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Objective(s): One of the most significant influencing factors in patient safety is the existence of a patient safety culture in the hospital. Patient safety culture is one of the important topics and one of the important concerns of managers and policy makers of the health system. This systematic review was conducted with the aim of determining the status of patient safety culture in Iranian hospitals. Methods: In this systematic review study, electronic search in Farsi and English using keywords Patient Safety, Hospital, Patient safety culture, in databases Medline, Google Scholar, Elsevier Direct Science, Ovid, PubMed and patient safety culture, patient safety and The hospital was conducted in the database of Jihad University Scientific Database (SID), Iran Nursing Publications Bank (Nindex), Magiran and Iranmedex between 2010 and 2020. Articles were extracted in 2021. Results: A total of 182 articles were extracted and finally 23 articles were analyzed. In most hospitals, the overall scores of patient safety culture were reported as low and moderate. The highest score was related to the dimensions of the manager's expectations and actions in the direction of patient safety and the transfer of important patient information between different departments and shifts, team work within the department and organizational learning, and the lowest score was related to the dimensions of non-punitive response to events and the dimension of openness of communication channels. Conclusion: valuing patient safety can be effective in the development and progress of hospitals in the country in order to improve the culture of patient safety. Improving relationships and teamwork within hospital units and creating a non-punitive environment can be effective in improving patient safety in the hospital.

In this study, for the first time, a novel strategy for the synthesis of graft copolymers using polystyrene (PSt) monomer from surface modification of poly(ethylene terephthalate) PET through surface-initiated nitroxide-mediated radical polymerization was performed. For this purpose, the PET surface was first aminated by 1,3-diamino propane, which was used as an amination agent. Second, phenyl chloro acetylation of PET was prepared by coupling amino and hydroxyl groups with α-phenyl chloro acetyl chloride. Afterward, 2,2,6,6-tetramethyl-1-piperidinyloxy (TEMPO) was synthesized, then 1-hydroxy-2,2,6,6-tetramethylpiperidine (TEMPO–OH) was obtained by reduction of TEMPO with sodium ascorbate and coupled with chloroacetylated PET to obtain PET-TEMPO macroinitiator. Furthermore, the (St) monomer was grafted onto the PET surfaces through the “grafting from” technique. The obtained macroinitiator for living radical polymerization was heated in the adjacency of (St) monomer to obtain the graft copolymer (PET-g-PSt) onto the PET surfaces. Finally, PET-g-PSt/MMt nanocomposite was synthesized by the solution intercalation method. The surface combination, morphology, and thermal properties of the modified PET films were proved using various characterization methods such as transform infrared spectroscopy (FT-IR), 1H nuclear magnetic resonance (1H NMR), differential scanning calorimetry (DSC), thermogravimetric analysis, X-ray photoelectron spectroscopy, and termination electron microscopy (TEM).

Abstract Background Multi-drug resistant bacteria hazards to the health of humans could be an agent in the destruction of human generation. Natural products of Bacillus species are the main source to access progressive antibiotics that can be a good candidate for the discovery of novel antibiotics. Wild honey as a valuable food has been used in medicine with antimicrobial effects. Objective Bacillus strains isolated from wild honey were evaluated for the potential antimicrobial activity against human and plant bacterial and fungal pathogens. Methods Three bacterial isolates were identified as strain Khuz-1 (98.27% similarity with Bacillus safensis subsp. Safensis strain FO-36bT), strain Khuz-2 (99.18% similarity with Bacillus rugosus strain SPB7T), and strain Khuz-3 (99.78% similarity with Bacillus velezensis strain CR-502 T) by 16S rRNA gene sequences. The strains were characterized by their ability to inhibit the growth of human and phytopathogenic fungi. Results The results indicated that B. rugosus strain Khuz-2 inhibited the growth of phytopathogenic and human fungal more effective than other ones. It seems that the strain Khuz-2 has a suitable antimicrobial and antifungal potential as a good candidate for further pharmaceutical research. Conclusion Based on the results of GC–MS, Pyrrolo [1,2-a] pyrazine-1,4-dion, hexahydro-3-(2-methylpropyle) (PPDHM) was the major compound for all strains which have a various pharmacological effect. Isolation and identification of beneficial bacteria from natural sources can play an important role in future pharmaceutical and industrial applications.

