Search

A crucial role in the continuation of economic activities is played by the financing of services and production in supply chains. A key element of optimizing the financial flow of these complex networks is to pay attention to the financial aspects of these complex networks since they are becoming more and more complex and expanding. This study aims to investigate the supply chain of a pharmaceutical company's holding company and its subsidiaries while using internal resource valuation to develop a new strategy for financing the company's operations. There is a process of money circulation through the chain, which consists of passing through two treasuries (primary and secondary), which provide liquidity to compensate the deficits of some institutions with the excess liquidity of other institutions. In this article, we present three simulation-based models based on a case study conducted at Shafa Darou Investment Company in Tehran-Iran, a leading pharmaceutical investment company in the country, to examine the impact of implementing this idea in the real world. Considering the study's results, it has been shown that the supply chain as a whole has improved in terms of its working capital. Using a set of local treasuries is generally associated with reducing risks and a greater level of stability when relying on the excess liquidity of chain members provided that financial independence from external institutions, such as banks, is maintained. In addition, if the members' excess liquidity is deposited in a set of local treasuries rather than a bank, the profit and internal financial flow within the chain will be circulated throughout the chain, and more added value will be generated. [ABSTRACT FROM AUTHOR]

Aims The new coronavirus disease (COVID-19), as a second epidemic of the 21st century, causes severe acute respiratory syndrome in patients. This study was designed to determine the causes of not vaccinating against COVID-19 in the eligible population of Fars province. Instruments & Methods This cross-sectional study was carried out in December 2021 to March 2022 on unvaccinated people of Fars province, Iran. The data of 12889 individuals were added to the study. The data collection tool was a researcher-made checklist with closed-ended questions that were completed through a telephone interview. Data were analyzed using SPSS 22 software through descriptive statistics and a Chi-square test. Findings The largest age group was 25 to 35 years old (19.8%). The percentage of unvaccinated females was significantly higher than males (p<0.001). Homemakers and college and school students were the occupational groups with the highest frequency of not receiving the vaccine. The considerable reasons for not being vaccinated are the side effects anxiety, and lack of belief in the vaccine conspiracy. Conclusioi The women of reproductive age and college and school students are the most frequent unvaccinated groups. Having an underlying disease and the lack of follow-up by the healthcare staff are the most frequent reason for not being vaccinated. [ABSTRACT FROM AUTHOR]

Statement of Problem: Deliberating the patients' rights is one of the major human ethical and legal principles which can be investigated through the agenda of professional and medical ethics accordingly, the students of dentistry have to be educated about this issue and achieve the necessary skills in deliberating and concerning the patients' rights. Purpose: The present study aimed to investigate Shiraz dental students' awareness and attitude regarding the patients' rights as well as the principles of dental ethics in order to design methods for organizing and improving the ethics in dentistry. Materials and Method: The present descriptive-analytical study was conducted on 111 students of different departments of Shiraz Dental School. The study data were collected through a questionnaire designed based on the patients' rights charter in Iran, ADA ethical codes which are internationally acceptable in the field of dentistry, and the guidelines of the ministry of health, treatment, and medical education (No. 140588). Then, the data were entered into the SPSS statistical software and analyzed. Results: Of all participants, 21.6% were men and 78.4% were women. According to the results, 71% of the students were acquainted with the patients' rights. In addition, the patients' characteristics, including gender and nationality, were not important for 58.6% of the students. Conclusion: The study findings showed that 71% of the participants were acquainted with the patients' rights Establishment of a comprehensive, integrated charter in Iran is needed. With rapid development of medical sciences, new issues appear which necessitate taking into account the mutual rights of the physicians, people, and patients. [ABSTRACT FROM AUTHOR]

