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Background: Since brain temperature fluctuations are related to cognitive disorders, regulating brain temperature has become a key focus in cognitive studies. This study examined the effect of frontopolar cortical cooling on working memory using a cortical thermal stimulation device (CTSD). Methods: This phase II, randomized, controlled trial included twenty participants randomly divided into two groups to receive 30 minutes of frontopolar cortical cooling across four sessions. The control group received sham cooling, while the intervention group received real cooling. Spatial working memory tests were recorded from both groups before and after the first and after the fourth sessions. The cortical thermal stimulation device used for cooling operates through the flow of water and alcohol in a closed loop.Results: After four sessions of frontopolar cortical cooling, a significant improvement in working memory was observed. The analysis of working memory results, based on an ANCOVA test, showed an improvement in the Spatial Working Memory (SWM) test in the intervention group compared to the control group (p < 0.05).Conclusion: Considering the positive effect of frontopolar cortical cooling on working memory capacity, the results suggest that using an appropriate tool for cooling the cerebral cortex could become a practical approach in cognitive rehabilitation.

This study aimed to conduct a retrospective Middle East systematic review and meta-analysis on the prevalence and antibiotic susceptibility pattern for this microorganism isolated from cystic fibrosis patients. We searched MEDLINE, the Cochrane Library, SCOPUS, and Web of Science (ISI) to identify studies that reported the prevalence of Pseudomonas aeruginosa isolated from cystic fibrosis (CF) patients, and antibiotic resistance patterns. To assess the quality of publications was used of a checklist provided by the Joanna Briggs Institute. Finally, the data was analyzed by comprehensive meta-analysis software. The studied populations comprised children and young, and adult CF patients. Patients were aged between 3 months-65 years. A higher percentage of CF patients were males. Pseudomonas aeruginosa frequency varied between 5.9 and 76.2% in the studies included. The combined prevalence of P. aeruginosa was reported 34.3%. The lowest level resistance of P. aeruginosa was toward colistin (0%-13.3%) and ticarcillin (3.9%-24%). Our study showed the prevalence of P. aeruginosa and antibiotic resistance are almost high, while colistin and ticarcillin are the best antibiotics to decrease postantibiotic efects (PAEs) in CF patients from the Middle East. Therefore, physicians should pay more attention to therapeutic protocols to prevent further resistance.

Abstract Background and aim There have been a growing interest in investigating the effect of stewardship on other functions of rehabilitation service delivery. Effective stewardship of rehabilitation services can ensure that these services are of high quality, accessible, affordable, and sustainable, and can help achieve the goals of universal health coverage. The purpose of this study was to identify and analyze the policies adopted in the field of rehabilitation services in Iran and in the international arena, and finally to identify policy gaps, areas for improvement, and areas that have been overlooked. Method This research is a policy analysis, carried out through document analysis and Dalglish et al.’s READ approach. Data were analyzed and interpreted using qualitative methodology and directed content analysis. For this purpose, Veillard et al.‘s health system stewardship framework was used to analyze the stewardship of rehabilitation services. The dimensions of the stewardship framework, were: Defining the vision for health and strategies and policies to achieve better health; influencing all sectors and advocating for better health; ensuring good governance in line with prevailing values; ensuring the alignment of system design with health system goals; improving existing legal and regulatory instruments; and compiling, disseminating, and applying information. Scott’s four criteria were used to assess the authenticity, credibility, representativeness, and meaning of the documents. Those that did not meet even one of the Scott’s criteria were excluded from content analysis. Findings A total of 16 documents were identified, all of which met Scott’s criteria and none were excluded from the study. A total of six themes and 56 subthemes were extracted. The contents of all the documents were extracted under six themes of Veillard et al.‘s health system stewardship framework. Overall, the results show that national documents place greater emphasis on the development of preventive healthcare and health promotion. Documents often focus on engaging NGOs and the families of people with disabilities and on intersectoral collaboration for knowledge production and the development of intersectoral knowledge networks. In terms of health system governance in line with prevailing values, documents are mainly focused on health system stewardship by the Ministry of Health and on evidence-based decision-making with the participation of target groups. Also, documents place more emphasis on upgrading the national infrastructure and increasing access to rehabilitation services. Conclusion In some areas of rehabilitation services, there is a gap between national documents, which reflects differences in priorities, approaches, resources, and instruments available to strengthen rehabilitation services at the national and international levels.

