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Abstract Background and objectives Medical students experience different types of challenges during their MD program, which become more challenging when it comes to the internship, putting too much pressure on them. This study aimed to explore the challenges of medical interns of Shiraz University of Medical Sciences (SUMS), Shiraz, Iran. Methods In this qualitative research, which was conducted from September 2023 March 2024, medical interns of SUMS were selected using purposeful sampling method. The data were collected through deep and semi-structured interviews, and it was continued until data saturation was achieved. The data analysis was performed through thematic content analysis. Results A total of 13 participants (6 men and 7 women) with a mean ± SD age of 25 ± 1.6 years were interviewed. The challenges of medical interns consisted of 423 meaning units, 79 open codes, 14 subthemes, and 6 main themes; the main themes consisted of educational challenges, challenges following university regulations, health and behavioral issues, economic/employment-related issues, sociocultural and recreational challenges, and ethical issues. Conclusion The results of this study highlight the necessity for reforms in the medical internship phase aiming to tackle interns’ issues and establish a supportive and nurturing environment for future medical doctors.

Background. The coronavirus disease 19 (COVID-19) is one of the most important public health issues, and the evaluation and improvement of COVID-19 health literacy and self-care can be effective in preventing its spread. This study was conducted to investigate the health literacy of COVID-19 and its relationship with self-care among the health ambassadors of Urmia in 2021. Methods. In this descriptive-analytical study, 400 health ambassadors of Urmia were selected using the cluster random sampling method. The data-gathering tool was a questionnaire, including questions about self-care, COVID-19 health literacy, and demographic information. The data were analyzed by SPSS 19 using analysis of variance and regression tests. Results. COVID-19-related health literacy was reported to be at a good level (63.5%) in most health ambassadors. In addition, it had a statistically significant relationship with the level of education and economic status. Similarly, there was a significant relationship between self-care and demographic characteristics such as age, gender, level of education, occupation, and economic status (P>0.05). On the other hand, according to data analysis results, with an increase in health literacy related to COVID-19, regression modeling could predict 22% of self-care behaviors in the participants of the present study. Conclusion. Overall, there is a need for interventions by healthcare professionals for training to increase health literacy related to COVID-19 that results in self-care and adoption of health behaviors in health ambassadors, given the significance of COVID-19-related health literacy and its effects on self-care in these ambassadors. Practical Implications. The findings of this study can be presented to the Deputy of Health and healthcare providers so that actions can be taken to promote health literacy and self-care and prevent similar epidemics.

Background: Long COVID syndrome (LCS) is characterized by chronic symptoms of fatigue, cough, etc. after contracting COVID-19. This study aimed to identify the longevity of the symptoms of adults who reported suffering from LCS in our previous study which was conducted in 2021. The study population included patients who were referred to healthcare facilities (55 centers) in Fars province, Iran. Materials and Methods: This longitudinal retrospective and follow-up cohort study was conducted on adult patients who were hospitalized with COVID-19. We inquired about their current health status and obtained the information after they consented to participate and answer questions over the phone. Results: In total, 2383 people participated in the study, 543 of whom (27.3%) reported experiencing symptoms of LCS. Fatigue (12.2%) and exercise intolerance (10%) were the two most common symptoms of persistent LCS. On the other hand, 240 people (12.1%) who did not report any symptoms of LCS in phase 1 of the study reported experiencing problems that are compatible with the diagnosis of LCS. Patients with persistent LCS (long-LCS) had longer hospital stays during their initial illness (7 days vs. 5 days) and were more frequently admitted to ICUs (15.8% vs. 8.9%) compared with those without long-LCS. Conclusion: More than one-quarter of adults will continue to suffer from the symptoms of long-COVID for more than one year after their initial infection. The scientific community should develop validated measures and biomarkers to objectively diagnose and follow up this condition.

Abstract Papaver bracteatum, known for its high thebaine content and absence of morphine, has emerged as a promising alternative to opium poppy for codeine production. In this study, our objective was to create a diverse panel representing the natural variation of this species in Iran. To achieve this, we employed genotyping-by-sequencing to obtain genome-wide distributed single-nucleotide polymorphisms (SNPs) for phylogeographic analysis, population structure assessment, and evaluation of genetic diversity within P. bracteatum populations. A total of 244 P. bracteatum individuals from 13 distinct populations formed seven genetic groups, along with one highly admixed population. We observed a clear split between the populations inhabiting the Alborz Mts. in the east and Zagros Mts. in the west. In between these mountain ranges, the population of Kachal Mangan exhibited a high degree of genetic admixture between both genetic groups. At or after the end of the last glacial maximum, when climate conditions rapidly changed, all P. bracteatum populations experienced a strong demographic bottleneck reducing the already small effective population sizes further before they increased to their recent strengths. Our results suggest that the ongoing climate change together with human pressure on the species’ habitats and limited seed-dispersal ability are potential factors contributing today to rising genetic isolation of P. bracteatum populations. Our results provide genetic data that can be used for conservation measures to safeguard the species’ genetic diversity as a resource for future breeding approaches in this medicinally important species.

Abstract This study investigates the lifetime costs associated with concrete barriers and steel guardrails. We introduce a cost analysis methodology that incorporates critical factors such as construction costs, maintenance costs, exposure risks during maintenance activities, and the costs imposed to traveling public through the increased traffic and the crash outcomes. We integrate various parameters including economic factors, road geometry, general weather condition, and traffic mix to estimate a location-dependent cost for each type of barrier accurately. A software tool, named CalBarrier, was developed during this study to carry out the calculations and the comparison of lifetime cost of aforementioned barriers. An inherent strength of this research is its reliance on recent real data extracted from various databases of California Department of Transportation (Caltrans), ensuring precision and relevance in accounting for various influential factors. Drawing insights from Caltrans practices and interviews with their personnel, this study emphasizes the intricate decision-making process involved in mitigating safety risks and reducing operational expenses. Although our data originates from California, the methodology for life cycle cost analysis, and our software are applicable for regions with different socio-economic conditions by deploying user input costs, making our findings a valuable resource for other areas facing comparable challenges.

Abstract Three novel deep-red to near-infrared (DR to NIR) emitters based on mononuclear and dinuclear ruthenium(II) complexes with bulky structures were presented herein. For the first time, the unusual effects of metal coordination mode on the electroluminescence properties of a binuclear emitter were investigated. Unexpectedly, the mononuclear complexes showed superior performance in deep-red light-emitting electrochemical cells (DR-LEC) compared to the dinuclear complex. Likewise, substituting various ancillary ligands improved the radiance and lifetime of devices by 2.5 and 1.5 times, respectively. To the best of our knowledge, the obtained efficiency is among the best reported to date for DR-LECs based on ruthenium polypyridyl complexes.

Objective(s): Basal cell carcinoma (BCC) is the most common form of skin cancer and the most frequently occurring form of all cancers, affecting sun-exposed areas like the face. Surgery is the main treatment, focusing on safe and minimally invasive methods for better outcomes. Technology has enabled the development of artificial skin substitutes for tissue repair. Tissue engineering uses scaffolds to create functional replacements. This project aims to create an alginate-based hydrogel with PEG-coated gold nanoparticles. Materials and Methods: The project extensively explored the modification of alginate hydrogels with PEG-coated gold nanoparticles, involving the synthesis of gold nanoparticles, their integration with the polymer, and the subsequent preparation of the concentrated hybrid hydrogel. Utilizing various physicochemical techniques, such as UV-visible spectroscopy, transmission electron microscopy, dynamic light scattering, zeta potential analysis, scanning electron microscopy, and Fourier transform infrared spectroscopy, the fabrication process was optimized and characterized. Results: The successful synthesis of the hybrid biomaterial was achieved through robust and highly reproducible methods. The MTT assay results offered valuable insights into the biocompatibility and safety of the PEG-coated gold nanoparticle-loaded alginate-based films. The incorporation of PEG-coated gold nanoparticles allowed for potential drug loading on the nanoparticle surface and, consequently, within the hydrogel. Cellular assays were conducted to assess the potential applications of this novel biomaterial. Conclusion: The addition of polyethylene glycol made it possible to load different drugs onto the gold nanoparticles and also within the hydrogel. This makes it a promising choice for potential uses in tissue engineering.

