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Abstract In this study, the contamination, ecological and human health risks as well as source apportionment of As, Cd, Co, Cr, Cu, Mn, Ni, Pb, Zn, and V in street dusts of different land-uses in Kermanshah, Iran were investigated. A total of 192 dust samples were taken from 16 sites and were analyzed for their elemental contents using ICP-OES. The computed mean values for the geo-accumulation index (I-geo) and the pollution index (PI) ranged from − 6.07 to 2.67 and from 0.023 to 9.58, respectively, indicating ‘unpolluted’ to ‘moderately to heavily polluted’, and ‘slight to very high polluted’ pollution levels, respectively. The pollution load index (PLI) with a cumulative mean value of 1.03 reflected moderate pollution levels across the entire study area. Moreover, the ecological risk (RI) of 135 indicated moderate ecological risks throughout the study region. The mean hazard index (HI) values for the analyzed potentially toxic elements (PTEs) for both adults and children were all within the safe limit (

This paper deals with the effect of fractional order on the fractional Euler-Bernoulli beams model. This model is based on the elastic curve that can be approximated using tangent lines and the osculating circle. We introduce a general form of the fractional Green’s function for the highest-order term 1

Purpose: To investigate the effect of topical Polyvinylpyrrolidone-iodine (PVP-I) 0.6% on the clinical course of adenoviral keratoconjunctivitis compared with PVP-I 1% and artificial tears. Methods: We prospectively enrolled all patients over 18 years of age with a polymerase chain reaction (PCR)-confirmed diagnosis of adenoviral keratoconjunctivitis who presented to the hospital between November 2022 and June 2023. Patients were randomized into 3 groups: artificial tears (control), PVP-I 1%, and PVP-I 0.6% eye drops, 4 times daily for 5 days. Clinical signs at presentation and at 6 follow-up visits during the 1st 3 weeks of the acute phase were recorded. Patients were also followed up at 1 and 3 months. Results: Ninety-four patients completed the study, of which 30, 31, and 33 were in the control, PVP-I 1%, and PVP-I 0.6% groups, respectively. The mean age of the patients was 37.2 years (interquartile range: 25-46). The PCR result was positive in 75.6% of patients with the clinical suspicion. PVP-I, regardless of the concentration, was superior to the artificial tears in terms of time to resolution of lid swelling, discharge, and incidence of subsequent subepithelial infiltrates (P < 0.05). However, a concentration of 0.6% was equivalent to 1%. No significant adverse events were reported in any group. Conclusions: The PVP-I 0.6% topical drops are safe and well tolerated in patients with acute adenoviral keratoconjunctivitis. It can be substituted for the 1% solution as it has comparable effects in improving the clinical course and reducing subsequent complications.

Purpose: The measurement of public library services in the area of social entrepreneurship can be significantly impacted by the use of the standard tool for measuring social entrepreneurship. This study aimed to develop and validate a social entrepreneurship scale for its use in Iranian public libraries. Method: In terms of purpose, the present research is applied, and in terms of data collection it is a descriptive correlation. The statistical population of this research includes all the librarians of Iran's public libraries, amounting to 7000 and of them, 300 librarians were selected by multi-stage cluster sampling method. A researcher-made questionnaire was used to collect data and the instrument's validity was calculated using content validity and exploratory and confirmatory factor analysis. The reliability of the tool was also higher than .60 using Cronbach's alpha for each index and was obtained by the binomial method. In this method, a value of .82 was obtained for odd items and.78 for even items, which showed that the questionnaire has the necessary reliability. The online questionnaire was provided to the librarians of public libraries in the country through the internal network of public libraries. The total number of collected questionnaires was 289. Findings: Based on the findings of this research, all factor loadings of social entrepreneurship indicators in public libraries (lifelong learning, emergency response, civic engagement, economic development, health, and diversity and inclusion) were obtained above .5, and the results of factor analysis, exploratory and confirmatory validity and appropriate reliability of the tool confirmed this. Considering the appropriateness of the social entrepreneurship measuring tool in Iran's public libraries, it can be identified as a valid tool in related research. The results of this research are useful for target groups such as library and information science students to evaluate social entrepreneurship services. It also could be useful for public library librarians and managers to provide social entrepreneurship services and policy-making in this direction. Finally, it can be said that the construction of this tool leads to a better understanding of the needs of society, better use of financial resources, improved coordination between public library managers and human forces, more freedom in choosing resources to satisfy the needs of society, and making more effective and efficient activities in public libraries. Originality/Value: Public libraries, using social entrepreneurship, deal with challenges such as unequal economic access and unequal capacities of society in benefiting from public services. According to the review of the research background, the lack of research in the field of social entrepreneurship in public libraries was evident and most of the research in the field of entrepreneurship was done in general. On the other hand, a standard tool that can evaluate the state of social entrepreneurship in public libraries was not found in previous research. Therefore, the current research is innovative from the thematic and methodological aspects. The present study is helpful because it designed and validated the social entrepreneurship measurement tool in the context of public libraries in Iran.

Traditional Iranian bathhouses (hammams) represent remarkable examples of vernacular architecture optimized for thermal performance in hot arid climates. This study quantitatively evaluates and compares multiple passive heating strategies employed in hammams to mitigate envelope heat loss through thermal simulations of two exemplar cases - the Khan and Golshan baths in Yazd.A post-positivist research approach combined physical documentation, computational modeling using DesignBuilder V7.0.1.004 software, and quantitative analysis. Heat transfer through the caldarium (hot room) envelope was simulated sequentially, first without any heat retention strategies, then adding thermal mass, unconditioned buffer spaces, earth-coupling, and finally urban morphology factors.Results indicate thermal mass was the most effective approach in the studied Yazdi hammams, yielding 37.5 % and 37.3 % reductions in winter heat loss compared to 8.4 %, 5.3 %, and 1.8 % from unconditioned zones, earth-sheltering, and integrated compact urban fabric, respectively. Overall, leveraging thermal mass outperformed the combined impact of the other three strategies by over five times for these cases.The quantified insights highlight vernacular passive heating principles extracted from this historic architectural typology that can potentially inform sustainable high-performance building practices for hot arid regions.

Abstract Introduction The quality of care and patient satisfaction is closely linked with dignity, which is a crucial component of therapy and care. However, there is very little study on dignity in the context of mental health care. Planning for ongoing patient care might benefit from an understanding of the notion of dignity by exploring the experiences of patients, caregivers and companions of patients who have a history of hospitalization in mental health institutions. To retain patients' dignity while they were being treated in mental wards, this study sought to understand the experiences of patients, caregivers and companions of patients. Materials and Methods This investigation was qualitative. Semistructured interviews and focus groups were utilized to collect the data. The purposeful sampling method was employed for participant recruitment, which continued until data saturation. Two focus group discussions and 27 interviews were conducted. Participants included 8 patients, 2 patients' family members (companions), 3 psychologists, 4 nurses and 11 psychiatrists. Two focus group discussions were held with seven family members or companions of patients. Thematic analysis was used for data analysis. Results The primary theme that emerged was the infringement of patients' dignity, through negative guardianship, dehumanization and violations of their rights. Subthemes included dehumanization, worthlessness and namelessness, patient rights violations and stripping patients of authority. Conclusion Our results suggest that, regardless of the severity of the illness, the nature of psychiatric illness significantly compromises patients' dignity. Mental health practitioners, due to their sense of guardianship, may unintentionally treat patients with mental health disorders, thus compromising the patient's dignity. Patient or Public Contribution The research team's experiences as a psychiatrist, doctor and nurse informed the study's objectives. Nurses and psychiatrists who work in the healthcare industry designed and conducted the study. The primary authors, who are healthcare providers, collected and analysed the required data. Furthermore, the entire study team contributed to the writing of the manuscript. Study participants were involved in the data collection and analysis.