Abstract The tumor microenvironment (TME) and the cellular interactions within it can be critical to tumor progression and treatment response. Although technologies to generate multiplex images of the TME are advancing, the many ways in which TME imaging data can be mined to elucidate cellular interactions are only beginning to be realized. Here, we present a novel approach for multipronged computational immune synapse analysis (CISA) that reveals T-cell synaptic interactions from multiplex images. CISA enables automated discovery and quantification of immune synapse interactions based on the localization of proteins on cell membranes. We first demonstrate the ability of CISA to detect T-cell:APC (antigen presenting cell) synaptic interactions in two independent human melanoma imaging mass cytometry (IMC) tissue microarray datasets. We then verify CISA’s applicability across data modalities with melanoma histocytometry whole slide images, revealing that T-cell:macrophage synapse formation correlates with T-cell proliferation. We next show the generality of CISA by extending it to breast cancer IMC images, finding that CISA quantifications of T-cell:B-cell synapses are predictive of improved patient survival. Our work demonstrates the biological and clinical significance of spatially resolving cell-cell synaptic interactions in the TME and provides a robust method to do so across imaging modalities and cancer types.

Abstract Objective We conducted this study to summarize the results of studies reporting the role of NLR (neutrophil to lymphocyte ratio) in PSCC (penile squamous cell carcinoma). Methods This meta-analysis was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria. A systematic search was conducted on PubMed, Scopus, and web of science up to March 10, 2023. Fourteen studies were included in the review. The NOS (Newcastle–Ottawa Scale) was used to determine the quality of the included studies. This meta-analysis was conducted on the studies reporting the relationship between NLR and survival using HR (hazard ratio) and 95% CI (confidence interval). Results There was a significant association between NLR levels and the prognosis, nodal stage, and anatomical tumor stage of PSCC patients. In the meta-analysis of the association of NLR with survival, NLR level was significantly associated with lower cancer-specific survival (HR = 3.51, 95% CI = 2.07–5.98, p

Abstract The study examined mass transfer coefficients in a structured CO2 absorption column using machine learning (ML) and response surface methodology (RSM). Three correlations for the fractional effective area (af), gas phase mass transfer coefficient (kG), and liquid phase mass transfer coefficient (kL) were derived with coefficient of determination (R2) values of 0.9717, 0.9907 and 0.9323, respectively. To develop these correlations, four characteristics of structured packings, including packing surface area (ap), packing corrugation angle (θ), packing channel base (B), and packing crimp height (h), were used. ML used five models, represented as random forest (RF), radial basis function neural network (RBF), multilayer perceptron (MLP), XGB Regressor, and Extra Trees Regressor (ETR), with the best models being radial basis function neural network (RBF) for af (R2 = 0.9813, MSE = 0.00088), RBF for kG (R2 = 0.9933, MSE = 0.00056), and multilayer perceptron (MLP) for kL (R2 = 0.9871, MSE = 0.00089). The channel base had the most impact on af and kL, while crimp height affected kG the most. Although the RSM method produced adequate equations for each output variable with good predictability, the ML method provides superior modeling capabilities.

Abstract Background Doctoral programs have consistently garnered the attention of policymakers in medical education systems due to their significant impact on the socio-economic advancement of countries. Therefore, various doctoral programs have been implemented with diverse goals. In Iran, a research doctorate program, known as PhD by Research, was introduced primarily to engage in applied research related to healthcare needs. Nevertheless, the achievement of the program’s goals has been questioned. This study aimed to identify the implementation challenges of the Research Doctorate Program and its solutions in Iran. Method This descriptive qualitative study followed the Standards for Reporting Qualitative Research: A Synthesis of Recommendations and was conducted in two steps. Firstly, the challenges of the Iranian Ph.D. by research program were identified through the perspectives of the program’s students and graduates. In the second step, relevant solutions to these challenges were determined by focus groups of key informant experts. The transcripts were analyzed using qualitative content analysis. Results Five students and six graduates were interviewed in the first step and seven experts participated in the second one. The challenges and related solutions are explored in four main themes, including: (1) admission criteria, (2) program goals and expected outcomes, (3) curricula, and (4) financial and human resources. The study showed that various dimensions of the doctoral program are not aligned with each other and how to adapt the program in these dimensions. Conclusion The study revealed the importance of a systematic approach in defining various dimensions of doctoral programs according to program goals and provided specific solutions for defining a research doctorate program in the context of a low- and middle-income country.