Background and Objective: Neural, hormonal, and mechanical factors regulate the expression of fast-twitch isoforms in developing and mature muscle fibers. The transcriptional mechanisms responsible for regulating the gene expression of myosin heavy chain types are not well understood. This study aimed to determine the effect of a single session of intense resistance exercise with glutamine supplementation on the relative expression of the alpha and IIX isoforms of the myosin heavy chain gene in male rats. Methods: This experimental study was conducted on 30 adult male Wistar rats divided into three groups: control, intense resistance exercise (first experimental group), and fierce resistance exercise combined with glutamine supplementation (second experimental group). The exercise groups participated in a single session of resistance climbing on an inclined plane with 4 sets of 5 repetitions, 30 seconds of rest between repetitions, and 2 minutes of rest between sets. Glutamine supplement powder was dissolved in 100 ml of distilled water at a dose of 0.5 grams per kilogram of body weight and administered daily via gavage for 5 days. The expression of alpha and IIX isoforms of the myosin heavy chain gene was examined in the extensor digitorum longus muscle tissue. Results: The relative expression of the alpha myosin heavy chain gene in the fast-twitch muscle fibers increased significantly in the first experimental group (1.93±0.298) and the second experimental group (1.65±0.195) compared to the control group (P

Background. Recently, it has been found that tyrosol and farnesol can replace antibiotics due to their known antimicrobial and medicinal effects. Niosomes have been extensively researched for drug delivery during the last few decades, and their efficiency has been proven. The current study aimed to investigate the physical properties and antibacterial effects of niosomes loaded with tyrosol and farnesol. Methods. Nanoniosomes loaded with farnesol and tyrosol were synthesized by the thin-layer hydration method. The physical properties of nanoformulations were measured using dynamic light scattering and scanning electron microscopy (SEM), and the release of farnesol and tyrosol from the nanocarrier was examined using a dialysis bag. In addition, Fourier-transform infrared spectroscopy was used to check the functional groups, and the stability studies of nanoniosomes were performed at temperatures of 25 °C and 4 °C for two months. Finally, its antimicrobial properties against the bacterial pathogens Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), and Pseudomonas aeruginosa (P. aeruginosa) underwent investigation. The cytotoxicity of free and farnesol- and tyrosol-loaded nanoniosomes on human foreskin fibroblast cells was also evaluated by the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide method. Results. The size of nanoniosomes and farnesol- and tyrosol-loaded nanoniosomes was estimated to be 208 nm and 240 nm, respectively. SEM results indicated the spherical structure of niosomes. The slow release of farnesol and tyrosol from niosomes was observed, so that almost half of the drug was released from nanoniosomes after 72 hours. Nanoniosomes loaded with the above-mentioned drugs demonstrated good stability at 4 °C for 60 days. The results of the minimum inhibitory and bactericidal concentrations confirmed the antibacterial effects of both free farnesol and tyrosol and nanoniosomes loaded with farnesol and tyrosol against all three bacterial species, although these effects were more considerable for the nanoniosomes formulation. Conclusion. Nanoniosomes loaded with farnesol and tyrosol have the potential to be used in the treatment of some common bacterial wound infections. However, clinical studies are needed in this field. Practical Implications. Farnesol- and tyrosol-loaded nanoniosomes had strong inhibitory effects on S. aureus, E. coli, and P. aeruginosa.

Abstract The present study focused on evaluating the antibacterial properties, radical scavenging, and photocatalytic activities of Centaurea behen-mediated silver nanoparticles (Cb-AgNPs). The formation of Cb-AgNPs was approved by UV–Vis spectrometry, Fourier-transform infrared spectroscopy, transmission electron microscopy, scanning electron microscopy (SEM), energy dispersive X-ray and X-ray diffraction. The results showed that the obtained AgNPs have a maximum absorbance peak at 450 nm with spherical morphology and an average size of 13.03 ± 5.8 nm. The catalytic activity of the Cb-AgNPs was investigated using Safranin O (SO) solution as a cationic dye model. The Cb-AgNPs performed well in the removal of SO. The coupled physical adsorption/photocatalysis reaction calculated about 68% and 98% degradation of SO dye under solar irradiation. The Cb-AgNPs inhibited the growth of gram-negative or positive bacteria strains and had excellent DPPH radicals scavenging ability (100% in a concentration of 200 µg/ml) as well as a good effect on reducing coagulation time (at concentrations of 200 and 500 µg/mL reduced clotting time up to 3 min). Considering the fact that green synthesized Cb-AgNPs have antioxidant and antibacterial properties and have a good ability to reduce coagulation time, they can be used in wound dressings. As well as these NPs with good photocatalytic activity can be a suitable option for degrading organic pollutants.

Abstract In this study, the structural, elastic, electronic, and thermoelectric properties of full Li2BeAl and Li2BeGa Heusler alloys were explored using density functional and the Boltzmann transport theories. The GGA and HSE approximations have been used for the exchange–correlation potential. Results indicated that these two compounds are more energetically stable in the inverse Heusler structure. Additionally, both Li2BeAl and Li2BeGa Heusler alloys were found to be mechanically stable due to the positive values of the elastic constants. Also, the high values of the Young's modulus indicate that these compounds are stiff and exhibit a semi-metallic nature. The band gaps were determined to be 0.13 eV and − 0.22 eV for Li2BeAl and Li2BeGa alloys, respectively, using the GGA approximation. By employing the HSE hybrid functional, however, the band gap for Li2BeAl increased to 0.26 eV, and for Li2BeGa, it decreased to − 0.16 eV. Regarding thermoelectric properties, Seebeck coefficient, electrical conductivity, electronic and lattice thermal conductivities, power factor, and the figure of merit have been calculated for both Li2BeAl and Li2BeGa Heusler alloys at different temperatures. Seebeck coefficient in both alloys decreases with increasing the temperature and has the highest value at 300 K. Thermal conductivity and electrical conductivity increase with increasing the temperature, which confirms the intermetallic behavior of the Heusler alloys. The results obtained for both alloys show that n-type doping has better thermoelectric properties than p-type doping. The maximum value of the figure of merit (ZT) was obtained for n-type doping, which was 1.43 at 660 K for Li2BeAl and 0.39 at 1000 K for Li2BeGa alloy. The high values of ZT especially for electron-dopped Li2BeAl suggest the great potential of this material for use in thermoelectric devices. This study suggests that the proposed materials have potential applications in spintronic devices and thermoelectric materials due to their intermetallic character and effective thermoelectric coefficients.