Background: Hospitals, as the most important medical institutions, must be adequately prepared before accidents to cope with emergencies and provide rapid response to disasters. This study aimed to determine the preparedness of hospitals in Ardabil Province during the COVID-19 pandemic. Materials and Methods: The present study is a cross-sectional study, and the study population included all hospitals in Ardabil Province, Iran (17 hospitals in total). The data collection tool was a standard checklist of 92 questions for COVID-19 Crisis Preparedness issued by the Iran Ministry of Health and Medical Education. The obtained data were analyzed using descriptive and inferential statistics (the Pearson correlation analysis) in SPSS software v. 22. Results: The mean relative score of preparation for the COVID-19 pandemic was 80.27% among the hospitals in the province. In the studied hospitals, the relative scores of preparedness were as follows: leadership and coordination, 92.64%, resource management, 94.36%; information management, 79.90%; communications, 77.94%; human resources, 77.69%; surge-capacity, 86.55%; rapid identification, 57.18%; diagnosis, 71.32%; isolation and patient management, 81.09%; and infection prevention and control, 84.05%. Conclusion: The level of hospital preparedness in most dimensions (9 out of 10 dimensions) was good, and only in the area of ​​rapid identification was at a moderate level. However, further evaluation is needed at different stages of an epidemic.

Early-stage drug discovery is highly dependent upon drug target evaluation, understanding of disease progression and identification of patient characteristics linked to disease progression overlaid upon chemical libraries of potential drug candidates. Artificial intelligence (AI) has become a credible approach towards dealing with the diversity and volume of data in the modern drug development phase. There are a growing number of services and solutions available to pharmaceutical sponsors though most prefer to constrain their own data to closed solutions given the intellectual property considerations. Newer platforms offer an alternative, outsourced solution leveraging sponsors data with other, external open-source data to anchor predictions (often proprietary algorithms) which are refined given data indexed upon the sponsor’s own chemical libraries. Digital research environments (DREs) provide a mechanism to ingest, curate, integrate and otherwise manage the diverse data types relevant for drug discovery activities and also provide workspace services from which target sharing and collaboration can occur providing yet another alternative with sponsors being in control of the platform, data and predictive algorithms. Regulatory engagement will be essential in the operationalizing of the various solutions and alternatives; current treatment of drug discovery data may not be adequate with respect to both quality and useability in the future. More sophisticated AI/ML algorithms are likely based on current performance metrics and diverse data types (e.g., imaging and genomic data) will certainly be a more consistent part of the myriad of data types that fuel future AI-based algorithms. This favors a dynamic DRE-enabled environment to support drug discovery.

Objective (s): Hospital indicators are very important in indicating their performance. Indicators are used as a tool to compare the number of services, evaluate services, compare services with standards or compare them with previous years. The aim of this study was to determine performance indicators of hospitals in a number of teaching hospitals and comparing them with performance indicators of Ministry of Health and Medical Education, 2019 Methods: This was a cross-sectional study that descriptively examined the performance indicators of 12 hospitals affiliated to Ardabil University of Medical Sciences. The data were collected by referring to statistical unit of health deputy and analyzed using SPSS22 software. Results: The ratio of active beds to fixed in 9 hospitals (75%), bed performance ratio, admission ratio per bed and average length of stay in 10 hospitals (83.3%) and bed turnover interval in 7 hospitals (58.4%) were desirable. The bed occupancy ratio in 7 hospitals (58.4%) was poor compared to the standards. Conclusion: The performance indicators of the hospitals affiliated to Ardabil University of Medical Sciences were relatively good compared to the standards. However, there is a need for promotion and improvements. Therefore, it is necessary that managers take the necessary proceedings to increase hospitals’ performance indicators.

