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Statement of Problem: Bite force is generated due to the consonance between different parts of the masticatory system. In dentistry, measurement of the bite force is quite common through several methods and devices. Objective: The aim was to present a novel bite force-measuring device that could help reducing the costs. Materials and Methods:This study presented the design, fabrication, and calibration method of a novel low-cost bite force-measuring device based on a force-sensitive resistor and application of strain gages. The FSR 402 was the selected sensor, which was suitable in size for placement in mouth, sterilizable for reuse, and contained biocompatible material.It could measure a large bite force of up to 90 kg with high repeatability.The device had a liquid crystal display (LCD) for immediate visualization of the results and a system for quick calibration of the device in office. To assess the accuracy of the device, some forces were applied to the sensor in nine values from11 to 80kg. The mean of measured force, absolute error, and error percentage were measured and recorded. Results: The mean relative error was almost 2% within the range of 11-80kg. The lowest error percentage was 0.46% at the load of 52kg and the highest error percentage was 3.97% at the load of 28 kg.Error percentage was 2.51% in the lowest range (11kg) and 2.65% in the highest range (80kg).The relative error in different ranges did not follow a particular trend. Conclusions:The bite force-measuring device is an economical and user-friendly appliance that can be simply used for routine practice in the office. The device shows good linearity and repeatability. It also has a calibration apparatus that can help maintaining the device accuracy.

Abstract Background One of the most significant advantages of Helicopter Emergency Medical Service (HEMS) in disaster relief efforts is their ability to reach inaccessible or remote areas quickly. This is especially important in the aftermath of natural disasters such as earthquakes, floods, or hurricanes, where roads may be blocked or damaged, and conventional ground transportation may not be available. There are many factors can affect the performance of Helicopter Emergency Medical Service (HEMS) in disasters. This study aims to investigate the factors affecting the Helicopter Emergency Medical Service (HEMS) in disasters. Methods The systematic search in Cochran Library, PubMed, Scopus, Science Direct, Web of Science, ProQuest, and Google Scholar databases between the first of January in 1975 and the thirty-first of May in 2023. The articles were selected based on the keywords of the authors. At last, the criteria were extracted from the selected ones. Results The primary search included 839 articles. After studying their title, abstract, and full context, only nine articles, including two qualitative and seven quantitative ones, were chosen for analysis. After analysis and extracting data from the final studies, the preparation factors were categorized into 6 general classes of human resources: training and practicing, management, instructions and standards, equipment, and structure. Among these, the role of training is highlighted by holding practice and maneuvers to improve and prepare the personnel and manage disasters and incidents. Conclusion The results obtained from this systematic review provide a total view of the factors affecting the preparation of the air ambulance during disasters and incidents. It is recommended that senior managers and policy makers use the findings of the present study to identify the factors which affect preparedness of HEMS in disasters and take the necessary measures to eliminate to obstacles.

Abstract This paper is concerned with investigating the spatial behavior of solutions for a class of hyperbolic equations in semi-infinite cylindrical domains, where nonlinear dissipative boundary conditions imposed on the lateral surface of the cylinder. The main tool used is the weighted energy method. Mathematics Subject Classification (2010) 35B40, 35L05, 35L35

Objectives Since older people make up a great percent of the population is Iran, and they experienced higher mental, physical, and emotional pressures due to quarantine and lockdown during the COVID-19 pandemic, the present study aims to investigate the lived experiences of older adults during the COVID-19 pandemic in Iran. Methods & Materials This qualitative phenomenological study was conducted in Fars, Kermanshah, and Tehran provinces of Iran from October 1, 2021 to January 30, 2022. The data were collected through interviewing 16 older adults. Data analysis was done by Smith’s interpretative phenomenology analysis. Results Of 16 older adults, 9 were male and 7 were female, with a mean age of 73 years. Their lived experiences were classified into three main categories: Psychological tensions, resilience (healing) measures, and economic tensions. Conclusion Iranian older people experienced various types of tensions during the COVID-19 pandemic. Social distancing and quarantine increased the concerns about their mental health. Therefore, it is very important to identify and analyze the psychological concepts and protective factors along with preparing practical guidelines to protect their mental health during the COVID-19 pandemic.