Abstract Background and Aims There are many difficulties in treating Klebsiella pneumoniae, necessitating the creation of more preventative/therapeutic measures like vaccinations. However, after numerous attempts, there is still no authorized and widely accessible vaccine. The present study aimed to systematically review published studies on K. pneumoniae vaccines in human subjects/samples. Methods To find published studies, several electronic databases, including Scopus, PubMed, Web of Science, ClinicalKey, ClinicalTrials.gov, and Cochrane Library were searched without time limitation using the appropriate keywords. Studies were scrutinized, and the information from those that met our inclusion criteria was gathered and analyzed. Results In total, 691 studies were found, of which 14 articles were included for systematic review. Bacterial lysate containing K. pneumoniae was the most studied vaccine candidate. As the main indicator of human immune responses to K. pneumoniae, antibody responses were determined by most studies. The antigen amount, the route of immunization, and the immunization schedule were varying in the studies and were chosen based on several factors such as the disease model, the vaccine type, the vaccination setting (prophylactic or therapeutic), and so on. Conclusion The majority of studies asserted that their vaccination was efficient and safe, which was demonstrated by a decrease in the rate of infections and the induction of protective antibody, cell‐dependent, and/or cytokine responses. Altogether, the information provided here will help researchers examine the K. pneumoniae vaccine candidates more closely and take future actions that will be more consistently successful.

Background and purpose: In universities, the issue of attracting and retaining faculty members is of great importance. If this is not possible for any reason, it can lead to the academic stagnation of academic staff members the loss of motivation in their career path, and interruption in the implementation of their seven duties. Considering the importance of the advancement of academic staff members as educational and research elites of the country and their significant role in training skilled human resources, especially the role of academic staff members of the Ministry of Health and Medical Education in training graduates of medical sciences that are related to the general health of the society, are related, this study was carried out to identify, diagnosing the factors and ways to prevent their scientific stagnation. Materials and methods: This study was conducted with a qualitative method from January to December 2023. In this research, according to the nature of qualitative research, to explain the perceptions, attitudes, and behaviors of the participants, the purposeful sampling method with maximum diversity was used, as well as the snowball sampling method because the goal was to select participants, Which was a rich source of information and helped the researcher to better understand the concept of scientific stagnation. The participants were faculty members who had been faculty members for at least 10 years. In addition to conducting in-depth and semi-structured interviews, upstream documents and the results of similar studies were also examined. Results: In total, 3 themes, 18 categories, and 118 codes were extracted as follows: The main themes of this study are the causes of scientific stagnation, the challenges of the advancement path, and the strategies to prevent scientific stagnation. The theme of scientific stagnation includes 47 codes and 6 categories (individual, organizational, psychological, skill, job, and research factors). The content of the challenges of the promotion path, including 33 codes and 6 categories (the challenges of the path of the promotion regulations, challenges in cultural, educational, research, executive activities, and challenges of examining cases for promotion of scientific rank). The content of the solutions to prevent scientific stagnation includes 38 codes and 6 categories (the solution to prevent scientific stagnation in connection with the regulation of promotion, cultural, educational, research, executive activities, and the review of files for the promotion of scientific rank.) Conclusion: Based on the results of the present study, the researchers identified the causes of scientific stagnation; also, they believe that revising the promotion regulations is the most important way to prevent scientific stagnation. They stated that in the revision of the bylaws, in addition to the quantitative indicators, in each of the scoring factors, their quality can also be addressed. In terms of education, the quality and innovation of education should be considered. In the research section, pay attention to the applicability of the research. They believed that scientific stagnation is preventable and can be countered through broader scientific productivity measures and reward systems that encourage innovative and exploratory projects. In the executive department, the quality of work and useful changes and developments during the executive activity should be the criteria. In cultural activities, pay attention to social and quality activities; also, they brought up the faster process of promotion cases and the existence of elite human resources to handle possible problems. They stated that with the approach of delegating authority to the country's medical sciences universities and revising the promotion and promotion bylaws, it is possible to deal with the factors causing scientific stagnation and take a step towards a responsive university.

Abstract Phytoremediation is a cost-effective and environmentally friendly method, offering a suitable alternative to chemical and physical approaches for the removal of pollutants from soil. This research explored the phytoremediation potential of Alhagi camelorum, a plant species, for total petroleum hydrocarbons (TPHs) and heavy metals (HMs), specifically lead (Pb), chromium (Cr), nickel (Ni), and cadmium (Cd), in oil-contaminated soil. A field-scale study spanning six months was conducted, involving the cultivation of A. camelorum seeds in a nursery and subsequent transplantation of seedlings onto prepared soil plots. Control plots, devoid of any plants, were also incorporated for comparison. Soil samples were analyzed throughout the study period using inductively coupled plasma-optical emission spectroscopy (ICP‒OES) for HMs and gas chromatography‒mass spectrometry (GC‒MS) for TPHs. The results showed that after six months, the average removal percentage was 53.6 ± 2.8% for TPHs and varying percentages observed for the HMs (Pb: 50 ± 2.1%, Cr: 47.6 ± 2.5%, Ni: 48.1 ± 1.6%, and Cd: 45.4 ± 3.5%). The upward trajectory in the population of heterotrophic bacteria and the level of microbial respiration, in contrast to the control plots, suggests that the presence of the plant plays a significant role in promoting soil microbial growth (P 0.8). These results collectively suggest that phytoremediation employing A. camelorum can effectively reduce pollutants in oil-contaminated soils.

Abstract Synthesis and manufacturing of metal–organic framework derived carbon/metal oxide nanomaterials with an advisable porous structure and composition are essential as catalysts in various organic transformation processes for the preparation of environmentally friendly catalysts. In this work, we report a scalable synthesis of sulfur-doped porous carbon-containing copper oxide nanoparticles (marked CuxO@CS-400) via direct pyrolysis of a mixture of metal–organic framework precursor called HKUST-1 and diphenyl disulfide for aromatic nitro compounds reduction. X-ray diffraction, surface area analysis (BET), X-ray energy diffraction (EDX) spectroscopy, thermal gravimetric analysis, elemental mapping, infrared spectroscopy (FT-IR), transmission electron microscope, and scanning electron microscope (FE-SEM) analysis were accomplished to acknowledge and investigate the effect of S and CuxO as active sites in heterogeneous catalyst to perform the reduction-nitro aromatic compounds reaction in the presence of CuxO@CS-400 as an effective heterogeneous catalyst. The studies showed that doping sulfur in the resulting carbon/metal oxide substrate increased the catalytic activity compared to the material without sulfur doping.

Abstract This paper presents a novel metaheuristic algorithm inspired by the actions of stadium spectators affecting behavior of players during a match which will be called stadium spectators optimizer (SSO) algorithm. The mathematical model of the SSO algorithm is presented and the performance and efficiency of the presented method is tested on some of the well-known mathematical test functions and also CEC-BC-2017 functions. The SSO algorithm is a parameter-free optimization method since it doesn't require any additional parameter setup at any point throughout the optimization process. It seems urgently necessary to design a novel metaheuristic algorithm that is parameter-free and capable of solving any optimization problem without taking into account extra parameters, as the majority of metaheuristic algorithms rely on the configuration of extra parameters to solve different problems efficiently. A positive point for the SSO algorithm can be seen in the results of the suggested technique, which indicate a partial improvement in performance. The results are compared with those of golf optimization algorithm (GOA), Tiki taka optimization algorithm (TTA), Harris Hawks optimization algorithm (HHO), the arithmetic optimization algorithm (AOA), CMA-ES and EBOwithCMAR algorithms. The statistical tests are carried out for the obtained results and the tests reveal the capability of the presented method in solving different optimization problems with different dimensions. SSO algorithm performs comparably and robustly with the state-of-the-art optimization techniques in 14 of the mathematical test functions. For CEC-BC-2017 functions with ten dimensions, EBOwithCMAR performs better than the proposed method. However, for most functions of CEC-BC-2017 with ten dimensions, the SSO algorithm ranks second after EBOwithCMAR, which is an advantage of the SSO since the proposed method performs better than the well-known CMA-ES optimization algorithm. The overall performance of the SSO algorithm in CEC-BC-2017 functions with 10 dimensions was acceptable, in dimension of 30, 50 and 100, the performance of the proposed method in some functions decreased.