PurposeThe management of rectal adenocarcinoma has evolved during the last decade, shifting from a conventional neoadjuvant chemoradiotherapy, surgery, and adjuvant chemotherapy in all cases to a total neoadjuvant approach, especially in locally advanced tumors when a sphincter-sparing surgery has been planned. However, the exact indications and the neoadjuvant regimen with the highest response remain unresolved. We aimed to assess whether administering neoadjuvant chemotherapy before and after preoperative chemoradiotherapy could increase the pathological complete response (pCR) rates.MethodsWe conducted a phase 3, multicenter, randomized trial at four hospitals in Iran. Adult patients with a newly diagnosed, biopsy-proven, locally advanced non-metastatic rectal adenocarcinoma with an ECOG performance status of 0–2 were randomly assigned (2:2) to either the total neoadjuvant treatment (TNT) or the standard-of-care groups using a block randomized design. Investigators and participants were not masked to treatment allocation and groups. The TNT group received neoadjuvant chemotherapy with FOLFOX6 (intravenous 85 mg/m2 oxaliplatin and 400 mg/m2 leucovorin, followed by intravenous 400 mg/m2 fluorouracil bolus and then continuous infusion at a dose of 2,400 mg/m2 over 46 h every 14 days for four cycles before and four cycles after chemoradiotherapy), chemoradiotherapy (50.4 Gy during 28 fractions and 800 mg/m2 concurrent oral capecitabine twice daily 5 days per week), and total mesorectal excision. The standard-of-care group received neoadjuvant chemoradiotherapy, total mesorectal excision, and adjuvant chemotherapy (eight cycles). The primary endpoint was the pathological complete response. Safety analyses were conducted on treated patients.ResultsOverall, 25 and 27 patients were enrolled in the TNT and standard-of-care groups, respectively. Both groups were similar in terms of gender, age, and tumor differentiation. The tumors in the standard-of-care group were significantly located closer to the anal verge compared with those in the TNT group (9.4 ± 3.7 cm in TNT vs. 6.8 ± 4 cm in standard, p = 0.02). A pCR was reached in 48% (12/25) and 25.9% (7/27) of patients in the TNT and standard-of-care groups, respectively (p = 0.4). The R0 resection rates were identical between the two groups (92% vs. 88.9%, p = 0.3). Moreover, the toxicity rates were similar between the two groups.ConclusionOur results showed that TNT is a safe and feasible treatment approach in patients with rectal cancer and may improve the overall pCR rate compared with standard treatment.Clinical trial registrationhttps://irct.behdasht.gov.ir/trial/65666, identifier IRCT20220723055527N1.

Purpose: This study aimed to evaluate the impact of lidocaine-saline solution compared to saline alone for washing out the lumpectomy cavity, focusing on its effect on acute postoperative pain—a prevalent and significant concern among patients undergoing breast surgery. Methods: In this comparative study, 72 patients scheduled for lumpectomy surgery were randomly assigned to either the lidocaine-saline or saline group. The lidocaine-saline group was administered a washout of the lumpectomy cavity with 2 % lidocaine at a dosage of 1.75 mg/kg in 0.9 % normal saline, whereas the saline group received a washout with an equivalent volume of 0.9 % normal saline. We recorded the participants' basic characteristics, heart rate, blood pressure, the incidence and intensity of pain (measured by the visual analogue scale), and the usage of postoperative analgesics. Results: The two study groups did not differ significantly in their basic characteristics, heart rate and blood pressure. The saline group had significantly higher pain intensity than the lidocaine-saline group at 30 min after surgery (4.61 vs. 2.88, P

