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Abstract Owning pets offers various potential health benefits; however, it can be associated with gastrointestinal illnesses due to poor food safety knowledge and practices. This study aimed to evaluate the level of food safety knowledge and practices among pet owners in Lebanon, exploring the association between their knowledge/practices and socio-demographic characteristics. The participants included 300 pet owners, representing various genders, ages, educational levels, educational backgrounds, and incomes. They completed a questionnaire of 72 food handling practices and knowledge questions related to preparation, cross-contamination, storage and hygiene. In parallel, 300 non-pet owners with comparable sociodemographic characteristics to pet owners (control group) completed the questionnaire. On average, food safety knowledge scores were 62.1 ± 14.9% and 58.7 ± 15.5% among pet and non-pet owners, respectively, and the difference was significant (p = 0.05). On the other hand, mean food safety practice scores were 41.3 ± 14.8% and 40.4 ± 15.3% among pet and non-pet owners, respectively, and the difference was not significant (p = 0.41). In the food safety knowledge part, non-pet owners who were young, high income, university graduate, and from health-related majors scored significantly (p

Abstract Cartilage tissue engineering aims to develop functional substitutes for treating cartilage defects and osteoarthritis. Traditional two-dimensional (2D) cell culture systems lack the complexity of native cartilage, leading to the development of 3D regenerative cartilage models. In this study, we developed a 3D model using Gelatin Methacryloyl (GelMA)-based hydrogels seeded with Y201 cells, a bone marrow mesenchymal stem cell line. The model investigated chondrogenic differentiation potential in response to Wnt3a stimulation within the GelMA scaffold and validated using known chondrogenic agonists. Y201 cells demonstrated suitability for the model, with increased proteoglycan content and upregulated chondrogenic marker expression under chondrogenic conditions. Wnt3a enhanced cell proliferation, indicating activation of the Wnt/β-catenin pathway, which plays a role in cartilage development. GelMA hydrogels provided an optimal scaffold, supporting cell viability and proliferation. The 3D model exhibited consistent responses to chondrogenic agonists, with TGF-β3 enhancing cartilage-specific extracellular matrix (ECM) production and chondrogenic differentiation. The combination of Wnt3a and TGF-β3 showed synergistic effects, promoting chondrogenic differentiation and ECM production. This study presents a 3D regenerative cartilage model with potential for investigating cartilage biology, disease mechanisms, and drug screening. The model provides insights into complex cartilage regeneration mechanisms and offers a platform for developing therapeutic approaches for cartilage repair and osteoarthritis treatment.

Abstract Extensive research efforts have been dedicated to developing electrode materials with high capacity to address the increasing complexities arising from the energy crisis. Herein, a new nanocomposite was synthesized via the sol–gel method by immobilizing K6ZnW12O40 within the surface of NiZn2O4. ZnW12O40@NiZn2O4 was characterized by FT-IR, UV–Vis, XRD, SEM, EDX, BET, and TGA-DTG methods. The electrochemical characteristics of the materials were examined using cyclic voltammogram (CV) and charge–discharge chronopotentiometry (CHP) techniques. Multiple factors affecting the hydrogen storage capacity, including current density (j), surface area of the copper foam, and the consequences of repeated cycles of hydrogen adsorption–desorption were evaluated. The initial cycle led to an impressive hydrogen discharge capability of 340 mAh/g, which subsequently increased to 900 mAh/g after 20 cycles with a current density of 2 mA in 6.0 M KOH medium. The surface area and the electrocatalytic characteristics of the nanoparticles contribute to facilitate the formation of electrons and provide good diffusion channels for the movement of electrolyte ions throughout the charge–discharge procedure.

Abstract In this research, a new and eco-friendly heterogeneous catalyst (ND@Tannicacid-Cu) was synthesized based on nanodiamond and copper tannic acid via esterification process. The as-prepared catalyst was characterized by Fourier transforms infrared spectroscopy (FT-IR), energy dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), and X-ray diffraction (XRD) methods. The catalytic efficacy of the intended catalyst was examined by one-step three-component reaction of 1,4-benzodiazepine derivatives from a mixture of ortho-phenylenediamine, aromatic aldehydes, and dimedone under mild conditions. In all instances, corresponding 2,4-benzodiazepines derivatives were synthesized with high efficiency, short reaction time, straightforward work up procedure, no requirement for column-chromatography, and cost-effective catalyst. The heterogeneous catalyst was easily recycled using fillers, and it can be reused for eight cycles without significantly diminishing its performance.

Abstract Characterization of the microbial activity impacts on transport and storage of hydrogen is a crucial aspect of successful Underground Hydrogen Storage (UHS). Microbes can use hydrogen for their metabolism, which can then lead to formation of biofilms. Biofilms can potentially alter the wettability of the system and, consequently, impact the flow dynamics and trapping mechanisms in the reservoir. In this study, we investigate the impact of microbial activity on wettability of the hydrogen/brine/rock system, using the captive-bubble cell experimental approach. Apparent contact angles are measured for bubbles of pure hydrogen in contact with a solid surface inside a cell filled with living brine which contains sulphate reducing microbes. To investigate the impact of surface roughness, two different solid samples are used: a “rough” Bentheimer Sandstone sample and a “smooth” pure Quartz sample. It is found that, in systems where buoyancy and interfacial forces are the main acting forces, the impact of biofilm formation on the apparent contact angle highly depends on the surface roughness. For the “rough” Bentheimer sandstone, the apparent contact angle was unchanged by biofilm formation, while for the smooth pure Quartz sample the apparent contact angle decreased significantly, making the system more water-wet. This decrease in apparent contact angle is in contrast with an earlier study present in the literature where a significant increase in contact angle due to microbial activity was reported. The wettability of the biofilm is mainly determined by the consistency of the Extracellular Polymeric Substances (EPS) which depends on the growth conditions in the system. Therefore, to determine the impact of microbial activity on the wettability during UHS will require accurate replication of the reservoir conditions including surface roughness, chemical composition of the brine, the microbial community, as well as temperature, pressure and pH-value conditions.

Background: Understanding the experiences of patients’ family members witnessing resuscitation helps develop care plans. Accordingly, this study aimed to explore the experiences of witnessing resuscitation among the patients’ family members.Methods: A total of 15 patients’ family members were interviewed over a 4-month period (from April to July 2019). The participants were recruited through purposive sampling, and they were enlisted from three educational hospitals in Tabriz. Data were analyzed using Smith’s interpretative phenomenological analysis (IPA) via the MAXQDA12 software.Results: Data analysis led to the identification of four main themes and nine subthemes. The main themes included “the insistence on being present”, “achieving calmness”, “partnership and collaboration” and “hindrance”.Conclusion: Although family members reported feelings of agitation towards the health professionals, there was also strong evidence of the benefits of witnessing resuscitation such as open communication, psychological support, and facilitating acceptance of the patient’s prognosis. The study highlighted the importance of developing formal policies based on a family-centered care (FCC) approach to observe family presence during resuscitation while maintaining the patient’s and family’s rights.