Abstract Background: Metabolic risk factors play a critical role in metabolic syndrome (MetS), and endothelial dysfunction is important in its development. On the other hand, Helicobacter pylori (H. pylori) infection has an essential role in MetS. The goal of present study was to evaluate the effect of H. pylori infection on endothelial dysfunction in MetS patients. Methods: Based on the International Diabetes Federation (IDF) criteria, 80 MetS patients (59 females and 21 males, mean age: 48.94 ± 10.00 years) were selected. Plasma samples were assayed for H. pylori IgG using the ELISA method. Endothelial function was also evaluated by measuring plasma concentrations of endothelin-1 (ET-1), E-selectin, and intracellular adhesion molecule-1 (ICAM-1) using ELISA method. Also, NO 2 - and NO 3 - concentrations were measured by Griess method. Results: Fifty patients (62.5%) had H. pylori infection. Plasma concentrations of ET-1, NO 2 - , and NO 3 - were significantly higher in MetS patients with positive H. pylori infection than in MetS patients with negative H. pylori infection (ET-1: 2.92 ± 2.33 vs 1.9 ± 1.4 pg/ml; P = 0.037; NO 2 - :19.46 ± 7.11 vs 15.46 ± 4.56 μM; P = 0.003; NO 3 - : 20.8 ± 10.53 vs 16.85 ± 6.03 μM, P = 0.036). However, plasma concentrations of ICAM-1 and E-selectin did not show any significant difference in the two groups. Conclusion: The results showed a relationship between H. pylori infection and endothelial dysfunction. H. pylori infection can lead to atherosclerosis by causing chronic inflammation and affecting the factors contributing to the MetS.

Key Clinical Message As there is no significant mutual relationship between Helicobacter pylori infection and chronic kidney disease in children, its routine study is not justified and is recommended only in symptomatic cases. Abstract Children suffering from chronic kidney disease (CKD) often complain of indigestion but, if it is accompanied by abdominal pain, it is necessary to investigate and rule out Helicobacter pylori infection to confirm functional dyspepsia. Epidemiological studies in adults have conflicting results regarding the association between Helicobacter pylori infection and CKD. In this study, we determined the prevalence of H. pylori in children with kidney failure and its relationship to their gastrointestinal symptoms. In this retrospective study, 54 children with chronic kidney failure admitted to the hemodialysis ward of the Children's Medical Center, Tehran, Iran between 2012 and 2020 were studied. The mean age of our patients was 11.89 ± 3.99 years and their sex distribution was equal. H. pylori infection was reported in only three patients with 5.6%. Based on our findings, epigastric pain in children was the most common gastrointestinal symptom (70.4%). Among all patients, three patients (5.6%) died, all of them were male (P = 0.075). The most prevalent underlying cause of kidney failure in our patients was neurogenic bladder. We did not find any significant relationship between the increased risk of chronic kidney failure and co‐infection with H. pylori. Investigating the cause of epigastric pain and looking for H. pylori is very important in CKD children under hemodialysis because if they receive a transplant the possibility of gastrointestinal complications will be increased with the use of steroid and immunosuppressive drugs.

Background: This study aimed to investigate the effects of combined alpha-lipoic acid (ALA) and mitoquinone (Mito Q) supplementation on cardiac function and the underlying mechanisms in aged rats with myocardial infarction (MI). Methods: The aged rats underwent left anterior descending artery (LADA) occlusion for 30 min, followed by reperfusion for 24 h. ALA (100 mg/kg, gavage) and Mito Q (10 mg/kg, IP) were administered daily for two weeks before ischemia. Cardiac function, inflammatory, and apoptotic markers were evaluated 24 h after ischemia. Results: The results of this study indicated that the administration of the combination of ALA and Mito Q significantly improved cardiac function. This improvement was linked to a reduction in the expression of pro-inflammatory cytokines TNF-α, IL-6, and IL-1β (P

Abstract The emergence of long COVID during the ongoing COVID-19 pandemic has presented considerable challenges for healthcare professionals and researchers. The task of identifying relevant literature is particularly daunting due to the rapidly evolving scientific landscape, inconsistent definitions, and a lack of standardized nomenclature. This paper proposes a novel solution to this challenge by employing machine learning techniques to classify long COVID literature. However, the scarcity of annotated data for machine learning poses a significant obstacle. To overcome this, we introduce a strategy called medical paraphrasing, which diversifies the training data while maintaining the original content. Additionally, we propose a Data-Reweighting-Based Multi-Level Optimization Framework for Domain Adaptive Paraphrasing, supported by a Meta-Weight-Network (MWN). This innovative approach incorporates feedback from the downstream text classification model to influence the training of the paraphrasing model. During the training process, the framework assigns higher weights to the training examples that contribute more effectively to the downstream task of long COVID text classification. Our findings demonstrate that this method substantially improves the accuracy and efficiency of long COVID literature classification, offering a valuable tool for physicians and researchers navigating this complex and ever-evolving field.

Introduction and purpose: The education system of any country is subject to fundamental change according to the wishes of society. The need for change in the health care system, medical education and other related sciences, including environmental health, has become increasingly evident in this country in recent years. In the present study, we investigated the revision of educational content in environmental health and the answers to the fundamental questions related to it. Methods: The current study was cross-sectional and comprehensively evaluated at the national level with the participation of professors in the field of environmental health. The study involved 78 distinguished professors of environmental health, and a checklist was prepared and a survey was conducted to obtain their opinions. Data analysis was conducted using SPSS-22 software. The Friedman test was used to compare different areas. Results: The survey results show that 69.3% of the professors believe that the educational content in the field of environmental health in Iran is fundamentally different from that in developed countries. 89.8% of the distinguished professors believed that the aspects and conditions of environmental health in the country are significantly different from the first year of determining the content and curriculum in the field of environmental health. 96.2% of the distinguished professors of environmental health in the country thought that the expected skills included in the curricula of different levels of the field of environmental health should be revised. At the same time, 85.9% of the professors agreed that the monitoring of environmental pollutants that affect health is one of the most important topics in environmental health. Conclusion: Based on the survey conducted among the professors of the country ‘s health faculties, it is necessary and useful to revise the definition of environmental health and its educational content to meet the needs of society, given the new conditions in the field of environmental health.

Abstract Considering the spread of the COVID-19 pandemic, finding new drugs along with the development of effective drug delivery methods can help in the treatment of this disease. For this reason, in this research work, the possibility of drug-delivery of Favipiravir (FP), one of the drugs approved in the treatment of COVID-19, by pristine chitosan (Chit) nanoparticles (NP), and functionalized chitosan nanoparticles with N-acylate, N-methyl, O-acetyl, and Oxazoline functional groups was studied using quantum mechanical DFT methods at B3LYP-D3(BJ)/6-311 + g(d,p) theoretical level in water medium. The QTAIM, NBO, DOS, frontier orbital, conceptual-DFT indices, and non-covalent interaction analysis were further implemented to investigate the possible interactions between FP and Chit NPs. The results show that the adsorption of FP on Chit NPs is done through the creation of hydrogen bonds, and the highest absorption energy of − 18.15 kcal/mol between pristine chitosan and FP. In the case of all functionalized Chit NPs, a decrease in the absorption energy is observed, which is more noticeable in the case of N-acylated and O-acetyl functionalize Chit NPs, and indicates the weakening of the van der Waals interactions for these cases. Considering the compatibility of Chit NPs with the human body and their non-toxicity, as well as the fact that factors such as pH, solubility, the ionic strength, and so on can be adjusted to control the release rate using the functionalized Chit NPs, it seems that the results of this work can be a comprehensive guide to design the drug delivery methods of FP drug using Chit NPs, to reduce the symptoms of COVID-19 disease.