The lack of accurate understanding of the environment and its surrounding fauna has led to the spread of misconceptions about the behaviors of certain animals, such as lizards. This is evident even in articles that lack scientific rigor. For instance, one article claims that the painful bites of lizards can cause fear and infection.[1]Additionally, many people believe that lizards possess poisonous tails, leading to the erroneous assumption that if they were to fall into cooking pots and be consumed, it could result in death due to cyanide poisoning. Such beliefs, particularly regarding Iranian lizards, are unfounded. This fear is largely rooted in superstition; it is important to note that lizards do not pose a threat to human life. They are completely harmless creatures, and even when captured or trapped, they do not endanger humans. Over the past 35 years, various species of Iranian lizards-ranging from 2 to 80 centimeters in size-have coexisted in both natural environments and traditional and modern homes without causing any harm [Figure 1].This fear is entirely baseless and primarily stems from cultural misconceptions that should be addressed through public awareness initiatives. Lizards are not merely pests; they are also among the best biological pest control agents.[2,3] They can effectively hunt mosquitoes for hours behind window screens in homes. As some of the most efficient insectivores, lizards have adapted well to a variety of habitats, including deserts, mountains, forests, and both urban and rural residential areas, without causing any harm or damage. They play a vital role in controlling pests such as cockroaches and mosquitoes.[4] However, awareness of the benefits of these creatures in Iran remains low.Having a lizard in the house is akin to hiring someone to tirelessly combat household pests day and night-without incurring any expenses, chemical pollution, or the need for management and supervision.[5]While some lizards are venomous, they belong to specific families. The Iguanidae family includes the green iguana (Iguana iguana), which has a weak venom and is found from Mexico to Brazil. The Helodermatidae family features well-known venomous species such as the Gila monster (Heloderma suspectum), which inhabits areas in the southern United States-including Arizona, California, Nevada, Utah, New Mexico-and parts of Mexico such as Sonora and Sinaloa, as well as Guatemala's borders. Human bites from these lizards are rare, with the last reported death occurring in 1939.[6,7]A significant number of venomous species have been reported within the Varanidae family. Among them is the West African Nile monitor, Varanus niloticus stellatus, which possesses mild and harmless venom. The Crocodile monitor, Varanus salvadorii, native to the islands of New Guinea, is known for its invasive nature. Another notable species is the Malayan water monitor, Varanus salvator, which has been reported in regions such as Bengal, Sri Lanka, and China. The Komodo dragon, Varanus komodoensis, is one of the largest lizards in the world and inhabits the Komodo Islands of Indonesia.[8,9] Recent studies have identified 171 lizard species in Iran, three of which belong to the Varanidae family. While many of the world's venomous lizard species are part of this family, no venomous species have been documented in Iran to date.[10,11To date, there has been no documented evidence indicating that Iranian lizards are poisonous or venomous. Many individuals mistakenly believe that lizards shed their tails to distract predators, leading to the predator's demise due to toxins such as cyanide or other harmful substances. Occasionally, we hear unfounded claims that people have died after a lizard fell into a pot of food or a milk churn.Some researchers have demonstrated that ingesting domestic lizards in Iran does not result in any poisonous effects, such as nausea, diarrhea, stomach pain, drowsiness, dizziness, weakness, high fever, chills, loss of appetite, headaches, irritability, difficulty swallowing (dysphagia), breathing difficulties, excessive salivation, skin rashes, cyanosis (blue lips and skin), burns around the nose or mouth, double vision or blurred vision, mental confusion, seizures or convulsions, loss of consciousness, or coma.[12]The fear or phobia of lizards, similar to apprehensions regarding other phenomena, is widespread globally and manifests in hundreds of phobia types across various cultures and geographical regions. The role of researchers is not to endorse or validate these unfounded fears stemming from ignorance but rather to educate the public about the true nature of these creatures. Education should begin at the earliest stages of life. It is notable that while most members of society may enjoy seeing a sheep's head in a pot, they often express concern about having a lizard in their home. This reaction is not inherent but rather a set of cultural behaviors passed down through generations. If this fear and discomfort regarding lizards become widespread, it could exacerbate the situation. Certainly, we know individuals who may have sensitivities or aversions to certain foods or fruits; however, these sensitivities often diminish over time with increased experience or knowledge.Lizards play a crucial role in ecosystems, particularly in controlling rodent populations. By preying on rodents, they help maintain balance within the food web and contribute to the overall health of their environments. This ecological function is especially important in agricultural settings, where rodent infestations can cause significant crop damage and economic losses.The reliance on chemical pesticides for pest control has raised numerous environmental concerns. Pesticides can have detrimental effects on non-target species, including beneficial insects, birds, and aquatic life. Additionally, the need to change pesticide formulations over time often leads to the use of more potent chemicals, further harming ecosystems and potentially impacting human health.In contrast, biological control methods-such as using natural predators like lizards, rodents, and predatory birds-offer a more sustainable approach to pest management. This method not only reduces reliance on chemical pesticides but also promotes biodiversity and enhances ecosystem resilience. By integrating lizards into pest management strategies, farmers can harness their natural predation abilities, resulting in healthier crops and improved public health outcomes.Furthermore, fostering lizard populations in agricultural areas can decrease the prevalence of pests that transmit diseases to humans and livestock, underscoring their importance in maintaining ecological balance. As awareness of these benefits grows, more agricultural practices are likely to incorporate biological control methods, recognizing the invaluable contributions of lizards and other natural predators to sustainable farming and environmental health.Lizards primarily feed on rodents, making them a vital natural control factor for rodent populations.[9] Consequently, they hold significant ecological value within the energy pyramid. By removing lizards from the natural ecosystem, humans would eliminate one of the key players in maintaining population balance.Experts in agricultural and environmental sciences have concluded that the use of pesticides for pest control should be minimized due to their harmful effects on the environment. Furthermore, every few years, the types of pesticides used must be changed to maintain their effectiveness against pests, often resulting in the application of stronger chemicals that exacerbate environmental damage.In response to these challenges, humans have increasingly turned to breeding and utilizing various natural predators, such as lizards, rodents, and predatory birds, to combat agricultural pests. This approach, known as biological control, is now widely adopted in many countries. By controlling populations of both agricultural and health-related pests, lizards play a crucial role in enhancing public health and increasing crop yields.[5,9]