Abstract Background and Aims The reasons for the unfavorable performance of hospitals in providing care to Coronavirus Disease 2019 (COVID‐19) patients include the lack of preparation, knowledge, and relevant skills, making it necessary to evaluate the preparedness of nurses to respond to COVID‐19. Therefore, the present study aimed to investigate the preparedness of hospitals affiliated with Shahrekord University of Medical Sciences during the COVID‐19 pandemic in 2022. Methods In this analytical study, data were collected from 350 randomly selected nurses who worked in three hospitals affiliated with Shahrekord University of Medical Sciences; demographic information tools and the preparation of nurses for COVID‐19 patients were used to collect the data. We analyzed the data using SPSS software version 26. Results The mean and standard deviation of the total preparation score was 118.85 ± 0.98. The lowest (6.80 ± 0.18) and highest (23.35 ± 0.19) average values belonged to risk assessment and management and COVID‐19, respectively. The score of nurses' preparedness to deal with COVID‐19 was not statistically correlated with age, work experience, and so on. The average preparation score was significantly different in different treatment departments (operating room and COVID‐19). Conclusion The preparation of nurses was low in dealing with COVID‐19. Thus, managers of nursing services should design and implement educational programs to strengthen the nurses' weaknesses and ultimately increase their awareness and skills in dealing with disasters.

Leachate production and management is a challenging environmental issue in municipal landfills and depots in Iran. Leachate contains toxic materials, heavy metals, and organic and microbial pollutants on a significant scale. Its uncontrolled entrance into the surface, groundwater, and soils can also substantially inverse impacts on human health and natural habitats. In Mazandaran province, during the last decades, depots and landfilling of municipal and industrial waste have led to environmental degradation in its eco-sensitive natural zones and brought a series of health, social, and security challenges to the region. Due to the region's high precipitation rate and landfills with no cover, these places practically convert into an extensive resource for leachate production. To diminish the environmental impacts, a lot of work has been done in recent years to develop a sort of leakage gathering system and treatment plants in these landfills, based primarily on an overall estimation. In this study, a calculating computer model has been developed for leakage production based on regional climate conditions and the characteristics of municipal waste. This model is different from the HELP model, which is commonly used for sanitary landfills and is specifically developed for the waste depots of the Mazandaran province. In this model, hydrological methods, which are based on the water balance in the landfill sites, were used for the calculation. The developed model was uploaded as an online service for public use. By referring to the internet address provided, the developed model in the landfill part and the leachate section, the amount of produced leachate for the landfill site of Mazandaran province can be calculated. Also, the leachate volume of the Babol Anjilsi landfill has been calculated as a case study. As a result of this study, the lowest and highest amount of the production leachate for hot and dry months of the year (June and July) and for wet and rainy months (October) was about 63.39 and 260.07 cubic meters per day, respectively.

In this paper, we analyze the eighth grade students performance in Fars province in cognitive and content domains in mathematics by TIMSS 2019 assessment results. Due to the cultural, social and economic proximity of Fars and Isfahan provinces, corresponding results have been obtained for students of Isfahan province and comparisons have been made in each domain by using appropriate tests. Also, gender analysis has been derived in both cognitive and content dimensions and in all of their domains in mathematics for students of both provinces

Abstract Background and Aims The effective response of emergency medical services in mass casualty incidents (MCIs) calls for sufficient preparation. The components of preparation must be determined first to achieve this goal. This study aimed to describe the elements of preparedness of emergency medical services for MCIs. Methods A qualitative study was carried out on emergency medical service systems in Iran (from April 2022 to mid‐March 2023), using in‐depth semistructured interviews with participants who were managers and members of the incident command team, experts, technicians, paramedics, and telecommunicators of emergency medical services. Interviews were carried out face‐to‐face and via telephone. The data were collected using voice recorder and transcript and analyzed by content analysis method. This study was conducted using the consolidated criteria for reporting qualitative research. Results Thirty‐six participants were included in the study. A total of 834 codes were analyzed. Thirteen components were extracted from the study and classified as five categories including “Strengthening management and organization,” “individual and group empowerment,” “capacity expansion,” “technology and infrastructure development,” and “operational response measures.” Conclusion Emergency medical service preparedness in response to MCIs is a critical issue. For improving preparedness, the main components must be identified. The study results described the elements of emergency medical service preparedness, which could be used as a framework for developing the national model of emergency medical service preparedness in MCIs.

