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Background: The emergence of COVID-19 caused significant changes in the lifestyle of older adults and developed psychological disorders such as anxiety. This study aims to evaluate the relationship between anxiety caused by COVID-19 and changes in the lifestyle behaviors of older adults in Iran. Materials and Methods: This descriptive-correlational study with a cross-sectional design was conducted on 265 older adults covered by the comprehensive health service centers in Zanjan, Iran in 2022. They were selected using a convenience sampling method from among randomly selected comprehensive health centers. Data was collected using a demographic form, Bernardo’s coronavirus pandemic anxiety scale, and Kumari’s lifestyle-related behavior change scale. Descriptive statistics (frequency, percentage, Mean±SD) were used to describe the data. Pearson’s correlation test was utilized to examine the relationship between the study variables in SPSS software, version 16. Results: All participants had severe anxiety (Mean total score: 22.23+3.47). The mean score for the non-somatic symptoms of anxiety (11.55+2.34) was higher than that of somatic symptoms (10.67+1.94). The mean score of changes in lifestyle behaviors indicated the occurrence of more unfavorable changes (-2.38±7.13). A negative and significant correlation was found between COVID-19-related anxiety and lifestyle behavior changes among older adults (P

Abstract In recent years, biologists and clinicians have witnessed prominent advances in in vitro 3D culture techniques related to biomimetic human/animal tissue analogs. Numerous data have confirmed that unicellular and multicellular (tumoroids) tumor spheroids with dense native cells in certain matrices are sensitive and valid analytical tools for drug screening, cancer cell dynamic growth, behavior, etc. in laboratory settings. Angiogenesis/vascularization is a very critical biological phenomenon to support oxygen and nutrients to tumor cells within the deep layer of solid masses. It has been shown that endothelial cell (EC)-incorporated or -free spheroid/tumoroid systems provide a relatively reliable biological platform for monitoring the formation of nascent blood vessels in micron/micrometer scales. Besides, the paracrine angiogenic activity of cells within the spheroid/tumoroid systems can be monitored after being treated with different therapeutic approaches. Here, we aimed to collect recent advances and findings related to the monitoring of cancer angiogenesis using unicellular and multicellular tumor spheroids. Vascularized spheroids/tumoroids can help us in the elucidation of mechanisms related to cancer formation, development, and metastasis by monitoring the main influencing factors.

Abstract Background Waist circumference (WC), or waist-to-hip ratio (WHR), potentially offers a more accurate reflection of intra-abdominal fat accumulation and could serve as a superior predictor of type 2 diabetes mellitus (T2DM) risk compared to BMI. The current study investigated the relationship between WHR and its influencing factors among diabetes patients enrolled in the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan Cohort study (PGCS). Method In this cross-sectional study of 10,520 participants, 2,531 had T2DM. Waist and hip circumference, body mass index (BMI), underlying diseases, and demographical data of participants were recorded. Also, fasting blood sugar (FBS), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides (TG) were assessed. All data was analyzed using SPSS version 16; the significant level was

Abstract Background The wounded healer concept refers to healthcare providers who, in the past, have had similar experiences to those of their clients and now draw on these challenging experiences to assist their clients. This study explored the positive traits of nurses with chronic cardiovascular diseases who transitioned to wounded healers. Methods A qualitative content analysis study was conducted within hospitals in Tehran, Iran, between November 2023 and March 2024. Sampling was conducted using a purposive sampling method in accordance with the study objectives and inclusion criteria. The data were collected through semi-structured face-to-face interviews. Twenty-three participants, comprising 16 females and 7 males, participated in the interviews. Data analysis was conducted by employing a qualitative content analysis approach, including creating codes, subcategories, generic categories, and main categories. MAXQDA v20 software was utilized to facilitate the analysis process. Results The data analysis revealed one main category that aligned with the research question: the positive traits of a wounded healer nurse, consisting of three generic categories: (1) traits related to interpersonal and professional relationships; (2) traits related to the professional dimension; and (3) traits related to the personal dimension. wounded healer nurses demonstrate positive traits that enhance patient care. Conclusions The findings of this study have important implications for nursing practice and education. By identifying the positive traits exhibited by nurses as wounded healers affected by chronic cardiovascular diseases, nursing programs can emphasize and strengthen these qualities to convert challenges into opportunities and bridge the theory-practice gap.

Objectives This study explores the factors leading to decreased professional commitment among nurses and proposes actionable solutions to mitigate the challenges posed by this phenomenon in nursing. Methods This research was conducted by employing the scoping review methodology. To this end, the relevant studies were obtained by two researchers independently searching over Scopus, Medline (via PubMed), Proquest, SID, Magiran, and Web of Science databases. The extracted data from the primary studies were organized into a table, including author names, publication year, study population, study objectives, study methodology, and key findings. Results Based on the primary research question, seven main themes contributing to the decline in professional commitment to nursing were determined as follows: professional and organizational challenges, human relations, personal wellbeing and coping, work–life balance and success, organizational culture, the nature of the nursing profession and beliefs, human emotions, values, and ethics. Also, the secondary question of the research was responded to by identifying four main themes: (1) empowering nurses, (2) nursing leadership and support, (3) safety concerns and interactions with patients, and (4) welfare facilities. Conclusion The findings of this study highlight the necessity of implementing nurse empowerment programs and providing financial and moral support from the organization and nursing leaders to enhance professional commitment to nursing.

Abstract Aim To examine the correlation between moral courage and caregiving behaviour among nurses who are employed in the COVID‐19 ward in Iran. Design This study is a descriptive‐correlational and cross‐sectional research conducted in 2021 in the city of Tehran, Iran. Methods A total of 270 nurses employed in COVID‐19 wards, who had been working in these wards for at least 1 month, were recruited from XXX hospitals and XXX Hospital. Data collection was conducted from September to November 2021. The data collection tools included a demographic information form, the Caring Dimension Inventory (CDI‐25), and the Professional Moral Courage Scale (PMC). The designed questionnaire links were provided to the participants virtually through the Persian platform ‘Pars Line’ and via WhatsApp. Descriptive statistics and inferential statistics were used to examine the relationship between moral courage and care behaviour. Results There was a significant difference in the mean of caring behaviour between the age groups (40 years old), and the work experience groups (15 years) (p 10 years) (p > 0.05). The level of moral courage among the nurses was higher than the median score of the instrument (87.31 ± 10.37). Among the dimensions of moral courage, the highest score was related to the dimension of ethical factors (17.64 ± 2.64), and the lowest score was related to the dimension of multiple values (17.26 ± 2.78). The level of caring behaviours among the nurses was lower than the median score of the instrument (46.11 ± 10.84). Among the dimensions of caring behaviours, the highest score was related to physical‐technical behaviours (19.22 ± 5.27), and the lowest score was related to professional behaviours (1.35 ± 0.67). Based on the analysis, moral courage had a weak and inverse correlation with caring behaviours among nurses. The higher moral courage does not necessarily result in improved caregiving behaviours, emphasizing the need for further research to explore and address this relationship. Patient No Patient or Public Contribution.