Aridity indices have been widely applied in dividing climate regimes and monitoring drought events. The knowledge of the aridity index and reference evapotranspiration is very important not only for understanding climate change and its effects on ecosystem stability but also for managing agricultural water resources. Therefore, in this work, we studied the spatial-temporal variation and trend of ETo, Tmean, and four aridity indices, such as the De Martonne aridity index, Pinna combinative index, FAO aridity index, and Thornthwaite aridity index, and its climatic attribution in Northeast Iran using the observed climate records from 10 synoptic meteorological stations from 1950 to 2021. The results showed that ETo for Northeast Iran as a whole exhibited an increase at a rate of +9.65 mmyr-1; Tmean showed an increasing trend at the rate of 0.03 ºC year−1 from the beginning of the statistical period of each station until 2021. Also, the AIT, AIDM, AIP, and AIF increased significantly by +0.001, -0.03, -0.01, and -0.001 year-1, respectively. Approximately 100% of stations showed an increasing trend in AIT and AIF, while 50% of stations reached up to a significant increasing level, and about 60% of stations showed an increasing trend in AIDM and AIP, while 70% of stations reached a significantly increasing level, which demonstrated that Northeast Iran was getting drier for the recent 40 years. This analysis of this study enhances the understanding of the relationship between climate change and drought in Northeast Iran, may be helpful for the agricultural irrigation system.

Abstract Smartphone sensors have gained considerable traction in Human Activity Recognition (HAR), drawing attention for their diverse applications. Accelerometer data monitoring holds promise in understanding students’ physical activities, fostering healthier lifestyles. This technology tracks exercise routines, sedentary behavior, and overall fitness levels, potentially encouraging better habits, preempting health issues, and bolstering students’ well-being. Traditionally, HAR involved analyzing signals linked to physical activities using handcrafted features. However, recent years have witnessed the integration of deep learning into HAR tasks, leveraging digital physiological signals from smartwatches and learning features automatically from raw sensory data. The Long Short-Term Memory (LSTM) network stands out as a potent algorithm for analyzing physiological signals, promising improved accuracy and scalability in automated signal analysis. In this article, we propose a feature analysis framework for recognizing student activity and monitoring health based on smartphone accelerometer data through an edge computing platform. Our objective is to boost HAR performance by accounting for the dynamic nature of human behavior. Nonetheless, the current LSTM network’s presetting of hidden units and initial learning rate relies on prior knowledge, potentially leading to suboptimal states. To counter this, we employ Bidirectional LSTM (BiLSTM), enhancing sequence processing models. Furthermore, Bayesian optimization aids in fine-tuning the BiLSTM model architecture. Through fivefold cross-validation on training and testing datasets, our model showcases a classification accuracy of 97.5% on the tested dataset. Moreover, edge computing offers real-time processing, reduced latency, enhanced privacy, bandwidth efficiency, offline capabilities, energy efficiency, personalization, and scalability. Extensive experimental results validate that our proposed approach surpasses state-of-the-art methodologies in recognizing human activities and monitoring health based on smartphone accelerometer data.