Among the recognized patterns in traditional Iranian architecture, bathhouses have been considered to prevent the heat loss required by users during bathing. In this regard, various assumptions have been made about effective strategies to reduce heat loss and energy storage in different interpretations of traditional bathhouses. However, the function of these strategies has not been investigated with respect to the climatic differences of different cities in Iran. Therefore, the aim of this research is to compare more accurately the recognized physical strategies in this regard, including "density in texture and neighborhood", "entering the ground", "thermal mass of the building", and "enclosing the greenhouse space among uncontrolled spaces" in two bathhouses in Kerman city. This issue has been carried out quantitatively and with an energy simulation solution, and can have more computational credibility compared to previous estimates due to the extraction of calculations from thermal modeling of the discussed bathhouses. In the research process, two bathhouses, "Ganj Ali Khan" and "Vakil Kerman", were selected as examples and the amount of heat loss was calculated during cold months using Design Builder software based on volumetric and structural evidence of the discussed bathhouses. The results of this study indicate that the thermal mass of the building and enclosing the greenhouse space among uncontrolled spaces were the most effective strategies in preventing heat loss in the discussed bathhouses. These two strategies, depending on the type of walls and the centrality of the greenhouse among other spaces, had similar efficiencies while having diverse functions. The thermal mass of the walls in Ganj Ali Khan and Vakil Kerman bathhouses had an average impact of 39% and 44%, respectively, on reducing heat loss. This value was 23% and 14%, respectively, for using uncontrolled spaces around the greenhouse. The efficiency of these two strategies was approximately two to eight times higher compared to "entering the ground" and "density in texture and neighborhood", emphasizing their importance in design.

Purpose: Knowledge and information science specialists can succeed in creating and providing entrepreneurial services by using knowledge of the society, the needs of the audience and having an entrepreneurial attitude. In the field of knowledge and information science, entrepreneurship is a type of social or value entrepreneurship service. Accordingly, the purpose of this research is to investigate the effect of entrepreneurship education in changing the entrepreneurial attitude of public library librarians in Birjand city. Method: The present study is a type of applied research. In terms of data collection, it is a quasi- experimental study with a control group, a pre-test and a follow-up test to determine the duration over times. The statistical population of the study included 30 librarians of public libraries affiliated to the library of the city of Birjand; Data collection was done by Entrepreneurship Attitude questionnaire (Robinson et al., 1991) and SPSS software was used to analyze the information collected through the questionnaire. Findings: The results of the tests showed that entrepreneurial training has led to a shift in the attitudes of librarians in the test group, and entrepreneurial training has led to a shift in the orientation of self-esteem, Succession, innovation and personal entrepreneurial control of the group librarians and the post-test scores of the two control and experimental groups were reported differently (F = 5/568, P > 0/05). The average of librarians’ desire for success in the post-test stage (M = 4/528) has changed compared to the pre-test stages (M = 4/313). Also, the test of the repeated measurement design, which included librarians in the experimental group in the follow-up stage, showed that that the change in the orientation of personal entrepreneurial control of librarians has become significant, which has caused stability and stability in them. Self-esteem components such as confidence in one’s ability, confidence in work results, ability to solve personal problems, ambition and self-belief can be influenced to a large extent by changing librarians’ views due to the increase in the level of advertisements and their knowledge about entrepreneurship. Originality/value: The current research considers entrepreneurship in public libraries as a great opportunity for managers and librarians. Considering that entrepreneurship can be acquired in libraries, librarians can use the benefits of entrepreneurial training to raise their level of work and provide entrepreneurial services to users. According to the goals and social roles of public libraries, entrepreneurship training in the society of librarians and users should be considered and implemented as one of the special requirements based on the goals and functions of these types of libraries because entrepreneurship training causes a change in the direction of personal entrepreneurial control of people and increase the amount of their personal control.

Background: Leisure activities are an important part of life for people with multiple sclerosis )MS). Unfortunately, there are no proper assessment tools for evaluating the leisure activities of MS patients. The current research purposed to develop such a questionnaire and to determine its factor structure.Methods: This psychometric study aimed to determine the factor structure of a questionnaire for evaluating the leisure activities of MS patients and was conducted in explanatory and confirmatory phases.Results: The questionnaire was completed, and the data were entered in SPSS for the explanatory phase and using linear structural relations (LISREL) for the confirmatory phase. The lowest Eigenvalue was 1.01, which corresponds to the Kaiser criterion. The validity coefficients of the extracted factors are considerable. There is a very slight difference between the highest coefficient thatis related to the third factor (0.846) and the lowest coefficient that is related to the fifth factor (0.799), indicating the number of factors was correctly determined. Confirmatory factor analysis illustrated that the goodness-of-fit (GFI) and the comparative fit index (CFI) indices were considerable (higher than 0.95),showing good fit of data. RMSEA was 0.024.Conclusion: It can be concluded that the 5-factor structure (difficult, social,spiritual/religious, outdoor-physical, and cultural-artistic activities) of the multiple sclerosis leisure questionnaire with 50 items is confirmed.

Abstract Spatial quality is one of the features of Iranian anatomical architecture, which, like the legacy of past architects, has been passed down from generation to generation and has been advanced and expanded in the architecture of each era consistent with its needs. This sequence of alteration from the late Qajar period to the beginning of the Islamic Republic has a different procedure that can be discussed according to the other changes in this period of adjustment. Via the interpretive method, processing design documents and field observations of well-known buildings in the Pahlavi area have been processed and, after initial estimation, the hypothesis in selected samples is tested to identify volume processing solutions. In the physical volume processing literature, empty space does not act as a mass in the volume and mass design stages, like the courtyards of traditional houses. In the process of physical space, residential buildings evolve from a continuous space to spots in plan, changes, and porosity in the facade, and finally, the total volume due to the structural systems and the boldness of the architects enter. Spatial quality is one of the features of Iranian anatomical architecture, which, like the legacy of past architects, has been passed down from generation to generation and has been advanced and expanded in the architecture of each era consistent with its needs. This sequence of alteration in the late Qajar period to the beginning of the Islamic Republic has a different procedure that can be discussed according to the other changes in this period of adjustment. This issue is significant when the architects of this era, due to politics, cultural nature, and educational practice, tried to develop creativity by modeling imported architecture and did not hide such an issue. However, compared to the previous era, life experiences in the previous space caused a secret connection in this period. This study aims to understand how sufficient empty space is present in the quality of contemporary housing and residential buildings in Tehran and what changes have been made in the design system from the late Qajar period to the beginning of the Islamic Republic. In this regard, via the interpretive method, processing design documents and field observations of well-known buildings in the Pahlavi area were examined and, after initial estimation, the hypothesis in selected samples was tested to identify volume processing solutions.