Abstract In recent decades, emerging data have highlighted the critical role of extracellular vesicles (EVs), especially (exosomes) Exos, in the progression and development of several cancer types. These nano-sized vesicles are released by different cell lineages within the cancer niche and maintain a suitable platform for the interchange of various signaling molecules in a paracrine manner. Based on several studies, Exos can transfer oncogenic factors to other cells, and alter the activity of immune cells, and tumor microenvironment, leading to the expansion of tumor cells and metastasis to the remote sites. It has been indicated that the cell-to-cell crosstalk is so complicated and a wide array of factors are involved in this process. How and by which mechanisms Exos can regulate the behavior of tumor cells and non-cancer cells is at the center of debate. Here, we scrutinize the molecular mechanisms involved in the oncogenic behavior of Exos released by different cell lineages of tumor parenchyma. Besides, tumoricidal properties of Exos from various stem cell (SC) types are discussed in detail.

Background: While dishonesty is considered unethical, its occurrence within the healthcare system is not rare; therefore, addressing and controlling this behavior requires targeted interventions to address its root causes. This study investigates the encounters of patients with COVID-19, their families, and healthcare workers with white lies during the COVID-19 pandemic in Iran. Materials and Methods: In this qualitative study, we employed a content analysis approach. Semi-structured interviews were conducted with 50 participants, including healthcare workers, individuals diagnosed with COVID-19, and their families. The research was carried out at teaching hospitals affiliated with the Tehran University of Medical Sciences in 2020. For data analysis, the methodology proposed by Graneheim and Lundman was used. In addition, the management and analysis of data were facilitated through MAXQDA software, version 12. Results: This study included 23 female and 27 male participants, with a mean age of 35±6.3 years. Through data analysis, a total of 3201 codes were identified and subsequently organized into 5 main categories as follows: social stigma, media inconsistencies, fear and uncertainty, negligence, and breaking free from quarantine. These categories further branched into 11 sub-categories. Conclusion: Employing white lies as a means to sidestep social stigma and discrimination, along with grappling with fear and xenophobia, emerged as prevalent experiences. The articulation of transparent and truthful information at the community level plays a crucial role in priming public perceptions to acknowledge factual circumstances. To achieve this, healthcare authorities and the media bear the responsibility of disseminating coherent and honest information, thereby mitigating and managing the proliferation of rumors within the community amidst the ongoing pandemic.

BackgroundThe diagnosis and treatment of gastrointestinal cancer not only impose significant physical challenges but also deeply affect patients emotionally and psychologically, significantly influencing their overall quality of life. Among the various factors that can positively impact life satisfaction in individuals facing gastrointestinal cancer, spirituality emerges as a crucial aspect. This study aimed to determine the effect of a spiritual intervention on life satisfaction in patients with gastrointestinal cancer.MethodsThis quasi-experimental study was conducted with two groups of 85 gastrointestinal cancer patients from two major hospitals in Tehran. The intervention group received spiritual support through social media for six sessions over three weeks to learn how to effectively improve their spiritual state. The control group received routine medical visits and care. The Satisfaction with Life Scale (SWLS) was used before and after the spiritual support in both the intervention and control groups. The research was approved by the institutional ethics committee.ResultsIn the pre-test stage, there was no significant difference in average life satisfaction between the intervention and control groups (t = 1.887, d = 0.30, p > 0.05). However, positive changes occurred in the post-test stage. Notably, the disparity in average life satisfaction between the intervention and control groups was significant in the post-test stage (t = 13.118, d = 0.95, p 0.05).ConclusionThe results can guide health care providers in dealing with the problems of cancer patients. Assessing patients’ spiritual needs and empowering them to promote their spiritual recovery and find meaning in their suffering can lead to improved quality of life and satisfaction with holistic care.

Purpose: CMS hybrid seed production systems are employed effectively for onion. Cytoplasmic male sterility (CMS) has long been used to economically produce hybrids that harness growth vigor through heterosis. Three types of onion CMS (CMS-S, CMS-R, and CMS-T) have been used in hybrid onion breeding. Findings: The sources of onion CMS, their maintainer plants and fertility restorer lines can be distinguished by markers, saving times spent on crop establishment and avoiding the complex of phenotypic screening. Numerous molecular markers especially PCR markers associated with male-sterile (CMS-S and CMS-T) cytoplasms, male-fertile normal (N) cytoplasm and nuclear-male- fertility restorers (Ms locus) were developed. These simple PCR markers are valuable tools for the marker-assisted selection of segregating individuals in onion F1 hybrid breeding programs. The present review reveals practical utility and functional effectiveness in the MAS of male-sterile cytoplasm types with nuclear-fertility-restorer locus. Limitations: the environment effect especially temperature may cause male-sterility instability and deviations in segregation ratios for male sterility. Also, maximum exploitation of molecular markers linked to Ms/ms and CMS-S, -T genes aid in the recovery of male-sterile traits requires to a perfect linkage disequilibrium that must be investigated further. Directions for future research: Furthermore, this information could highly have paved the way for hybrid onion development by applicating of the molecular findings to identify onion male sterility, maintainer and male fertility restorer lines.

The present work deals with the hot deformation behavior of selective laser melted 316L stainless steel with an emphasize on the involved recrystallization mechanisms. Toward this end, a series of hot compression test have been conducted in the temperature range of 700–1000 °C under the various strain rates of 0.001, 0.01 and 0.1s−1. The flow pattern analysis through Jonas-Poliak method verifies the occurrence of dynamic recrystallization in whole investigated temperature range. The intensified substructure development and continuous recrystallization is identified as the main softening mechanism in the course of thermomechanical processing. This causes appearance of a broad peak and low softening fraction in corresponding flow curves. The cellular substructure in the as-printed state facilitates low-angle into high-angle boundaries conversion, which provide a proper condition for the occurrence of continuous mechanisms and increases the rate of recrystallization. However, detailed investigation of the sub-boundary maps indicates the contribution of discontinuous and geometric dynamic recrystallization mechanisms. Dynamic recrystallization causes substantial refinement; and the percentage of the grain holding size lower than 10 μm increases from 2 % in printed microstructure to 16.8 % and 24 % in the microstructure deformed at 700 and 1000 °C.