Abstract Background & Objective Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of the present study was to explore midwives’ lived experiences of delivering continuous midwife-led intrapartum care. Methods This study took a qualitative approach in meeting its aim. Participants were midwives working in the labour wards of private and public hospitals in Iran. The data were purposefully collected in 2019 through in-depth, semi-structured, and face-to-face interviews with midwives (n = 10) aged between 26 and 55 years. A thematic analysis based on descriptive phenomenology was undertaken to make sense of the data collected. Results “Wanting to lead continuous woman-centered care but being unable to” was identified as an overarching theme. Three other themes “emphasis on the non-interventional care”, “midwifery-specific focus” and “barriers and challenges of midwifery care” were also identified. Ultimately, midwives described knowing how to and wanting to lead continuous ‘woman’-centered care but being unable to. Perceived barriers included lack of familiarity with and knowledge in relation to childbirth, the insignificant role of midwives in decision making, obstetrician utilitarianism, high workloads along with work-related stress argument-driven communication between midwives and obstetricians and an absence of a ‘triangle of trust’ in care. Conclusion Future research strategies could usefully include obstetricians and focus on the upscaling of midwifery in Iran using continuity of care models, highlight the value of midwives, identify why uptake of antenatal education in Iran is poor and develop user friendly, evidence based, midwife-led programs. Initiatives aiming to promote mutual professional respect, trust and collegiality and increased remuneration for midwifery work would be also welcomed in pursuit of reducing maternal and infant mortality in Iran.

Laughter is a nonverbal vocalization occurring in every known culture, ubiquitous across all forms of human social interaction. Here, we examined whether listeners around the world, irrespective of their own native language and culture, can distinguish between spontaneous laughter and volitional laughter-laugh types likely generated by different vocal-production systems. Using a set of 36 recorded laughs produced by female English speakers in tests involving 884 participants from 21 societies across six regions of the world, we asked listeners to determine whether each laugh was real or fake, and listeners differentiated between the two laugh types with an accuracy of 56% to 69%. Acoustic analysis revealed that sound features associated with arousal in vocal production predicted listeners' judgments fairly uniformly across societies. These results demonstrate high consistency across cultures in laughter judgments, underscoring the potential importance of nonverbal vocal communicative phenomena in human affiliation and cooperation.

BackgroundCOVID-19 pandemic has resulted in drastic changes around the world, revealing vulnerable aspects of healthcare systems. This study aimed to explore how Iranian healthcare system experienced the paradigm shift during the pandemic and determine the aspects that need improvement during the pandemic era.MethodThis qualitative study was conducted in 2021. A framework analysis approach was used to analyze the content of the 19 semi-structured interviews with the healthcare system experts from Shiraz University of Medical Sciences (SUMS). The interviews‘ audio files changed into transcript after each session and data was saturated at the 19 interview. To increase the trustworthiness of the study, Guba and Lincoln's criteria including credibility, transferability, dependability, and confirmability were used. Goldsmith's five-step framework analysis was used applying MAX QDA version 10 software.ResultEight main themes and 20 subthemes were explored. The main themes included “strengthening the electronic health infrastructure,” “research for evidence-based decision making,” “dedicated financing to the pandemic,” “prevention of disruption in the effective provision of services and medicines,” “enriching the authority of the Ministry of Health by focusing on interactions,” “recruiting, managing and empowering health human resources with attention to financial and non-financial incentives,” “reforming educational approaches in training students in medical universities,” as well as “lessons learned from neglected aspects.”ConclusionTo be ready to respond to a possible future pandemic and for a paradigm shift, bold steps must be taken to make fundamental changes in various aspects of the healthcare system including e-health development, evidence-based decision making, dedicated budgets for pandemics, reinforcement of interactions at the national and international level, as well as sufficient attention to healthcare workers from all financial, non-financial and educational aspects.