Background and purpose: Fluoride varnish application is a successful approach in preventative dentistry. Considering the antimicrobial capabilities of Grape Seed Extract (GSE) and its impact on tooth re-mineralization, the current study was conducted to comparre the effect of this extract, with and without fluoride varnish, as well as their synergistic effects on the caries-causing bacteria Streptococcus mutans and Lactobacillus acidophilus. Materials and methods: In the current laboratory-analytical study, the disk agar diffusion (growth inhibition halo) and microbroth dilution tests were used to investigate the antibacterial properties and minimum inhibitory concentration (MIC) of the compounds. Ampicillin and Erythromycin discs were utilized for positive control, and sterile physiological serum was used for negative control. The collected data was analyzed using SPSS software (version 16) and analysis of variance (ANOVA), Kruskal-Wallis, U-Man-Whitney, and independent t-tests. Results: The largest diameter of the growth inhibition halos in S. mutans and L. acidophilus were found in 2.5 mg/ml varnish (12.0±0.7 mm) and 5 mg/ml GSE (13.6±1.1 mm), respectively. Moreover, the smallest halo diameter was recorded in 2.5 mg/ml GSE (7.0±0.9 mm) and the combination of the two extracts at 2.5 mg/ml concentration (5.6±0.9 mm), respectively. Varnish had the lowest MIC in both bacterial species tested (1.8±0.7 mg/ml), and there was no evidence of a synergistic interaction between the two compounds; however, GSE performed comparatively similar to varnish at a dosage of 5 mg/ml. Conclusion: Based on the findings of the present study, GSE can be considered an acceptable alternative to fluoride varnish in the early phases of dental caries treatment and prevention.

ObjectiveThe current study aimed to identify the association between COVID-19 vaccination and prolonged post-COVID symptoms (long-COVID) in adults who reported suffering from this condition.MethodsThis was a retrospective follow-up study of adults with long-COVID syndrome. The data were collected during a phone call to the participants in January-February 2022. We inquired about their current health status and also their vaccination status if they agreed to participate.ResultsIn total, 1236 people were studied; 543 individuals reported suffering from long long- COVID (43.9%). Chi square test showed that 15 out of 51 people (29.4%) with no vaccination and 528 out of 1185 participants (44.6%) who received at least one dose of any vaccine had long long- COVID symptoms (p = 0.032).ConclusionsIn people who have already contracted COVID-19 and now suffer from long-COVID, receiving a COVID vaccination has a significant association with prolonged symptoms of long-COVID for more than one year after the initial infection. However, vaccines reduce the risk of severe COVID-19 (including reinfections) and its catastrophic consequences (e.g., death). Therefore, it is strongly recommended that all people, even those with a history of COVID-19, receive vaccines to protect themselves against this fatal viral infection.

Background & Aims: Unsuitable management of municipal solid waste (MSW) is one of the main factors in environmental degradation, particularly in developing countries. This study aimed to analyze the quantitative and qualitative properties of MSW for energy recovery in the city of Mahabad, located in the West Azerbaijan Province, Iran. Materials & Methods: Sampling from MSW was taken during the four seasons in 2014. Quality and quantity analyses included chemical composition, moisture percentage, dry weight, ash percentage, and heat value, which were performed in the lab as per the American Society for Testing and Materials Method D 5231-92. The experience modeling was used to extract chemical composition and heat value. Results: The results showed that MSW was composed of 75% food waste, 12% ash, and 61% moisture. In the MSW organic fraction (C28.7H43.6O15.3N1S0,065), carbon/nitrogen and heat values were found at 28.7 and 2.1 × 104 Kj Kg-1, respectively. Also, in the MSW biodegradable organic fraction (C23.7H37.7O14.69N1S0.069), heat value and produced methane were calculated to be 10077 Kj Kg-1 and 207 liters (148 g), respectively. Any carbon dioxide added to the atmosphere will hang around for a long time, between 200 and 200 ton day-1, which contributes to trapping heat and warming the atmosphere. Conclusion: This study shows energy recovery from MSW is a good option, due to the high heat value. However, it is not an eco-friendly method as it will produce more greenhouse and poison gases and needs control systems.

BACKGROUND: The mental load of work is one of the important and influential factors on the behavior and performance of nurses in the work environment. The purpose of this study was to evaluate the relationship between the mental load of work and the quality of work life in working nurses. METHODS: In a descriptive-analytical study, 125 nurses working in the general and special departments of Kurdistan University of Medical Sciences, Sanandaj, Iran, in October and November of 2016 were examined. Data collection was done using a demographic form, a quality of work life questionnaire, and a mental workload index. The resulting data were analyzed using SPSS software and descriptive and inferential tests. RESULTS: A significant relationship was observed between the components of physical demand, the level of frustration, and the effort score with the quality of work life (P < 0.05). CONCLUSION: The results of the study show that the quality of work life of most nurses is average and this issue is related to the mental load of work.

Kawasaki disease (KD), the most common cause of acquired heart disease in children, can be easily missed as it shares clinical findings with other pediatric illnesses, leading to risk of myocardial infarction or death. KD remains a clinical diagnosis for which there is no diagnostic test, yet there are classic findings on exam that can be captured in a photograph. This study aimed to develop a deep convolutional neural network, KD-CNN, to differentiate photographs of KD clinical signs from those of other pediatric illnesses. To create the dataset, we used an innovative combination of crowdsourcing images and downloading from public domains on the Internet. KD-CNN was then pretrained using transfer learning from VGG-16 and fine-tuned on the KD dataset, and methods to compensate for limited data were explored to improve model performance and generalizability. KD-CNN achieved a median AUC of 0.90 (IQR 0.10 from tenfold cross validation), with a sensitivity of 0.80 (IQR 0.18) and specificity of 0.85 (IQR 0.19) to distinguish between children with and without clinical manifestations of KD. KD-CNN is a novel application of CNN in medicine, with the potential to assist clinicians in differentiating KD from other pediatric illnesses and thus reduce KD morbidity and mortality.