Introduction Disease uncertainty refers to the inability to assign meaning to events related to the illness. Uncertainty of the disease can affect various aspects of human life such as psychological aspects. Objectives This study aims to examine the relationship between disease uncertainty and perceived stress in COVID-19 patients. Methods An analytical cross-sectional study was conducted on 212 hospitalized COVID-19 patients who were initially admitted to the intensive care units (ICUs) and later transferred to general wards within the same hospitals. Three instruments were utilized to collect data for this study. The Demographic Information Questionnaire, Mishel Uncertainty in Illness Scale (MUIS) for disease uncertainty, and Perceived Stress Questionnaire. For data analysis, both descriptive and inferential statistics were employed using IBM SPSS Statistics version 25. Results The Pearson correlation coefficient matrix results showed a positive and significant relationship between uncertainty about the illness ( P

Introduction. This study aimed to identify, assess, and isolate strong lactobacilli demonstrating broad antibacterial and anti-biofilm activity against drug-resistant strains of Acinetobacter baumannii. Additionally, the mechanism of inhibition of these organisms was to be determined. Methods. Over a 6-month period (from December 2021 to June 2022), 53 clinical A. baumannii strains were collected from clinical samples. Twenty probiotic strains were isolated from local dairy products. Antibacterial activity of Lactobacillus strains’ cell-free supernatant (CFS) was identified using the agar well diffusion method and the microbroth dilution test. Anti-biofilm effect was performed by the microtiter plate assay. The MTT assay was also used to look into the probiotics’ cytotoxic effects on the L929 fibroblast cell line. Results. During the 6-month period, 53 clinical A. baumannii strains were obtained and identified. Out of 20 lactobacillus strains, the CFS of a lactobacillus strain (named L9) showed an inhibitory effect against all A. baumannii strains. Using the broth microdilution method, it was shown that the minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of CFS extracts of L9 strains against A. baumannii strains were both ¼ mg/mL. The result of the anti-biofilm showed that the selected probiotic could inhibit biofilm formation. The most common organic acid produced by all Lactobacillus strains, according to the HPLC method, was lactic acid, which was followed by acetic acid. The L929 fibroblast cell line was used in the cytotoxicity assay, which revealed that 100% of the cells in the L929 fibroblast cell line survived treatment with successive doses of CFSs for a full day. Conclusion. The probiotic strain isolated from local yogurt in this study showed potential anti-biofilm and antimicrobial properties against all drug-resistant Acinetobacter isolates. Given the increasing interest in probiotic microorganisms based on their high health benefits, further studies are recommended on the mechanisms of action between probiotics and A. baumannii strains to find new solutions for biological control and treatment of these infections without the use of antibiotics.

Introduction: Recent developments in echocardiography made assessing pulmonary arterial hypertension (PAH) in the heart, a suitable choice. This study aimed to investigate the association of myocardial right ventricular relaxation time and systolic pulmonary artery pressure (SPAP) in PAH patients.Materials and Methods: The present study evaluated 74 patients with PAH (n=49) and age- and sex-matched healthy controls (n=25). All patients underwent transthoracic echocardiography. We evaluated the right ventricular (RV) function's echocardiographic parameters, including IVRT, IVCT, S, E, A, S’, E’, A’, ET, DT, TAPSE, FAC, and SPAP.Results: We found no significant differences in age and gender between the two studied groups (p>0.05). However, we observed a significant difference in IVRT, IVCT, E’, A’ (p=0.004), A, S’, DT, TAPSE, FAC and SPSP (p0.05).Conclusion: Our findings revealed that IVRT and IVCT might not be affected by the SPAP and, therefore, could be used in the assessment of right ventricular function in patients with PAH.

Introduction Nurses who are at the forefront of the fight against Covid-19 have faced problems such as anxiety and stress due to the high contagiousness of this disease and the challenges of providing services to infected patients. Death anxiety and the resulting fear following the Covid-19 pandemic can affect caring behaviors and the quality of nursing care services. Objective The present study was conducted with the aim of determining the association between caring behaviors and death anxiety among Iranian nurses working in COVID-19 wards. Methods This cross-sectional study was conducted in 2021 in Tehran. The participants consisted of 233 nurses who were purposively selected from university hospitals in Iran. Data collection tools included Demographic Information Form, Death Anxiety Scale, and Caring Dimension Inventory (CDI-25). Data analysis was done using SPSS (version 16). Results Most of the participants were female (79.4%), had less than 5 years of work experience (50.6%), and had bachelor's degree (88.8%). Based on the results, the level of death anxiety among nurses was moderate (7.05 ± 3.85) and their caring behavior was at optimal level (103.03 ± 13.15). Among the subscales of caring behavior, physical-technical behaviors with mean of 46.43 ± 6.20 got the highest score, and unnecessary behaviors with mean of 4.39 ± 0.73 got the lowest score compared to other subscales. Based on data analysis findings, caring behavior and its dimensions had no significant correlation with nurses’ death anxiety ( p = 0.111). Conclusions Our results showed that despite having a moderate level of anxiety, nurses try to provide good care behaviors to patients with covid-19. However, reducing nurses’ anxiety can improve caring behaviors.

Abstract Introduction A novel metabolomics survey proposed lactic acid as a diagnostic biomarker to detect ectopic pregnancy (EP). Here we investigate the plasma level of lactate for early diagnosis of EP as a potential biomarker. Methods In a case‐control study, the reproductive aged women with definite tubal EP (6–10 weeks' gestation), referred to our department during 2021–2022, considered as case group, and women with normal singleton pregnancy in the same gestational age as control group. After informed concept, demographic data (maternal and gestational age and parity) recorded and 5 mL venous blood samples were taken to detect the lactate plasma level. The data analyzed using SPSS software ver22. Results Finally, 95 participations (50 in case and 45 in control group) enrolled. The clinical results showed that the most of case group were aged more than 35 years old with had higher parity and body mass index, but, no statistically significant difference showed up. On the other hand, although the lactate level was slightly higher in women with EP, but, the plasma lactate level did not statistically differ between the two study groups. Also, the logistic regression showed no relationship between the demographic variables and the lactate plasma level. Conclusion It seems that the plasma level of lactate cannot be a diagnostic biomarker for EP.

