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Abstract Objective Emergency physicians are always faced with the challenge of choosing the appropriate disposition for elderly patients in order to ensure an acceptable care plan and effective use of resources. A clinical decision rule, Geriatric Fever Score (GFS) has been proposed but not validated to help ED physicians with decision-making. This rule employs leukocytosis, severe coma, and thrombocytopenia as predictors of 30-day mortality. Through our study determines the performance of this clinical prediction rule in a prospective study in a setting different from where it was developed. Method and materials In this prospective cohort study in a 1200-bed tertiary care, patients older than 65 years old who visited the ED with fever were enrolled. All elements of the rule were collected and the total score was calculated for each patient. Patients were also categorized as low risk (score 0–1) or high risk (score ≥ 2). Thirty-day follow-up was performed to determine the patient outcome (survival or mortality). Results A total of 296 patients were included in our final analysis. The mortality rate was 33.1% for patients with a Score of 0, 42.1% for a score of 1, 57.1% for a score of 2, and 100% for a score of 3. When divided into two risk groups, patients’ mortality rates were as follows: low risk group 37.9% and high-risk group 40.5%. Conclusion Our study showed that elderly patients who present to ED with fever and have a score of 2 or higher on the Geriatric Fever Score are at higher risk of mortality at 30 days.

Abstract This systematic review aimed to evaluate the potential of deep learning algorithms for converting low-dose Positron Emission Tomography (PET) images to full-dose PET images in different body regions. A total of 55 articles published between 2017 and 2023 by searching PubMed, Web of Science, Scopus and IEEE databases were included in this review, which utilized various deep learning models, such as generative adversarial networks and UNET, to synthesize high-quality PET images. The studies involved different datasets, image preprocessing techniques, input data types, and loss functions. The evaluation of the generated PET images was conducted using both quantitative and qualitative methods, including physician evaluations and various denoising techniques. The findings of this review suggest that deep learning algorithms have promising potential in generating high-quality PET images from low-dose PET images, which can be useful in clinical practice.

Hassina Shadab,1 Aisha Nawabi,1 Abdurrahman Anwari,2 Mohammad Bashir Nejabi,3 Elaha Somaya Ghafari,1 Sajeya Karimi,1 Mohammad Eissa Ahmadi1 1Periodontics Department, Kabul University of Medical Sciences (KUMS), Kabul, Afghanistan; 2Operative/ Restorative Dentistry and Endodontics Department, Kabul University of Medical Sciences (KUMS), Kabul, Afghanistan; 3Prosthodontics Department, Kabul University of Medical Sciences (KUMS), Kabul, AfghanistanCorrespondence: Abdurrahman Anwari, Operative/ Restorative Dentistry and Endodontics Department, Kabul University of Medical Sciences (KUMS), Jamal Mena, 3rd District, Kabul, Afghanistan, Tel +93795125522, Email yammamyama@gmail.comAbstract: Hereditary gingival fibromatosis (HGF) is an uncommon genetic condition marked by gradual and progressive overgrowth of fibrous tissue in the gums, which is benign in nature. It is a genetic disorder inherited in an autosomal dominant pattern, known for its considerable genetic diversity. The marginal, attached, and interdental gingivae are affected by this condition. The affected area appears pink, does not bleed easily, and exhibits a firm, fibrotic texture. Additionally, it displays a hard, widespread nodular growth that is smooth to stippled and has little bleeding tendency. Nevertheless, in certain instances, the enlargement may feel so dense and firm that it resembles bone upon palpation. Accordingly, esthetics and functions related to a healthy gingiva is also affected. The choice of treatment modality often depends on factors such as the severity of gingival overgrowth, available resources, and patient-specific considerations. Laser techniques and electrosurgery have emerged as valuable options, providing benefits like reduced discomfort and enhanced precision. However, traditional surgical methods remain highly effective, particularly when advanced technologies are not available. This article reports on three cases of hereditary gingival fibromatosis (HGF) treated with conventional gingivectomy, flap procedures, and resective osseous surgery (osteoplasty and osteotomy). The aim is to support the efficacy of these interventions in addressing patient complaints and preparing the groundwork for managing additional issues, such as speech and mastication difficulties, delayed eruption of permanent teeth, and malocclusion. The surgical treatment led to significant improvements: masticatory function was markedly enhanced, aesthetic outcomes were notably better, and oral hygiene significantly improved. Additionally, the procedures created favorable conditions for future treatments, including orthodontics, implants, or prosthetics, by providing a more manageable and functional oral environment.Keywords: hereditary gingival fibromatosis, gingivectomy, osteoplasty, gingival enlargement, case series