Abstract Background and Aims The COVID‐19 pandemic has changed people's lifestyles as well as the way healthcare services are delivered. Undoubtedly, the difficulties associated with COVID‐19 infection and rehabilitation and those associated with quarantine and viral preventive efforts may exacerbate the need for virtual reality to be used as a part of a complete rehabilitation strategy for these individuals. Thus, the present research aimed to evaluate the potential uses of virtual reality for the rehabilitation of individuals suffering from COVID‐19. Methods From 2019 to March 1, 2022, a systematic search was conducted in PubMed, Cochran Library, Scopus, Science Direct, ProQuest, and Web of Science databases. The papers were selected based on search terms and those that discussed the use of virtual reality in the rehabilitation of COVID‐19 patients were reviewed. Each step of the study was reviewed by two authors. Results A total of 699 papers were found during the first search. Three papers were chosen for further investigation after a thorough evaluation of the publications' titles, abstracts, and full texts. Cross‐sectional studies, randomized controlled clinical trials, and case reports comprised 33%, 33%, and 33% of the publications, respectively. Based on the results, people suffering from COVID‐19 were the focus of two papers (66%) that employed immersion virtual reality for cognitive rehabilitation, whereas one study (33%) used non‐immersive virtual reality for physical rehabilitation. In two papers (66%), virtual reality was also offered to patients in the form of a game. Conclusion According to the results of the present research, virtual reality games may enhance functional and cognitive consequences, contentment levels among patients, and their ability to take charge of their own health care. In light of the obstacles faced by COVID‐19 patients, alterations in the delivery of healthcare, and the significance of rehabilitation in this group during quarantine, new techniques have been considered for these patients to maintain treatment, return to regular life, and enhance their standard of life.

Background: The present study aimed to evaluate the surge capability of Shahid Rajaee Trauma Hospital in Shiraz City, Iran, in response to a mass causality incident. Materials and Methods: This descriptive study was conducted in Shahid Rajaee Hospital in Shiraz in 2017. The Delphi technique was used in this study. Three checklists were used for the Emergency Department, Operating Room, and Intensive Care Unit. The surge capacity was calculated for each unit based on the formulas derived from different studies. Results: The surge capacities of the Emergency Department, Intensive Care Unit, and Operating Room were obtained 36%, 20%, and 17.5%, respectively. Shahid Rajaee Hospital of Shiraz can quickly increase its capacity by 27% based on the scenario defined in this study. However, if an accident leads to more causalities, it will likely face several limiting factors for increasing the surge capacity. Conclusion: Due to the critical role of hospitals in the crisis, it seems that the studied hospital should look for ways to increase its surge capacity to cope with unexpected accidents as soon as possible.

Information technology and its implications have shown significant developments in the last decades. The internet revolution and digital marketing have created a shrinking force on mass media advertising. They have formed the backbone of personalisation, marketing automation, neuromarketing, viral marketing, voice recognition, and conversion optimisation, and thus, Artificial Intelligence (AI) has risen as the phenomenon in marketing activities. Theoretical analysis of relevant researches on AI tools and future trends, presentation of conceptual framework and methodology design, and presentation of the research findings are the objectives of the research. This study has potential limitations such as the data collection process and access to the relevant literature. AI for marketing has already become a significant part of today’s competitive world, which utilising the marketing opportunities to obtain business goals and create breakthrough using AI. Hence, this paper aims to illustrate the theoretical review on the nexus between AI and marketing, which would lead to understanding the future scope of AI and its penetration in marketing activities.