Background: An issue that hinders researchers’ access to Natural Killer (NK) cells is their low proportion in peripheral blood leukocytes. This issue is currently addressed by methods involving a series of differentiation and expansions that are time-consuming and expensive.Objective: We have investigated whether the used leukocyte reduction filters, a by-product in the blood transfusion practice that currently is considered waste, can be utilized as a source of the NK cells.Methods: Following the blood donation of 46 donors based on the Iranian Blood Transfusion Organization’s protocols, a sample of peripheral blood of each donor and the leukocyte reduction filter used in their donation procedure have been obtained. The entrapped cells were flushed back from the leukocyte reduction filters. Both groups of samples were analyzed using an automatic hematological analyzer. NK cell isolation was done by the MACS negative selection method. The samples have been comparatively analyzed utilizing flow cytometry data of NK cells’ subpopulation compositions, viability, degranulation patterns, and cytotoxic capacity against the K562 cell line.Results: Every major leukocyte population was abundant in the samples extracted from the used leukocyte reduction filters. The NK cells extracted from leukocyte reduction filters did not show any statistically meaningful differences (P

Abstract Generalisation of one‐dimensional dictionary learning (1DDL) algorithms to Multidimensional (MD) mode and its utilisation in MD data applications, increases the speed and reduces the computational complexity. An example of such an application is 3D inverse synthetic aperture radar (ISAR) image reconstruction and noise reduction. In this study, in addition to MD mode generalisation, the formulation structure of the multidimensional dictionary learning (MDDL) problem is discussed followed by two novel algorithms to solve it. The first one is based on the K‐singular value decomposition algorithm for 1DDL, which uses alternating minimisation and singular value decomposition. The second algorithm is the extension of the sequential generalisation of K‐means 1DDL algorithm to the MD mode. Moreover, the MD tensor denoising method based on the MDDL algorithm (MDDL‐ALG) is proposed. As an application, the proposed method is used to denoise the 3D ISAR image. The numerical simulations reveal that the proposed methods, in addition to reducing the memory consumption and the computational complexity, also enjoy higher convergence rate in comparison to 1D algorithms. Specifically, convergence speed of MD algorithms, depending on the training data size, is up to at least 10 times faster than the equivalent 1D counterparts. As revealed through the simulations, the amount of signal to noise ratio recovered by the proposed methods is almost 2 dB higher than the case using a pre‐designed dictionary for denoising. Moreover, it outperforms about 10 dB over the case with the conventional 3D‐IFFT method for image construction.

Objective: To design and conduct the effectiveness of Ketamine vs Dexmedetomidine in children’s sedation atemergency department (ED).Methods: This randomized clinical trial study was carried out at the two trauma centers in Mashhad, Iran. Thepatients were divided into two groups by means of a random numbers table to be treated with Ketamine (N=20)or Dexmedetomidine (N=20). Their demographic information and sedation times of drugs were collected andanalyzed.Results: In general, sedation time was significantly higher in the ketamine group, 14.35 minutes (IQR:9.82-19) than in the dexmedetomidine group, 9.7 minutes (8.35-14.23) (p=0.023). Time of injection to completeanesthesia was 45.25 (IQR:30-58) and 72 (IQR:60.25-82) minutes in ketamine and dexmedetomidine groups,respectively (p

Abstract Pathogenic variants in the EPS8 gene result in nonsyndromic hearing loss. This gene encodes the EPS8 protein in cochlear inner hair cells and performs critical roles in stimulating actin polymerization and bundling. Thus far, only four pathogenic variations in EPS8 have been described. In this study, we report the fifth pathogenic variant in the EPS8 gene in an Iranian patient with DFNB102. Furthermore, we review literature cases with EPS8 mutations.

Background: Nurses may be threatened with professional moral courage while providing care to patients with Covid-19. The present study aimed to evaluate the professional moral courage of nurses caring for patients with Covid-19. Methods: This study was a cross-sectional study. In this study, 200 nurses working in COVID wards participated by convenience sampling method. Data collection tools were personal profile forms and valid and reliable tool of professional moral courage. Data were analyzed using descriptive statistics and inferential statistics (ANOVA And T-TEST) under SPSS software version 16. Results: The overall score of nurses' professional moral courage was 56.25±7.02. Other findings of the study indicated that among the personal characteristics of nurses, professional moral courage and organizational position (P = 0.005) and nursing work experience in the COVID ward (P = 0.003) had a statistically significant relationship. Conclusion: Considering the average state of moral courage and the fact that the average score of supervisors is lower than that of nurses, it is obligatory for nursing managers to plan for the promotion of professional moral courage of nurses to face future crises. The most important of these actions can be holding educational workshops with ethical themes for nurses and students so that they can obtain professional moral courage in their profession in more desirable way.

Background: Nurses who care for patients with coronavirus disease 2019 (COVID-19) face challenges in providing care for these patients. This study aimed to explain the nurses’ perception of challenges in caring for patients with COVID-19.Methods: This study was carried out using the content analysis method in 2020. In this study, 28 nurses were selected via purposive sampling. Individual and semi-structured interviews were conducted to collect the data. Data collection continued until data saturation. Content analysis was used to categorize the data and the method proposed by Elo and Kyngäs was also applied to analyze the data.Results: Nurses’ challenges were classified into three categories including organizational problems, defective communication process, and psychosocial challenges. The first category was divided into two subcategories including shortage of nurses and lack of personal protective equipment. The second category included two subcategories of defective communication with colleagues and defective communication with the patients and their families. Moreover, the third category was classified into two subcategories including psychological distress and sociocultural challenges.Conclusion: To address the challenges of nurses in caring for patients with COVID-19, the shortage of nurses should be eliminated. Nurses need to participate in comprehensive communication skills training courses. Furthermore, it is necessary to develop educational programs and present them to the public based on the cultural context of the society.

Abstract By generalising dictionary learning (DL) algorithms to multidimensional (MD) mode and using them in applications where signals are inherently multidimensional, such as in three‐dimensional (3D) inverse synthetic aperture radar (ISAR) imaging, it is possible to achieve much higher speed and less computational complexity. In this study, the formulation of the multidimensional dictionary learning (MDDL) problem is expressed and two algorithms are proposed to solve it. The first one is based on the method of optimum directions (MOD) algorithm for 1D dictionary learning (1DDL), which uses alternating minimisation and gradient projection approach. As the MDDL problem is non‐convex, the second algorithm approximates the non‐convex objective with a new jointly convex function and efficiently solves it. As an application, we use the proposed methods to restore and denoise the ISAR image. Numerical experiments highlight that the proposed algorithms, in addition to reducing the computational complexity and the amount of required memory, also entail less training data for learning the dictionary, and enjoy higher convergence speed in comparison to their one‐dimensional (1D) counterparts. Specifically, convergence speed of MD algorithms, depending on the size of the training data, is up to at least 10.7 times faster than the equivalent 1DDL algorithm. According to the simulation results, the SNR value achieved by the proposed algorithms is higher than the case where we use the 3D‐IFFT for image reconstruction and the case of fixed dictionaries, by approximately 12 and 4 dB, respectively.