Abstract Surfaces on transit vehicles are frequently touched and could potentially act as reservoirs for micro-organism transmission. Regular cleaning and disinfection to minimize the spread of micro-organisms is operationally challenging due to the need to keep vehicles in circulation. The application of copper (Cu) alloys to high- touch surfaces could help reduce the risk of cross-contamination, however, little is known about the durability and efficacy of engineered copper surfaces after prolonged use. Three Cu products (decal, thermal fabrication, and alloy covers) were assessed over a 12-month period. These Cu products were randomly installed on 110 stanchions on three buses and four train (SkyTrain) cars in Vancouver and three buses, two subway cars, and two streetcars in Toronto with mirrored control surfaces directly opposite. Bacterial counts (Colony forming units, CFU) and ATP bioluminescence (ATPB) were measured every two months after peak morning routes. Durability of the Cu products were assessed monthly through visual inspection and colorimetry assays or by ex-situ microscopy. Cu products on stanchions reduced the mean colony forming units (CFU) of all vehicles by 42.7% in the mean CFU (0.573 (CI 95% 0.453–0.726), p-value

Introduction Families with children who have cystic fibrosis (CF) face a multitude of challenges. They require complex and time-consuming daily care, various forms of knowledge and intricate care responsibilities. One of the most critical challenges that Iranian families of children with CF face is the lack of adequate support from health teams in the early stages of diagnosis, frequent hospitalisation and the postdischarge process. Unfortunately, limited studies have been conducted in this field, and the Iranian society lacks a comprehensive support programme for these families after leaving treatment centres or home care teams. Therefore, it is necessary to identify and redefine the needs of these families for better care and support in Iran.Methods and analysis A mixed-method research design with an exploratory sequential approach will be used in this study. The study consists of three stages: stage (1) the qualitative phase (conventional content analysis and scoping review); stage (2) the programme design phase (development of a support programme) and stage (3) the quantitative phase (validation of the programme through the Delphi method). In the first stage, data will be collected through interviews. Key concepts, evidence and gaps in research will also be identified, collected and analysed through a scoping review. In the second stage, a support programme will be designed based on the results of the content analysis of interviews and the findings from the scoping review. In the final phase, the study will aim to validate the designed programme through a Delphi study.Ethics and dissemination This study formed part of a Ph.D. degree and was approved by the ethics committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.1402.395). Informed consent will be obtained from all study participants. Findings will be published in a peer-reviewed journal.

Abstract Background Breast cancer remains a primary global health concern due to its limited treatment options, frequent disease recurrence, and high rates of morbidity and mortality. Thereby, there is a need for more effective treatment approaches. The proposal suggests that the combination of targeted therapy with other antitumoral agents could potentially address drug resistance. In this study, we examined the antitumoral effect of combining metformin, an antidiabetic drug, with targeted therapies, including tamoxifen for estrogen receptor-positive (MCF-7), trastuzumab for HER2-positive (SKBR-3), and antibody against ROR1 receptor for triple-negative breast cancer (MDA-MB-231). Methods Once the expression of relevant receptors on each cell line was confirmed and appropriate drug concentrations were selected through cytotoxicity assays, the antitumor effects of both monotherapy and combination therapy on colony formation, migration, invasion were assessed in in vitro as well as tumor area and metastatic potential in ex ovo Chick chorioallantoic membrane (CAM) models. Results The results exhibited the enhanced effects of tamoxifen when combined with targeted therapy. This combination effectively inhibited cell growth, colony formation, migration, and invasion in vitro. Additionally, it significantly reduced tumor size and metastatic potential in an ex ovo CAM model. Conclusions The findings indicate that a favorable strategy to enhance the efficacy of breast cancer treatment would be to combine metformin with targeted therapies. Graphical Abstract

Abstract During the cryopreservation of sperm, the production of highly reactive oxygen species (ROS) can reduce their viability and fertility. However, the addition of antioxidants can help reduce the harmful effects of ROS. One such antioxidant is selenium, which is a co-factor of the glutathione peroxidase enzyme that is effective in scavenging ROS. Cysteamine can also take part in the structure of this enzyme. The use of nanoparticles can be less toxic to cells than their salt form. To this end, researchers synthesized Se-NPs using the streptococcus bacteria and loaded cysteamine onto the synthesized Se-NPs. The biosynthesis of Se-NPs and cysteamine loaded on Se-NPs was confirmed by UV–visible spectroscopy, X-ray diffraction (EDX), Fourier transforms infrared (FTIR) spectroscopy, and Field Emission Scanning Electron Microscope (FE-SEM). For cryopreservation, ram semen samples were diluted, and different concentrations (0, 1, 5, 25, and 125 µg/mL) of cysteamine, Se-NPs, cysteamine loaded on Se-NPs, and sodium selenite were added. An extender containing no supplement was considered as control group. After cooling the semen samples, they were frozen and stored in liquid nitrogen for evaluation. The samples were thawed and analyzed for mobility, viability, membrane and DNA integrity, and sperm abnormalities, as well as malondialdehyde level (MDA) and superoxide dismutase (SOD). The data was processed using SPSS, and a significance level of p

Background. Root canals feature a high incidence of post-treatment flare-ups, characterized by pain, swelling, or discomfort following endodontic procedures, which remain a concern in dental practice. This study aims to evaluate the host-related factors behind the prevalence of post-endodontic flare-ups. Methodology. A retrospective study was conducted on the records of 93 patients who were treated endodontically between January 2017 and December 2021. Data extracted from records included age, medical conditions, diagnosis, and tooth type. SPSS 27.0 was used to analyze the data. Multivariate logistic regression analysis was employed to identify significant predictors while controlling for potential confounding factors. Results. The flare-up rate among patients who had received endodontic treatment was 31.2% in the study population. Multivariate logistic regression analysis demonstrated that age and the presence of a vital pulp were significant predictors of flare-ups. Older patients exhibited an increased likelihood of experiencing flare-ups (p 0.05). Conclusion. The study provided insights into the frequency of post-endodontic flare-ups and the impact of host-related factors on their occurrence. Age and vital pulp were found to be important predictors, highlighting the significance of individualized treatment planning. These results highlight the possibility of improved patient outcomes through a thorough understanding of post-endodontic problems and contribute to evidence-based endodontic practice.

Background and purpose: Dental pulp stem cells (DPSCs) with the ability to differentiate into different types of adult cells have provided a new vision in the treatment of various diseases. However, different challenges remain with differentiation methods to produce insulin-producing cells (IPCs). In the present study, the differentiation of dental pulp stem cells into IPCs using platelet-rich plasma (PRP) has been addressed. Materials and methods: In this experimental study for generation of IPCs, DPSCs were cultured in the first step, and then to confirm the characteristics of stem cells, the morphology of stem cells was confirmed by microscopic observation, and then the expression of CD90 and CD105 markers assessed by flow cytometry. After confirming the pluripotency of the stem cells, a 18days differentiation protocol into IPCs began. Following that, pancreatic endocrine genes such as insulin, pdx1, glut2 and glucagon were analyzed using Real-Time PCR. Insulin and C-peptide release was assessed using ELISA. To investigate the effect of platelet-rich plasma on cell viability, the MTT test was performed. Results: Results showed that the use of the above-mentioned differentiation protocol, in the differentiation group containing PRP, the cells resembled Langerhans islet clusters. The expression of pancreatic endocrine genes in the differentiation group containing PRP was significantly higher than the other groups. Additionally, in two differentiation groups with and without PRP, the cells responded differently to glucose concentrations compared to insulin and C-peptide release. Furthermore, the rate of cell proliferation in the differentiation group containing PRP was higher than the other groups. Conclusion: Based on the availability of dental pulp stem cells and PRP, the absence of invasive methods for obtaining these resources, as well as the low immunogenicity due to the use of the patient's tissues, seems to be appropriate method for producing insulin-secreting cells.