The maritime industry is moving towards a sustainable supply chain (SSC), intending to increase the quality of logistics and make more profit. The sustainability of the maritime supply chain (MSC) in Iran is one of the topics that has not been widely studied. Ports play a crucial role in promoting Iran's position in the international transit of products, strengthening economic, social, and environmental connections with neighboring eastern and northeastern countries, improving GDP, and promoting the role of the free zone in the national development of the country. Port development is one of the essential elements in the government's strategic planning in developing and activating the East axis. It has a special priority in line with government policies based on deprivation elimination and improving people's living standards. This paper considers five significant ports of Iran that are part of special economic zones and studies the sustainability of those ports. In this research, different multi-criteria decision-making methods were applied to solve a sustainability-ranking problem of major Iranian ports. First of all, by using the SWARA method, sub-criteria of loading and unloading oil, pier length, and population obtained the highest scores in economic, environmental, and social aspects of sustainability, respectively, which shows that they had the greatest impact on the sustainability assessment of Iranian ports. Finally, the MARCOS and CoCoSo techniques were the most similar in all three dimensions of sustainability, and both seemed to be suitable methods for evaluating the sustainability of ports. Furthermore, the implementation of sensitivity analysis and definition of different scenarios for port evaluation and the high efficiency of the MARCOS method were determined in solving the port-ranking problem. According to the MARCOS method results, economic, environmental, and social criteria were all effective criteria in the sustainable development of major Iranian ports and have been largely applied in Astara, Bushehr, and Imam Khomeini ports. Based on the analysis of the results, several managerial insights to make better industry decisions are also revealed. [ABSTRACT FROM AUTHOR]

Today, an increase in the drought and water shortage all around the world is a challengeable threat for different governments and international committees. Water supply chain aims to manage the water consumption and to control the water shortage. Contrary to most of previous studies focused on the forward directions of the water supply chain, this paper also considers the reverse logistics known as a Closed-Loop Supply Chain (CLSC). Hence, an integrated Water Supply and Wastewater Collection System (WSWCS) under uncertainty is proposed. Furthermore, regarding the trend of sustainable development, the environmental dimensions and social benefits of the integrated WSWCS are contributed. To meet the standards of the sustainable development in developing countries, a case study in Iran is applied to a novel multi-objective stochastic optimization model based on triple bottom lines of sustainability. Having already been employed to similar optimization problems, the Social Engineering Optimizer (SEO) has been never applied in this research area. Another innovation of this study is to introduce an improved multi-objective SEO to solve this complicated model. Eventually, with regards to an extensive comparison contributing to the Pareto-based metrics and different sensitivities, some managerial implications are concluded as the main findings. • Developing a novel multi-objective stochastic optimization model to design a sustainable water supply network. • Considering triple bottom lines of sustainability for an integrated water supply and wastewater collection system. • Applying the life cycle assessment method to estimate the sustainability aspects. • Solving the case study of Urmia Lake by an improved social engineering optimizer. [ABSTRACT FROM AUTHOR]

Background: The rise of the internet and social media has led to increased interest among diabetes patients in using technology for information gathering and disease management. However, adequate eHealth literacy is crucial for protecting patients from unreliable diabetes-related information online., Objective: To examine the psychometric characteristics and explore the preliminary validity of the Persian version of the Condition-specific eHealth Literacy Scale for Diabetes (Persian CeHLS-D) to assess eHealth literacy in the context of diabetes care., Methods: After adapting, translating, examining content validity, and pilot testing the questionnaire, it was administered to 300 patients with type 2 diabetes mellitus (T2DM). Construct validity was assessed through confirmatory factor analysis, convergent and known-groups validity. The internal consistency (Cronbach's alpha), composite reliability and maximum reliability, and test-retest correlation were assessed., Results: Factor analysis supported the hypothesized two-factor model with 10 items, and the standardized factor loadings ranged from 0.44 to 0.86 (P-values < 0.001). Cronbach's alpha and test-retest correlation were good for each factor. Convergent validity was confirmed by significant correlations of Persian CeHLS-D with diabetes health literacy, perceived usefulness and importance of using the internet for health information, internet anxiety, and perceived physical and mental health. Know-groups validity determined using groups with different internet-use frequencies, and different attitudes towards providing online healthcare services, were satisfied., Conclusion: This study demonstrated the Persian CeHLS-D as a reliable and valid measure of eHealth literacy among patients with T2DM in Iran. Its satisfactory psychometric properties support its use in research and clinical settings to assess eHealth literacy and inform interventions., (© 2024. The Author(s).)