Abstract Background Hemodialysis patients are at risk of acquiring healthcare-related infections due to using non-sterile water to prepare hemodialysis fluid. Therefore, microbiological control and monitoring of used water are of crucial importance. Materials and methods In this work, we identified bacterial populations occupying a hemodialysis water distribution system for almost a 6-month period in Ahvaz city, southwest of Iran. A total of 18 samples from three points were collected. We found high colony counts of bacteria on R2A agar. 31 bacteria with different morphological and biochemical characteristics were identified by molecular-genetic methods based on 16 S rRNA gene sequencing. Endotoxin concentrations were measured, using Endosafe® Rapid LAL Single-Test Vials. Results A diverse bacterial community was identified, containing predominantly Gram-negative bacilli. The most frequently isolated genus was Sphingomonas. Five species including M. fortuitum, M. lentiflavum, M.szulgai, M. barrassiae, and M. gordonae was identified .Despite the presence of Gram-negative bacteria the endotoxin analysis of all samples revealed that their endotoxin values were below the detection limit. Conclusion The members of Sphingomonas genus along with Bosea and mycobacteria could be regarded as pioneers in surface colonization and biofilm creation. These bacteria with others like Pelomonas, Bradyrhizobium, staphylococcus, and Microbacterium may represent a potential health risk to patients under hemodialysis treatment.

Abstract Background Streptococcus mutans has been implicated as a primary causative agent of dental caries and one of its important virulence properties is an ability to form biofilm on tooth surfaces. Thus, strategies to prevent and control S. mutans biofilms are requested. The present study aimed to examine the eradication of S. mutans planktonic and biofilm cells using riboflavin (Rib)-mediated antimicrobial photodynamic therapy (aPDT) enhanced by postbiotic mediators derived from Lactobacillus species. Materials and methods Minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of Rib and postbiotic mediators were determined. The antimicrobial and anti-biofilm effects of Rib-mediated aPDT (Rib plus blue light), Rib-mediated aPDT in combination with postbiotic mediators derived from Lactobacillus casei (LC) (aPDT+ LC), and Rib-mediated aPDT in combination with postbiotic mediators derived from Lactobacillus plantarum (LP) (aPDT+ LP) were evaluated. The anti-virulence potential of Rib-mediated aPDT, aPDT+ LC, and aPDT+ LP were assessed by measuring the expression of the gtfB gene using quantitative real-time polymerase chain reaction (qRT-PCR) at the highest concentrations of Rib, LC, and LP, at which the S. mutans had proliferation as the same as in the control (non-treated) group. Results According to the results, the MIC doses of LC, LP, and Rib were 64 µg/mL, 128 µg/mL, and 128 µg/mL, respectively, while the MBC values of LC, LP, and Rib were 128 µg/mL, 256 µg/mL, and 256 µg/mL, respectively. Rib-mediated aPDT, aPDT+ LP, and aPDT+ LC showed a significant reduction in Log10 CFU/mL of S. mutans compared to the control group (4.2, 4.9, and 5.2 Log10 CFU/mL, respectively; all P