Background: The second victim phenomenon is an incident that occurs after an adverse medical event; while the patient is the first victim of the incident, the nurses and healthcare personnel become the second victims because they feel ashamed after that. The present research aimed to investigate various dimensions of the second victim phenomenon among nurses in South Khorasan Province, Iran.Materials and Methods: The current research was a descriptive study. The sample selection method was multi-stage cluster randomization, including 200 nurses working in South Khorasan Province, Iran. The data was collected using a demographic questionnaire and the second victim experience and support tool (SVEST) and analyzed using SPSS version 21.Results: The scores of incidence of psychological distress (14.60), professional self-efficacy (9.42), supervisor support (15.97), institutional support (10.71), turnover intentions and absenteeism (13.35), non-work-related support (expected sources of support) (25.25) and the total score of second victim phenomenon (114.55) were higher than the expected average; but other scores including colleague support (8.56), family support (5.41), and physical distress (11.31) were significantly lower than the expected average (p

Background and purpose: Pseudoviruses, due to their immunity and adaptability, are valuable tools for developing vaccines and therapeutic drugs, particularly for emerging viruses. SARS-CoV-2, due to its high mortality rate and ease of transmission, should be handled under Biosafety Level 3 conditions, making the development of vaccines and therapeutic drugs challenging in many research centers. The present study aimed to produce a lentivirus pseudotype that can be used in neutralization assays based on pseudovirus under Biosafety Level 2 conditions. Materials and methods: The SARS-CoV-2 Spike protein gene was inserted into the HIV-1 genome. Confirmation of entry was obtained through flow cytometry, electron microscopy, and immunofluorescence. Finally, the neutralization capacity of convalescent COVID-19 patients' sera was measured using the pseudovirus-based neutralization assay. Results: The results of flow cytometry, electron microscopy, and immunofluorescence confirmed the entry of the Spike gene. Furthermore, the sera of convalescent patients showed significantly higher neutralizing capacity compared to the control group that had not been exposed to SARS-CoV-2. Conclusion: The results of this study demonstrated that the use of the produced lentivirus pseudotype can measure the neutralizing capacity of patients' sera, and the pseudovirus-based neutralization assay serves as a suitable alternative for assessing the neutralization of live SARS-CoV-2. Moreover, this test can effectively evaluate vaccines or therapeutic drugs for combating this deadly virus.

Abstract Sulfur compounds are among the most unfavorable constituents of petroleum derivatives, so stringent regulations have been established to curb their atmospheric emissions. In this regard, a new nanocomposite ((n-C4H9)4N)4H[PW11FeO39]@NiO) was synthesized composed of quaternary ammonium bromide salt of ironIII-substituted Keggin-type polyoxometalate immobilized on nickel(II) oxide nanoceramics via sol–gel method. The assembled (n-C4H9)4N)4H[PW11FeO39]@NiO nanocomposite was identified by FT-IR, UV–Vis, XRD, SEM, EDX, and TGA-DTG methods. The characterization results exhibited that ((n-C4H9)4N)4H[PW11FeO39] dispersed uniformly over the surface of the NiO nanoceramics. The ((n-C4H9)4N)4H[PW11FeO39]@NiO nanocomposite was employed as a heterogeneous nanocatalyst in the extractive coupled oxidation desulfurization (ECOD) of real gas oil and dibenzothiophene (DBT) as a model compound. Under relatively moderate conditions, the catalytic performance of the ((n-C4H9)4N)4H[PW11FeO39]@NiO in the ECOD procedure was studied by incorporating acetic acid/hydrogen peroxide as an oxidant system at a volume ratio of 1:2. According to the ECOD results, the ((n-C4H9)4N)4H[PW11FeO39]@NiO demonstrated the effectiveness of up to 95% with 0.1 g at 60 °C under optimal operating conditions. Moreover, the ((n-C4H9)4N)4H[PW11FeO39]@NiO nanocatalyst could be separated and reused for five runs without a noticeable decrease in the ECOD process. This study provides a promising way to meet the target of ultra-low sulfur as an essential process in oil refineries.

Abstract Siltation significantly threatens a reservoir’s original storage capacity and lifespan. Pressure flushing is an effective measure against siltation through the partial drawdown of the reservoir water level with limited flushed cone volumes in front of the bottom outlet. In this study, a novel configuration with submerged vanes has been proposed and tested experimentally to increase the flushed sediment volume during pressure flushing. In the new configuration, submerged vanes aligned with ten skew angles (θ) of 10°, 20°, 30°, 45°, 70°, 110°, 135°, 150°, 160°, and 170° to the flow direction in noncohesive sediment bed materials were used. The results showed that increasing the skew angle at 45° ≤ θ ≤ 160° increased the flushing cone geometry. The minimum and maximum flushing cone dimensions and volume occurred at skew angles of θ = 45° and 135° ≤ θ ≤ 160° around the bottom outlet. The sediment flushing volume in the presence of submerged vanes at 135° ≤ θ ≤ 160° increased 25 times compared to tests without submerged vanes. Eventually, nonlinear regression analysis yielded an equation for estimating flushing cone volumes. The developed equation was tested in real case studies of a target reservoir, and an acceptable correlation between the calculated and experimental results was obtained.

Abstract Reservoir simulations for subsurface processes play an important role in successful deployment of geoscience applications such as geothermal energy extraction and geo-storage of fluids. These simulations provide time-lapse dynamics of the coupled poromechanical processes within the reservoir and its over-, under-, and side-burden environments. For more reliable operations, it is crucial to connect these reservoir simulation results with the seismic surveys (i.e., observation data). However, despite being crucial, such integration is challenging due to the fact that the reservoir dynamics alters the seismic parameters. In this work, a coupled reservoir simulation and time-lapse seismic methodology is developed for multiphase flow operations in subsurface reservoirs. To this end, a poromechanical simulator is designed for multiphase flow and connected to a forward seismic modeller. This simulator is then used to assess a novel methodology of seismic monitoring by isolating the reservoir signal from the entire reflection response. This methodology is shown to be able to track the development of the fluid front over time, even in the presence of a highly reflective overburden with strong time-lapse variations. These results suggest that the proposed methodology can contribute to a better understanding of fluid flow in the subsurface. Ultimately, this will lead to improved monitoring of reservoirs for underground energy storage or production.