Abstract Formaldehyde, a known carcinogenic compound, is commonly used in various medical settings. The objective of this study was to assess the carcinogenic and non-carcinogenic risks associated with occupational exposure to formaldehyde. This study was conducted in the pathology labs of four hospitals in Tehran. Cancer and non-cancer risks were evaluated using the quantitative risk assessment method proposed by the United States environmental protection agency (USEPA), along with its provided database known as the integrated risk information system (IRIS). Respiratory symptoms were assessed using the American thoracic society (ATS) questionnaire. The results indicated that 91.23% of exposure levels in occupational groups exceed the NIOSH standard of 0.016 ppm. Regarding carcinogenic risk, 41.03% of all the studied subjects were in the definite carcinogenic risk range (LCR > 10−4), 23.08% were in the possible carcinogenic risk range (10−5 1.0). Overall, the findings revealed significantly higher carcinogenic and non-carcinogenic risks among lab technicians and pathologists. Therefore, it is imperative to implement control measures across various hospital departments to mitigate occupational formaldehyde exposure levels proactively. These findings can be valuable for policymakers in the health sector, aiding in the elimination or reduction of airborne formaldehyde exposure in work environments.

Abstract Background Endometriosis is one of the most common and costly diseases among women. This study was carried out to investigate pregnancy outcomes in women with endometriosis because of the high prevalence of endometriosis in reproductive ages and its effect on pregnancy-related complications outcomes. Methods This was a cross-sectional study performed on 379 pregnant women with endometriosis who were referred to the endometriosis clinic of the Avicenna Infertility Treatment Center from 2014 to 2020. Maternal and neonatal outcomes were assessed for the endometriosis group and healthy mothers. The group with endometriosis was further divided into two groups: those who underwent surgery and those who either received medication alone or were left untreated before becoming pregnant. The analysis of the data was done using SPSS 18. Results The mean age of the patients was 33.65 ± 7.9 years. The frequency of endometriosis stage (P = 0.622) and surgery (P = 0.400) in different age groups were not statistically significant. The highest rates of RIF and infertility were in stages 3 (N = 46, 17.2%) (P = 0.067), and 4 (N = 129, 48.3%) (P = 0.073), respectively, but these differences were not statistically different, and the highest rate of pregnancy with ART/spontaneous pregnancy was observed in stage 4 without significant differences (P = 0.259). Besides, the frequency of clinical/ectopic pregnancy and cesarean section was not statistically different across stages (P > 0.05). There is no significant relationship between endometriosis surgery and infertility (P = 0.089) and RIF (P = 0.232). Most of the people who had endometriosis surgery with assisted reproductive methods got pregnant, and this relationship was statistically significant (P = 0.002) in which 77.1% (N = 138) of ART and 63% (N = 264) of spontaneous pregnancies were reported in patients with endometriosis surgery. The rate of live births (59.4%) was not statistically significant for different endometriosis stages (P = 0.638). There was no stillbirth or neonatal death in this study. All cases with preeclampsia (N = 5) were reported in stage 4. 66.7% (N = 8) of the preterm labor was in stage 4 and 33.3% (N = 4) was in stage 3 (P = 0.005). Antepartum bleeding, antepartum hospital admission, preterm labor, gestational diabetes, gestational hypertension, abortion, placental complications and NICU admission were higher in stage 4, but this difference had no statistical difference. Conclusion Endometriosis is significantly correlated with infertility. The highest rates of RIF and infertility are observed in stages 3 and 4 of endometriosis. The rate of pregnancy with ART/spontaneous pregnancy, preterm labor, preeclampsia and pregnancy-related complications is higher in stage 4. Most of the people who had endometriosis surgery with assisted reproductive methods got significantly pregnant. Clinical/ectopic pregnancy, cesarean sections, and live birth were not affected by the endometriosis stages.

Abstract Background Ophthalmic artery aneurysm (OAA) can be secured in endovascular or microsurgical approaches. Still there are controversies in technique selection and their long term outcomes. Methods All the patients with OAA were treated microsurgically and followed. Demographic data, neurological status, physical examination findings, angiographic data, operation details, and intraoperative and postoperative events were recorded and analyzed. P

Aim and Background: The current study aimed to investigate the effectiveness of a combined treatment based on virtual reality and mindfulness on trait-state anxiety in individuals with panic disorder. Methods and Materials: The research employed a semi-experimental design with two experimental and control groups, utilizing pre-test, post-test, and a 45-day follow-up. The target population included all individuals exhibiting symptoms of panic disorder seeking counseling and psychotherapy services in Tehran during the years 1401-1402. The sample size consisted of 30 individuals diagnosed with panic disorder, selected purposively, and randomly assigned to the experimental (15 individuals) and the control groups (15 individuals). The experimental group underwent eight sessions of combined virtual reality and mindfulness-based therapy. Both groups answered the State-Trait Anxiety Inventory (STAI) questionnaire in three phases (pre-test, post-test, and 45-day follow-up). The research data were analyzed using SPSS23 statistical software, employing mixed analysis of variance (ANOVA) and independent and dependent t-tests for analysis. Findings: The results showed that the average scores of trait and state anxiety in the experimental group at post-test and follow-up stages compared to the control group had a significant decrease (p