Abstract Background Oral corticosteroids are important components of pharmacotherapy in severe asthma. Our objective was to describe the extent, trends, and factors associated with exposure to oral corticosteroids (OCS) in a severe asthma cohort. Methods We used administrative health databases of British Columbia, Canada (2000–2014) and validated algorithms to retrospectively create a cohort of severe asthma patients. Exposure to OCS within each year of follow-up was measured in two ways: maintenance use as receiving on average ≥ 2.5 mg/day (prednisone-equivalent) OCS, and episodic use as the number of distinct episodes of OCS exposure for up to 14 days. Trends and factors associated with exposure on three time axes (calendar year, age, and time since diagnosis) were evaluated using Poisson regression. Results 21,144 patients (55.4% female; mean entry age 28.7) contributed 40,803 follow-up years, in 8.2% of which OCS was used as maintenance therapy. Maintenance OCS use declined by 3.8%/calendar year (p

Abstract The importance of vaccinations for COPD patients has been previously described. However, there is still a gap between guideline recommendations and the implementation of preventive care delivery for these patients. Specially, the rise of SARS-CoV-2 pandemic has made the significance of vaccination adherence more critical to address. Our study showed that referral to pulmonary clinic is associated with increased odds of receiving influenza (OR = 1.97, [95% CI 1.07, 3.65]) and pneumococcal vaccinations (PCV13 OR = 3.55, [1.47, 8.54]; PPSV23 OR = 4.92, [1.51, 16.02]). These data suggest that partnerships between primary care physicians and pulmonologists can potentially improve the vaccination rates for patients with COPD.

Abstract Application of side weirs with high effective length is necessary to discharge excessive flows, to control the flow in water conveyance systems, and irrigation and drainage systems. Most of the studies on the side weirs have been conducted on the straight channels and linear weirs. The flow pattern on the outer arc of the curved channels and its suitability for side weir can be used and combined with the piano key weirs. So far, no comparison has been made on rectangular piano key side weirs (RPKSW) at a 120° Section of a 180° Curved Channel. In this study, an experimental study was performed on A-, B-, C-, and D-type RPKSW at a bend angle of 120 degrees. The results showed that the specific energy at two ends of the RPKSWs was the same, with a slight difference of 3.4% for A-Type, 1.3% for B-Type, 1.1% for C-Type, and 1.8% for D-Type weirs. The discharge coefficients of the studied weirs were also investigated, and it was concluded that B-Type weir has better performance than other weirs. On average, the discharge coefficient of B-Type weir was 9.9%, 21.2%, and 24.1% higher than that of A-Type, C-Type, and D-Type weir, respectively. It was shown that the ratio of P/h1 is the main parameter affecting the weir discharge coefficient. Finally, an empirical equation was proposed for each weir. The proposed equation has MAE = 0.028 for A-Type weir, MAE = 0.041 for B-Type weir, MAE = 0.049 for C-Type weir, and MAE = 0.053 for D-Type weir.

Background: Optimal stress distribution around implants plays an important role in the success of mandibular overdentures. This study sought to assess the pattern of stress distribution around short (6 mm) and long (10 mm) implants in mandibular two implant-supported overdentures using finite element analysis (FEA). Materials and Methods: In this descriptive and experimental study two implant-supported overdenture models with bar and clip attachment system on an edentulous mandible were used. Two vertical implants were connected by a bar. The implant length was 6 mm (short implant) in the first and 10 mm (long implant) in the second model. Vertical loads (35, 65, and 100 N) were applied bilaterally to the second molar area. In another analysis, vertical loads of 43.3 N and 21.6 N were applied to working and nonworking sides, respectively, at the second molar area. Furthermore, the lateral force (17.5 N) was applied to the canine area of overdenture. The stress distribution pattern around implants was analyzed using FEA. Results: The maximum von Mises stress was 57, 106, and 164 MPa around short implants and 64, 118, and 172 MPa around long implants following the application of 35, 65, and 100 N bilateral forces, respectively. Application of bilateral loads created 87 and 65 MPa stress around working and nonworking short implants, respectively; while these values were reported to be 92 and 76 MPa for long implants at the working and nonworking sides, respectively. Increasing the vertical loads increased the level of stress distributed around the implants; however, no considerable differences were noted between long and short implants for similar forces. Following unequal load application, the stress in the working side bone was more than that in the nonworking side, but no major differences were noted in similar areas around long and short implants. Following lateral load application, the stress distributed in the peri-implant bone at the force side was more than that in the opposite side. In similar areas, no notable differences were observed between long and short implants regarding the maximum stress values. Conclusion: Using implants with different lengths in mandibular overdenture caused no major changes in stress distribution in peri-implant bone; short implants were somehow comparable to long implants.