IntroductionIn medical education, department chairs should play a significant role. The present qualitative study was conducted to identify factors that influence the performance improvement of department chairs at medical schools in Iran.MethodsThe study was conducted in Iran in 2022 and used a thematic analysis method. Using a purposeful sampling method, 20 participants were invited to participate, including medical school deans and department chairs. Focus group discussion (FGD) was used for qualitative data gathering. Braun and Clarke's thematic analysis was used to analyze data.ResultsThere were 18 males and 2 females among the participants. The mean age of the participants was 45±4 years. Five overarching themes were formulated: human resource management, organizational behavior management, performance support system, leadership, and financial resources. Also, nine subthemes emerged, including performance evaluation, job and work design, educational and non-educational support, motivational efforts, organization culture, organizational knowledge management, planning for change, and financing.ConclusionsIn this study, we found factors influencing DC performance improvement. Department chairs' effective performance may have a positive impact on department operations, processes, or outcomes.

Objective This study explored nurses’ perceptions of the core competencies required for providing postresuscitation care in both in-hospital and out-of-hospital cardiac arrest.Design Qualitative conventional content analysis.Participants 17 nurses selected with purposeful sampling method.Setting Three educational hospitals in northwest of Iran.Data collection and analysis Semi-structured interviews were used for data collection and they were analysed using conventional content analysis.Results Seven main categories have emerged from the data. The core competencies for nurses providing postresuscitation were identified as: quality assurance, providing evidence-based care, monitoring and presence, situation management, professionalism, positive attitude and providing family centred care.Conclusions The postresuscitation period is a unique and critical time requiring highly competent nursing care. Several core competencies for providing high-quality nursing care during postresuscitation period were identified through nurses’ experience in caring for patients postresuscitation.

Background: Patient handover in the emergency department (ED) is a 2-way communication process between the paramedics and in-hospital emergency personnel, which can result in miscommunication and delivery challenges. This study aimed to explore the lived experience of paramedics on patient handover to the ED. Methods: Over a period of 5 months, an interpretative phenomenological analysis (IPA) was used to explore the lived experiences of 15 paramedics in Tabriz, Iran. Semi-structured interviews were conducted in the emergency medical stations using the Smith approach for data collection and analysis. The researcher used 4 criteria to ensure rigor, including credibility, dependability, confirmability, and transferability, according to Lincoln and Guba. Results: Three main themes emerged from the data analysis, including “the hole of hope,” “the boring issues,” and “paramedics are only a driver.” A further 11 sub-themes emerged under the main themes. Conclusion: The highlighted issues that need to be considered during the process are the presence of staff in front of the ED's door to welcome the patient, removal of structural defects and defective hospital equipment, the presence of medical supplies in emergency triage to prevent the paramedics from stumbling, and listening to paramedics by physicians and nurses to obtain the patients’ history.

Introduction: The increasing trend of cancer morbidity and mortality is a major human health concern, indicating the necessity for the design and introduction of novel anticancer compounds. The use of nanotechnology products is a new approach to cancer treatment. Therefore, the current study was performed to synthesize Titanium Dioxide nanoparticles (NPs) functionalized with glutamine and conjugated to Thiosemicarbazide (TiO2@Gln-TSC) to inhibit the proliferation of liver cancer cells line (HepG2) and evaluate the effect of TiO2@Gln-TSC NPs on the expression of apoptotic genes. Material & Methods: TiO2@Gln-TSC NPs were synthesized by a chemical method and characterized by Fourier-transform infrared spectroscopy (FT-IR), Energy-dispersive X-ray spectroscopy (EDS), Scanning electron microscopy (SEM), and Transmission electron microscopy (TEM). The cytotoxicity of the Titanium Dioxide nanoparticles was evaluated by the MTT assay, and relative gene expression was studied by Real Time PCR method. Findings: The results showed that the synthesized Titanium Dioxide nanoparticles were spherical with a size range of 59 to 82 nm. The particles had a considerable anti-proliferative effect on liver cancer cells line with IC50 of 80 µg/mL. The treatment of the cancer cell line with TiO2@Gln-TSC NPs significantly increased the expression of the CASP3, BAX, and BCL2 by 2.8, 2.7, and 1.3 folds, respectively, which indicated the activation of apoptotic pathways in the treated cells. Discussion & Conclusion: The results showed that the TiO2@Gln-TSC NPs could inhibit the proliferation of liver cancer cells line and by triggering the apoptosis pathway.

BACKGROUND: In the present study, electrical stimulation of the brain from the skull using transcranial direct current stimulation (tDCS) was integrated with a stress-based stress reduction program. The aim of this study was to compare the effectiveness of mindfulness-based stress reduction training with tDCS in reducing anxiety in adolescents with cancer. METHODS: In this quasi-experimental study, the statistical population included all adolescents with cancer in Mahak Hospital in Tehran, Iran, in 2020. According to the inclusion and exclusion criteria, 40 people were selected and purposefully placed in 3 experimental groups and 1 control group. Patients were randomly assigned to experimental and control groups. The data collection tool used was the Penn State Worry Questionnaire (PSWQ). Members of the experimental group participated in sessions of a mindfulness-based stress reduction program and tDCS intervention. Members of the control group did not receive any intervention. To analyze the data, multivariate analysis of covariance (MANCOVA), repeated measures analysis of variance (ANOVA), and least significant difference post hoc tests were used (P < 0.05). RESULTS: The mindfulness-based stress reduction program combined with tDCS was more effective than the separate use of these interventions and reduced anxiety in adolescents with cancer (P < 0.05). Mindfulness-based stress reduction program is more effective than tDCS intervention (P < 0.05). Mindfulness-based stress reduction programs are more effective than tDCS intervention (P < 0.05). CONCLUSION: The use of a combination of mindfulness-based stress reduction therapy with tDCS is more effective than using each of these interventions separately and can be combined with the other standard treatment for these patients.

Background and Aims: Post-traumatic stress disorder (PTSD) is one of the psychological problems after the COVID-19 pandemic. Some people can cope with this trauma and return to their previous status or even achieve a higher level of performance, which is called post-traumatic growth. This study aimed to investigate the prevalence and the relationship between the PTSD and post-traumatic growth symptoms among patients discharged from COVID-19 intensive care units (ICU). Materials and Methods: The present study was a descriptive study conducted on 172 patients discharged from COVID-19 ICU. Samples were selected with cluster randomized multistage method from the patients discharged from the ICU, with previous six months recovery. Data were collected using demographic questionnaire, and post-traumatic stress and post-traumatic growth checklists. Then, the collected data were analyzed in SPSS software (version 21). Results: Results showed that 34.3% and 58.96% of patients experienced PTSD and post-traumatic growth, respectively. Pearson correlation analysis showed that with the increase in PTSD score, the post-traumatic growth score also increased in these patients (r=0.524, P=0.001). Conclusion: Post-traumatic stress disorder and post-traumatic growth symptoms were common among COVID-19 patients admitted to the ICU. In addition, the more the patients experienced post-traumatic stress symptoms, the more likely they were to experience the post-traumatic growth.