Introduction: Progesterone can be used instead of GnRH agonists and antagonists in order to avert a premature LH surge during controlled ovarian stimulation (COS) protocol. Nonetheless, there is limited knowledge regarding its utilization. Thus, this study compared the effects of progesterone and GnRH antagonists (GnRH-ant) on premature LH surges and assisted reproductive technology (ART) results in infertile women undergoing ART., Materials and Methods: In this clinical trial, the progesterone protocol (study group) and GnRH-ant protocol (control group) were tested in 300 infertile individuals undergoing IVF/ICSI. The main outcome was the number of oocytes retrieved. The secondary outcomes included premature LH rise/surge, the quantity of follicles measuring ≥ 10 and 14 mm, oocyte maturity and fertilization rate, the number of viable embryos, high-quality embryo rate and pregnancy outcomes., Results: The study group exhibited a statistically significant increase in the number of retrieved oocytes, follicles measuring 14 mm or greater, and viable embryos compared to the control group (P < 0.05). The study group also increased oocyte maturity, chemical pregnancy rate, and clinical pregnancy rate (P < 0.05). Both groups had similar mean serum LH, progesterone, and E2 levels on trigger day. The control group had more premature LH rise than the study group, although this difference was not statistically significant., Conclusion: In conclusion, it can be stated that the progesterone protocol and the GnRH-ant protocol exhibit similar rates of sudden premature LH surge in infertile patients. However, it is important to note that the two regiments differ in their outcomes in ART., Trial Registration: This study was retrospectively registered in the Iranian website ( www.irct.ir ) for clinical trials registration ( http://www.irct.ir : IRCT-ID: IRCT20201029049183N, 2020-11-27)., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The study aimed to estimate the prevalence of lipid abnormalities in Iranian adults by demographic characterization, geographical distribution, and associated risk factors using national and sub-national representative samples of the STEPs 2021 survey in Iran. In this population-based household survey, a total of 18,119 individuals aged over 25 years provided blood samples for biochemical analysis. Dyslipidemia was defined by the presence of at least one of the lipid abnormalities of hypertriglyceridemia (≥ 150 mg/dL), hypercholesterolemia (≥ 200 mg/dL), high LDL-C (≥ 130 mg/dL), and low HDL-C (< 50 mg/dL in women, < 40 mg/dL in men), or self-reported use of lipid-lowering medications. Mixed dyslipidemia was characterized as the coexistence of high LDL-C with at least one of the hypertriglyceridemia and low HDL-C. The prevalence of each lipid abnormality was determined by each population strata, and the determinants of abnormal lipid levels were identified using a multiple logistic regression model. The prevalence was 39.7% for hypertriglyceridemia, 21.2% for hypercholesterolemia, 16.4% for high LDL-C, 68.4% for low HDL-C, and 81.0% for dyslipidemia. Hypercholesterolemia and low HDL-C were more prevalent in women, and hypertriglyceridemia was more prevalent in men. The prevalence of dyslipidemia was higher in women (OR = 1.8), obese (OR = 2.8) and overweight (OR = 2.3) persons, those residents in urban areas (OR = 1.1), those with inappropriate physical activity (OR = 1.2), patients with diabetes (OR = 2.7) and hypertension (OR = 1.9), and participants with a history (OR = 1.6) or familial history of CVDs (OR = 1.2). Mixed dyslipidemia prevalence was 13.6% in women and 11.4% in men (P < 0.05). The prevalence of lipid abnormalities was highly heterogeneous among provinces, and East Azarbaijan with 85.3% (81.5-89.1) and Golestan with 68.5% (64.8-72.2) had the highest and lowest prevalence of dyslipidemia, respectively. Although the prevalence of high cholesterol and LDL-C had a descending trend in the 2016-2021 period, the prevalence of dyslipidemia remained unchanged. There are modifiable risk factors associated with dyslipidemia that can be targeted by the primary healthcare system. To modify these risk factors and promote metabolic health in the country, action plans should come to action through a multi-sectoral and collaborative approach., (© 2023. Springer Nature Limited.)

This study aimed to investigate the diabetes mellitus (DM) and prediabetes epidemiology, care cascade, and compliance with global coverage targets. We recruited the results of the nationally representative Iran STEPS Survey 2021. Diabetes and prediabetes were two main outcomes. Diabetes awareness, treatment coverage, and glycemic control were calculated for all population with diabetes to investigate the care cascade. Four global coverage targets for diabetes developed by the World Health Organization were adopted to assess the DM diagnosis and control status. Among 18,119 participants, the national prevalence of DM and prediabetes were 14.2% (95% confidence interval 13.4-14.9) and 24.8% (23.9-25.7), respectively. The prevalence of DM treatment coverage was 65.0% (62.4-67.7), while the prevalence of good (HbA1C < 7%) glycemic control was 28.0% (25.0-31.0) among all individuals with diabetes. DM diagnosis and statin use statics were close to global targets (73.3% vs 80%, and 50.1% vs 60%); however, good glycemic control and strict blood pressure control statistics, were much way behind the goals (36.7% vs 80%, and 28.5% vs 80%). A major proportion of the Iranian population are affected by DM and prediabetes, and glycemic control is poorly achieved, indicating a sub-optimal care for diabetes and comorbidities like hypertension., (© 2023. Springer Nature Limited.)