Abstract Background The majority of patients with asthma have the mild form of the disease. Whether mild asthma patients receive appropriate asthma medications has not received much attention in the literature. We examined the trends in indicators of controller/reliever balance. Methods Using administrative health databases of British Columbia, Canada (2000 to 2013), we created a population-based cohort of adolescents/adults with mild asthma using validated case definition algorithms. Each patient-year of follow-up was assessed based on two markers of inappropriate medication prescription: whether the ratio of controller medications (inhaled corticosteroids [ICS] and leukotriene receptor antagonists [LTRA]) to total asthma-related prescriptions was low (cut-off 0.5 according to previous validation studies), and whether short-acting beta agonists (SABA) were prescribed inappropriately according to previously published criteria that considers SABA in relation to ICS prescriptions. Generalized linear models were used to evaluate trends and to examine the association between patient-, disease-, and healthcare-related factors and medication use. Results The final cohort consisted of 195,941 mild asthma patients (59.5% female; mean age at entry 29.6 years) contributing 1.83 million patient-years. In 48.8% of patient-years, controller medications were suboptimally prescribed, while in 7.2%, SABAs were inappropriately prescribed. There was a modest year-over-year decline in inappropriate SABA prescription (relative change − 1.3%/year, P

Background Chronic obstructive pulmonary disease (COPD) is a common comorbidity in heart failure with reduced ejection fraction, associated with undertreatment and worse outcomes. New treatments for heart failure with reduced ejection fraction may be particularly important in patients with concomitant COPD. Methods and Results We examined outcomes in 8399 patients with heart failure with reduced ejection fraction, according to COPD status, in the PARADIGM‐HF (Prospective Comparison of Angiotensin Receptor Blocker–Neprilysin Inhibitor With Angiotensin‐Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial. Cox regression models were used to compare COPD versus non‐COPD subgroups and the effects of sacubitril/valsartan versus enalapril. Patients with COPD (n=1080, 12.9%) were older than patients without COPD (mean 67 versus 63 years; P

Mitochondria play a key role in metabolic transitions involved in the reprogramming of somatic cells into induced pluripotent stem cells (iPSCs), but the underlying molecular mechanisms remain largely unexplored. To obtain new insight into the mechanisms of cellular reprogramming, we studied the role of FAH domain-containing protein 1 (FAHD1) in the reprogramming of murine embryonic fibroblasts (MEFs) into iPSCs and their subsequent differentiation into neuronal cells. MEFs from wild type (WT) and Fahd1-knock-out (KO) mice were reprogrammed into iPSCs and characterized for alterations in metabolic parameters and the expression of marker genes indicating mitochondrial biogenesis. Fahd1-KO MEFs showed a higher reprogramming efficiency accompanied by a significant increase in glycolytic activity as compared to WT. We also observed a strong increase of mitochondrial DNA copy number and expression of biogenesis marker genes in Fahd1-KO iPSCs relative to WT. Neuronal differentiation of iPSCs was accompanied by increased expression of mitochondrial biogenesis genes in both WT and Fahd1-KO neurons with higher expression in Fahd1-KO neurons. Together these observations establish a role of FAHD1 as a potential negative regulator of reprogramming and add additional insight into mechanisms by which FAHD1 modulates mitochondrial functions.

Purpose: Breast cancer is the most frequent malignancy diagnosed in women both in developed and developing countries. Natural products especially those from herbal origin have high potential in producing drug components with a source of novel structures. The present study was designed to explore the cytotoxic effects and the cell death mechanism of Scrophularia atropatana extracts. Methods: MTT assay was employed to evaluate the cytotoxic activity of the extracts of S. atropatana on the MCF-7 as well as non-malignant cells. Furthermore, induction of apoptosis was evaluated by TUNEL assay, cell death detection ELISA, DNA fragmentation test, western blotting and Real Time PCR. Results: In vitro exposures of the MCF-7 cells with different concentration of S. atropatana extract significantly inhibited their growth and viability and induced apoptosis in the MCF-7 cells. Cleavage PARP protein, decrease in the mRNA expression levels of bcl-2 and increase expression of Caspase-3 and Caspase-9 mRNA, highlights that the induction of apoptosis was the main mechanism of cell death. Moreover the expression study of Caspase-9 mRNA showed that, the extracts have induced apoptosis via intrinsic mitochondrial pathway. Conclusion: Our results demonstrated that dichloromethane extract of Scrophularia atropatana has an apoptotic effects and it can be developed as anticancer agents.