Objectives Despite credible evidence, optimal neonates’ pain management in the neonatal intensive care unit (NICU) is a challenging issue. In this regard, the organisational context is an essential factor. The existing challenges vary depending on the context, and investigating them can help to improve the quality of care. The study aimed to explore organisational challenges to neonates’ pain management in the NICU.Methods This qualitative study included 31 nurses and physicians in the NICU of Children’s Hospital, Tabriz, Iran. Data collection was done through individual and focus group interviews. For data analysis, we used conventional content analysis.Results The identified challenges included organisational culture (poor interprofessional collaboration and low parental participation), organisational structure (lack of unified approach in relieving pain and limited supervision for pain management) and organisational resources (lack of time due to high workload and inadequate educational programmes).Conclusions Many organisational factors consistently affect neonatal pain management. Adopting some approaches to enhance the cooperation of treatment team members, holding educational programmes, proper organisational supervision and implementing a unified neonatal-based pain management programme could improve neonatal pain management.

Abstract Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.

Abstract Subsurface geological formations can be utilized to safely store large-scale (TWh) renewable energy in the form of green gases such as hydrogen. Successful implementation of this technology involves estimating feasible storage sites, including rigorous mechanical safety analyses. Geological formations are often highly heterogeneous and entail complex nonlinear inelastic rock deformation physics when utilized for cyclic energy storage. In this work, we present a novel scalable computational framework to analyse the impact of nonlinear deformation of porous reservoirs under cyclic loading. The proposed methodology includes three different time-dependent nonlinear constitutive models to appropriately describe the behavior of sandstone, shale rock and salt rock. These constitutive models are studied and benchmarked against both numerical and experimental results in the literature. An implicit time-integration scheme is developed to preserve the stability of the simulation. In order to ensure its scalability, the numerical strategy adopts a multiscale finite element formulation, in which coarse scale systems with locally-computed basis functions are constructed and solved. Further, the effect of heterogeneity on the results and estimation of deformation is analyzed. Lastly, the Bergermeer test case—an active Dutch natural gas storage field—is studied to investigate the influence of inelastic deformation on the uplift caused by cyclic injection and production of gas. The present study shows acceptable subsidence predictions in this field-scale test, once the properties of the finite element representative elementary volumes are tuned with the experimental data.

Abstract SiRNA is a new generation of drug molecules and a new approach for treating a variety of diseases such as cancer and viral infections. SiRNA delivery to cells and translocation into cytoplasm are the main challenges in the clinical application of siRNA. Lipid carriers are one of the most successful carriers for siRNA delivery. In this study, we investigated the interaction of siRNA with a zwitterionic bilayer and how ion concentration and lipid conjugation can affect it. The divalent cation such as Mg2+ ions could promote the siRNA adsorption on the bilayer surface. The cation ions can bind to the head groups of lipids and the grooves of siRNA molecules and form bridges between the siRNA and bilayer surface. Our findings demonstrated the bridges formed by divalent ions could facilitate the attachment of siRNA to the membrane surface. We showed that the divalent cations can regulate the bridging-driven membrane attachment and it seems the result of this modulation can be used for designing biomimetic devices. In the following, we examined the effect of cations on the interaction between siRNA modified by cholesterol and the membrane surface. Our MD simulations showed that in the presence of Mg2+, the electrostatic and vdW energy between the membrane and siRNA were higher compared to those in the presence of NA+. We showed that the electrostatic interaction between membrane and siRNA cannot be facilitated only by cholesterol conjugated. Indeed, cations are essential to create coulomb repulsion and enable membrane attachment. This study provides important insight into liposome carriers for siRNA delivery and could help us in the development of siRNA-based therapeutics. Due to the coronavirus pandemic outbreak, these results may shed light on the new approach for treating these diseases and their molecular details.

Abstract Objectives F wave is one of the nerve conduction studies, mainly used to study the proximal pathway of peripheral nerves. One of its applications is dynamic assessment, i.e., before and after physical activity, when symptoms develop in some patients. Best to our knowledge, few studies evaluate normal dynamic F wave values in healthy individuals. This study aims to determine and compare normal values of several parameters of Compound Muscle Action Potential (CMAP) and F waves of tibial nerves dynamically before and after physical activity in the lower extremities of 34 normal subjects. These parameters were recorded before and after 15 min of continuous walking at intervals of 1, 5, and 10 min after the end of physical activity. Results Normal values of CMAP onset latency and amplitude, minimum, maximum, and mean latency of 10 F waves, F chronodispersion, and F persistence were dynamically collected before and during 10 min after physical activity in three phases. Some of the parameters showed significant changes (P

Abstract Geological porous reservoirs provide the volume capacity needed for large scale underground hydrogen storage (UHS). To effectively exploit these reservoirs for UHS, it is crucial to characterize the hydrogen transport properties inside porous rocks. In this work, for the first time in the community, we have performed $${\text {H}}_2$$ H 2 /water multiphase flow experiments at core scale under medical X-ray CT scanner. This has allowed us to directly image the complex transport properties of $${\text {H}}_2$$ H 2 when it is injected or retracted from the porous rock. The important effective functions of capillary pressure and relative permeability are also measured, for both drainage and imbibition. The capillary pressure measurements are combined with MICP data to derive a receding contact angle for the $${\text {H}}_2$$ H 2 /water/sandstone rock system. The rock core sample is a heterogeneous Berea sandstone (17 cm long and 3.8 cm diameter). Our investigation reveals the interplay between gravitational, capillary, and viscous forces. More specifically, it illustrates complex displacement patterns in the rock, including gravity segregation, enhancement of spreading of $${\text {H}}_2$$ H 2 due to capillary barriers, and the formation of fingers/channel during imbibition which lead to significant trapping of hydrogen. These findings shed new light on our fundamental understanding of the transport characteristics of $${\text {H}}_2$$ H 2 /water relevant for UHS.

Background and purpose: Nowadays, plants are more available and many are used for treatment purposes, therefore, the rate of poisoning by plants has increased. According to the geographical location of Isfahan in Iran, the present study aimed at investigating this problem since there is paucity of information about plant poisoning in the region. Materials and methods: In this cross-sectional study, patient data poisoned with poisonous plants were collected from Khorshid Hospital (a referral center for poisoning) in Isfahan between 2010 and 2019. Demographic and clinical, paraclinical and, therapeutic information were studied. Results: In 72 patients with plant poisoning, the most common cause was unknown plants (29%) followed by castor seed poisoning (22.2%) and datura (16.6%). The majority of patients were male (60%) and the highest rate of poisoning occurred in people aged 20-39 years old. Conscious poisoning was most often reported to be with datura (46.7%) in patients of 10-19 years old, while accidental poisoning was found to be more common with unknown plants (34.1%) in children (0-9 years of age). Poisoning due to treatment purposes was seen manily by unknown plants and castor seeds (61.6%). Suicide by self-poisoning was mainly done by oleander (66.7%). At admission, patients with datura poisoning often had tachycardia (58%) and mydriasis pupils (91%). In patients with castor bean poisoning, gastrointestinal symptoms were more frequent (nausea and vomiting in 94%). Most of the patients were discharged within 24 hours after admission. None of the patients needed antidote and intubation and all were discharged with supportive treatment and complete recovery. Conclusion: Most of the cases studied had mild symptoms and only needed supportive care. ‎

During the COVID-19 pandemic, patients with better general conditions are sent to their own homes for self-quarantine due to a lack of resources in the health system, especially the lack of beds and human resources. Improving patient care may force households to inevitably use home care services, which can be examined from the health equity perspective. In the first step, home care services should be expanded by medical universities in all regions of the country, including less developed areas. In the second step, the financial protection of the recipients of these services should be provided through interventions, such as health insurance coverage. In addition, after the COVID-19 pandemic (post-corona period), it is necessary to organize home care services as soon as possible due to the population aging trend. Finally, despite the problems caused by the COVID-19 pandemic in the country, it is better to use the challenges, actions, and lessons learned from this crisis to complete the infrastructure of the health system in various ways.