Tamana Barakati,1 Elaha Somaya Ghafari,2 Somayeh Niakan,3 Omid Humkar,4 Hasina Shadab,2 Hedayatullah Ehsan5 1Research Department, Queen Mary University of London, London, UK; 2Department of Periodontology, Kabul University of Medical Science, Kabul, Afghanistan; 3Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran; 4Oral Medicine Department, Noman Sadat Institute of Higher Education, Kabul, Afghanistan; 5Medical Sciences Research Center, Ghalib University, Kabul, AfghanistanCorrespondence: Hedayatullah Ehsan, Khushal Khan Mina, Kabul, 1010, Afghanistan, Tel +93775816022, Email hedayatullahehsan@gmail.comAbstract: Speaking, chewing, and swallowing difficulties can result from Parkinson’s disease (PD), which frequently affects the oro-pharyngeal muscles. The reduction in food and hydration intake that is unavoidable leads to a worsening of neurological symptoms. Patients with Parkinson’s disease experience significant challenges when adjusting to wearing entire dentures. Each of these problems presents a considerable challenge for the doctor in terms of prosthodontic rehabilitation. This case study describes how a patient with Parkinson’s disease was able to employ flexible removable partial dentures supported by implants to replace both their full and partial set of missing teeth. A well-made prosthesis will help the patient with their psychological, functional, and aesthetic impairments.Keywords: Parkinson disease, dentistry, implants, jaw relation

Abstract Bell nonlocality refers to correlations between two distant, entangled particles that challenge classical notions of local causality. Beyond its foundational significance, nonlocality is crucial for device-independent technologies like quantum key distribution and randomness generation. Nonlocality quickly deteriorates in the presence of noise, and restoring nonlocal correlations requires additional resources. These often come in the form of many instances of the input state and joint measurements, incurring a significant resource overhead. Here, we experimentally demonstrate that single copies of Bell-local states, incapable of violating any standard Bell inequality, can give rise to nonlocality after being embedded into a quantum network of multiple parties. We subject the initial entangled state to a quantum channel that broadcasts part of the state to two independent receivers and certify the nonlocality in the resulting network by violating a tailored Bell-like inequality. We obtain these results without making any assumptions about the prepared states, the quantum channel, or the validity of quantum theory. Our findings have fundamental implications for nonlocality and enable the practical use of nonlocal correlations in real-world applications, even in scenarios dominated by noise.

Blastocystis spp. is a common intestinal parasite found in humans and various animals, including marine species like fish, bivalves, and sponges. While traditionally considered non-pathogenic, emerging evidence suggests potential foodborne concerns, especially for vulnerable populations. The present systematic review and meta-analysis reviewed four electronic databases (PubMed, Scopus, Google Scholar, and Web of Science) until June 13, 2024, for studies reporting the prevalence and subtypes (STs) distribution of Blastocystis spp. in marine animals, including fish, bivalves, and sponges, to assess foodborne concern and zoonotic importance. In the analysis of 11 studies involving 1329 marine animals from nine countries, five studies/datasets (742 samples) focused on fish, five studies/datasets (567 samples) on bivalves, and one (20 samples) on sponges. This review found that 12.4 % (95 % CI: 4.3–31 %) of marine animals globally were infected by Blastocystis spp., with bivalves showing the highest infection rate at 32 % (95 % CI: 13–59.7 %), exceeding sponges with a single study at 10 % (95 % CI: 2.5–32.4 %), and fish at 4.4 % (95 % CI: 2–9.3 %). Sensitivity analysis assessed changes in weighted prevalence after excluding certain studies. A subgroup analysis of Blastocystis spp. prevalence was conducted based on publication years, countries, continents, WHO regions, and sample sizes. The data collected indicated that marine animals serve as suitable reservoirs for various Blastocystis spp. STs (ST1-ST4, ST7, ST8, ST10, ST14, ST23, ST26, and ST44), with most (except for ST26 and ST44) having the potential for zoonotic transmission. Overall, the findings emphasize the potential for foodborne risk posed by Blastocystis spp. in marine animals and highlight the need for improved monitoring and control measures to ensure food safety.