The solutions that best optimize the design process must be determined using singlecriterion and multicriteria approaches. In this research, a multicriteria optimization approach is carried out to determine the circular hydrostatic journal bearing design parameters based on the power requirement, the bearing coefficient and the minimization of the temperature rise of the oil, so that the total performance of the system is optimal. The optimization results of more than two criteria are presented and compared with previous research outcomes. Computational experimental results are given to demonstrate the effectiveness of the present approach. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via the original article.

Phytochemical analysis of the methanolic and dichloromethane extracts of the aerial parts of Scutellaria pinnatifida led to the isolation of a phenylpropanoid, 1-o-feruloyl-ß-D-glucose [1], two known flavonoids including luteolin-7-o-glucoside (2) and apigenin-7-o-glucoside (3), three known phenylethanoid glycosides composed of phlomisethanoside (4), syringalide A (5), and verbascoside (6), and oleic acid (7). Isolation and structural elucidation of compounds were accomplished by HPLC and spectroscopic methods (UV, 1H- NMR, 13C-NMR). The extracts were also evaluated for their radical scavenging activity and insecticidal property by 2,2-diphenyl-1-picryl-hydrazyl (DPPH) assay and contact toxicity method, respectively. Among the extracts, the methanol extract showed the most potent free radical scavenging activity with a RC50 value of 0.044 ± 0.350 mg/mL which could be attributed to the presence of the isolated phenolic compounds. In the case of insecticidal activity, the n-hexane extract displayed the most potent activity and caused 10%, 15%, and 40% mortality to Oryzaephilus mercator at the concentration of 5, 10, and 15 mg/mL after 4 h of exposure.

Background. Wear resistance of pit and fissure sealant materials can influence their retention. Wear characteristics of sealant materials may determine scheduling of check-up visits. The aim of this study was to compare wear resistance of two flowable composite resins with that of posterior composite resin materials. Methods. Thirty-five disk-shaped specimens were prepared in 5 groups, including two flowable composite resins (Estelite Flow Quick and Estelite Flow Quick High Flow), Filtek P90 and Filtek P60 and Tetric N-Ceram. The disk-shaped samples were prepared in 25-mm diameter by packing them into a two-piece aluminum mold and then light-cured. All the specimens were polished for 1minute using 600-grit sand paper. The samples were stored in distilled water at room temperature for 1 week and then worn by two-body abrasion test using "pin-on-disk" method (with distilled water under a 15-Nload at 0.05 m/s, for a distance of 100 meter with Steatite ceramic balls antagonists). A Profilometer was used for evaluating the surface wear. Data were analyzed with the one-way ANOVA. Results. Estelite Flow Quick exhibited 2708.9 ± 578.1 μm2 and Estelite Flow Quick High Flow exhibited 3206 ± 2445.1 μm2of wear but there were no significant differences between the groups. They demonstrated similar wear properties. Conclusion. Estelite flowable composite resins have wear resistance similar to nano- and micro-filled and micro-hybrid composite resins. Therefore, they can be recommended as pit and fissure sealant materials in the posterior region with appropriate mechanical characteristics.

Human fumarylacetoacetate hydrolase (FAH) domain containing protein 1 (FAHD1) is a mitochondrial oxalocatate decarboxylase, the first of its kind identified in eukaryotes. The physiological role of FAHD1 in other eukaryotes is still poorly understood. In C. elegans loss of the FAHD1 ortholog FAHD-1 was reported to impair mitochondrial function, locomotion and egg-laying behavior, yet the underlying mechanisms remained unclear. Using tissue-specific rescue of fahd-1(-) worms, we find that these phenotypic abnormalities are at least in part due to fahd-1's function in neurons. Moreover, we show that egg-laying defects in fahd-1(-) worms can be fully rescued by external dopamine administration and that depletion of fahd-1 expression induces expression of several enzymes involved in serotonin biosynthesis. Together, our results support a role for fahd-1 in modulating serotonin levels and suggest this protein as a novel link between metabolism and neurotransmitter signaling in the nervous system. Finally, we propose a model to explain how a metabolic defect could ultimately lead to marked changes in neuronal signaling.