Abstract A promising option for storing large-scale quantities of green gases (e.g., hydrogen) is in subsurface rock salt caverns. The mechanical performance of salt caverns utilized for long-term subsurface energy storage plays a significant role in long-term stability and serviceability. However, rock salt undergoes non-linear creep deformation due to long-term loading caused by subsurface storage. Salt caverns have complex geometries and the geological domain surrounding salt caverns has a vast amount of material heterogeneity. To safely store gases in caverns, a thorough analysis of the geological domain becomes crucial. To date, few studies have attempted to analyze the influence of geometrical and material heterogeneity on the state of stress in salt caverns subjected to long-term loading. In this work, we present a rigorous and systematic modeling study to quantify the impact of heterogeneity on the deformation of salt caverns and quantify the state of stress around the caverns. A 2D finite element simulator was developed to consistently account for the non-linear creep deformation and also to model tertiary creep. The computational scheme was benchmarked with the already existing experimental study. The impact of cyclic loading on the cavern was studied considering maximum and minimum pressure that depends on lithostatic pressure. The influence of geometric heterogeneity such as irregularly-shaped caverns and material heterogeneity, which involves different elastic and creep properties of the different materials in the geological domain, is rigorously studied and quantified. Moreover, multi-cavern simulations are conducted to investigate the influence of a cavern on the adjacent caverns. An elaborate sensitivity analysis of parameters involved with creep and damage constitutive laws is performed to understand the influence of creep and damage on deformation and stress evolution around the salt cavern configurations. The simulator developed in this work is publicly available at https://gitlab.tudelft.nl/ADMIRE_Public/Salt_Cavern .

Abstract Biomechanical and morphological analysis of the cells is a novel approach for monitoring the environmental features, drugs, and toxic compounds’ effects on cells. Graphene oxide (GO) has a broad range of medical applications such as tissue engineering and drug delivery. However, the effects of GO nanosheets on biological systems have not been completely understood. In this study, we focused on the biophysical characteristics of cells and their changes resulting from the effect of GO nanosheets. The biophysical properties of the cell population were characterized as follows: cell stiffness was calculated by atomic force microscopy, cell motility and invasive properties were characterized in the microfluidic chip in which the cells are able to visualize cell migration at a single-cell level. Intracellular actin was stained to establish a quantitative picture of the intracellular cytoskeleton. In addition, to understand the molecular interaction of GO nanosheets and actin filaments, coarse-grained (CG) molecular dynamics (MD) simulations were carried out. Our results showed that GO nanosheets can reduce cell stiffness in MCF7 cells and MDA-MB-231 cell lines and highly inhibited cell migration (39.2%) in MCF-7 and (38.6%) in MDA-MB-231 cell lines through the GO nanosheets-mediated disruption of the intracellular cytoskeleton. In the presence of GO nanosheets, the cell migration of both cell lines, as well as the cell stiffness, significantly decreased. Moreover, after GO nanosheets treatment, the cell actin network dramatically changed. The experimental and theoretical approaches established a quantitative picture of changes in these networks. Our results showed the reduction of the order parameter in actin filaments was 23% in the MCF7 cell line and 20.4% in the MDA-MB-231 cell line. The theoretical studies also showed that the GO nanosheet–actin filaments have stable interaction during MD simulation. Moreover, the 2D free energy plot indicated the GO nanosheet can induce conformational changes in actin filaments. Our findings showed that the GO nanosheets can increase the distance of actin-actin subunits from 3.22 to 3.5 nm and in addition disrupt native contacts between two subunits which lead to separate actin subunits from each other in actin filaments. In this study, the biomechanical characteristics were used to explain the effect of GO nanosheets on cells which presents a novel view of how GO nanosheets can affect the biological properties of cells without cell death. These findings have the potential to be applied in different biomedical applications.

Abstract Lung cancer is a leading cause of cancer death in both men and women worldwide. The high mortality rate in lung cancer is in part due to late-stage diagnostics as well as spread of cancer-cells to organs and tissues by metastasis. Automated lung cancer detection and its sub-types classification from cell’s images play a crucial role toward an early-stage cancer prognosis and more individualized therapy. The rapid development of machine learning techniques, especially deep learning algorithms, has attracted much interest in its application to medical image problems. In this study, to develop a reliable Computer-Aided Diagnosis (CAD) system for accurately distinguishing between cancer and healthy cells, we grew popular Non-Small Lung Cancer lines in a microfluidic chip followed by staining with Phalloidin and images were obtained by using an IX-81 inverted Olympus fluorescence microscope. We designed and tested a deep learning image analysis workflow for classification of lung cancer cell-line images into six classes, including five different cancer cell-lines (P-C9, SK-LU-1, H-1975, A-427, and A-549) and normal cell-line (16-HBE). Our results demonstrate that ResNet18, a residual learning convolutional neural network, is an efficient and promising method for lung cancer cell-lines categorization with a classification accuracy of 98.37% and F1-score of 97.29%. Our proposed workflow is also able to successfully distinguish normal versus cancerous cell-lines with a remarkable average accuracy of 99.77% and F1-score of 99.87%. The proposed CAD system completely eliminates the need for extensive user intervention, enabling the processing of large amounts of image data with robust and highly accurate results.

Background and Aim: Difficulty in perception of speech in noise is one of the main complaints of hearing-impaired people. Due to profound hearing loss in cochlear implant (CI) users, they need higher signal-to-noise ratio for a better perception. Bimodal fitting is a preferred way for CI users because it prevents auditory nerve degeneration, is a complement of frequency range at the opposite ear, an is less invasive to provide binaural hearing. Acceptable noise level (ANL), as a reliable test to assess noise tolerance, has not yet been used in comparing children with bimodal hearing and CI. This study aimed to determine whether bimodal fitting can help CI children tolerate more noise. Methods: This descriptive-analytical study was conducted on 13 children with unilateral CI and bimodal hearing. Audiometry test was performed at aided and non-aided conditions. Then, their noise tolerance was assessed by the Persian version of ANL test. Results: Bimodal hearing resulted in statistically significant increase in ANL. The mean of ANL at unilateral CI and bimodal hearing conditions were 6.15±2.90 and 4.77±1.70, respectively. Conclusion: Bimodal fitting lead to more noise tolerance in unilateral CI children due to the combination of binaural summation and binaural release from masking.