Background: Breast cancer (BC) is one of the most burdensome cancers worldwide. Despite advancements in diagnostic and treatment modalities, developing countries are still dealing with increasing burdens and existing disparities. This study provides estimates of BC burden and associated risk factors in Iran at the national and subnational levels over 30 years (1990-2019)., Methods: Data on BC burden for Iran were retrieved from the Global Burden of Disease (GBD) study from 1990 to 2019. GBD estimation methods were applied to explore BC incidence, prevalence, deaths, disability-adjusted life years (DALYs), and attributable burden to risk factors based on the GBD risk factors hierarchy. Moreover, decomposition analysis was performed to find the contribution of population growth, aging, and cause-specific incidence in the total incidence change. Age-standardized rates (per 100,000 population) and 95% uncertainty intervals (UI) were reported based on sex, age, and socio-demographic index (SDI)., Results: Age-standardized incidence rate (ASIR) increased from 18.8 (95% UI 15.3-24.1)/100,000 in 2019 to 34.0 (30.7-37.9)/100,000 in 2019 among females and from 0.2/100,000 (0.2-0.3) to 0.3/100,000 (0.3-0.4) among males. Age-standardized deaths rate (ASDR) increased slightly among females from 10.3 (8.2-13.6)/100,000 in 1990 to 11.9 (10.8-13.1)/100,000 in 2019 and remained almost the same among males-0.2/100,000 (0.1-0.2). Age-standardized DALYs rate also increased from 320.2 (265.4-405.4) to 368.7 (336.7-404.3) among females but decreased slightly in males from 4.5 (3.5-5.8) to 4.0 (3.5-4.5). Of the 417.6% increase in total incident cases from 1990-2019, 240.7% was related to cause-specific incidence. In both genders, the BC burden increased by age, including age groups under 50 before routine screening programs, and by SDI levels; the high and high-middle SDI regions had the highest BC burden in Iran. Based on the GBD risk factors hierarchy, high fasting plasma glucose (FPG) and alcohol were estimated to have the most and the least attributed DALYs for BC among females, respectively., Conclusions: BC burden increased from 1990 to 2019 in both genders, and considerable discrepancies were found among different provinces and SDI quintiles in Iran. These increasing trends appeared to be associated with social and economic developments and changes in demographic factors. Improvements in registry systems and diagnostic capacities were also probably responsible for these growing trends. Raising general awareness and improving screening programs, early detection measures, and equitable access to healthcare systems might be the initial steps to tackle the increasing trends., (© 2023. The Author(s).)

Introduction: Data on the distribution of the burden of diseases is vital for policymakers for the appropriate allocation of resources. In this study, we report the geographical and time trends of chronic respiratory diseases (CRDs) in Iran from 1990 to 2019 based on the Global burden of the Disease (GBD) study 2019., Methods: Data were extracted from the GBD 2019 study to report the burden of CRDs through disability-adjusted life years (DALYs), mortality, incidence, prevalence, Years of Life lost (YLL), and Years Lost to Disability (YLD). Moreover, we reported the burden attributed to the risk factors with evidence of causation at national and subnational levels. We also performed a decomposition analysis to determine the roots of incidence changes. All data were measured as counts and age-standardized rates (ASR) divided by sex and age group., Results: In 2019, the ASR of deaths, incidence, prevalence, and DALYs attributed to CRDs in Iran were 26.9 (23.2 to 29.1), 932.1 (799.7 to 1091.5), 5155.4 (4567.2 to 5859.6) and 587,911 (521,418 to 661,392) respectively. All burden measures were higher in males than females, but in older age groups, CRDs were more incident in females than males. While all crude numbers increased, all ASRs except for YLDs decreased over the studied period. Population growth was the main contributor to the changes in incidence at a national and subnational levels. The ASR of mortality in the province (Kerman) with the highest death rate (58.54 (29.42 to 68.73) was four times more than the province (Tehran) with the lowest death rate (14.52 (11.94 to 17.64)). The risk factors which imposed the most DALYs were smoking (216 (189.9 to 240.8)), ambient particulate matter pollution (117.9 (88.1 to 149.4)), and high body mass index (BMI) (57 (36.3 to 81.8)). Smoking was also the main risk factor in all provinces., Conclusion: Despite the overall decrease in ASR of burden measures, the crude counts are rising. Moreover, the ASIR of all CRDs except asthma is increasing. This suggests that the overall incidence of CRDs will continue to grow in the future, which calls for immediate action to reduce exposure to the known risk factors. Therefore, expanded national plans by policymakers are essential to prevent the economic and human burden of CRDs., (© 2023. The Author(s).)