Sex differences are widespread during neurodevelopment and play a role in neuropsychiatric conditions such as autism, which is more prevalent in males than females. In humans, males have been shown to have larger brain volumes than females with development of the hippocampus and amygdala showing prominent sex differences. Mechanistically, sex steroids and sex chromosomes drive these differences in brain development, which seem to peak during prenatal and pubertal stages. Animal models have played a crucial role in understanding sex differences, but the study of human sex differences requires an experimental model that can recapitulate complex genetic traits. To fill this gap, human induced pluripotent stem cell–derived brain organoids are now being used to study how complex genetic traits influence prenatal brain development. For example, brain organoids from individuals with autism and individuals with X chromosome–linked Rett syndrome and fragile X syndrome have revealed prenatal differences in cell proliferation, a measure of brain volume differences, and excitatory-inhibitory imbalances. Brain organoids have also revealed increased neurogenesis of excitatory neurons due to androgens. However, despite growing interest in using brain organoids, several key challenges remain that affect its validity as a model system. In this review, we discuss how sex steroids and the sex chromosomes each contribute to sex differences in brain development. Then, we examine the role of X chromosome inactivation as a factor that drives sex differences. Finally, we discuss the combined challenges of modeling X chromosome inactivation and limitations of brain organoids that need to be taken into consideration when studying sex differences.

Background: Focus of this study was on subjects suffering from new onset asthma, but actually, they may involve with an infection. Objectives: The target of this study was to determine the frequency of total control of asthma in new onset asthma. Methods: this is a phase 3 randomized clinical trial. The participants were 50 new onset asthma, who feel suffering from respiratory infection, however the physician diagnosis was asthma according to wheezy chest, spirometry and clear chest roentgenogram. Age less than 18 years and pregnant women were excluded. The subjects were randomly divided into two groups, doxycycline hyclate and the placebo arms. The drugs were repacked in similar in shape container. Primary endpoint was time to first recurrence. Secondary endpoints were frequency of total control of asthma, dyspnea, cough, asthma control test (ACT) score, FEV1, FEV1/FVC, eosinophil and neutrophil in blood and sputum. Results: The difference of clinical findings between two groups before the trial were not significant. Ten percent reported acute attack of asthma during last two months. Treatment with Doxycyline revealed significant improvement of clinical findings, asthma attack and ACT score after two months of treatment, however, complete resolution of clinical findings were significantly higher in Doxycyline group compare to placebo. Clinical findings and FEV1 percent predicted in Doxycyline group T2low asthma group showed significant improvement which were not depicted in T2high group. Eighteen months follow up of the subjects showed complete resolution of asthma symptoms in 12 (48%) on Doxycyline group, which was significantly higher than control group (5 (20%). Time to first exacerbation in doxycycline group was 13.6±5.64 months which was significantly longer than control group (7.49±6.95, P=0.002). Time to first exacerbation in CRP positive was significantly longer (13.64±5.35 months) than CRP negative subjects (9.67±7.76 months, P=0.02). Conclusion: Doxycycline is an effective antibiotic for preventing recurrence of asthma, in selected new subjects who suspicious for respiratory infection.

Nomophobia (no-mobile-phone phobia) is the fear and anxiety of being without a mobile phone. This study pioneers the investigation of nomophobia in Afghanistan using the Nomophobia Questionnaire (NMP-Q), addressing a crucial gap in the field. We collected statistical data from 754 undergraduate medical students, comprising men (56.50 %) and women (43.50 %), and analyzed the dimensions of nomophobia. While results revealed that all but two participants were nomophobic, they identified three significant dimensions affecting the level of nomophobia among participants: (a) gender, (b) age, and (c) marital status. The study's contributions are precious, given the peculiarity of Afghan political turmoil, security, and human rights issues, especially for women. For example, the study's data collection was abruptly halted in December 2022 due to the Taliban regime's decision to make it illegal for women to enroll in universities as students. Therefore, while examining the characteristics of nomophobia across societies is imperative, it is also vital to investigate what is true of one society, Afghanistan, at one point in time and space. The study concludes by emphasizing the need to broaden participants' scope in future studies to better understand the prevalence of nomophobia across broader societal contexts and forces.