Introduction. Paying attention to the improvement of teachers’ professional ethics is of special importance in educational organizations, especially secondary schools. Accordingly, the present study seeks to investigate the role of organizational culture in the emergence of teachers’ professional ethics. Materials and Methods. This research is descriptive-correlational in terms of data collection method. The statistical population of the study includes all teachers in Khosf, 180 people, of which according to Cochran’s formula, 123 people were selected as sample members by simple random sampling. Respondents included a majority of female. Denison’s Organizational Culture Questionnaire and Cadozier Professional Ethics Questionnaire were used to collect data. The validity of the questionnaires was confirmed using content validity and their reliability was obtained by Cronbachʼs alpha of 0.97 and 0.94, respectively. Data analysis was performed in SmartPLS 3 software environment using structural equation modeling method. Results. The results of testing the main hypothesis of the research showed that organizational culture plays a role in the development of teachers “professional ethics and about 94% of changes in teachers” professional ethics in schools are explained by organizational culture. Also, the results of testing the sub-hypotheses of the research based on examining the role of each component of organizational culture in the emergence of teachers’ professional ethics showed that each of the components of work engagement, integration, adaptation and mission explain the changes in the professional ethics of teachers in schools, among which, the mission component has the most and compatibility has the least impact. Discussion and Conclusion. The conclusions contribute to the development of the concept of organizational culture, provided that organizational culture and its components play a critical role in the development of teachers’ professional ethics. Accordingly, it can be concluded that a good organizational culture in schools can strengthen the professional ethics of teachers and create a good environment for the emergence of professional ethics among them.

Introduction: Evidence showed that cardiac complications may occur in coronavirus disease-19 (COVID-19) during the acute and post-infection phases. This study aimed to evaluate the association between the echocardiographic characteristics and in-hospital mortality of COVID-19 patients as well as the changes after one-month follow-up. Method: All adult (≥18 years old) hospitalized COVID-19 patients in need of echocardiography based on the guideline of the Iranian Society of Echocardiography for performing various types of echocardiography during the COVID-19 pandemic were included in this study. An expert cardiologist performed the echocardiography on all patients and also on all available patients one month after discharge. Results: 146 hospitalized cases of COVID-19 and 81 cases available for 1-month follow-up echocardiography were studied in this prospective study. Left ventricle wall hypokinesia, aorta valve stenosis, dilated Inferior Vena Cava (IVC), and Pulmonary Artery Systolic Pressure (PASP) of more than 35 were associated with 3.59 (95% CI: 1.19-10.79, p = 0.02), ‎11 (95% CI: 3.3 – 36.63, p = 0.001), ‎5.58 (95% CI: 1.04-29.41, p = 0.041)‎, and 2.91 (95% CI: 1.35 – 6.3, p = 0.001) times higher odds of mortality than healthy subjects. In 1-month follow-up of patients, deterioration in LVEF (p = 0.03) was detected in the not-fully vaccinated patients, and a significant decrease in PASP was observed in all cases (p = 0.04); but these changes were not clinically important. Conclusion: Left ventricle wall hypokinesia, aorta valve stenosis, dilated IVC, and PASP ≥ 35 were predictors of in-hospital mortality in our study. There were not any potential clinically significant differences in one-month echocardiographic follow-ups of the studied patients.

Introduction: As no specific pharmacological intervention has been known for COVID-19, medicinal plants may be a suitable candidate for management of this disease. The aim of this study was to investigate the efficacy of a herbal syrup from licorice as an adjuvant treatment in hospitalized patients with COVID-19. Materials and methods: 213 hospitalized patients diagnosed with COVID-19 were assigned to receive either standardized licorice syrup as an adjuvant treatment plus standard care [Syrup Group (SYRUP), N = 91], or standard care alone [Standard Group (STANDARD), N = 104], for 7 days. The primary endpoint was duration of hospitalization in survivors. The secondary endpoints included 25% increase in oxygen saturation, C-reactive protein (CRP) difference and lymphocyte difference from baseline, number of death and number of patients transferred to ICU. Results: Mean duration of admission was 5.24 days in SYRUP and 7.14 days in STANDARD (p

Background and Objective: The major pneumococcal pathogenesis factor is the capsular polysaccharide. the production of polysaccharide is regulated by cpsB and cpsD genes. Thus, every agent that induce or inhibition of expression of these genes probably increased pathogenesis of bacteria, intracellular survival and vis versa. The aim of this study was to assay the effect of Xylitol on Streptococcus pneumoniae cpsB, cpsD, psaA and aroE genes expression by Real Time RT-PCR. Materials and Methods: During 2019 in Baqiyatallah university laboratories, 20 clinical isolates and a reference strain Streptococcus pneumoniae (ATCC 6305) were studied. To assay the effect of Xylitol and fructose، different concentration of these sugars were exposed to BHI Broth media. Thereafter, the bacterial suspension was added to 5% Xylitol, 5%Xylitol + 5% fructose and control medium for 3hours. RNA was extracted and cDNA synthesis was carried out. Then, the cpsB, cpsD and psaA genes expression levels were measured. Results: The mean of cpsB gene expression ratio in presence of the % 5 Xylitol treated media compared with those in the control media and % 5 Xylitol + 5% fructose were 0.022 and 0.027 respectively. The means of the cpsD and psaA genes expression ratio in the % 5 Xylitol treated media compared with those in the control media and % 5 Xylitol + 5% fructose were 1.659 and 0.056, and 0.633 and 3.294 respectively. Conclusion: Our finding revealed that, the 5% Xylitol inhibit the cpsB gene expression properly. Therefore, it is possible to use of Xylitol for reductive on cpsB gene expression and superficial pneumococcal infections control.

BackgroundSevere acute respiratory syndrome (SARS) coronavirus-2 may infect red blood cells (RBCs) and impact oxygenation. We aimed to evaluate the efficacy of RBC exchange as an adjunctive treatment for hypoxemia and the survival rate of patients with severe coronavirus disease 2019 (COVID-19).MethodsIn a randomized clinical trial, we divided sixty patients with severe COVID-19 into two groups. The intervention group received the standard treatment of severe COVID-19 with RBC exchange three to four times in 2 days. The control group only received the standard treatment. Our primary outcomes were improving hypoxemia in 7 days, recovery or discharge, and death in 28 days. We conducted Chi-square test, independent samples t-test, and Fisher’s exact test to analyze the results. The ethical committee of Aja University of Medical Sciences approved the study (IR.AJAUMS.REC.1399.054), and the Iranian clinical trial registration organization registered it (IRCT20160316027081N2).ResultsTwenty-nine men and thirty-one women with a mean age of 67.5 years entered the study. The frequency of hypertension and diabetes mellitus was 86.7 and 68.3%, respectively. The most common symptoms of severe COVID-19 were dyspnea (91.6%), cough (75%), and fever (66.6%). Our results showed that hypoxemia improved in 21 of the 30 patients (70%) in the intervention group and 10 of the 30 patients (33.3%) in the control group (P < 0.004). The recovery and discharge rates were 19 of 30 patients (63.3%) in the intervention group and 2 of 30 patients (6.7%) in the control group (P < 0.001).ConclusionThe RBC exchange improved the oxygenation and survival rate in patients with severe COVID-19.

Crowdfunding is a new topic in management science, which means collecting funds to advance projects through popular contributions. This phenomenon, in order to attract public assistance in honoring new ideas and creative minds, calls for its operationalization in the community; However, there is a narrow difference in attracting public assistance for criminal acts, especially terrorism financing. In the financing of terrorism, the collection of funds or assets for the delivery of terrorist individuals or terrorist organizations can be of legal origin and popular assistance; therefore, the challenge of this article is that In a tangible criminal policy How should the distinction between innovative ideas and criminal thought be clarified? This paper, by examining the characteristics of crowdfunding, on the one hand, and the expression of the components of terrorism financing, on the other hand, has achieved that what determines this difference is the purpose of financing, not its origin and easing in source, along with the control of the destination (and not mere inquiring into the intentions of the citizens), can be a plan to support crowdfunding in society to fertilize ideas along with haltering the financing of terrorism.