Abstract Background The mission of medical schools is a sustainable commitment to orient education, research, and services based on the priorities and expectations of society. The most common complaints of patients from comprehensive health service centers (CHSCs) based on the data from electronic health records were assessed in order to determine primary health care (PHC) priorities for the educational planning of medical students in Iran. Methods A population-based national study was designed to assess clinical complaints of patients in all age groups who were referred to CHSCs at least once to be visited by physicians. All the data in the census were extracted from electronic health records in PHC system during 2015–2020, classified by the International Classification of Primary Care 2nd edition (ICPC-2e-English), and statistically analyzed. The total number of complaints that were recorded in the system was 17,430,139. Results 59% of the referring patients were women. The highest number of referrals was related to the age group of 18–59 years (56.9%), while the lowest belonged to the elderly people (13.3%). In all age and sex groups, the first ten complaints of patients with three top priorities in each category included process (follow-up, consultation, and results exam), digestive (toothache and gum complaint, abdominal pain, and diarrhea), respiratory (cough, sore throat, and runny nose), general (fever, pain, and weakness and fatigue), musculoskeletal (back pain, leg complaint, and knee injuries), endocrine and nutritional (weight gain, Feeding problem, and weight loss), cardiovascular (hypertension, palpitations, and Postural hypotension), neurological (headache, dizziness, and paralysis), sexual dysfunction (vaginal complaint, discharge, and irregular menstruation), and dermatological (pruritus, rash, and inflammation) problems. Conclusion High priorities in referring to PHC had a key role in assessing the country's health needs. Since this study was in line with the national pattern of complaints and patients' profile, the present findings can be helpful to amend policy-making, educational planning and curricula development in medical schools.

Objective: To investigate the relationship between salivary amylase level and computed tomoraphy (CT scan) findings in patients with isolated mild traumatic Brain Injury (mTBI) referred to the emergency department of Shahid Hasheminejad Hospital. Methods: Patients with isolated mTBI and indication for brain CT scan who referred to the trauma center of Shahid Hasheminejad Hospital, Mashhad, Iran in 2019 were included in a cross-sectional study. In the initial examination, the patient’s level of consciousness was measured using the Glasgow Coma Scale (GCS), and saliva samples were taken at the emergency department to determine the level of salivary amylase. A brain CT scan was performed for all patients. Age, gender, cause of trauma, the trauma severity and CT scan results were recorded. Statistical analysis was performed on the data. Results: One-hundred fifty patients were enrolled in this study (men=101, women=49). The trauma causes were included accidents (n=88; 58%), falls (n=37; 25%) and miscellaneous factors (e.g., quarrels; n=25; 17%). GCS was 15 in 142 patients and 14 in the rest. In all patients, the trauma severity was mild to high risk (Minor). CT scan results unfolded pathology in 10 cases (7%), while the residues (93%) had normal CT scans with no pathological evidence. Salivary amylase level in the patients’ saliva samples was between 137 to 8000 units per liter. Using the t-test to evaluate the relationship between salivary amylase levels and CT scan results uncovered a significant relationship. Spearman correlation revealed no significant relationship between the amylase and GCS levels. Conclusion: Data statistical analysis from 150 patients with isolated head trauma manifested that salivary amylase levels were significantly higher in the patients with pathological findings on CT scans. However, no significant relationship was found between salivary amylase level and age, gender, cause of trauma, and level of consciousness.

Background and purpose: Complementary medicine plays a major role in treatment of infertility. The aim of this study was to evaluate the effect of royal jelly on sperm parameters and testosterone levels in infertile men. Materials and methods: In this quasi-experimental study, 100 infertile men attending the infertility treatment center in Sari Imam Khomeini Hospital were monitored for two months and then underwent a spermogram test. Afterwards, they were treated with royal jelly (100 mg/daily) for two months and spermograms were performed again. Statistical analysis was performed in SPSS V21. Results: Royal jelly significantly increased sperm motility, improved morphology, and increased testosterone levels (P≤0.001), but, no significant difference was seen in sperm count before and after consumption of royal jelly (47.76 ± 23.59 and 50.28 ± 29.44, respectively, P≥ 0.2). Conclusion: According to current study, royal jelly could be used as a supplement along with other medications to boost fertility and treat male infertility. (Clinical Trials Registry Number: IRCT20180609040028N2)

Introduction: Osteoporosis is a common disease among middle-aged and older people. Because bone mineral density (BMD) is obtained by dividing bone mineral content by area, accurate measurement of the surface of the studied area plays an important role. Therefore, the purpose of this study was to investigate the area of the hip and forearm regions based on gender and height. Methods: In a cross-sectional descriptive study of 758 individuals (702 female and 56 male, divided into 2 groups of ≥50 years old and

Introduction: Macrolides are a group of antibacterial agents. Given their clinical importance, and the consistent rise in resistance among pathogenic bacteria, macrolides have been the targets of extensive research. Materials and Methods: This review considered the number of macrolides in different wastewater and the removal of these drugs. The antibiotics were frequently detected in influents and effluents, ranged from ng/L up to lower μg/L. In influent, the highest concentrations of clarithromycin (6080 ng/L), roxithromycin (>103 ng/L), erythromycin (3900 ng/L), and azithromycin (1949 ng/L) were detected in Croatia, Chinese, USA, and Singapore municipal wastewater treatment plants, respectively. Results: The removal efficiency of macrolides during wastewater treatment processes varies and is essentially dependent on a combination of macrolides physicochemical properties, location of municipal wastewater, and the operating conditions of the treatment systems. The application of alternative techniques, including membrane separation, activated carbon adsorption, advanced oxidation processes, biodegradation, and disinfection were the dominant removal routes for macrolides in different wastewater treatment processes. A combination of these techniques can also be used, leading to higher removals, which may be necessary before the final disposal of the effluents or their reuse for irrigation or groundwater recharge. Conclusion: Many antibiotics cannot be removed completely in wastewater treatment processes and would enter into the environment via effluent and sludge. The molecular structure of macrolides and their load-bearing capacity has led to the advantage of biological treatment over other treatments. However, the main part of the treatment has been done using biological treatment.