Objective The aim of this study was to examine parents’ and healthcare professionals’ experiences and perceptions of parental readiness for resuscitation of their child in a paediatric hospital.Design This exploratory descriptive qualitative study used content analysis. Participants shared their experiences and perceptions about parental readiness for cardiopulmonary resuscitation through semi-structured and in-depth interviews. MAXQDA 2020 software was also used for data analysis.Setting The setting was two large teaching paediatric hospitals in Iran (Este Azerbaijan and Mashhad).Participants Participants were 10 parents and 13 paediatric healthcare professionals (8 nurses and 5 physicians). Selection criteria were: (a) parents who experienced their child’s resuscitation crisis at least 3 months prior and (b) nurses and physicians who were working in emergency rooms or intensive care wards with at least 2 years of experience on the resuscitation team.Results Participants shared their experiences about parental readiness for resuscitation of their child in four categories: awareness (acceptance of resuscitation and its consequences; providing information about the child’s current condition and prognosis), chaos in providing information (defect of responsibility in informing; provide selective protection of information; hardness in obtaining information), providing situational information (honest information on the border of hope and hopeless; providing information with apathy; providing information as individual; dualism in blaming; assurance to parents; presence of parents to better understand the child’s situation) and psychological and spiritual requirements (reliance on supernatural power; need for access to a psychologist; sharing emotions; collecting mementos).Conclusion The results of this study provide insight on the needs of parents and strategies to use to prepare them for their child’s resuscitation crisis, which can be used to enhance family centred care practices in paediatric acute care settings.

Abstract Underground hydrogen storage (UHS) in initially brine-saturated deep porous rocks is a promising large-scale energy storage technology, due to hydrogen’s high specific energy capacity and the high volumetric capacity of aquifers. Appropriate selection of a feasible and safe storage site vitally depends on understanding hydrogen transport characteristics in the subsurface. Unfortunately there exist no robust experimental analyses in the literature to properly characterise this complex process. As such, in this work, we present a systematic pore-scale modelling study to quantify the crucial reservoir-scale functions of relative permeability and capillary pressure and their dependencies on fluid and reservoir rock conditions. To conduct a conclusive study, in the absence of sufficient experimental data, a rigorous sensitivity analysis has been performed to quantify the impacts of uncertain fluid and rock properties on these upscaled functions. The parameters are varied around a base-case, which is obtained through matching to the existing experimental study. Moreover, cyclic hysteretic multiphase flow is also studied, which is a relevant aspect for cyclic hydrogen-brine energy storage projects. The present study applies pore-scale analysis to predict the flow of hydrogen in storage formations, and to quantify the sensitivity to the micro-scale characteristics of contact angle (i.e., wettability) and porous rock structure.

Background. In the central nervous system, glioblastoma multiforme (GBM) is one of the most important neoplasms in adults. Amplification of EGFR and VEGF genes is common in GBM. However, the role of overexpression of EGFR and VEGF in survival of patients with GBM has been a contentious issue. Therefore, we performed the present study to assess the survival rate of patients with EGFR and VEGF overexpression. Materials and methods. Resected samples of GBM patients were evaluated by immunohistochemistry for overexpression of VEGF and EGFR. The patients were followed up for a year. Results. The mean±sd of age of patients was 56.2±13.1 years. The majority of the patients were male (65.9%). Most of the patients had primary GBM (67%), notwithstanding 33% of the patients with secondary GBM. Moreover, 19.2% and 49.5% of the samples were VEGF-positive and EGFR-positive, respectively. Overall 6, 12-, and 18-month survival rates were shown to be 61.5±5.1%, 17.6±4%, and 4.4±2.1%, respectively. There was a significant difference between the mean±se survival rate in VEGF-negative patients (12±1.9 months) VEGF-positive patients (7.8±0.5 months) (P=0.045). Conclusions. We found an association between VEGF and EGFR over-expression and the survival rate of GBM patients. The VEGF overexpression was significantly associated with the overall survival rate of the GBM patients, but failed to have a prognostic value for their mortality rate. However, EGFR was a predictor of overall survival rate and mortality of GBM patients. Moreover, VEGF overexertion has a stronger association with survival rate in GBM, compared to EGFR overexpression.

Background and purpose: In 2019, the world has witnessed the emergence of a virus that caused acute respiratory distress syndrome in human with high mortality rates (approximately 3.7%). So far, no effective treatment has been proven against COVID-19. This study aimed at designing a multi-epitope vaccine combining several T-cell and B-cell epitopes of the SARS-CoV-2. Materials and methods: Based on immunoinformatics strategies, B-cell and T-cell epitopes were predicted using immune Epitope Database and Analysis Resource (IEDB). Then, the appropriate predicted epitopes were joined to each other by suitable linkers, and the multi-epitope vaccine constructed was suggested as a vaccine candidate against SARS-CoV-2. Results: In this study, 28 B-cell epitopes and 33 T-cell epitopes were predicted. Then, to design the multi epitope vaccine, 5 epitopes were used from the virion surface of spike protein and one epitope was used from intravirion region of the Envelope, Membrane, and Nucleocapsid proteins that later on were joined with flexible glycine linker. Conclusion: Based on the immunoinformatics results obtained, it seems that different epitopes from SARS-CoV-2 structural proteins have high ability to stimulate humoral and cellular immune responses, so the multi-epitope vaccine designed with these epitopes, can help to accelerate the production of effective vaccines against COVID-19.

Background and Objective: Extraction of impacted lower third molars is one of the most frequent surgeries of the oral cavity. This operation might be accompanied by inevitable complications, such as pain, swelling, and trismus after surgery. Therefore, the aim of this study was to evaluate the impact of low-intensity/power laser therapy on swelling and trismus after impacted mandibular third molar surgery. Materials and Methods: This randomized double-blind clinical trial was performed on 40 patients who required similar unilateral impacted third molars. These patients were randomly divided into two groups of 20, including the control group with no laser application and the test group receiving laser irradiation. In the intervention group, 1 cm2 of the tissue was irradiated immediately post-operation by 12 j/cm2 energy using a 980-nm laser setting with continuous wave mode at the output power of 200 MW for 60 s. Radiations were carried out at three regions, including two intraoral sites on the buccal and lingual sides of the operated area and an extraoral area on the joining point of the masseter muscle to the mandible. Inflammation and trismus were assessed by measuring the size of the face and maximum mouth opening on the second and seventh days after surgery. Results: Our findings demonstrated that in the laser group, on the second day post-operation the maximum mouth opening (trismus) was 28±6 and facial swelling was 217.8±12.8. The two groups were not significantly different on this day regarding the two evaluated variables (P>0.05). On the seventh day, trismus and facial swelling were reported as 39.85±6.97 and 209.2±13.45, respectively. Moreover, improvements were observed in the irradiated group at this time point. However, no statistically significant difference was found between the test and control group concerning these factors (P>0.05). Conclusion: According to the results of this study, laser application with the parameters set in this study had no significant positive effects on reducing the post-operation complications.