Introduction: Use of fluoride compounds is one of the most effective ways of preventing decay and among these varnishes have high acceptance among different fluoride products. Aim: Hence, the aim of this research was to evaluate the microhardness of tooth enamel after the usage of two different commercial products of fluoride varnish. Materials and Methods: This in vitro experimental study was performed on 51 extracted premolar teeth. The teeth were divided randomly into three 17-membered groups. The first group received Duraflor varnish, the second group received Ariadent Iranian varnish while the third group received no treatment. Micro hardness of tooth enamel was measured utilizing Vickers method before and after the use of fluoride varnish. ANOVA, Tukey, and Wilcoxon statistical tests were utilized for statistical analysis of data. Results: The comparison of mean change in micro hardness before and after the use of fluoride showed that increase in micro hardness in Duraflor varnish and Ariadent varnish group was significant when compared to control group (p0.05). Conclusion: According to the findings, the use of fluoride significantly increased the enamel micro hardness which did not show a significant difference between two groups of Duraflor varnish and Ariadent varnish.

While patients with obstructive sleep apnea (OSA) or multiple sclerosis (MS) are at high risk of developing postoperative complications, both of them have special anesthetic considerations in intraoperative and postoperative periods. A careful preoperative evaluation, use of the optimal anesthetic regimen and close postoperative care is essential for these patients. Rarity of coexistence of both obstructive sleep apnea and multiple sclerosis in a surgical patient necessitates careful anesthetic management. We here report anesthetic management of a female patient with OSA and MS who underwent anesthesia three times for surgery and review the literature.

Upper limb fractures are prevalent injuries. An essential element of fracture healing is to maintain the bones alignment. However there are lots of complications associated with traditional ways of treatment, such as compartment syndrome and stiffness due to immobility for long time. Also evaluation and observation of the limb under the casts for potential infections and skin issues are not possible. By this article an invention of puzzle shaped cast for upper limb is introduced. This novel cast is made up of different parts that they complete each other and join as pieces of a puzzle to shape a cast. By this mean physical examination during the healing process is possible and the complications could be less.