Young calves are more susceptible to cold than older animals due to their limited ability to regulate body temperature and lack of fat reserves and may have difficulty consuming the energy needed to cope with the cold by maintaining body temperature and meeting their metabolic needs, especially when fed constant levels of waste milk (WM) with less solids, which can be detrimental to health and future performance. An alternative to overcome this problem is increasing the milk's solids content to the existing volume by using different sources [milk replacer powder (MR) or transition milk (TM)]. Thus, we aimed to evaluate the effects of increasing the total solids of WM via MR (WM+MR) or TM (WM+TM) on the performance, feeding behavior, and health-related variables of cold-stressed dairy calves during pre- and post-weaning. We hypothesized that feeding WM supplemented with MR or TM as potential liquid feed enhancers would improve milk dry matter and energy intake of the calves with a positive impact on body development and have no negative impact on feeding behavior and health. Additionally, we hypothesized that MR would not differ from TM. As a sample size calculation at 80% power using power analysis (PROC POWER) in SAS 9.4, a total of 51 Holstein-Friesian vigorous male calves [vigor score 21-27; 17 per treatment; 4-d old; body weight (BW) = 40.0 ± 0.63 kg (mean ± SD)] were selected, assigned randomly to treatments, and housed in individual pens in an outdoor barn. Irrespective of the type of treatment, all calves were fed 6 kg/d liquid feed from d 1 to d 53 of the experiment. In a step-down weaning program, calves received 0.5 kg liquid feed from d 54 to d 60. All calves were weaned on d 61 and remained in the study until d 101 as post-weaning evaluation. The calves had ad libitum access to starter feed and fresh drinking water across the experiment. Intake, growth, and behavior data were analyzed using a general linear mixed model and health data were analyzed using mixed logistic regression, mixed linear regression, and survival analysis models in SAS. We found that supplementation was responsible for a greater dry matter intake (DMI; P = 0.004), superior average BW (P = 0.037), and increased crude protein (CP; P = 0.001) and crude fat (CF; P = 0.001) intakes, with the most favorable outcomes observed for the WM+TM group when compared with WM+MR. Animals fed WM (control group; CON) showed a smaller average daily gain during the first 40-d of life (P = 0.026), showing slight changes during the whole period of evaluation when compared with the supplemented groups (SUP; WM+MR and WM+TM). No difference between MR- and TM-SUP groups, probability of having abnormal appearance (P = 0.032) and pneumonia occurrence (P = 0.022) was reduced in the SUP than in CON animals, with no effect on diarrhea among treatment groups (P = 0.461). Using milk supplements added to WM is an alternative to improve the intake, performance, and health of young calves under cold stress. Our findings showed that SUP animals outperformed the CON group in terms of DMI, average BW, and intake of CP and CF, with the TM-SUP group displaying the most favorable outcomes. Moreover, the SUP groups demonstrated reduced odds of experiencing abnormal appearance and pneumonia, highlighting the positive impact of supplementation on calf health.

Background and objectivesThis study aimed to assess the association between the 10-year implementation of tobacco control policies, cigarette affordability index and changes in tobacco smoking prevalence across Eastern Mediterranean (EMR) countries.Materials and methodsAn ecologic study was conducted using EMR countries as the analytical unit. Data from three sources were utilized: the MPOWER scale to measure tobacco control policy implementation (2010-2020), the tobacco affordability index (expressed as a percentage of GDP per capita required to purchase 2000 cigarettes, from 2010 to 2020), and national tobacco smoking prevalence data for EMR countries (2010-2023). Linear Fixed-effect regression was employed to investigate associations between changes in MPOWER scores, the cigarette affordability index, and alterations in tobacco prevalence over a decade.ResultsStatistically significant inverse associations were observed between changes in MPOWER scores and tobacco smoking prevalence among both men and women in EMR countries (P-valueConclusionThis study underscored the effectiveness of enhancing the implementation of tobacco control policies and increasing the cigarette affordability index as preventive measures to reduce tobacco smoking prevalence in EMR countries over the past decade.

Objectives This study aimed to gain a comprehensive understanding of the determinants that influence oral healthcare behaviours among Iranian pregnant women.Study design Qualitative study.Setting Comprehensive health service centres.Participants A sample consisting of all people involved in the process of oral care during pregnancy, 18 pregnant women, 7 midwives/healthcare workers, 3 supervisors of prenatal care services and 3 dentists) were purposefully sampled in terms of demographic characteristics.Methods The qualitative content analysis study conducted 31 semistructured individual interviews in 2022, utilising MAXQDA V.10.Results The participants identified 3 main categories and 11 subcategories: individual and physiological determinants (care needs, perceived importance, motivation, oral health literacy and inherent pregnancy limitations), organisational determinants (costs, access to equipment and services, review of service delivery process and professional behaviour) and social-cultural determinants (educational services and support from family and friends).Conclusions The results can be used in interventions to improve oral healthcare for pregnant women. This study highlights the importance of addressing individual, organisational and social-cultural determinants to improve oral healthcare during pregnancy.

Background and Objective: Stroke is one of the main causes of death and disability in the world, and its treatment includes the re-supply of blood to the brain tissue using different methods, including alteplase injection. The aim of this study is to determine the outcome of treatment with intravenous alteplase. Methods: This cross-sectional study was conducted on all stroke patients referred to Babol Rouhani Hospital in 2019-2021. Patients were divided into two groups receiving intravenous alteplase and routine and supportive treatment groups. Demographic information and the scores of National Institutes of Health Stroke Scale (NIHSS) to evaluate the improvement of stroke symptoms and Modified Rankin Scale (mRS) to evaluate the severity of disability in three periods of 7, 30 and 90 days were investigated and compared. Findings: Out of 100 studied patients, 49 people were in alteplase group and 51 people were in routine and supportive treatment group. In examining the NIHSS scale of patients in three follow-up periods, there was a significant difference in the alteplase group compared to the routine and supportive treatment group (p

Dentists always prioritize the preservation of the dental pulp. Nowadays, minimally invasive endodontic techniques such as Vital Pulp Therapy (VPT) are considered due to their affordability and remarkable success compared to conventional treatments such as Root Canal Treatment (RCT). VPT aims at preserving healthy portions of the exposed pulp while removing the inflamed parts with biocompatible materials to seal the pulp.The present case report aimed to describe a successful VPT of a right mandibular permanent first molar with reversible pulpitis using Calcium Enriched Mixture (CEM) cement in an 18-year-old female patient. As pulp exposure happened regarding extensive caries removal, 2 mm of the inflamed pulp was removed and replaced with CEM cement. CEM was covered with Resin-modified glass ionomers (RMGI) and the tooth was restored with amalgam. Regular follow-ups were performed at 3 and 6 months and 1, 2, and 4 years after treatment.Conclusion: The tooth was clinically and radiographically functional without signs and symptoms of infection or inflammation. The result of this case suggests that pinpoint pulp exposure during deep caries excavation can be successfully treated with VPT using CEM cement.

Background and Objective: Some single nucleotide polymorphisms of the HOTAIR gene are associated with various types of cancer, such as breast, ovarian, colorectal, and lung cancer. The HOTAIR gene product is a long non-coding RNA that is involved in the regulation of gene expression and apoptosis, and is therefore considered an oncogene. This study was conducted with the aim of investigating the rs1899663 G>T polymorphism in breast cancer susceptibility in the northwestern region of Iran. Methods: In this case-control study, the peripheral blood of 164 breast cancer patients referred to Tabriz hospitals and 172 healthy individuals was collected. After DNA extraction using saturated salt and proteinase K, single nucleotide polymorphism rs1899663 G>T of HOTAIR gene was investigated using tetra-primer ARMS-PCR. The association between this polymorphism and some clinical and pathological features of breast cancer including age, tumor type, tumor grade, tumor size, lymph node involvement and involved side was investigated. Findings: The frequency of GG, GT, TT genotypes in sick people was 33.4%, 55.6% and 11%, respectively and in healthy people was 51.7%, 42.3% and 6%, respectively. GG (p=0.001) and GT (p=0.029) genotypes showed a significant association with breast cancer. This polymorphism is not associated with any of the clinicopathological features of breast cancer in this population. Conclusion: Our data show that patients with GT and GG genotypes of rs1899663 G>T polymorphism of HOTAIR gene are more susceptible to breast cancer, while people with TT genotypes have a lower susceptibility to breast cancer development. The results of in silico analyses also show that these single nucleotide polymorphisms can increase the risk of breast cancer.