IntroductionEffectiveness of hospital management of disasters requires a well-defined and rehearsed system. The Hospital Incident Command System (HICS), as a standardized method for command and control, was established in Iranian hospitals, but it has performed fairly during disaster exercises. This paper describes the process for, and modifications to HICS undertaken to optimize disaster management in hospitals in Iran.MethodsIn 2013, a group of 11 subject matter experts participated in an expert consensus modified Delphi to develop modifications to the 2006 version of HICS.ResultsThe following changes were recommended by the expert panel and subsequently implemented: 1) A Quality Control Officer was added to the Command group; 2) Security was defined as a new section; 3) Infrastructure and Business Continuity Branches were moved from the Operations Section to the Logistics and the Administration Sections, respectively; and 4) the Planning Section was merged within the Finance/Administration Section.ConclusionAn expert consensus group developed a modified HICS that is more feasible to implement given the managerial organization of hospitals in Iran. This new model may enhance hospital performance in managing disasters. Additional studies are needed to test the feasibility and efficacy of the modified HICS in Iran, both during simulations and actual disasters. This process may be a useful model for other countries desiring to improve disaster incident management systems for their hospitals.

BACKGROUND: Education is considered one of the critical elements of behavioral changes in societies with a high risk of disasters. Meanwhile, the role of adolescents, as the key and the largest group of stakeholders in planning for disaster preparedness and response, has often been neglected. The current study aimed to extract the components and effective factors in disaster education to increase adolescents' resilience in disasters in Iran. MATERIALS AND METHODS: This qualitative study was done by inductive approach through in-depth semi-structured interviews conducted with 21 key informants and 11 adolescents selected through purposive sampling. To extract the components and factors affecting education to increase adolescents' resilience in disasters, the data were analyzed by thematic analysis. RESULTS: The effective factors in increasing adolescents' disaster resilience were classified into four categories, namely, social participation, need-based education, scope of influence, and governance perspectives, and 19 subcategories. CONCLUSION: This study provided an overview and a comprehensive understanding of disaster education to increase adolescents' resilience. Recognizing these factors can help effectively in developing disaster education programs to improve adolescents' resilience against disasters. By encouraging natural hazard habits in this age group, it can also potentially increase the society's resilience in future.

BACKGROUND: Effective communications and secure information exchange platforms during disasters and emergencies are among the significant factors in inclusive disaster management and can radically contribute to better preparedness, efficient and timely responsiveness, and, finally, maximal reduction of damages and fatalities. The present study was to compare communications and information exchange among disaster response organizations in selected countries. MATERIALS AND METHOD: This applied research, carried out in 2022, was a qualitative descriptive-comparative study pursuing a content analysis approach. Australia, Turkey, India, America, Japan, and Iran constituted the statistical population of the study. The sampling was based on the countries' disaster histories and response experiences. The note-taking tool was used to extract and collect data during the review of texts, documents, and articles, and the qualitative content analysis method was employed for data analysis. RESULTS: The outcomes of the descriptive-comparative analysis fell into four main comparative axes of the selected countries, including comparing reference, authority, and coordinator organizations in the response phase, comparing planning records and histories in disaster and emergency management comparing the contribution or non-contribution of government, military institutions, and non-governmental organizations to disaster and emergency management, the commonalities of the selected countries' disaster and emergency management and dependence on government. CONCLUSION: The results revealed that all selected countries depended on the government in managing disasters and emergencies, and the four communication platforms, i.e., landline telephone, mobile phone, radio communications systems, and couriers, were the common communication and information acquisition sources.

Introduction: Early education and training are mandatory toraise the knowledge and awareness of the healthcare staff. Iranis a disaster prone area with a high number of emergencies.This study aimed to assess the need for disaster and emergencymanagement education for Iranian medical students.Methods: Using two-round Delphi technique in 2017, 15 expertswithin the field of disaster and emergency management wereasked for their opinions concerning the education required forIranian medical students. Highly important educational domainsand their sub-domains selected with an agreement of above 70-80% were prioritized by AHP technique.Results: Of 41 identified and prioritized educational subjects,four main groups were obtained: 1) crisis and disaster primaryconcepts, 2) disease control skills, 3) management skills, and4) medical care skills. The medical care skills had the highestpriority (with a weight of 0.546), compared to other areas afterthe final analysis.Conclusion: Different areas of competency are needed to raiseawareness and preparedness in medical students in combatingcrisis and disasters. We propose a curriculum for Iranian medicalstudents and suggest it to be used for other professionals, who areinvolved in the process of disaster management.Keywords: Disasters, Crisis, Medical students, Education, Interdisciplinary, Awareness