Background and Aim: Human cystic echinococcosis (CE) is an important, neglected zoonotic disease with worldwide distribution which has been reported in different regions of Iran, including the central areas (e.g. Qom Province). The disease is caused by the Echinococcus granulosus parasite living in the intestine of dogs and other canids as definitive hosts. This study aimed to investigate the epidemiology, burden, and geographical distribution of CE in Qom Province, Central Iran. Materials and Methods: In this descriptive-analytic study, the data of patients with diagnosed CE during 2011-2018 were collected from all urban and rural areas of Qom Province. The data of the epidemiological status of CE cases were extracted from the CE surveillance system in the Centers for Disease Control and Prevention in the Qom University of Medical Sciences which is owned and run by Iran's Ministry of Health and Medical Education. In addition, the economic burden of the disease was evaluated by Azarakhsh and Roozamad financial software; the geographical distribution of CE was obtained by ArcGIS 10.3 software (IBM Corp., Chicago, USA). Results: The results reveal that the incidence rate of CE was 6.81/100,000 people over the 8-year period of the study. More than half of the cases were females (57.95%), housewives (57.47%), and residents (89.77%). The majority of the cases were Iranian (88.77%) and the rest were from the two neighboring countries: Afghanistan and Pakistan. The economic burden of the human CE in the 8 years was estimated to be 3,761,352,526 rials (75,227 $). In terms of spatial distribution, the highest incidence rate of CE was observed in Salafchegan District in the southwest of Qom Province. Conclusion: The economic burden of human CE infection provided by governmental health-care systems or as out-of-pocket expenses is relatively high, and housewives, especially those living in Salafchegan District, are more likely to be affected. More studies are recommended on different epidemiological aspects and the definitive hosts of the parasite; besides, people at risk need to be warned and educated so that the incidence rate of the disease is reduced.

Background: Failure mode and effect analysis (FEMA) approach as one of the preventive risk management strategies to identify and prevent errors in the medication process in nursing care in the 10 intensive wards in two large hospitals in Khorramabad. Methods: This study is applied descriptive research, which is conducted as a mixed-method quantitative-qualitative approach using focus group discussion. Results: The average risk priority number (RPN) score for the intensive care unit (ICU) in this study was 20.97. The highest RPN scores were associated with the SICU (Surgical ICU) and EICU (Emergency ICU) wards with RPN of 24.66 and 22.71, respectively. Among the steps of the medication process, the first step “physician order” had the highest score (RPN = 26.08). Conclusions: The intensive wards, which had high RPN scores are exposed to more risk of the drug medication process like EICU and SICU; also, simple acts such as handwriting readable by a physician can considerably reduce risk in the ICU.

The length-weight relationships (LWRs), condition factor (Kn), growth, mortality and exploitation status of three polynemid fishes, i.e., Filimanus xanthonema (Valenciennes, 1831), Polynemus melanochir (Valenciennes, 1831) and Polynemus paradiseus (Linnaeus, 1758) from Batang Lassa River estuary were estimated. Fish samples were caught during April 2019 to September 2020 using the ESBN (locally called Gnian) having 1.25 to 4.00 cm mesh size. The total length (TL) and body weight of each individual fish was measured to the nearest 0.1 cm and 0.01 g respectively. The growth coefficients (b) for F. xanthonema, P. melanochir and P. paradiseus, were 2.880, 2.717 and 2.724 with the R2 values 0.956, 0.972 and 0.936 respectively. Estimated growth coefficients indicated a negative allometric growth pattern for all three threadfin fishes. To date, information regarding length-weight relationships for F. xanthonema and P. melanochir is insufficient whereas the information is available for P. paradiseus. About 40–48% of fishes exhibited flat or thin body shape (Kn < 1), 48–50% were rounded or fat (Kn > 1) and only 1–3% of fishes showed proportional body shape (Kn = 1). The growth parameters L∞, K and ϕ’ were estimated at 15.75 cm, 0.95 yr−1 and 2.37 for F. xanthonema; 27.61 cm 0.87 yr−1 and 2.82 for P. melanochir; and 27.30 cm, 0.58 yr−1 and 2.64 for P. paradiseus; respectively. The estimated natural mortality (M) included 2.10, 1.69 and 1.30 yr−1; the fishing mortality (F) 0.57, 0.67 and 0.60 yr−1; and exploitation ratio (E) 0.21, 0.28 and 0.31 for F. xanthonema, P. melanochir and P. paradiseus respectively. The study concluded that the stocks are still under exploitation (E < 0.5) condition. However, the studied Batang Lassa estuary could be a potential nursery ground considering the minimum lengths of 5.0, 3.8 and 4.0 cm for F. xanthonema, P. melanochir and P. paradiseus respectively. Therefore, management initiatives are needed to escape juvenile catches.

Objectives: Carbon nanotubes (CNTs) are allotropes of carbon with a length-to-diameter ratio greater than 106 with the potential uses as medical diagnostic or therapeutic agents. In vitro studies have revealed that gadolinium (Gd) nanoparticle-catalyzed single-walled carbon nanotubes (SWCNTs) possess superparamagnetic properties, which enable them to be used as contrast agents in magnetic resonance imaging (MRI). Our study synthesized Gd-CNT for use as MRI contrast agents. Methods: To reduce the toxicity and solubility of CNTs, it was functionalized, and after loading with Gd was coated with polyethylene glycols (PEG). We then synthesized different concentrations of Gdn3+@CNTs-PEG and Gadovist® to be evaluated as MRI contrast agents. Results: The analysis showed that the Gd concentration in Gadovist® was 12.18% higher than synthesized Gdn3+@CNTs-PEG, but the mean signal intensity of the Gdn3+@CNTs-PEG was approximately 3.3% times higher than Gadovist®. Conclusions: Our findings indicate that synthesized Gdn3+@CNTs-PEG has the potential to be used as an MRI contrast agent in vitro, but in vivo assessment is necessary to determine the bio-distribution, kinetic, and signal enhancement characteristics.

Objectives: Parents of Autism Spectrum Disorder (ASD) children often have a negative attitude towards themselves. They are often negatively affected by these challenges and the failure of their children. Thus, their interaction with their children is negatively influenced. The present study aimed to investigate the potential effect of family-centered nature therapy on the interaction of parents with their children. Methods: The present research was a quasi-experimental study with pre-test and post-test design and a control group. Statistical population included all ASD children aged 3-7 years in Tehran city, Iran. A sample of 14 children with ASD were selected through convenience sampling method. The subjects were non-randomly assigned into either the experimental or control groups. The necessary data were collected through Parent-Child Relationship Scale (PCRS) and the program of nature therapy developed on the basis of the current theoretical frameworks and research findings. The collected data were subjected to descriptive statistical analyses and Analysis of Covariance (ANCOVA). Results: The obtained results suggested that the Mean±SD score of experimental group on PCRS after the treatment was 100.14±11.82. While the Mean±SD score of the control group was 84.14±3.93. Moreover, the results of the statistical tests revealed that the difference between the experimental and control groups was statistically significant, indicating that the family-centered nature therapy was effective in improving the parents’ interactions with their ASD children. In addition, the ANCOVA results indicated that the estimated F (13.32) was statistically significant at P=0.001, indicating that the treatment had a positive effect on the dependent variable. Discussion: Family-centered nature therapy was effective in improving the parents’ relationship with their children. The ASD children had fewer conflicts with their parents, enjoyed a positive relationship with their parents, and showed lower dependence on their parents after receiving the treatment. Therefore, this therapy can be a complementary method along with other standard treatments received by ASD children. It is an effective, simple and readily accessible option to improve the interaction of parents with their ASD children.