The present research seeks to detail a phenomenological conceptualization of institutional core with a retroductive-deductive research strategy in the spatial planning of environmental quality in the case study. Planning polices in these settlements do not include stakeholders’ participation and are often top-down. Also, specialization and sectorial view in the planning of sustainable spatial development of the villages and the existence of a prevailing physical approach that did not pay attention to economic, socio-cultural, and ecological issues, led to the change of land use. Agricultural land has been used by other users, and with the passing of time, urbanism has become more popular with the spirit of consumerism, weakening of production morale, reducing the level of economic productivity, and eventually reducing the environmental quality of these villages. According to the lived experiences of the rural inhabitants and the participants, by focusing on rural groups and customs and behavioral patterns in their daily lives in the form of participatory workshops and using the snowball method, this study examined the environmental quality. In addition, in the framework of these two methods of planning, the methodology of participatory assessment of environmental quality and participatory assessment of rural communication were used to analyze the concepts with tools such as interviews and group discussions, which included 9 semi-structured interviews and 9 participatory workshops with the presence of rural groups, and the institutional cores were determined from the point of view of the participants in the definition of village, quality of values, knowledge, leadership, strategic planning, integration, rural-urban linkages and citizenship rights.

Introduction. The present study aims to predict students’ academic achievements based on the classroom climate, the mediating role of teacher-student interaction and academic motivation among Semnan University students. Materials and Methods. This study relied on correlation-and-description method of data collection. The sample population consisted of all undergraduate and postgraduate students at the Faculty of Engineering of Semnan University in the academic year of 2017–2018. Using a random stratified method, 200 subjects were selected as the sample (135 undergraduate and 65 master). Questionnaires of Patrick, Kaplan and Ryan’s classroom climate, Hernandez-Lopez’ teacher-student scale, Vallerand’s academic motivation questionnaire and Pace and Kuh’s student academic achievement scale were used. Reliability of the questionnaires was confirmed using Cronbach’s alpha test. Results. There is significant positive relationship between academic achievement and classroom climate, teacher-student interaction and academic motivation. Classroom climate has a direct and meaningful effect on students’ academic achievements. Also, the climate of the classroom by mediating the teacher-student interaction has indirect and significant effects on students’ academic achievements. Classroom climate by mediating educational motivation has an indirect and significant effect on students’ academic achievement. Discussion and Conclusion. The results of this study suggest the importance of openness to the classroom climate, interaction between teacher-student and academic motivation is to increase students’ academic achievements.

PurposeAvailable but insufficient evidence shows that changes may occur in the immune system following coronavirus disease 2019 (COVID-19). The present study aimed at evaluating immunological changes in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pneumonia compared with the control group.MethodThe present study was performed on 95 patients with COVID-19 (32 severe and 63 moderate cases) and 22 healthy controls. Relationship between immune cells, disease severity and lung involvement was assessed. Binary logistic regression and ROC curve tests were used for statistical analysis.ResultsA significant decrease was observed in CD20+ cell counts of the patients. To differentiate patients from healthy individuals, the cutoff point for the CD4+ cell count was 688 /μL, sensitivity 0.96, and specificity 0.84. An increase in CD4+ cells reduces the odds of severe disease (odds ratio = 0.82, P = 0.047) and death (odds ratio = 0.74, P = 0.029). CD4+ cells play a pivotal role in the severity of lung involvement (P = 0.03). In addition to CD4+ cells, Fc gamma receptor III (FcγRIII) (CD16) also played a significant prognosis (odds ratio = 0.55, P = 0.047). In severe cases, C-reactive protein, Blood urea nitrogen, and Creatine phosphokinase levels, as well as neutrophil counts, were significantly higher than those of moderate ones whereas lymphocyte count in severe cases was lower than that of moderate ones.ConclusionThe number of total T-cells and B-cells in patients with COVID-19 was lower than that of controls; however, their NK cells increased. FcγRIII and CD4+ cells are of great importance due to their association with COVID-19 prognosis.

The global crisis caused by the SARS Corona virus-2 infection is continuing through 2021, with more than 3.5 million deaths. Several risk factors for this virus’s severity and death were documented, including diabetes, hypertension, and ischemic heart disease. To evaluate the relation between serum vitamin D3 level, the disease severity, and prognosis of the patients with SARS Corona virus-2 infection. Patients with COVID-19 were evaluated for serum vitamin D levels and laboratory data. Correlation between vitamin D levels and laboratory data with disease severity and prognosis was assessed. Cox and logistic regression tests, as well as ROC curves, were used for data analysis. Ninety-eight patients with Corona virus-2 disease (COVID-19), which consisted of sixty patients with moderate COVID-19 in the general wards, and thirty-eight patients with severe COVID-19 in the intensive care unit (ICU), were evaluated. The mean age in the general wards was lower than in ICU (60.96±14.86 compared to 67.94±16.46, P=0.001), and the mean serum vitamin D level in the patients admitted in the general wards was higher than in the ICU (31 ng/mL compared to 20.57 ng/mL, P=0.003). Furthermore, vitamin D deficiency (25 (OH) D

It is possible to commission of quasi-intentional felony, the subject of three clauses of article 291, by omission with this condition that the most prominent example of felonies is to be committed by the omission in C section (falseness) of this article. In clause (a) and (b) of this article, the behavior is not effective and can consist of action and omission. The most challenging part of this research is the possibility of commission of simple mistake felony by omission. The commission of simple mistake felony, the subject of clause (a) of Article 292 is not possible by omission, since in this assumption, or the perpetrator is not responsible for the lack of the condition of ability or, in the case of liability, the crime is intentional or quasi-intentional. In clause (b) of this article, if the minor is undertaking in accordance with Article 85 of the Non-Litigious Matters Act, and a felony is committed by commission, this is simple mistake felony. Finally, although the commission of simple mistake felony, the subject of clause (c) of Article 292, is rare by omission, but it cannot be falsified.

This paper seeks to examine transformational and transactional leadership, employees’ organizational citizenship behavior, employees’ job satisfaction and perceived organizational sup­port; which are employees' organizational citizenship behavior associations. In addition, this study explores the mediating role of employees’ job satisfaction and perceived organizational support in the relationship between transformational and transactional leadership styles and employees’ organizational citizenship behavior. The study was conducted at the University of Birjand, Iran, on a sample of 250 employees. This research follows a descriptive and correlational approach. Our findings show that transformational leadership and employees’ job satisfaction and perceived organizational support positively and significantly influence employees’ organizational citizen-ship behavior. Additionally, results revealed that employees’ job satisfaction mediates the asso­ciation between transformational and transactional leadership and employees’ organizational citizenship behavior. Moreover, employees perceived organizational support mediates the asso­ciation between transformational and transactional leadership and employees’ organizational citi­zenship behavior. Iranian organizations, especially universities, should invest in transformational leadership and job satisfaction, as well as in the selection of managers with transformational lead­ership styles and employees who are eager to work at the university, in order to enrich the organi­zational citizenship behavior of employees.