Objective(s): HBsAg vaccine is unable to induce Th1 immune responses. Here, immune responses and long-lived IgG responses of HBsAg-Alum, HBsAg-MF59, as well as HBsAg-MF59 were compared when formulated with PPD. Materials and Methods: BALB/c mice were injected with the vaccines subcutaneously three times with a two-week interval. Then, specific IgG, long-lived IgG responses up to 220 days, and also IgG1 and IgG2a isotypes were assessed using ELISA. Furthermore, IFN-γ and IL-4 were assessed on spleen cell culture supernatant by ELISA. Results: IFN-γ cytokine response between MF59- and Alum-adjuvanted vaccines did not show a significant difference. HBsAg-Alum vaccine revealed an increase in IL-4 cytokine, as compared with those immunized with HBsAg-MF59 at borderline (P=0.0553). In addition, HBsAg-MF59+PPD 10 µg showed a significant decrease in IL-4 and IFN-γ cytokines, as compared with HBsAg-MF59. Furthermore, the HBsAg-MF59+PPD10 µg group showed a significant increase in the IL-2/IL-4 ratio, as compared with HBsAg-MF59 (P=0.0339). Specific IgG antibody showed a significant increase in HBsAg-MF59, as compared with HBsAg-Alum. Furthermore, HBsAg-MF59 plus PPD showed a significant increase in IgG responses, as compared with HBsAg-MF59 and HBsAg-Alum groups. Long-lived IgG responses up to 220 days after the final shot showed a significant increase in HBsAgMF59 versus HBsAg-Alum group and PPD in the HBsAg-MF59 vaccine formulation, resulting in a significant increase in IgG responses versus HBsAg-MF59 group. In addition, PPD in the HBsAg-MF59 vaccine formulation suppressed IgG1 response versus HBsAg-Alum. However, HBsAg-MF59 showed a significant increase in IgG2α versus the HBsAg-Alum group (P=0.0190). Immunization with HBsAg-MF59+PPD (10 µg) showed a significant increase versus the HBsAg-MF59 group (P=0.0040). Results from the IgG2a/IgG1 ratio in HBsAg-MF59+PPD1µg and HBsAg-MF59+PPD10 µg groups showed a significant increase as compared with HBsAg-MF59 groups (P

We assessed the blood levels of the most important factors such as cytokines/chemokines in Coronavirus disease-2019 (COVID-19). PubMed/Medline and Scopus as two important databases were searched up to March 26, 2020. To analyze the data, we used Review Manager 5.3 software. Out of forty-two records retrieved from two databases, 10 studies were involved in the analysis. Thirty-three cytokines/chemokines were checked. The levels of 27 cytokines/chemokines in COVID-19 patients were higher than the healthy controls, and among 20 cytokines/chemokines; the levels of 10 cytokines/chemokines in severe COVID-19 patients were higher than non-severe COVID-19 patients. Also, out of three cytokines, one had a higher level in the intensive care unit (ICU) patients compared to the non-ICU patients. The findings showed the cytokine storm syndrome in COVID-19 patients, especially in patients with severe disease.

Introduction Finding biomarkers for highly lethal cancers is a priority.

Abstract Kawasaki disease (KD), the most common cause of acquired heart disease in children, can be easily missed as it shares clinical findings with other pediatric illnesses, leading to risk of myocardial infarction or death. KD remains a clinical diagnosis for which there is no diagnostic test, yet there are classic findings on exam that can be captured in a photograph. This study aimed to develop a deep convolutional neural network, KD-CNN, to differentiate photographs of KD clinical signs from those of other pediatric illnesses. To create the dataset, we used an innovative combination of crowdsourcing images and downloading from public domains on the Internet. KD-CNN was then pretrained using transfer learning from VGG-16 and fine-tuned on the KD dataset, and methods to compensate for limited data were explored to improve model performance and generalizability. KD-CNN achieved a median AUC of 0.90 (IQR 0.10 from tenfold cross validation), with a sensitivity of 0.80 (IQR 0.18) and specificity of 0.85 (IQR 0.19) to distinguish between children with and without clinical manifestations of KD. KD-CNN is a novel application of CNN in medicine, with the potential to assist clinicians in differentiating KD from other pediatric illnesses and thus reduce KD morbidity and mortality.

Background: The use of advanced and expensive technologies requires financial, human and capital resources. Brain Magnetic Resonance Imaging (MRI) has high contrast sensitivity for visualizing differences among the tissues. Unnecessary diagnostic imaging imposes excessive cost on health systems. This study aimed to determine the appropriateness of brain MRI prescriptions in 2021. Methods: This cross-sectional study recruited 274 patients who referred to Bushehr teaching hospital. They had been prescribed MRI of the brain due to headache and dizziness. We used the data collection form developed in the previous study. The appropriateness of the brain MRI prescription was determined based on the appropriate indications during 2021. Results: About 61 % of the referrals were due to headache and 39 % were because of dizziness. Overall, MRI was evaluated as inappropriate for about 38 % of the patients. The appropriateness of prescriptions had a significant relationship with age, gender, education, job status, complaint, prescribing physician, and MRI applicant with P-value > 0.050. Conclusion: Findings revealed more than one-third of brain MRI services were not clinically appropriate. Due to the high cost of MRI, it is necessary to make prescriptions in accordance with indications to prevent unnecessary diagnostic procedures and to prevent induced demand. Health system policymakers and healthcare providers should develop clinical guidelines and implement them to reduce the costs of health systems.

Background: Medical tourism provides Effective economic, political and social profits to the countries active in the field, which should be taken into account in a competitive market. This study aimed to evaluate the relationship between foreign patients' satisfaction and other aspects of health tourism in educational and medical centers of the Iran University of Medical Sciences (IUMS). Methods: This was a descriptive correlational study with a researcher-made questionnaire. The first part of the questionnaire contained the demographic characteristics of the participants, and the second part included 30 questions about the components that affect receiving medical services by foreign nations. The reliability coefficient of the questionnaire was determined by using Cronbach's alpha (0.980). Expert judgment was used to assess the validity of the questionnaire. Out of 70 hospitals affiliated with the University of Iran in 2019, 10 hospitals from 35 licensed centers in the field of international health were randomly selected, and 300 questionnaires were delivered to foreign patients who were willing to complete the questionnaire. The received information was from Random sampling recorded in SPSS25 software. Descriptive Statistics was used to determine the effective factors. Results: The largest numbers of foreign patients in this study were from Iraq (64 %) and Kuwait (24 %), respectively. In correlation review, there was a significant relationship between satisfaction of foreign patients and financial dimension (0.785), quality of treatment dimension (0.914), medical facilities dimension (0.799) and tourism facilities dimension (0.918) in hospitals. Conclusion: This study demonstrates that there is a significant relationship between satisfaction of foreign patients and other aspects of health tourism (such as financial dimension, treatment quality, treatment and tourism facilities) in hospitals, Which needs to be given special attention by health tourism managers for short-term and long-term planning for its development.

Abstract The inherent flexibility of machine learning-based clinical predictive models to learn from episodes of patient care at a new institution (site-specific training) comes at the cost of performance degradation when applied to external patient cohorts. To exploit the full potential of cross-institutional clinical big data, machine learning systems must gain the ability to transfer their knowledge across institutional boundaries and learn from new episodes of patient care without forgetting previously learned patterns. In this work, we developed a privacy-preserving learning algorithm named WUPERR (Weight Uncertainty Propagation and Episodic Representation Replay) and validated the algorithm in the context of early prediction of sepsis using data from over 104,000 patients across four distinct healthcare systems. We tested the hypothesis, that the proposed continual learning algorithm can maintain higher predictive performance than competing methods on previous cohorts once it has been trained on a new patient cohort. In the sepsis prediction task, after incremental training of a deep learning model across four hospital systems (namely hospitals H-A, H-B, H-C, and H-D), WUPERR maintained the highest positive predictive value across the first three hospitals compared to a baseline transfer learning approach (H-A: 39.27% vs. 31.27%, H-B: 25.34% vs. 22.34%, H-C: 30.33% vs. 28.33%). The proposed approach has the potential to construct more generalizable models that can learn from cross-institutional clinical big data in a privacy-preserving manner.