Background: Following the coronavirus disease 2019 (COVID-19) pandemic, pregnant women are at a higher risk of developing severe COVID-19 disease. This study investigated whether pregnant women should get vaccinated against COVID-19 or not. Pregnant women in comparison with non-pregnant women. Materials and Methods: This study was a systematic review that searched the PubMed, Embase, and Scopus databases using the keywords “COVID-19” OR “SARS-CoV-2” OR “Coronavirus Disease” OR “2019-nCoV” AND “pregnancy “OR “pregnant” AND “vaccine” OR “vaccination” from January 2020 to April 2022. Results: Of the 37 selected studies, 15 (40.50%) declared positive views, 9 (24.30%) had inconclusive views, and 13 (35.20%) opposed vaccination due to a lack of adequate information. Conclusions: Despite the discrepancies among the studies, one-third of the studies suggested that pregnant women be enrolled in clinical trials to investigate the outcomes of the COVID-19 vaccination on maternal and fetal outcomes. However, the majority of the studies recommended maternal immunization against COVID-19.

Evidence suggests that subcortical structures play a role in high-level cognitive functions such as the allocation of spatial attention. While there is abundant evidence in humans for posterior alpha band oscillations being modulated by spatial attention, little is known about how subcortical regions contribute to these oscillatory modulations, particularly under varying conditions of cognitive challenge. In this study, we combined MEG and structural MRI data to investigate the role of subcortical structures in controlling the allocation of attentional resources by employing a cued spatial attention paradigm with varying levels of perceptual load. We asked whether hemispheric lateralization of volumetric measures of the thalamus and basal ganglia predicted the hemispheric modulation of alpha-band power. Lateral asymmetry of the globus pallidus, caudate nucleus, and thalamus predicted attention-related modulations of posterior alpha oscillations. When the perceptual load was applied to the target and the distractor was salient caudate nucleus asymmetry predicted alpha-band modulations. Globus pallidus was predictive of alpha-band modulations when either the target had a high load, or the distractor was salient, but not both. Finally, the asymmetry of the thalamus predicted alpha band modulation when neither component of the task was perceptually demanding. In addition to delivering new insight into the subcortical circuity controlling alpha oscillations with spatial attention, our finding might also have clinical applications. We provide a framework that could be followed for detecting how structural changes in subcortical regions that are associated with neurological disorders can be reflected in the modulation of oscillatory brain activity.

Several years after the initial usage of continuous ambulatory peritoneal dialysis (CAPD), the percentage of patients using this continues to be very low constituting about 15% of all patients with end-stage renal disease (ESRD). In this study, we attempt to define the impact of an educational program for improving the use of CAPD. This is a quasi-experimental study (before-after) conducted with educational materials including workshop, teaching by booklet and showing educational films, performed in Urmia, Iran. We designed a questionnaire for data col-lection and enrolled 160 patients with an aim-based sampling method. We used descriptive sta-tistics and Friedman test for analysis in SPSS software version 11.5. The overall patients′ infor-mation about CAPD defined by total scoring was as follows: 75% had little information; 19% had moderate information and 6% of patients were well informed. All the information levels increased after intervention. Our study suggests that the poor utilization of CAPD is due to relative un-awareness about PD and/or lack of adequate facilities.

Post-transplantation Diabetes Mellitus (PTDM) is a serious complication after organ transplantation, which could lead to cardiovascular morbidity and mortality. The rate of PTDM increased in recent years, probably due to new immunosuppressive drugs such as Tacrolimus. In this study, we retrospectively evaluated the frequency of PTDM and related risk factors in 644 non diabetic patients who underwent renal transplantation. Data was analyzed by chi-square and Fisher′s exact test in SPSS software ver11.5. Among 644 patients PTDM developed in 10.2% similar to literature. PTDM was significantly correlated to age (P value = 0.000), positive familial history (P= 0.003) and HBV infection (P= 0.046). In conclusion, PTDM is not uncommon in Iranian patients and a positive family history of diabetes, HBV infection and older age increases the likelihood to develop PTDM.