The purpose of this study was to investigate the relationship between the use of social networks and students' preferred teaching styles of teachers with the mediating role of their learning styles. The present study is descriptive and correlational. The statistical population was all students of Farhangian University, Shahid Bahonar Campus in Birjand who were studying in the academic year 1399-1400. A total of 156 teacher students were selected as the sample size by the available sampling method. Data collection tools included the Learning Styles Questionnaire, the Preferred Teaching Style Questionnaire, and the Social Network Questionnaire. The reliability of the instruments was confirmed using Cronbach's alpha coefficient and their validity was confirmed using confirmatory factor analysis and correlation between components. Findings showed that the direct effect of using social networks on teaching styles and also the direct effect of learning styles on teaching styles were significant, but the direct effect of using social networks on learning styles was not significant. In addition, the indirect effect of using social networks on teaching styles through learning styles was not significant. Therefore, it is not possible to predict their preferred teaching styles through the use of social networks due to student-teacher learning styles.

Background: Several studies indicate that the structure of scientific articles in Phycology, particularly in methodology, have not met the required scientific standards. To achieve standardization, it is required to analyze the structure and configuration of articles as well as the components such as research design, characteristics of sample groups, instruments, and statistical methods. Aims: The present study aims to analyze scientific articles in different branches of psychology, in order to identify condition of the research papers based on: authors’ interest, diversity, gaps, inconsistencies, and deficiencies in methodology. One thousand one hundred twenty-six original articles from scientific research journals approved by Iranian Ministry of Science, Research, and Technology during the 2007 - 2010 period were reviewed. Nine postgraduate students extracted the data and the four authors re-examined them. Method: This study has a descriptive design, and data is displayed in frequency tables. Results: The results indicate that, the use of some research designs, sample groups, instruments, and statistical methods were very low or non-existent; and in contrast, some other research design, instruments, and methods were widely applied in the studies. Conclusions: The findings were compared to the frame work suggested by known scientist associations, and suggestions for improving the structure and writing style of methodologies are put forth.

Background and Objectives: Mycoplasmas hominis is one of the important causes of bacterial infections of the reproductive system, which through changes in the volume, pH, motility, morphology, and sperm count in men, can lead to reduction in the level of fertility or infertility and sterility. In this research, the frequency of Mycoplasma hominis, was assessed by PCR method, and biological parameters, were investigated in the semen samples of infertile men referred to Qom jihad daneshgahi infertility treatment center. Methods: In this descriptive-analytic study, a total of 187 semen samples were collected from infertile men referred to Qom jihad daneshgahi infertility treatment center from April to September 2016. Semen analysis was performed according to the guideline of World Health Organization. After the extraction of genomic DNA, detection of Mycoplasma hominis, was performed by PCR method using 16S rRNA specific primers. Data were analyzed using dependent and independent t-test. Results: Among 187 semen samples studied by PCR, 71 samples (38%), were positive for Mycoplasma hominis. In the assessment of parameters, there was a significant association between bacterial infection and C class mean difference (in situ sperm motility( (p=0.008). Conclusion: The results of the present study showed that high percentage of infertile men are infected with Mycoplasma hominis, which may lead to pelvic inflammatory diseases, urethritis, and infertility. PCR method is a rapid and efficient technique for detection of mycoplasma, which can be useful in the control of sexual transmitted diseases.

Background and purpose: Fast diagnosis of pneumococcal infections is of great importance in achieving successful outcomes. The aim of this study was to use PCR process based on capsular encoding genes of Streptococcus pneumonia. Materials and methods: In this experimental study, specific primers were designed based on the reference sequences of the Streptococcus pneumoniae cpsB, cpsD, aroE, and psaA genes. All bacteria were subjected to DNA extraction separately. Then, the PCR protocol was performed. Sequencing of the PCR products was done and data was analyzed descriptively. Results: The primer pairs against the cpsB, cpsD, aroE, and psaA genes amplified 159, 202, 254, and 286 bp fragments, respectively. The alignments and comparison of amplified sequences showed a high homology (100%) with the reference genes. Conclusion: According to this study, it is possible to diagnose Streptococcus pneumoniae based on virulence genes, and differentiate the pathogenic Streptococcus pneumoniae from nonpathogenic strains and also viridans groups. Therefore, this method is suggested in diagnosis of pathogenic Streptococcus pneumoniae strains.

Some believe the mathematics as the highway to engineering; some others believe mathematics as a goalkeeper for entering the talented people to the engineering world. According to researches and observations, math is an important factor in engineer’s dropout. At first step the aim of this research is to find which one of math courses including calculus 1, calculus 2, differential equations and engineering mathematics is the main predictor of academic performance of engineering students. Another aim is to find the role of math epistemological beliefs in beliefs students’ performance at the main course which identify at first phase. Descriptive correlational method is used to achieve research goals. The research statistical population was all senior undergraduate students, of Industrial University of Birjand in the 2015-2016 who educate in the fields of electric, computer, civil and industrial engineering. They were estimated to be 550 students who 225 students were selected among them using cluster sampling method. Regression analysis showed that 32.7 percent of the variance of students’ GPA explained by these math course and calculus 1 is the most important predictor. Regression analysis showed math Epistemological belief explains that 8.1 percent of the variation of student`s score is anticipated by in math 1. Source of knowledge, speed of knowledge acquisition and innate ability are three components which are important for anticipating the success of engineering students in a math 1. These findings are discussed and suggestions is proposed to enhance the quality and success probability of engineering students in calculus.

Contrary to Sunny scholars, Shia scholars believe that infallibility and immunity of Holy Prophet's successors (peace be upon him and his progeny) from any mistake, sin, error, and fault is a necessary and essential condition. Therefore, Imams (peace be upon them) must be infallible and immune from any sin and error. Shia theologians and scholars, particularly Khawja Nasir al-din Tusi, have provided several transmitted and rational arguments for the necessity of infallibility of Imams (peace be upon them) who are the successors of Holy Prophet. Therefore, any neglect of divine injunctions and commands, whether intentionally or unintentionally, overt or covert, is inconsistent with taking the position of Imam and succeeding Holy Prophet. Fakhr Razi and his followers, however, cast doubt on and even denied the necessity of the condition of infallibility for Holy Prophet's successors and finally reduced infallibility into justice. The present paper elaborates on the most important arguments of Muslim theologians, particularly Mohaqqeq Tusi, for the necessity and exigency of infallibility of Imams, criticizes and rejects Fakhr Razi's most important doubts and objections, and finally concludes that infallibility is a necessary and essential condition for Holy Prophet's successors.

Background. Meaning in life is one of the psychological domains that is most severely affected in patients with life-threatening illnesses. The importance of meaning-making mandates the development of reliable tools to assess this construct. Steger’s Meaning in Life Questionnaire (MLQ) is one of the most valid and reliable instruments that determines the search for and presence of meaning in life. The present study was conducted to provide psychometric data on the MLQ in a sample of patients with life-threatening illnesses. Methods. The MLQ was completed by 301 patients (aged 20–80 years) diagnosed with life-threatening illnesses (cancer and multiple sclerosis) and referred to hospitals. Confirmatory factor analysis and Pearson’s correlation test were used to determine the construct validity of the questionnaire. Results. The confirmatory factor analysis supported the original two-factor model of the MLQ, comprised of the presence of meaning (five items) and search for meaning (five items). The responses to the MLQ did not differ by sociodemographic factors. Most importantly, contrary to previous findings, the correlation between the two subscales, i.e., search for meaning and presence of meaning, was significant and positive. Conclusion. The results showed that the MLQ is a valid and reliable measure for assessing meaning in life that can be applied in research on meaning in life among other patient populations.