Abstracts Background The widespread prevalence of COVID-19 has disrupted the social life, physical function, and daily activities of patients, leading to reduced quality of their lives. Because of the nature of this disease and its comprehensive impact on patients’ lives, a follow-up based on the conditions of these patients is necessary. This study was conducted to determine the impact of nurse education and telephone follow-up (telenursing) on the quality of life of COVID-19 patients. Methods This quasi-experimental study included 120 COVID-19 patients discharged from 22nd-Bahman Hospital in Khaf city and was conducted over 6 months from July 20, 2020, to December 20, 2020. The participants were selected by convenience sampling method and were assigned into two matching groups. The training was delivered through telenursing based on the quality of life criteria for 1 month in the intervention group. The controls did not receive any intervention. Both groups completed the 36-item SF health survey before and 1 month after the intervention. Results The two groups were not significantly different regarding the quality of life mean scores at baseline (p = 0.61). However, after the intervention, the mean and standard deviation of the total life quality score was significantly different between the control and intervention groups (63.62 ± 3.93 versus 72.62 ± 3.51, p

Abstract Background Wet-lab experiments for identification of interactions between drugs and target proteins are time-consuming, costly and labor-intensive. The use of computational prediction of drug–target interactions (DTIs), which is one of the significant points in drug discovery, has been considered by many researchers in recent years. It also reduces the search space of interactions by proposing potential interaction candidates. Results In this paper, a new approach based on unifying matrix factorization and nuclear norm minimization is proposed to find a low-rank interaction. In this combined method, to solve the low-rank matrix approximation, the terms in the DTI problem are used in such a way that the nuclear norm regularized problem is optimized by a bilinear factorization based on Rank-Restricted Soft Singular Value Decomposition (RRSSVD). In the proposed method, adjacencies between drugs and targets are encoded by graphs. Drug–target interaction, drug-drug similarity, target-target, and combination of similarities have also been used as input. Conclusions The proposed method is evaluated on four benchmark datasets known as Enzymes (E), Ion channels (ICs), G protein-coupled receptors (GPCRs) and nuclear receptors (NRs) based on AUC, AUPR, and time measure. The results show an improvement in the performance of the proposed method compared to the state-of-the-art techniques.

Abstract How we perceive the world is not solely determined by our experiences at a given moment in time, but also by what we have experienced in our immediate past. Here, we investigated whether such sequential effects influence the affective appraisal of food images. Participants from 16 different countries (N = 1278) watched a randomly presented sequence of 60 different food images and reported their affective appraisal of each image in terms of valence and arousal. For both measures, we conducted an inter-trial analysis, based on whether the rating on the preceding trial(s) was low or high. The analyses showed that valence and arousal ratings for a given food image are both assimilated towards the ratings on the previous trial (i.e., a positive serial dependence). For a given trial, the arousal rating depends on the arousal ratings up to three trials back. For valence, we observed a positive dependence for the immediately preceding trial only, while a negative (repulsive) dependence was present up to four trials back. These inter-trial effects were larger for males than for females, but independent of the participants’ BMI, age, and cultural background. The results of this exploratory study may be relevant for the design of websites of food delivery services and restaurant menus.

Introduction: Peripheral blood leukocytes are a suitable cell model for science research. However, blood samples from healthy volunteers are limited in volume and difficult to obtain due to the complexity of volunteer recruitment. Objective: Therefore, it is urgent to find an alternative source of peripheral blood leukocytes. Method: One of the possibilities is the use of leukocyte reduction filters (LRFs) in blood banks that is used for preparation of leukoreduced blood products. More than 90% of the leukocytes are trapped in the leukofilters allowing the desired blood product to pass through. Results: It has been reported that the biological function of leukocytes collected from the filters are no different from those isolated from buffy coats, leukapheresis products and whole blood (WB) cells. Moreover, LRFs are waste products that are discarded after leukoreduction. Conclusion: Thus, leukofilters represent an economic source of human cell populations that can be used for a variety of investigative purposes, with no cost. In the present study, we reviewed the different usage of LRFs in the research, clinical and commercial applications.

Background: Congenital heart defect (CHD) is one of the leading causes of neonatal death. Although the majority of CHDs are isolated, a significant number of them are associated with noncardiac anomalies. Esophageal Atresia (EA)/ Tracheoesophageal Fistula (TEF) is the most common congenital disorder of the upper GI tract. It is estimated that up to 70% of EA/TEF infants have other associated congenital anomalies such as CHD. This study determined the proportion of heart anomalies among the diseases of the upper GI tract in Imam Reza Hospital of Mashhad.Methods: The records of 38 infants with upper GI obstruction who were referred to the Pediatric Cardiology Clinic of Imam Reza Hospital in Mashhad between 2001 and 2017 were evaluated in this retrospective study. Data were coded and entered into SPSS software (version 16) and analyzed using Chi-square and T-test.Results: In this study, 38 babies with upper GI obstruction were evaluated (20 patients were female, 52.6%), and the average birth weight was 2.390 +-0.870 gr. Among the parents, 13 patients (34.2%) were relative (third-degree or more) and 25 patients (65.8%) were nonrelative. The initial and final diagnosis was different at 14 pt (36.8%) that was confirmed with echocardiographic findings. CHDs were divided into two groups in this study. Malformations such as PFO (patent foramen ovale) or FMV without MR (floppy mitral valve without mitral regurgitation) considered as non-important congenital heart diseases. Other malformations that require interventional or medical management such as VSD, ASD, TOF, or other CHDs are considered important CHDs. Nineteen pt (50%) had important CHD and 16 pt (42.1%) had non-important CHD and 3 pt (7.9%) had normal echocardiographic findings.Conclusion: The heart defect is the most common associated anomaly in children with EA/TEF, which is divided into two subgroups. The first important one is CHD, which is effective in gastric surgery and management, and VSD is the most common type. The other group is non important CHD such as PFO or FMV without MR that are not effective in their management. The patients with EA/TEF are at risk for low birth weight and preterm delivery.

Background: The role of preschool administrators in raising children is increasing day by day, so the purpose of this study was to detect the validity and reliability of the professional competency questionnaire and its psychometric assessment in preschool administrators. Methods: This descriptive study was conducted on 380 preschool administrators with a minimum age of 25 and a maximum of 65 year participated in 2018. The sampling method was stratified from four regions of north, south, west and east of Tehran, Iran. Rosenberg self-esteem questionnaire was used for convergent validity. Cronbach's alpha coefficient was used to examine the internal consistency. Face validity, content validity and structural validity were also calculated. The data collection tool was a researcher-made questionnaire. Results: The questionnaire of professional competency of preschool administrators was appropriate in terms of face validity. Indicators related to content validity were appropriate in terms of relevance, transparency and necessity in this study. Cronbach's alpha coefficient was 0.98. The correlation between the total score of the managers' professional competency test and self-esteem was equal to 0.08 with a significance level of 0.58. Conclusion: The professional competency questionnaire of preschool administrators had good validity and reliability to assess the level of professional competency of preschool administrators. Researchers can use this questionnaire to assess the professional competency of preschool administrators.