Objective(s): Toxoplasma gondii is a common parasite in the world. Pharmaceutical options for toxoplasmosis treatment are limited. Several studies have been conducted on the anti-infectious properties of miltefosine (MLF). We investigated the effectiveness of nanoemulsion miltefosine (NEM) in tachyzoites of T. gondii, RH strain.Materials and Methods: Various NEM formulations were designed considering pseudo-ternary phase diagrams. Physicochemical properties of the developed nanoemulsions (NEs), including pH, polydispersity index (PDI), droplet size, and refractive index (RI) were evaluated. The considered formulation was analyzed for dilution and stability tests. MTT assay was performed on Vero cells for calculation CC50 and on Vero cells with RH strain tachyzoite for calculation IC50. Sulfadiazine (SDZ) and pyrimethamine (PYR) were positive controls. The trypan blue method was used to investigate the effect of drugs (NEM, MLF, SDZ, PYR) in reducing the number of infected Vero cells and reducing the intracellular proliferation of tachyzoites. Next, the viability of tachyzoites was measured in the tube in the direct vicinity of different drug concentrations.Results: The final particle size of NEM was calculated to be 17.463 nm by DLS and TEM. The CC50 of NEM (75.7 µg/mL) indicated lower toxicity than the other drugs. IC50 obtained by trypan blue, MTT, and test tube methods showed that NEM (28.43 µg/mL) has a suitable IC50 against Toxoplasma tachyzoites.Conclusion: The calculated selectivity index (SI) demonstrated that NEM (SI=2.66) is a more suitable drug candidate than the MLF and positive controls. The trypan blue assay indicated the excellent reduction effect of NEM on T. gondii intracellular proliferation rate and the number of infected cells.

High energy collisions at the High-Luminosity Large Hadron Collider (LHC) produce a large number of particles along the beam collision axis, outside of the acceptance of existing LHC experiments. The proposed Forward Physics Facility (FPF), to be located several hundred meters from the ATLAS interaction point and shielded by concrete and rock, will host a suite of experiments to probe standard model (SM) processes and search for physics beyond the standard model (BSM). In this report, we review the status of the civil engineering plans and the experiments to explore the diverse physics signals that can be uniquely probed in the forward region. FPF experiments will be sensitive to a broad range of BSM physics through searches for new particle scattering or decay signatures and deviations from SM expectations in high statistics analyses with TeV neutrinos in this low-background environment. High statistics neutrino detection will also provide valuable data for fundamental topics in perturbative and non-perturbative QCD and in weak interactions. Experiments at the FPF will enable synergies between forward particle production at the LHC and astroparticle physics to be exploited. We report here on these physics topics, on infrastructure, detector, and simulation studies, and on future directions to realize the FPF's physics potential.

BackgroundOpium use disorder is a significant health problem in our country, leading to a considerable number of health issues. Opium has several detrimental effects on its consumers. However, the effect of Opium use disorder on intracerebral hemorrhage (ICH) has not been evaluated. This study aims to evaluate the relationship between Opium use disorder and ICH.MethodsIn this case–control study, 402 patients with ICH and 404 patients without ICH enrolled. Opium use disorder, other vascular risk factors including diabetes mellitus, hypertension, hyperlipidemia, and tobacco smoking was compared between these groups. Patients with ICH were divided into two groups; first group are patients with history of Opioid Use Disorder and second group are those patients without Opioid Use Disorder. ICH features including clinical and imaging characteristics and prognostic findings were compared between patients with and without Opium use disorder.ResultsThis case–control study of 806 participants found that hypertension (OR = 6.84, 95% CI: 5.03–9.34, p-value:

Investors' beliefs and expectations form the foundation for their decision-making and behavior. Assets are crucial for companies' current and future decisions, significantly influencing investors' perceptions. Accounting for assets reduces uncertainty about a stock's intrinsic value and shapes expectations regarding the company. Additionally, accounting assets informativeness is a key factor in distinguishing earnings. Hence, the earnings quality may not affect the relationship between assets informativeness and investors' beliefs. This study investigates the relationship between accounting assets informativeness and investors' beliefs, with a focus on the impact of accounting earnings quality. A sample of 249 companies listed on the Tehran Stock Exchange between 2013 and 2023 was selected for analysis. The research model was estimated using panel data, controlling for year and industry effects, through the ordinary least squares method with robust standard errors (clustering errors at the company level). To measure assets informativeness, a ten-year rolling regression of a company's net operating assets against its earnings was employed. The results indicate that increased assets informativeness positively influences investors' beliefs both at the aggregate and discretionary levels. However, assets informativeness related to inherent factors does not impact investors' beliefs. Furthermore, low earnings quality does not weaken the relationship between assets informativeness at the aggregate level and discretionary factors with investors' beliefs. These findings can assist financial statement users, particularly investors and shareholders, in considering the awareness of accounting assets when estimating a share's intrinsic value for investment decisions.

Wellness tourism has grown popular and augmented the global market due to increasing healthy lifestyles. Based on the expectancy disconfirmation theory, the study aims to determine the antecedents and significance of tourists’ revisit intention for wellness tourism. A quantitative method has been adopted. Data was collected from 361 tourists at wellness centres in Malaysia, and structural equation modelling was used to analyze the measurement and structural model. The majority of respondents are female, aged between 21 and 30, unmarried, with an average monthly income of USD 2,000. The study found that tourists’ satisfaction was influenced by perceived value from social and emotional perspectives, while their experience was shaped by their emotional and quality perception of value content. Rewards had a significant impact on both satisfaction and travel experience. Tourists were more likely to recommend a wellness vacation if they were satisfied, but it was their unique travel experience that triggered revisit intention. E-word-of-mouth played a mediating role and revealed a positive relationship between satisfaction, revisit intention, and word-of-mouth. This study demonstrated the importance of determining the underlying factors to create tourists’ revisit intention. The implications from theoretical and managerial viewpoints provide insights to scholars and practitioners to revitalize the tourism industry after COVID-19.

Background: This study is done to determine the translation and psychometric properties of the Persian version of Neonatal Intensive Care Unit Parental Belief Scale (NICU-PBS) in Iranian parents. Materials and Methods: The present study was conducted by the descriptive cross-sectional method. This research was conducted from January to August 2021. The population included all parents whose infants were hospitalized in NICUs of two university-affiliated hospitals (Kermanshah University of Medical Sciences and Shiraz University of Medical Sciences). Out of them, 291 subjects were selected by the purposeful sampling method. The utilized questionnaires included a demographic information form, NICU-PBS, Beck Depression Inventory, and Maternal role adaptation scale. The descriptive statistical indexes, Cronbach’s alpha, intra-class correlation coefficient, and Pearson’s correlation coefficient were used for data analysis. Also, to evaluate the construct validity of the NICU-PBS, we used Confirmatory Factor Analysis (CFA). Results: The participants included 97 fathers (33.33%) and 194 mothers (66.67%). According to the CFA results, the three-factor model NICU-PBS (confidence in the parental role, parent–child interaction, parental knowledge of the NICU) was approved in Iranian parents (χ2/df = 1.79; p < 0.001; GFI = 0.91; AGFI = 0.89; CFI = 0.91; RMSEA = 0.05). NICU-PBS with BDI-II (r = -0.42) has divergent validity, and material role adaptation (r = 0.46) has moderate and acceptable convergence validity (p < 0.01). The results of Cronbach’s alpha for the total NICU-PBS were 0.85. Conclusions: The results demonstrated the proper and acceptable validity and reliability of NICU-PBS among Iranian parents.

Aim: To evaluate the role of lumbar sacralization (LS) on the surgical outcomes of L4-L5 microdiscectomy. Methods: This prospective cohort study was conducted in a university referral hospital. The patients with L4-L5 disc herniation and eligible for microdiscectomy were enrolled and allocated in G1 (with LS) and G2 (no LS). After the L4-L5 microdiscectomy patients were followed, clinical and radiological parameters were collected to investigate the influence on the outcomes. Recurrence, low back outcome score (LBOS), and the Oswestry disability index (ODI) were defined as main outcomes. Results: Two hundred and forty patients (n = 120, each), were reviewed in the final analysis. There was no difference between groups regarding baseline characteristics. Postoperative radicular and back pain was more severe in LS(P