Purpose: The purpose of this research was to evaluate the quality of work life and job burnout among public librarians of South Khorasan Province in Iran. Methodology: we used survey method for this research. The population consisted of all librarians (110 person) working in public libraries in South Khorasan Province. 86 person selected with simple random method as sample. The “Walton” questionnaire of quality of work life and “Maslach” burnout inventory were used for data collection. content validity of questionnaire approved with a few number of experts. albeit, questionnaires used previously by other researchers and validity of questionnaires successfully tested by them. For evaluation of questionnaires reliability, we used Cronbach's alpha. Estimated values were 0.92 for the quality of working life, and 0.90 for the job burnout. Findings: Altogether, the quality of work life of public librarians was significantly lower than the desired level (Mestimate= 2.96, desired level=3 ). The job Burnout of public librarians was significantly higher than the desired level (Mestimate = 4.24, desired level=3). There was a meaningful negative relationship between the quality of work life and job burnout and Librarians’ job burnout was predictable from the quality of work life. Originality/Value: This research is valuable because of indication of high level job burnout of Iranian public librarians. This level of burnout could be alarming for administration of Iran Public Libraries Foundation.

Introduction: Biochemical markers of myocardial injuries have radical importance in diagnosis or dismissing cardiac events, especially in cases that electrocardiographic findings are not present. Therefore, this study was designed aiming to appraise 1-month outcome of patients presenting to emergency department (ED) following acute coronary syndrome (ACS) with positive creatine kinase-MB (CK-MB) and negative troponin. Methods: This prospective cross-sectional study was done on patients presenting to ED with complaint of acute chest pain and diagnosis of ACS. Patients who did not have a clear electrocardiographic finding indicating acute myocardial infarction (MI) (ST segment elevation) and had positive CK-MB and negative troponin in laboratory tests of serum were included. Demographic data and baseline characteristics, CK serum level, CK-MB, troponin, and 30-day outcome of the patients were analyzed using SPSS version 19. Results: 13759 patients had visited the ED with complaint of chest pain during the study period (57% female). 1003 (7.3%) patients had positive troponin test and 12704 (92.3%) had negative CK-MB index and were therefore eliminated from the study. Finally, 52 (0.4%) had both positive CK-MB and negative troponin indices. 35 (67.3%) of them were discharged from ED after serial electrocardiography and negative troponin test. 11 (21.2%) were admitted to critical care unit but were discharged due to having 2 negative troponin tests in 12 hours and normal serial electrocardiogram. 6 (11.5%) were referred for surgical interventions. No mortality was seen in 1-month follow-up. Conclusion: Based on the results of the present study, only 0.4% of ACS patients presenting to the studied ED had positive CK-MB and negative troponin indices. During 1-month follow-up, no case of mortality or MI was observed among them. Only 2 (3.8%) cases needed surgical intervention.

The purpose of this study was to investigate the mediating role of attitude toward math and math self-efficacy on the relationship between the teachers’ perception of academic optimism with math achievement. To do so, 315 high school students of Birjand (133 females and 182 males) were selected using multi-stage cluster sampling method. They completed attitudes toward math questionnaire (Aiken, 1978), the teachers’ perception of academic optimism questionnaire (woolfolk Hoy, Hoy & Kurz, 2008) and math self-efficacy scale (Liu, Koirala & May, 2009). Also, math achievement was assessed through math test grade of students at the end of the term. The data was analyzed using path analysis. The path analysis model showed a good fit to the data. The findings suggested that the direct effect of the teachers’ perception of academic optimism and attitudes toward math on math achievement is not significant, but the direct effect of the math self-efficacy on math achievement is significant. Findings also showed that the indirect effect of the teachers’ perception of academic optimism on math achievement through attitudes toward math and math self-efficacy is significant. In addition, the direct effect of the attitudes toward math on math self-efficacy is significant and the indirect effect of attitude toward math on math achievement through math self-efficacy is significant. It was concluded that the students perceptions of teachers’ academic optimism through other mediated variables, i.e., the attitudes toward math and math self-efficacy in math achievement is effective.

Introduction: Traffic accidents are the 8th cause of mortality in different countries and are expected to rise to the 3rd rank by 2020. Based on the Haddon matrix numerous factors such as environment, host, and agent can affect the severity of traffic-related traumas. Therefore, the present study aimed to evaluate the effective factors in severity of these traumas based on Haddon matrix. Methods: In the present 1-month cross-sectional study, all the patients injured in traffic accidents, who were referred to the ED of Imam Khomeini and Golestan Hospitals, Ahvaz, Iran, during March 2013 were evaluated. Based on the Haddon matrix, effective factors in accident occurrence were defined in 3 groups of host, agent, and environment. Demographic data of the patients and data regarding Haddon risk factors were extracted and analyzed using SPSS version 20. Results: 700 injured people with the mean age of 29.66 ± 12.64 years (3-82) were evaluated (92.4% male). Trauma mechanism was car-pedestrian in 308 (44%) of the cases and car-motorcycle in 175 (25%). 610 (87.1%) cases were traffic accidents and 371 (53%) occurred in the time between 2 pm and 8 pm. Violation of speed limit was the most common violation with 570 (81.4%) cases, followed by violation of right-of-way in 57 (8.1%) patients. 59.9% of the severe and critical injuries had occurred on road accidents, while 61.3% of the injuries caused by traffic accidents were mild to moderate (p < 0.001). The most common mechanisms of trauma for critical injuries were rollover (72.5%), motorcycle-pedestrian (23.8%), and car-motorcycle (13.14%) accidents (p < 0.001). Conclusion: Based on the results of the present study, the most important effective factors in severity of traffic accident-related traumas were age over 50, not using safety tools, and undertaking among host-related factors; insufficient environment safety, road accidents and time between 2 pm and 8 pm among environmental factors; and finally, rollover, car-pedestrian, and motorcycle-pedestrian accidents among the agent factors.

Background: Leisure time is one of the most important aspects of life, especially for people with chronic diseases. The concept and types of leisure have frequently been evaluated in different socio-cultural populations. The aim of this study was to identify the nature of leisure activities among a sample of Iranian patients with multiple sclerosis (MS) and classify the identified types of activities in the context of Iranian culture. Methods: In this qualitative study, semi-structured interview was applied to gather data from 34 MS patients that were selected through purposive sampling. The interviews were continued up to the point of saturation. Content analysis was used to explore experiences of the interviewees regarding their leisure activities. Results: Six categories of leisure activities were extracted for the studied patients with MS i.e.physical, social, individual, art/cultural, educational and spiritual/religious. Conclusion: The results represented the range and heterogeneity of leisure activities amongst the MS patients. Considering participation in spiritual/religious and social activities as leisure time undertaking might reflect cultural diversity in the perception and use of time for recreation. For mental health promotion purposes, paying special attention to the types of activities that people of different socio-cultural background choose for their refreshment could help health care providers in giving tailored advice for patients with MS and other chronic debilitating disease.

