐release progesterone 5 days after insemination, respectively. Blood sampling was carried out on Day 20 after AI for progesterone measurement and evaluation of gene expression for ISG15, MX1 and MX2 genes. Results One injection of sustained‐release progesterone increased the expression of ISG15, MX1 and MX2 genes with differences between two different progesterone concentrations. For all three genes, the level of gene expression was higher in progesterone‐supplemented group than in control group, when P400 and P600 groups considered together. The level of MX2 gene expression was significantly higher in pregnant cows than non‐pregnant cows. There was a significant positive correlation between expression level of all three genes and blood progesterone concentration. The expression level of ISG15 gene showed a significant positive correlation with MX1 and MX2 gene expression. Conclusion The use of this sustained‐release progesterone is simple and can be used in repeat‐breeder cows to improve fertility.

Background Senior dental students are more aware of the harmful effects of cariogenic snacks and are expected to better watch their diet compared with freshmen dental students. This study aimed to compare the frequency of consumption of cariogenic snacks by senior and freshmen dental students of Tehran city and the related factors.Methods This cross-sectional study evaluated the senior and freshmen dental students attending dental schools in Tehran in 2018, who were selected by census sampling. A cariogenic snack record form was used to collect information regarding the frequency of consumption of cariogenic snacks both prospectively (within the upcoming week) and retrospectively (previous 24 hours). We also collected information on the demographic characteristics of the participants. The plaque-producing and decay-producing potential of the diet (PAP) index was calculated for each dental student. Data were analysed by the backward regression model using SPSS.Results A total of 294 dental students with a mean age of 22±2.85 years participated in this study. The mean PAP score was 76.48±49.91 for the freshmen and 89.87±49.41 for the senior dental students with a significant difference between them (p=0.023). Older dental students (p=0.008) and those not living with their parents (p=0.001) acquired a higher PAP score.Conclusion The mean PAP score of freshmen and senior dental students in Tehran was slightly higher than the optimal level. So the instructional techniques of dental curricula are better to be revised to improve the performance of dental students to cut down the consumption of cariogenic snacks.

Objective: This research aims to evaluate patterns of prescription of medications used to manage acute agitation in adult Iranian patients at the emergency department (ED) of Roozbeh Psychiatric Hospital in Tehran. Method: The study analyzed data from the medical records of 252 patients who received pharmacotherapy for agitation. Results: The findings revealed that 181 patients (71.82%) were given typical antipsychotics, with haloperidol being the most commonly prescribed medication. Atypical antipsychotics were administered to 24 participants (9.52%), primarily olanzapine, and 52 patients (20.63%) received benzodiazepines, predominantly lorazepam. The treatment response was also assessed as appropriate in 224 patients (88.89%) and inappropriate in 28 patients (11.11%). Conclusion: The study recommends providing new-generation medications to developing countries and underscores the importance of updating student educational programs.

Background: Central venous catheter (CVC) thrombosis is one of the most common complications of CVC that occurs in children and adults. Prevention of this blockage improves the treatment process and reduces treatment costs. Due to the lack of studies on preventive methods of CVC thrombosis, this study aimed to examine the effect of NS flushing heparinized and prophylactic dose of enoxaparin in prevention of CVC induced thrombosis in hospitalized patients in pediatric intensive care unit (PICU). Methods: Eighty pediatrics with Central venous catheter admitted to the PICU enrolled in this trial and were divided into two groups as receiving heparinized normal saline was flushed every 8 hours under sterile conditions and receiving enoxaparin trough injection subcutaneously every 12 hours. The incidence of CVC-related thrombosis, diagnosed using color Doppler ultrasound of the vein containing the catheter was measured. Patients were monitored daily in terms of clinical symptoms related to thrombosis. Results: There was no statistically significant difference in gender, age, anthropometric findings and vital sign as well as risk factors between two groups of the trial (P>0.05). Additionally, the finding showed a statistically significant relationship between major surgery (P=0.01) and heart disease (P=0.03) with symptomatic and asymptomatic thrombosis between the enoxaparin and heparinized normal saline groups. The rate of sepsis and bleeding were lower in enoxaparin group but it was not significant between study groups. Conclusion: These findings indicate that enoxaparin may be considered as a clinical approach in thrombosis management and more clinical trials are needed.

Thoracic endovascular repair (TEVAR) is a valuable alternative to open surgical repair for aortic aneurysms, offering several benefits. However, one potential complication that demands attention is endoleak. This case report highlights a unique occurrence of type 2 endoleak, typically associated with aortic aneurysms treated by TEVAR, originating from an undiagnosed patent ductus arteriosus (PDA). The patient, a 68-year-old woman, underwent TEVAR for an aortic aneurysm complicated by underlying lung disease and pulmonary artery hypertension. During the procedure, an unexpected shunt between the aorta and the pulmonary artery was identified and subsequently revealed to be an undiagnosed PDA. Remarkably, the decision was made to continue with TEVAR while simultaneously deploying a stent graft to close the PDA. This case underscores the significance of comprehensive preprocedural aortic assessment and careful consideration of PDA closure to prevent type 2 endoleak in TEVAR, reinforcing the importance of thorough evaluation before such procedures.