Objective(s): Many people all around the world encounter major problems due to nervous system injuries. Among the various methods of treating, neural tissue engineering has attracted a lot of attention from nerve science researchers.Materials and Methods: There are various methods for fabrication of soft tissue, however the electrospinning method (ELS) is a simple and cost-effective method that can produce porous fiber scaffolds to simulate the environment of the extracellular matrix (ECM). In this study, an ELS technique was used to fabricate polyvinyl alcohol (PVA) tissues and graphene nanosheet (Gr-NS) added with omega-3 fatty acids (O3FA) was loaded in these tissues that support nerve tissue regeneration. For this purpose, PVA and Gr-NS for biaxial ELS, PVA containing 0.5 wt%, and 1 wt% of Gr-NS was used.. Then, the morphology of these scaffolds was observed by optical microscopy and scanning electron microscopy (SEM) technique. Results: The results show after loading of O3FA, the fiber diameter reaches 0.573±0.12 µm, which is within the range of dimensions required for nerve tissue engineering. FTIR analysis indicates that Gr-NS and O3FA have been well loaded in the scaffolds. The results of water absorption and biodegradation tests demonstrated that the sample with 0.5% Gr-NS has 211.98% and 16.54% water absorption and biodegradation after 48 hr and 6 days, respectively. Conclusion: Finally, the results of this study indicate that scaffolds loaded with 0.5% Gr-NS have a homogeneous, porous, and integrated structure which can be effective in nerve tissue engineering.

Objective(s): Bioresorbable scaffolds have been advocated as the new generation in interventional cardiology because they could provide temporary scaffolds and then disappear with resorption. Although, the available stents in clinical trials exhibited biosafety, efficacy, no death, and no apparent thrombosis, Mg-substrate degradation on drug release has not been investigated.Materials and Methods: Therefore, more research has been needed to legitimize the replacement of current stents with Mg-based stents. UV-Vis spectrophotometer, scanning electron microscope (SEM), X-ray diffraction (XRD), pH measurement, H₂ evolution, and corrosion tests determined the change in hybrid properties and drug release rate. Results: The effect of Mg degradation on drug release from poly-L-lactide (PLLA) specimen was much higher than that of the L605/PLLA sample. Hydrogen evolution caused by magnesium degradation compelled everolimus out without significant PLLA decomposition during the first 100 days, while formation of Mg(OH)2 caused the PLLA to deform and crack. Conclusion: A combined mechanism of lattice/hole diffusion-dissolution governed the release of everolimus with the activation energies of 5.409 kJ/mol and 4.936 kJ/mol for the first 24 hr and diffusion coefficients 6.06×10-10 and 3.64×10-11cm2/s for the 50th to 100th days. Prolonged suppression of hyperplasia within the smooth muscle cells by hybrid stent insertion could bring about the cessation of restenosis.

Background and Objective: Studies show that single nucleotide polymorphisms of the HOTAIR gene are associated with a variety of cancers, including colorectal, breast, and thyroid cancers. The product of the HOTAIR gene is a long non-coding RNA that is involved in regulating gene expression, cell cycle and apoptosis and is considered an oncogene. The present study was conducted to investigate the association between HOTAIR rs1899663 G>T gene polymorphism and thyroid cancer susceptibility in northwestern Iran. Methods: In this case-control study, peripheral blood was obtained from 90 patients with thyroid cancer referred to Tabriz hospitals as well as 198 healthy individuals. After DNA extraction by saturated salt and proteinase K method, single nucleotide polymorphism of HOTAIR rs1899663 gene was examined by tetra-primers ARMS PCR. Then, allelic and genotypic frequencies of control and case groups were calculated and compared. Findings: In this study, the genotypic frequencies of GG, GT and TT in the case group were 23.3%, 49% and 27.7%, and in the control group were 20.2%, 41% and 38.8%, respectively. Allele frequencies of G and T were 48% and 52.2% in the case group and 41% and 59% in the control group, respectively. Allelic and genotypic comparisons between case and control groups showed no significant relationship. Conclusion: The results of the study showed that HOTAIR rs1899663 gene polymorphism is not associated with any of the clinicopathological features of thyroid cancer.

Introduction: Evidence-based medicine is considered as a new and reliable approach which has new discussions on judgment to find the best evidence or qualitative evidence. This study was designed in Bushehr province for designing, implementing, and evaluating physician empowerment courses in evidence-based MRI prescriptions in the training hospitals of Bushehr University of Medical Sciences in 2021. Methods: The present study was an educational scholarship which was conducted in Bushehr province. This study was performed in two phases in accordance with Glassic criteria. A number of five workshops were designed and conducted by researchers using the ADDIE Model in systemic educational design. The course was designed through the review of texts and interviews with experts and in-depth group discussions (FGD) with the presence of seven experts. After that, this training course was evaluated and the end-of-course test was performed using the Kirkpatrick model. In order to evaluate the reaction of participants during the training course, a questionnaire was designed and its face validity and content validity were approved by experts. In addition, a four-choice test was designed based on the presented scientific content to evaluate the learning level of participants. A number of 40 questions were designed for five workshops. Descriptive statistics (frequency, mean) were used in SPSS22 for data analysis. Results: In terms of gender, 53.7 % were male and 46.3 % were female. In terms of age, 24.4 % were in the age group of 31-35 years. In terms of improving awareness, 34.1 % of participants were at a very good level after the empowerment course. Learning findings indicated that 85.7 % of participants in the final test received a passing score while 14.3 % failed. Conclusion: In general, the findings of the study indicated that holding an empowerment course for physicians in Bushehr improved their awareness and knowledge. In fact, such improvement in awareness and knowledge can reduce unnecessary prescriptions and treatment costs but improve the quality of services.

Objective(s): Atherosclerosis is the main cause of cardiovascular disease (CVD) which has a key role in the development of coronary artery disease (CAD). Based on clinical studies, HSP60 is the only HSP that can cause atherosclerosis. In this paper, the expression level of HSP60 and the pathogenic degree of its cloned part was investigated in atherosclerosis condition.Materials and Methods: After the designation of the specific primers for HSP60, PCR was done by the Pfu enzyme. Subsequently, the PCR products were cloned into a prokaryotic expression vector pET-28a. The resultant recombinant vector was transferred in BL21 and purified. Purification of protein was done by the Nickel affinity column. After confirmation of Western blotting and HSP60 protein purification, purified protein concentration was measured by the Bradford method, and purity was analyzed by SDS PAGE 12%. New Zealand rabbits were tested as an animal model. At the next step, the recombinant protein was injected into the animal model that was on a fatty diet.Results: The prokaryotic expression plasmid pET28a-hps60 was successfully constructed, the HSP60 protein was expressed and purified in Escherichia coli BL21 (DE3). We found that the rabbit that was receiving the recombinant vaccine with the fatty diet showed a lower amount of fat deposition at the media endothelial level than the rabbit which received only the fatty diet. Conclusion: Taking recombinant protein concomitant with a fatty diet, causes betterment of atherosclerosis via decreasing aggregation of cholesterol and thickness of the endothelial media.