There are several ways of performing vesico-ureteral anastomosis in kidney trans-plantation (Tx); they are broadly classified into two categories: extra-vesical and intra-vesical. Extra-vesical methods are preferred in kidney transplantation. In this study, we attempt to integ-rate two extra-vesical techniques of Barry and Taguchi and to evaluate the frequency of occu-rrence of vesico-ureteral reflux (VUR) with this technique. Also, an attempt is made to compare the results with other techniques reported in the literature. Fifty consecutive transplant recipients, who underwent uretero-neo-cystostomy (uretero-vesical anastomosis) by the new technique of Barry-Taguchi were evaluated for VUR by sonography and cystoureterography, six months after Tx. The mean age of the study subjects was 34.8 years; there were 33 males and 17 females. The mean time between Tx and evaluating for VUR was 6.6 months. Two cases of asymptomatic VUR (4%) were detected at the end of the study period. The occurrence of 4% asymptomatic VUR suggests that this technique is more acceptable compared to others. Because of the simple nature of the procedure as well as the short time required, this technique could be a suitable choice in kidney transplantation.

Background and aims: Diabetes is a common non-communicable and metabolic disease, and its prevalence is predicted to double by 2045. It is also a significant risk factor for cardiovascular complications and mortality. The study investigated the association between egg consumption and the prevalence of type 2 diabetes (T2D) in a cohort of Iranian adults. Methods: This study compared 261 cases of T2D with 261 controls matched for age and features and assessed their dietary intake using a food frequency questionnaire. The inclusion criterion involved the absence of concurrent chronic diseases apart from T2D. Results: Based on the results, the participants’ average age was 53.32 years, with a slightly higher proportion of females in both groups. Logistic regression analysis revealed that increased consumption of eggs is associated with a diminished risk of developing T2D (P=0.01). Conclusion: The study suggests that egg consumption may have beneficial effects on glucose metabolism and insulin sensitivity, and regional and genetic differences may influence the relationship between egg consumption and T2D. It calls for further longitudinal and interventional studies to confirm the findings.

Abstract Background Since evaluating sleep quality among students is of great importance and is one of the challenges facing the health field regarding this group, we were determined to conduct this study to evaluate the psychometric properties of the Sleep Quality Questionnaire (SQQ) among the medical students at the Guilan University of Medical Sciences. Methods This research was conducted as a cross-sectional study. In the procedure, a random group of medical students at Guilan University of Medical Sciences were provided with questionnaires and the study’s pre-prepared checklist and were asked to answer them accurately. The questionnaires used in this study include the Sleep Quality Questionnaire (SQQ), and the Pittsburgh Sleep Quality Index (PSQI). After collecting the entries, all the data were subjected to a statistical analysis using the SPSS software. Results In this study, 249 medical students with an average age of 23.88 ± 2.46 were evaluated, of which 140 (56.2%) were female and the rest were male. According to the results, the average sleep quality for SQQ was 19.31 ± 8.06, and the Pittsburgh Sleep Quality Index (PSQI) was 7.95 ± 3.76. Based on the results obtained from the exploratory analysis, it was determined that no high overlap exists between the two evaluated factors in the sleep quality questionnaires, confirming their divergent validity. In evaluating the convergent validity, the correlation between the SQQ and PSQI questionnaires was reported as 0.642, which was significant (p

Objective(s): In the present study, we evaluated the effect of a nanofibrous scaffold including polycaprolactone (PCL), chitosan (CHT), and bentonite nanoparticles (Ben-NPS) on wound healing in order to introduce a novel dressing for burn wounds. Materials and Methods: PCL, PCL/CHT, and PCL/CHT/Ben-NPS nanofibrous scaffolds were fabricated by the electrospinning technique. Their structural and physiochemical characteristics were investigated by Fourier-transform infrared spectroscopy (FTIR) analysis, scanning electron microscopy (SEM), tensile strength, water contact angle, as well as, swelling and degradation profiles test. The disc diffusion assay was carried out to investigate the antibacterial potential of the scaffolds. In addition, the cell viability and proliferation ability of human dermal fibroblasts (HDFs) on the scaffolds were assessed using MTT assay as well as SEM imaging. The wound-healing property of the nanofibrous scaffolds was evaluated by histopathological investigations during 3,7, and 14 days in a rat model of burn wounds. Results: SEM showed that all scaffolds had three-dimensional, beadles-integrated structures. Adding Ben-NPS into the PCL/CHT polymeric composite significantly enhanced the mechanical, swelling, and antibacterial properties. HDFs had the most cell viability and proliferation values on the PCL/CHT/Ben-NPS scaffold. Histopathological evaluation in the rat model revealed that dressing animal wounds with the PCL/CHT/Ben-NPS scaffold promotes wound healing. Conclusion: The PCL/CHT/Ben-NPS scaffold has promising regenerative properties for accelerating skin wound healing.