Abstract The challenges of commercial species with the threats of climate change make it necessary to predict the changes in the distributional shifts and habitat preferences of the species under possible future scenarios. We aim to demonstrate how future climatic changes will affect the habitat suitability of three species of commercial fish using the predictive technique MaxEnt. The dataset used to extract geographical records included OBIS (54%), GBIF (1%), and literature (45%). The output of the model indicated accurate projections of MaxEnt (AUC above 0.9). Temperature was the main descriptor responsible for the main effects on the distribution of commercial fish. With increasing RCP from 2.5 to 8.5, the species would prefer saltier, higher temperatures and deeper waters in the future. We observed different percentages of suitable habitats between species during RCPs showing distinct sensitivity of each fish in facing climate changes. Negative effects from climate change on the distribution patterns of commercial fish were predicted to lead to varying degrees of reduction and changes of suitable habitats and movement of species towards higher latitudes. The finding emphasizes to implement adaptive management measures to preserve the stocks of these commercial fish considering that the intensification of the effects of climate change on subtropical areas and overexploited species is predicted.

Abstract Background Nasal surgeries, addressing anatomical variations for form and function, require careful anesthesia administration, including dexmedetomidine and remifentanil. This meta-analysis evaluates their safety and efficacy variations in nasal surgeries, emphasizing patient comfort and optimal outcomes. Methods Four electronic databases (PubMed, Scopus, Web of Science, and CINAHL Complete) were searched for records in English. Studies that measure the effect of dexmedetomidine versus remifentanil on patients underwent nasal surgery were included. The Cochrane Collaboration’s tool was used to assess the quality of the included studies. A random-effect model was preferred and statistical analysis was performed by Stata software version 17. Results Out of an initial pool of 63 articles, five studies were selected for this analysis. All of these chosen studies were Randomized Controlled Trials (RCTs). The meta-analysis involved a total of 302 participants, with 152 in the remifentanil group and 150 in the dexmedetomidine group. The analysis aimed to compare the effects of Dexmedetomidine and Remifentanil on heart rate (HR) and mean arterial pressure (MAP) during surgery. Both groups exhibited similar MAP and HR, with the exception of a slightly lower HR in the remifentanil group at the 15th minute of surgery (Standardized Mean Difference: -0.24 [-0.83, 0.34]). Furthermore, when evaluating the impact of these medications on post-surgery outcomes, including pain levels, the use of pain relief medications, patient-surgeon satisfaction, agitation scores, and recovery time, no significant differences were observed between the two medications in any of these aspects. Conclusion In summary, the study compared Dexmedetomidine and Remifentanil in nasal surgeries anesthesia. No significant differences were found in heart rate, blood pressure, satisfaction, pain, agitation, or recovery time. The study had limitations, and future research should establish standardized protocols and consider various surgical factors.

Abstract Schizophrenia is associated with increased risk of medical comorbidity, possibly including osteoporosis, which is a public health concern due to its significant social and health consequences. In this systematic review and meta-analysis, we aimed to determine whether schizophrenia is associated with bone fragility. The protocol for this review has been registered with PROSPERO (CRD42020171959). The research question and inclusion/exclusion criteria were developed and presented according to the PECO (Population, Exposure, Comparison, Outcome) framework. Schizophrenia was identified from medical records, DSM-IV/5 or the ICD. The outcomes for this review were bone fragility [i.e., bone mineral density (BMD), fracture, bone turnover markers, bone quality]. A search strategy was developed and implemented for the electronic databases. A narrative synthesis was undertaken for all included studies; the results from eligible studies reporting on BMD and fracture were pooled using a random effects model to complete a meta-analysis. The conduct of the review and reporting of results adhered to PRISMA guidelines. Our search yielded 3103 studies, of which 29 met the predetermined eligibility criteria. Thirty-seven reports from 29 studies constituted 17 studies investigating BMD, eight investigating fracture, three investigating bone quality and nine investigating bone turnover markers. The meta-analyses revealed that people with schizophrenia had lower BMD at the lumbar spine [standardised mean difference (SMD) −0.74, 95% CI −1.27, −0.20; Z = −2.71, p = 0.01] and at the femoral neck (SMD −0.78, 95% CI −1.03, −0.53; Z = −6.18, p ≤ 0.001). Also observed was a higher risk of fracture (OR 1.43, 95% CI 1.27, 1.61; Z = 5.88, p ≤ 0.001). Following adjustment for publication bias, the association between schizophrenia and femoral neck BMD (SMD −0.63, 95% CI −0.97, −0.29) and fracture (OR 1.32, 95% CI 1.28, 1.35) remained. Significantly increased risk of bone fragility was observed in people with schizophrenia. This association was independent of sex, participant number, methodological quality and year of publication.