Introduction: Nausea and vomiting are common complaints among patients who refer to the emergency department with head trauma. This study aimed to compare the effect of aromatherapy with isopropyl alcohol versus intravenous ondansetron in management of mild head trauma nausea and vomiting. Methods: This randomized clinical trial was conducted on patients with isolated mild head trauma complaining of nausea and vomiting who were referred to emergency department during a 6-month period. Patients were randomly divided into control (IV ondansetron + aromatherapy with saline) and intervention (IV saline + aromatherapy with isopropyl alcohol) groups. The frequency of vomiting and the severity of nausea (from 0 to 100 with the verbal scaling) were written before, and 10 and 30 minutes after intervention and compared between groups. Results: A total of 210 patients (105 patients in each group) with a median age of 38 years were included in the study, 112 (54.3%) of which were male. Ten minutes after aromatherapy, no significant difference was observed in nausea and vomiting between the two groups (p >0.05). Nausea score after 30 minutes (p = 0.015) was significantly lower in the intervention group compared to the control group, but vomiting after 30 minutes (p

Water cut is a vital monitoring and surveillance parameter with great significance in oil production operations and processing. Water-cut measurements are also challenging due to the significant variations and the harsh measurement environment. The objective of this article is to review the current water-cut measurement techniques and suggest future areas that are expanding to overcome existing measurement challenges. Commercially available online methods such as capacitance-based sensors, tomography techniques, gamma densitometry, ultrasonic meters and infrared meters, and the traditional laboratory offline methods, are discussed, along with their principle of operation, detection range, and sensing resolution. Also, the discussed techniques are summarized, highlighting their main advantages and limitations. Furthermore, future trends and research areas, such as Artificial Intelligence (AI), soft computing, Metamaterials, and Nuclear Magnetic Resonance (NMR), which are integrated with water-cut measurements, are briefly mentioned. The current research hotspots are directed toward integrating full-range measurements with multi-parameter detection, high sensitivity, and reliability.

Purpose: Modern onion breeding is almost completely based on the production of hybrid seed. This project was performed to evaluate the effectiveness of marker-assisted selection (MAS) in identification of the cytoplasmic types and Ms locus in 123 onion accessions. Research method: Three cytoplasmic markers cob, accD and MK were used to identify the sterility (S) from the fertility (N) cytoplasm and four nuclear molecular markers (OPT, PsaO, Jnurf-13 and AcSKP1) were used for genotyping of Ms alleles. Findings: The results showed that the two accD and cob markers were quite similar in the detection of the type of cytoplasm with 100% male sterility for male sterile lines and 100% fertility for maintainer lines. The MK marker was able to distinguish T-type cytoplasm as well. Based on the results, the frequency of fertility (N) was much more than the frequency of sterility (S and T) cytoplasm found to be 90% in Dorche (pop.1), 100% in Dorche (pop.2) and Kashan based on marker cob and accD and with MK marker, was found to be 80%, 90% and 82% in Dorche (pop.1), Dorche (pop.2) and Kashan, respectively. Limitations: In this study, nuclear markers were not successful due to not finding linkage disequilibrium with the Ms locus, suggested more markers to be evaluated. Originality/Value: Molecuar markers were very suitable for the indentification of S or N lines. Cytotype (N/S) determination of plants by usingmolecular markers (cob, accD and MK), could easily reduce the population size required for the production of onion hybrid seeds.

Background and purpose: Theory of Mind (TOM) is a cognitive ability to understand the beliefs, emotions, and desires of oneself and others, and its development is associated with proper development of other cognitive skills, including language. This study aimed at investigating the relationship between language and TOM and comparing the grammatical and lexical performances and TOM skills between children with high-functioning autism (HFA) and developmental language disorder (DLD) and typically developing (TD) children. Materials and methods: A cross-sectional study was carried out in 50 children aged 6-11 years old, native speakers of Persian language, with DLD (n= 14) and HFA (n= 11), and in TD (n= 25) children. Assessment of language skills was done by lexical and syntactic indicators obtained from the analysis of narrative speech sample and Persian grammar expression test (PEGT) and TOM skills using Persian mind theory test. Data were analyzed in SPSS V22 using ANOVA, Pearson Correlation, Kruskal-Wallis test, and Spearman correlation. Results: There were no significant differences in most grammatical, lexical, and TOM scores between children with DLD and HFA (P0.05). Significant correlation was observed between overall scores and TOM and PEGT scores in all three groups (P< .05). Conclusion: The current study revealed that children with HFA and DLD have weaker TOM skills than TD children which could be due to their language deficits.

Abstract Background Cystic fibrosis (CF) is a genetic disorder, which is caused by the CFTR protein defects. Along with CFTR dysfunction, inflammation plays a key role in the disease outcomes. Inflammation may develop due to the internal dysfunction of the CFTR protein or external factors. Curcumin affects the CFTR protein function primarily as a corrector and potentiator and secondary as an anti-inflammatory and antimicrobial agent. The present study aims to assess the impact of nano-curcumin on clinical and inflammatory markers in children with CF. Methods This prospective, double blind control trial will be conducted at the Akbar Children’s Hospital in Mashhad, Iran. Children with CF will be enrolled based on the eligibility criteria. Placebo and curcumin with the maximum dose of 80 mg considering the body surface of the patients will be administrated for 3 months. The primary outcome is to evaluate inflammation based on serum interleukin-6, interleukin-10, and hs-CRP, stool calprotectin, and neutrophil count of nasopharyngeal swab. The secondary outcome involved clinical assessment via spirometry, anthropometrics, and quality of life. They will be assessed before and after 3 months. Discussion Due to the multifarious effects of curcumin on CF disease, it could be proposed as a nutritional strategy in the treatment of cystic fibrosis. Trial registration Iranian Registry of Clinical Trials IRCT20200705048018N1 . Registered on July 10, 2020.

Introduction: Based on the needs of the health system, continuous revising and monitoring are essential for General Practice (GP) Curriculum. The present study was conducted to investigate thediseases of GP Curriculum based on the students’ and professors’ viewpoints.Methods: This cross-sectional study was carried out at Mashhad University of Medical Sciences in 2018. A total of 80 GP students of internship and 71 professors of the faculty of medicine in clinical and basic science disciplines were enrolled in the study using quota and convenience sampling methods, respectively. Two self-made, reliable, and validated 4-point scale questionnaires(ranging from totally agree to totally disagree) were used to collect the data on the viewpoints of students and professors on the diseases of GP curriculum. The mean score and percentage ofagreement between professors and students on the incidence of each disease were calculated.Results: The highest and lowest rates of agreement between the professors and students in terms of the presence of curriculum diseases belonged to the echolalia curriculum with a mean and standard deviation of 1.92±0.68 and the dean denial with a mean and standard deviation of 2.0±6.68, respectively. The results showed a statistically significant difference between the viewpoints of professors and students regarding the diseases of the carcinoma of the curriculum (p

Abstract A middle‐aged woman with a history of COVID‐19 vaccine administration and valve replacement surgery was admitted with bilateral palpable purpuric lesions in the lower extremities and headache. Based on the initial diagnosis of vasculitis, corticosteroid therapy was initiated, which led to the resolution of skin lesions.