Background and purpose: Scholarship is an integral aspect of academia, educational scholarship is the kind of outstanding scientific activity and innovation in the fields of discovery, education, application of original research results, and integration of information obtained from different components of a field or different scientific fields. The identification of the strategies for the development of educational research in the faculty members of the universities can provide a suitable background for the excellence and growth of the medical universities, considering that in the search made in the sources, there are evidences of monitoring the presentation of the solutions. And we did not find the challenges of developing educational research, this study was conducted to investigate and analyze the challenges and solutions of developing educational research from the perspective of the academic staff of Mazandaran University of Medical Sciences. Materials and methods: The current research was a qualitative and content analysis type of research. The samples of this study were selected purposefully. The samples included academic faculty members who have innovative educational processes and academic faculty members who participated in scholarship workshops and developed innovative educational processes but did not develop a process. The collection of information continued until the collected data was a repetition of the previous data so that no new information was found and data saturation took place. For data collection, semi-structured interview with a focused group discussion method were used, and for data analysis, the conventional content analysis method was used. Results: After merging the codes extracted from two focus group discussion sessions and repeated revisions, 75 codes were finally identified. Then, these codes were classified into 14 categories, which include educational leadership and management, inappropriate policies, empowerment, financial resources, material and spiritual support, information resources, supportive educational environment, group and teamwork, publishing results, creating a culture of innovation, and identifying needs. Education, change management, mentoring, and interdisciplinary convergence. Finally, the first 6 categories below were placed under the theme of challenges and the other 8 categories were placed under the theme of solutions. Conclusion: The results of this study showed that from the point of view of university faculty members, the most important challenges in the development of educational scholarship are the difficulty of developing educational processes, the high score of research activities compared to research activities, the alienation of academic staff members from research and educational processes, and the most important solutions for the development of scholarship; The promotion of interprofessional cooperation for the formulation of educational processes, the use of change management for the development of scholarship activities, the development of group activities for Scholarship activities in educational groups.

Natural resources such as land and mountains and seas are one of the God-given riches of societies protect and utilize it is one of the major tasks of governments. One of the most important natural resources is national land; it may be forest or grassland or desert. It is extremely important to distinguish national lands that belong to all people from agricultural lands that belong to a private owner. The that law gives the rangers the right to identify these two types of lands based on certain legal rules and criteria. Since there is always the possibility of rangers mistake in this diagnosis, in case of objection of the interested party, special legal authorities to deal with the objection and invalidation of ranger theory are provided in the law, which in some cases a special commission and in some other cases It is legal. In addition, according to the general principles of law, such as the principle of compensation for all illegitimate damages, and also according to the jurisprudential rule, it should be said that if the warlord has committed a mistake in identifying lands, the owner of the land, who has already suffered damage due to this misdiagnosis, can file a lawsuit against the warlord in the General Court of Legal Law in accordance with the general rules of civil liability and claim the damages.

Background: The aim of this cross-sectional study was to investigate the prevalence of sleep disturbance and its possible associated factors among Iranian medical students. Additionally, a national meta-analysis was conducted to provide a comprehensive overview of sleep disturbance in this population. Methods: A sample of medical students from Guilan University of Medical Sciences, Iran was included in the study. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep disturbance. Demographic and lifestyle factors, as well as academic performance, were collected through a self-administered questionnaire. The data collected from this study were combined with existing studies through a meta-analysis to estimate the overall prevalence of sleep disturbance among Iranian medical students using the random effects model. Results: A total of 249 medical students participated in the study. The prevalence of sleep disturbance among Guilan University of Medical Sciences medical students was found to be 71.1%. A significant difference was observed in total PSQI means regarding medical students’ residency (p