Introductoin: The purpose of present research was to design Existential anxiety questionnaire (death, freedom, loneliness and meaninglessness) and investigate its validity and reliability. The research design was exploratory study of instrumentation and validity assessment. Method: This research consisted of three stages. The first stage was to investigate the theoretical foundations and conceptual frameworks of existential anxiety. The second stage was to construct a Questionnaire for Existential Anxiety and evaluate its content validity and the third stage involved expanding validation and assessing reliability of questionnaire. To evaluate the validity and reliability, 505 employees and students of 5 Tehran universities were selected as sample using multi-stage cluster sampling. Research tools included Demoralization scale (translated by Naghiyayi and Bahmani, 2013) and Collett- Lester Death Anxiety scale (1990) that estimate concurrent and convergent validity and Existential Anxiety Questionnaire. All the subjects replied to two scales. Results: Findings showed that according to 10 expert opinions, Concurrent validity was. 0.95 by ICC and Concurrent validity and convergent validity was obtained 0.82 and 0.95, respectively. Exploratory Factor Analysis and Varimax factor rotation indicated Questionnaire theoretical structure consists of 4 factors that factors nominated according to theoretical base. Confirmatory factor analysis also indicated the goodness of fit for these factors. Furthermore the Cronbach's alpha and test-retest reliability was 0.82 and 0.86, respectively. Discussion and Conclusion: It can be concluded that a standard Questionnaire with 29 items and 4 subscales is available for evaluating Existential Anxiety in Persian.

Introduction: Both midazolam and promethazine are recommended to be used as sedatives in many studies but each have some side effects that limits their use. Combination therapy as an alternative method, may decreases these limitations. Therefore, this study aimed to compare midazolam with midazolam-promethazine regarding induction, maintenance, and recovery characteristics following pediatric procedural sedation and analgesia. Methods: Children under 7 years old who needed sedation for being CT scanned were included in this double-blind randomized clinical trial. The patients were randomly divided into 2 groups: one only received midazolam (0.5 mg/kg), while the other group received a combination of midazolam (0.5 mg/kg) and promethazine (1.25 mg/kg). University of Michigan Sedation Scale (UMSS) was used to assess sedation induction. In addition to demographic data, the child’s vital signs were evaluated before prescribing the drugs and after inducing sedation (reaching UMSS level 2). The primary outcomes in the present study were onset of action after administration and duration of the drugs’ effect. Results: 107 patients were included in the study. Mean onset of action was 55.4±20.3 minutes for midazolam and 32.5±11.1 minutes for midazolam-promethazine combination (p

Tuberculous ventriculitis is an inflammatory infection of the ventricular system of the brain, and is caused by Mycobacterium tuberculosis. We herein present the case of an immunocompromised patient with brain tuberculomas who developed ventriculitis during treatment. The patient was successfully treated with a high dose of steroid, long-term antituberculosis drugs, and aggressive supportive care.

In order to evaluate the fresh weight, RWC, pigment content, total phenolics, proline and glycine betaine responses of maize inbred lines to osmotic stress, a factorial experiment was carried out under laboratory conditions with two maize inbred lines (B73 and MO17) and two osmotic stress levels induced by PEG (control and -0.6 MPa). Fresh weight significantly decreased under drought stress. On the basis of percent inhibition in fresh weight at the osmotic stress MO17 was ranked as tolerant (inhibition 45.30%), and B73 drought sensitive (inhibition more than 50%). Leaf relative water content (RWC) was significantly decreased in both inbred lines under osmotic stress. The pigment concentrations were substantially declined in both maize inbreds under osmotic stressed conditions. However, this reduction was less in B73 than MO17. Osmoitc stress declined the levels of total phenolics in both maize inbreds. On the other hand, the osmotic stress markedly enhanced the levels of proline and glycine betaine in both maize inbreds, but this was more pronounced in MO17. The present results showed that osmotic stress retards the growth and some biochemical attributes of maize inbreds. In conclusion, the level of proline and glycine betaine in maize could improve drought tolerance.

In today’s world, no one can deny the expansion of economic influence in the various aspects of social life and economization of immaterial issues of social life is becoming more obvious every day. The valuation of cultural goods, as one of the most important economic aspects related to arts and culture, is chosen to be considered in this study. The necessity of considering the economic valuation of the arts and culture comes from the competition between different public and merit goods which seek government. Considering this, the present study is conducted in order to determine the economic value of “Isfahan City of Arts” as a cultural center which is planned to be built in Isfahan as the largest center of supplying, educating and presenting cultural and artistic events in the whole country. In order to make this happen, we need to know how people value different parts and activities of this complex. Regarding different strength and week points of various economic valuation techniques, the Choice Experiment method (CE), as one the most efficient methodologies in estimating different aspects of nonmarket goods, has been used in this study for measuring WTP estimates. The results indicate that among eleven activities (aspects) of the complex, all activities, except for galleries, had positive and significant effects on choosing designed scenarios, and among the listed activities, Concert Hall, Cineplex and Fashion Hall had, relatively, the highest willingness to payment.

This study aimed to determine the effectiveness of cognitive-existential group therapy on spiritual health and image of God of parents of children with cancer using semi-experimental with pre - posttest control group was randomly assigned and by following up has done during six-month. For this purpose 30 parents (From 24 to 54 years old) that their children due to cancer were in Mahak hospital under medical treatment and had volunteered to participate in counseling programs, Were assigned randomly to two experimental and control groups. Before the therapeutic intervention, both groups with spiritual health questionnaire (1982) and religious status questionnaire RSI (2003) were evaluated. The experimental group participated in twelve 90-minute sessions of cognitive-existential therapy that attended 2 sessions per week, while the control group did not use any psychological intervention during this period. After treatment, both groups were evaluated with the above tests. This assessment was carried out for the experimental group separately within 6 months of treatment. The data were processed by using software SPSS-16 for performing statistical test of covariance analysis (ANCOVA). The results revealed a significant difference in the spiritual health and positive impression of God in the two groups in favor of the experimental group (05/0> p), respectively. These results still remained in a 6-month follow experimental group for both variables, and showed that cognitive-existential therapy can be effective to increase spiritual health and create a positive impression of God in parents of children with cancer.

Introduction: Both midazolam and promethazine are recommended to be used as sedatives in many studies but each have some side effects that limits their use. Combination therapy as an alternative method, may decreases these limitations. Therefore, this study aimed to compare midazolam with midazolam-promethazine regarding induction, maintenance, and recovery characteristics following pediatric procedural sedation and analgesia. Methods: Children under 7 years old who needed sedation for being CT scanned were included in this double-blind randomized clinical trial. The patients were randomly divided into 2 groups: one only received midazolam (0.5 mg/kg), while the other group received a combination of midazolam (0.5 mg/kg) and promethazine (1.25 mg/kg). University of Michigan Sedation Scale (UMSS) was used to assess sedation induction. In addition to demographic data, the child’s vital signs were evaluated before prescribing the drugs and after inducing sedation (reaching UMSS level 2). The primary outcomes in the present study were onset of action after administration and duration of the drugs’ effect. Results: 107 patients were included in the study. Mean onset of action was 55.4±20.3 minutes for midazolam and 32.5±11.1 minutes for midazolam-promethazine combination (pConclusion: Based on the findings of this study, it seems that using a combination of midazolam and promethazine not only speeds up the sedation induction, but also decreases unresponsiveness to the treatment and the need for a rescue dose.