Background: Smoking is very important during pregnancy because of severe fetal and maternal complications. No community-based studies have been conducted on pregnant women in Iran. This study aimed to investigate the prevalence of smoking during pregnancy, as well as maternal and neonatal complications in Mashhad, Iran, during 2017.Methods: This cross-sectional study reviewed the information of 1140 and 92,225 smoking and non-smoking pregnant women during pregnancy, respectively, and 3-5 days after delivery using Sina Electronic Health Record System in Mashhad, Iran, during 2017. All data were extracted, encoded, and entered into SPSS software (version 16).Results: Out of the total of 93,365 pregnant women with a mean age of 22.36 years, the prevalence of smoking during pregnancy was significantly higher among those who live in the city (i.e., Mashhad), compared to individuals living in the suburbs or villages. The mean rates of stillbirth, prematurity, very-low-birth-weight, and low-birth-weight were higher in smoking pregnant mothers, compared to non-smoking ones (p

Compassion is a basic approach to medical practice and is the core component of health care. The purpose of the present study was to explore nurses' perceptions of compassion-based care (CBC) for COVID-19 patients. In this qualitative study, the participants were selected using purposeful sampling. Individual and semi-structured interviews were conducted with 25 nurses, and conventional content analysis was used to categorize the data. In the care of COVID-19 patients, CBC consisted of three categories including pro-social behaviors, paying attention to the beliefs and values ​​of patients, and concern for family members. The first category had three subcategories including empathy, altruism, and helping in critical situations. The second category included the subcategories of the spiritual approach to care and respect for cultural aspects. The third category, concern for family members, had one subcategory: the need to consider the patient's family. Our findings may help to develop a comprehensive model in COVID-19 care according to which, in addition to routine patient care, nurses will consider concepts such as empathy, altruism, helping in critical situations, spirituality, cultural values, ​​and the family’s needs at the end of the patient's life.

The ability of sheep wool to remove Pb(II) ions and safranin dye from aqueous solutions through the adsorption process was investigated at room temperature. The metal ions concentration was determined by flame atomic absorption spectrophotometer method. The influence of pH, contact time, amount of adsorbent, temperature and initial metal ions concentration were examined by the batch method. The experimental data were analyzed using the Langmuir, Freundlich, Temkin and Dubinin-Radushkevich isotherm equations. The correlation coefficients were determined by analyzing each isotherm. The results indicate that the experimental data show better correlation with the Freundlich isotherm for Pb(II) ion and Langmuir isotherm for safranin dye than other isotherms. Thermodynamic parameters such as Gibbs free energy enthalpy and entropy have also been evaluated and it has been found that the sorption process was feasible, spontaneous and exothermic. The maximum amounts of Pb(II) and safranin dye adsorbed (qm), that show in order of 12.787 mg/g for Pb(II) and 4.6533 mg/g for safranin of wool sheep. The morphological analysis of the wool sheep was performed by the Scanning Electron Microscopy (SEM).

Background Concentrations of plasma lipids levels during pregnancy clearly increases. According to some studies, dyslipidemia is effective in the incidence of preeclampsia and insulin resistance. Objective: This study aimed to examine the relationship between hyperlipidemia and maternal and neonatal outcomes in pregnant women. Materials and Methods This is a cross-sectional study which was conducted on two groups of pregnant women with hyperlipidemia and normal ones to assess maternal and neonatal outcomes. Maternal data including gestational age, mother's age, body mass index, and maternal weight gain during pregnancy, gestational diabetes mellitus, preeclampsia, cholestasis, and delivery method. Also, birth weight and Apgar score were gathered as the neonatal outcomes. Results The results showed that the prevalence of abnormal lipid parameters increased with increasing gestational age. In pregnant women with dyslipidemia in combination with increased triglyceride, cholesterol and Low-density lipoprotein, and decreased High-density lipoprotein, the incidence rates of gestational diabetes (p < 0.001), preeclampsia (p < 0.001), cholestasis (p = 0.041), fetal growth retardation (p < 0.001), and macrosomia (p < 0.001) were statistically higher. Conclusion Dyslipidemia was associated with some adverse effects of pregnancy and harmful fetal outcomes. Therefore, it seems that adding laboratory assessment of lipid profiles before and during pregnancy can be effective in early diagnosis of dyslipidemia.

Objectives The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function. Methods There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated. Results The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD. Conclusion WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.

Orotracheal intubation is one of the sure ways to manage airways in critical patients (1, 2). Failed intubation (Failure to properly place the endotracheal tube (ETT) in trachea) is a rather common event (3). There have been many techniques to confirm proper intubation, but none of them are applicable in all conditions. Methods such as capnography, tracheal sonography and chest-X-ray, were introduced for verification of proper tracheal intubation but they have their own limitations (4, 5). Given the significance of proper airway management, the authors focused on a secondary method of verifying proper intubation using tracheal tactile method and compared it to existing methods.

The prevalence of multisystem inflammatory syndrome in children (MIS-C) has increased since the coronavirus disease 2019 (COVID-19) pandemic started. This study was aimed to describe clinical manifestation and outcomes of MIS-C associated with COVID-19. This systematic review and meta-analysis were conducted on all available literature until July 3rd, 2020. The screening was done by using the following keywords: (“novel coronavirus” Or COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus) and ("MIS-C" or "multisystem inflammatory" or Kawasaki). Data on gender, ethnicity, clinical presentations, need for mechanical ventilation or admission to intensive care unit (ICU), imaging, cardiac complications, and COVID-19 laboratory results were extracted to measure the pooled estimates. Out of 314 found articles, 16 articles with a total of 600 patients were included in the study, the most common presentation was fever (97%), followed by gastrointestinal symptoms (80%), and skin rashes (60%) as well as shock (55%), conjunctivitis (54%), and respiratory symptoms (39%). Less common presentations were neurologic problems (33%), and skin desquamation (30%), MIS-C was slightly more prevalent in males (53.7%) compared to females (46.3%). The findings of this meta-analysis on current evidence found that the common clinical presentations of COVID-19 associated MIS-C include a combination of fever and mucocutaneous involvements, similar to atypical Kawasaki disease, and multiple organ dysfunction. Due to the relatively higher morbidity and mortality rate, it is very important to diagnose this condition promptly.