Background: Recently, a number of papers have discussed the importance of evaluating service quality provided to customers. The purpose of this study is evaluating service quality of clinical diagnostic in Yazd Central Laboratory from customers’ point of views using the SERVQUAL and SERVPERF models in two simple and weighted types, and also, identifying the most suitable model for service quality evaluation. Methods: The present research was applied research in terms of purpose and descriptive-analytical in terms of method. According to Morgan's table, the statistical sample of this research included 250 people who referred to Yazd central laboratory in September 2023; they were selected by simple random sampling method and a valid and reliable questionnaire with 33 items which was distributed among them. In the next step, to analyze the data collected from the questionnaire, SPSS 16 software was used to analyze Kolmogorov–Smirnov test, Student's t-test, analysis of variance, Fisher's Z test, and least squares method. Results: The findings indicated that the expectations of service recipients are greater than their perceptions of the quality of the services received. The correlation coefficient between the overall satisfaction of the clients and the services and the level of service quality in the SERVPERF model (r = 0.7060) has a higher value than the weighted SERVPERF model (r = 0.6913), SERVQUAL model (r = 0.6890) and weighted SERVQUAL model (r = 0.6344). Moreover, the most valid models for measuring the quality of medical diagnosis services were respectively as follows: SERVPERF, weighted SERVPERF, SERVQUAL and weighted SERVQUAL. Conclusion: Based on the research findings, it is recommended that managers consider the needs and demands of the clients in their future planning in order to improve the quality of services in medical diagnosis services, which are relatively more difficult to evaluate. Also, the level of standards required to provide health services in clinical diagnosis laboratories should be explained to the clients so that they have correct expectations and perceptions of the quality of services.

Background: Salmonella osteoarticular involvement is a rare complication, occurring in about 2% of the cases. Septic arthritis is exceedingly rare, involving only 0.2 % of all salmonellosis patients. Endocarditis is another complication that occurs in less than 0.8 % of cases. These complications are more likely to happen among immunocompromised patients. Case Presentation: We report a previously healthy 25-year-old man who presented with left limb pain. He had been treated for brucellosis ten days earlier by his primary care physician. Arthrocentesis and subsequent hip-joint biopsy confirmed septic arthritis due to Salmonella. However, he was unresponsive to the treatment. We found no underlying immunosuppression. A trans-esophageal echo was performed due to the continued fever and positive blood cultures. It revealed Salmonella endocarditis of the naïve tricuspid valve. He was treated via arthrotomy and antimicrobials for four weeks. Follow-up after 20 months showed no underlying immunosuppression. Conclusion: This case highlights that in patients with positive Salmonella blood cultures and a focus of infection compatible with Salmonellosis but unresponsive to treatment, searching for other foci of infection is necessary. Furthermore, physicians in endemic areas of brucellosis should consider other differential diagnoses in patients with fever and limping because any delay in diagnosing Salmonella septic arthritis can destroy the joint space with lifelong discomfort.

Abstract The current study aimed to evaluate Y chromosome haplotypes obtained from 1353 unrelated Iranian males using the AmpFlSTRTM YfilerTM kit; 1353 out of the 1353 identified haplotypes were unique. The haplotype diversity (HD) and discriminating capacity (DC) values were 1.00000 and 0.997, respectively. Analysis of genetic distance was performed using molecular variance (AMOVA) and multidimensional scaling plots (MDS), revealing a statistically significant difference between the study population and previous data reported for other Iranian populations and other neighboring countries. The present findings are likely to be useful for forensic casework analyses and kinship investigations.

Abstract The emergence of viral variants with altered phenotypes is a public health challenge underscoring the need for advanced evolutionary forecasting methods. Given extensive epistatic interactions within viral genomes and known viral evolutionary history, efficient genomic surveillance necessitates early detection of emerging viral haplotypes rather than commonly targeted single mutations. Haplotype inference, however, is a significantly more challenging problem precluding the use of traditional approaches. Here, using SARS-CoV-2 evolutionary dynamics as a case study, we show that emerging haplotypes with altered transmissibility can be linked to dense communities in coordinated substitution networks, which become discernible significantly earlier than the haplotypes become prevalent. From these insights, we develop a computational framework for inference of viral variants and validate it by successful early detection of known SARS-CoV-2 strains. Our methodology offers greater scalability than phylogenetic lineage tracing and can be applied to any rapidly evolving pathogen with adequate genomic surveillance data.