Asthma is one of the most common disorders of respiratory tract, management of which still remains as a serious health problem. This study aimed to compare the efficacy of 3% hypertonic saline (HS) plus salbutamol with solely salbutamol on management of acute adults’ asthma based on peak flow meter findings. In this double-blind randomized clinical trial, 340 adult patients with acute asthma attacks admitted to emergency department of Ahvaz Golestan and Emam hospitals were enrolled during 2014-2015. The patients were allocated randomly to intervention group (nebulized 2.5 mg of salbutamol and 2.5 mL of 3% HS solution for three consecutive 20-min periods) and control group (nebulized only salbutamol in the same dose and time of the intervention group). The principal outcome measures were forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR), which were assessed at baseline, and 20, 40 and 60 minutes after treatment in both groups. HS plus salbutamol resulted in a significant increase compared with solely salbutamol in both PEFR and FEV1 in 40th min (0.11±1.36; p=0.036 and 0.05±1.16; p=0.033, respectively) and 60th min (0.15±1.12; p

Objective: This study was aimed to determine the prevalence of drug use among students of universities of Medical Sciences in Tehran. Method: Four thousands of medical students (both sexes) in academic year 1388-89 in different level of education, B.A., M.Sc. and Ph.D. were selected by random stratified sampling method. These students were selected from Iran, Tehran and Shahid Beheshti Universities of Medical Sciences considering their sex and level of education. We used drug use prevalence questionnaire. Findings: The most prevalent drug of abuse in life time period was qalyan (classical pipe), followed by cigarette, and alcohol. The least frequent drug of abuse was Shisheh, followed by heroine krack. As we expected, drugs morphine, ritalin and tramadol were placed in forth, fifth and sixth of prevalent drugs. Use of different substances was significantly more prevalent in male students. Conclusion: Using soft drugs (qalyan, cigarette and alcohol) was more prevalent than hard drugs (hashish, taryak, heroine kerack) among Universities Medical Sciences of Tehran. Similar to drug use pattern in society, use of all of drugs were more prevalent in male students. We should pay special attention to use of drugs such as tramadol, ritalin, petedin and morphine.

This semi-experimental study with control group and pre test-post test was conducted to evaluate the effectiveness of Olson's marriage enrichment group training on marital satisfaction of women whose husbands don't participate in the program. To this purpose using a non- randomly sampling method (accessible sampling) 40 volunteers from women who referred to one of Tehran's municipal health centers were selected and none randomly assigned to two experimental and control groups. As pre test, dependent variable in both groups measured by short form of ENRICH or 40 items form (Bahmani, Asgari, 1385). Members of experimental group participate in 10 training sessions of 90 minutes meeting which were held twice a week while control group members (waiting list) did not participate in any official intervention. Finally both groups measured as post-test. Data were processed by SPSS-16 to calculate statistical and inferential statistics. Analysis of covariance showed that global satisfaction score of experiential group was significantly (P‹ %1) higher than control group. Therefore it can be concluded that Olson's marriage enrichment program as an intervention that originally designed in such a way that both partners must be present simultaneously in training sessions, can increase women's marital satisfaction even when their husbands don't participate in the program

Evaluation of communication abilities in the elderly is crucial for activities which will be performed to improve their quality of life. A valid and reliable questionnaire is needed for assessing communication abilities. We aimed to translate and validate the speech, spatial, and qualities of hearing scale (SSQ) in Iran. The forward-backward procedure was applied to translate the questionnaire from English into Persian. After linguistic validation and pilot study, a cross-sectional study was carried out, and psychometric properties of the Iranian version of the SSQ were tested. Number of 333 elderly individuals with impaired hearing completed the questionnaire. Number 48.3% were hearing aid users and 51.7% was not. Reliability was assessed by internal consistency (Cronbach's alpha) and test-retest analysis. Exploratory factor analysis was performed for extracting factor structure of the Persian version of SSQ. Confirmatory factor analysis was performed to compare different models of factor loadings. The Mean age of participants was 62.00 years (SD=9.58 years), and the mean SSQ score was 5.1 (SD=1.2, ranged: 3.17-6.27). Reliability evaluation revealed high internal consistency and good test- retest reliability. Cronbach's alpha coefficient was 0.96 and the Pierson Correlation at test-retest analysis was 0.73 for Quality of hearing factor, 0.88 for Spatial and o.73 for Speech understanding factor. The results of exploratory factor analysis (EFA) indicated a four-factor solution for P-SSQ that jointly accounted for 52.40% of the variance observed. Confirmatory factor analysis approved the three factor solution but proposed a possible fourth factor. The Iranian version of the SSQ has acceptable psychometric properties, and it will be helpful for assessing different kinds of communication abilities in the Iranian elderly population.

Background. This study compares different risk factors in patients visiting a hospital during five rainfall-associated bronchospasm epidemics in Ahvaz and those visiting on other occasions. Methods. This case-control study was conducted on 5307 patients with bronchospasm admitted to the Emergency Department of Imam Khomeini Hospital in Ahvaz (Iran) from late October to December (as the epidemic) and 916 patients admitted from late January to March (as the nonepidemic) in 2011 to 2015. Results. A total of the 41.7% of the cases and 48.8% of the controls had episodes of bronchospasm, suggesting a significant difference between the two groups (P

Objective: Opium and stimulants are two kinds of illegal substances which are different from each other in chemical structure, psychological and biological effects (material), and their potential adverse effects on consumers. The present study compares the effect of abuse of each of the two (opium and stimulants) on violent behavior against wives. Materials & Methods: The present study was a non-experimental and comparative study. The study sample included 100 spouses of men addicted to opium and stimulants (50 opium and 50 stimulant addicts) who attended governmental or non-governmental centers or camps in Tehran city (from October 2011 to January 2012), in order to receive professional assistances. (Both groups of subjects were selected by convenient sampling method to ensure the compatibility with input and output data. The “revised conflict tactics scale” was used to assess the rates of violence (psychological, sexual coercion, negotiation, injury and physical assault) exerted by men. Results were analyzed using multi-variety analysis of variance and covariance. Results: Results showed that after controlling the age as a covariate, consumers of stimulants (especially methamphetamine) were more violent toward their wives than were consumers of opium (P&le0.001). There were also significant differences between the two groups in the psychological, sexual coercion, injury and physical assault subscales, but not in the negotiation subscale (P&le0.05). Conclusion: It seems that the psychopharmacological effect of stimulants leads to more violent behaviors in its consumers (especially by methamphetamine) than in consumers of opium.

Introduction: An appropriate procedural sedation and analgesia (PSA) is crucial to reduce a dislocated shoulder successfully in emergency department. This study compares sedative effect of inhalational Entonox® (En) to intra-venous (IV) Midazolam plus Fentanyl (F+M). Methods: 120 patients with recurrent anterior shoulder dislocation were randomly assigned into two groups. 60 patients (group F+M) received 0.1 mg/kg IV Midazolam plus 3µg/kg IV Fentanyl and 60 patients (group En) received Entonox® with self administration face mask on an on-demand basis. Traction/counter-traction method was used to reduce the dislocated shoulder joint in both groups. Results: 48 out of 60 (80%) patients in group F+M and 6 out of 60 (10%) patients in group En had successful reduction (p < 0.0001). The mean pain score reduction was 6.3 ± 1.2 for group F+M and 3 ± 0.9 for group En (p < 0.0001). There was a statistically significant difference in mean patient satisfaction (assessed with Likert score) between two groups (4.45 ± 0.6 for group F+M and 2.3 ± 1 for group En; p < 0.0001). Duration of entire procedure (since the beginning of PSA up to the end of successful or unsuccessful reduction) was shorter in Group F+M, but successful reductions occurred earlier in group En. No major side effect such as airway compromise, retracted respiratory depression, or circulatory failure was occurred in any group. Conclusion: Entonox® may not be an appropriate agent to help reducing a dislocated shoulder.