Aim: This study aims to examine the effect of the level of perceived social support in the postpartum period on maternal functioning and maternal attachment., Methods: This study was conducted between January and May 2023 in two family health centers selected by simple randomization among 11 family health centers affiliated with the Health Directorate located in eastern Türkiye. The population of the study consisted of 410 mothers in the postpartum period who had babies aged 6-11 weeks old. Data were collected face-to-face using the "Personal Information Form", the "Multidimensional Scale of Perceived Social Support", the "Barkin Index of Maternal Functioning Scale" and the "Maternal Attachment Scale". Data analysis was performed using numbers, percentages, arithmetic means, independent groups t-tests, ANOVA, Pearson correlation analysis, and simple linear regression analysis., Findings: A positive, moderately significant relationship was found between maternal attachment and maternal functioning (r = 0.554; p < .05). A positive, moderately significant relationship was found between maternal attachment and perceived social support (r = 0.585; p < .05). A positive, highly significant relationship was detected between social support and maternal functioning (r = 0.861; p < .05)., Conclusion: This study found that postpartum women's attachment levels increased with the increase in their maternal functioning. It was also found that mothers' attachment levels increased with the increase in their perceived social support levels. Social support levels were proven to be effective on maternal functioning as well as maternal attachment. Women's maternal functioning levels were found to increase with the increase in their social support levels., Practice Implications: In light of these findings, pediatric nurses and obstetric nurses have great responsibilities. Starting from the prenatal period and including the postnatal period, both the mother and everyone around her should be explained the importance of social support., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Individuals may develop different attitudes on bioethics in general and reproductive ethics in particular, due to the effects of different sociocultural environments. Individuals' attitudes toward surrogacy are affected positively or negatively depending on religious and cultural environments. This study was conducted to determine and compare the attitudes of different religions toward surrogacy. This study is cross-sectional and collected from individuals living in Turkey, India, Iran, the Turkish Republic of Northern Cyprus, Madagascar, Nepal, Nigeria, Pakistan, Mexico, England, and Japan between May 2022 and December 2022. The study was conducted with individuals belonging to Islam, Christianity, Hinduism, Buddhism, and Atheism. The study was conducted with 1177 individuals from different religions who agreed to participate in the study by snowball sampling method. The introductory Information Form and "Attitude Questionnaire Toward Surrogacy" were used as data collection tools. R programming language 4.1.3 was used for regression analysis with machine learning approach and artificial neural networks, and SPSS-25 was used for other statistical analyses. There was a significant difference between the total mean score of the individuals' Attitudes toward Surrogacy Questionnaire and their religious beliefs (p < 0.05). When the results of the analysis of the regression model with the dummy variable, which was carried out with the aim of revealing the effects of religious belief on the attitude toward surrogacy, are examined, statistical estimates of the regression model show that the model is significant and usable F(4,1172) = 5.005, p = 0.001). It explains 1.7% of the total variance of the level of religious belief's attitude toward surrogacy. In the regression model, when the t-test results regarding the significance of the regression coefficient are examined, among the participants, it was determined that the mean score of those who believed in Islam (t =  - 3.827, p < 0.001) and those who believed in Christianity (t =  - 2.548, p < 0.001) was lower than the mean score of those who believed in Hinduism (Constant) (p < 0.05). Individuals' attitudes toward surrogacy differ according to their religion. The best performing algorithm for the prediction model was random forest (RF) regression. The contributions of the variables to the model were calculated with Shapley values (Shapley Additive Explanations (SHAP)). The SHAP values of the variables in the best performing model were examined to avoid bias in terms of comparison in the performance criterion. SHAP values (Shapley Additive Explanations) show the contribution or importance of each variable in the estimation of the model. It is determined that the most important variable that should be in the model to predict the Attitude Toward Surrogacy Survey variable is the Nationality variable. It is recommended that studies on attitudes toward surrogacy should be conducted by taking religious and cultural values into consideration., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The superficial palmar arch is an important anatomical structure that contributes to the arterial supply of the palmar side of the hand in the upper extremity. However, there is limited information on the embryological morphological structure of the superficial palmar arch in the literature. We studied the types of the superficial palmar arch and determined their variations by dissecting 80 upper extremities of 40 formalin-fixed human fetuses (19 males, 21 females) 18-37 weeks of age. The types and variations of the superficial palmar arch were examined, and the median artery was imaged. The superficial palmar arch type was complete in 58 hands (72.5%) and incomplete in 22 hands (27.5%). The complete group consisted of type A (47.5%), type B (16.25%), type C (3.75%), type D (1.25%), and type E (3.75%). On the other hand, the incomplete group consisted of type F (15%), type G (8.75%), type H (2.5%), and type I (1.25%). A median artery that originated from the ulnar artery and passed through the carpal tunnel during its course was detected in two hands (2.5%). Knowledge of the superficial palmar arch variations will contribute to hand microsurgery particularly in vascular graft and free flap application interventions for arterial bleeding in the palmar region., (© 2022. The Author(s), under exclusive licence to Japanese Association of Anatomists.)

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders in children and the pathophysiology remains obscure. Some studies show that lipid imbalances are associated with ADHD etiology. We studied the association of serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride (TG) levels in ADHD. We examined 88 children aged 8-12 years who were diagnosed with ADHD and 88 healthy children. The exclusion criteria were as follows: obesity, any psychotropic use in the last 3 months, presence of a chronic disease and/or malignancy, history of medically treated lipid metabolism disease in family members, intelligence quotient (IQ) < 70, and comorbidities, with the exception of oppositional defiant disorder. The sample was evaluated using a semi-structured clinical assessment interview and Conners' rating scales. Despite controlling for age, sex, and body mass index (BMI) variables, the total cholesterol and LDL levels were significantly higher in the ADHD group than the levels of healthy controls, whereas the TG and HDL cholesterol levels were similar among groups. Conners' rating scales, reflecting symptom severity, and total cholesterol, TG, HDL, and LDL levels of the ADHD group were not correlated. The study results support the difference in serum lipid and lipoprotein profiles of children with ADHD compared with healthy controls. This difference is thought to be related with changes in oxidant/antioxidant balance states in ADHD., (Copyright © 2018 Elsevier B.V. All rights reserved.)