In the context of the coronavirus disease 2019 (COVID-19) pandemic, compliance with government regulations is a tremendous challenge in the effort to curb the viral transmission. The fact that specific communities and people across the world continue to ignore government regulations of COVID-19 is a crucial issue to address. Researchers sought to examine the political psychological and sociocultural determinants of adherence to COVID-19-related law and policy measures among waste pickers in a sub-urban slum community in Iran. A cross-sectional survey of 362 waste pickers from two municipalities in the countryside of Tehran, Iran, was conducted between January and May 2022. Multiple regression analysis was used to predict the significant difference between the direct or indirect effects of political psychological and sociocultural variables on compliance with COVID-19 emergency measures. Confidence intervals were estimated using the bootstrap method. The findings supported the proposed model. The results indicated that political ideology (β = - 0.13, 95% CI - 0.29 to 0.02), individualism worldview (β = - 0.14, 95% CI - 0.32 to 0.07), fatalism (β = - 0.18, 95% CI - 0.40 to 0.04), health literacy (β = 0.16, 95%CI - 0.05 to 0.37) and prosociality (β = 0.09, 95%CI 0.03-0.13) exert an indirect effect on compliance with the COVID-19 emergency measures through both trust in government and trust in science and scientific community. This study has implications for authorities in ensuring adherence to governmental orders for COVID-19 outbreak. A democracy-based and human rights-based approach and a flexible framework for proceeding more equitable COVID-19 legal and government regulations is critical to an effective and acceptable health response to COVID-19. Instituting slum emergency planning committees, incorporating the informal providers into all pandemic response plans in every urban informal settlement and providing an immediate guarantee of payments to waste packers will be indispensable., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Dental caries is the most prevalent child affliction in the world and can be reduced through effective preventive interventions. To plan cost-effective interventions, clear and integrated data are needed. This study has been designed to overcome the lack of national trend in deciduous dental caries in Iran., Objective: To estimate the dental caries trend in deciduous teeth in the Iranian population at different ages from 1990 to 2017., Methods: From 1990 to 2017 a literature search about dmf and its components (decayed, missed, and filled tooth, abbreviated as dt, mt, and ft) as well as dental caries was done in the Iranian population in three English (PubMed, Web of Science, and Scopus) and three national databases (in Persian). All eligible national oral health surveys in these 28 years were included. National dmft data were categorised based on age (1-4, 5-9, and 10-14), sex, province and year. The final trends were estimated using an age-spatio-temporal hierarchical model. We used the bootstrap method in multilevel models to predict the uncertainty interval (UI) of the modelled results. Finally, the estimations of dmft, dt, mt, and ft with a 95% UI were reported from 1990 to 2017., Results: Almost 22% of the Iranian deciduous teeth were involved with dental caries in 1990 [dmft = 4.37; (95% UI 2.23, 6.62)] which more than 83% of it was dt [3.64 (1.53, 5.88)] and less than 7% was ft [0.30 (0.06, 0.65)]. During 1990-2017, dmft increased by more than 15% [in 2017, dmft = 5.03 (2.82, 7.29)]. The highest increase was seen in dt which was more than 17% [in 2017, dt = 4.27 (1.96, 6.57)]., Conclusion: Increasing dental caries among Iranian children over 28 years shows that oral health policies in Iran need critical evaluation. We need cost-effective nationwide interventions (e.g., supervised tooth brushing and improving dietary habits) and training well-experienced intermediate manpower (e.g., dental hygienists) to reduce dental caries., (© 2022. The Author(s).)

Background: COVID-19 related stigma has been identified as a critical issue since the beginning of the pandemic. We developed a valid and reliable questionnaire to measure COVID-19 related enacted stigma, inflicted by the non-infected general population. We applied the questionnaire to measure COVID-19 related enacted stigma among Tehran citizens from 27 to 30 September 2020., Methods: A preliminary questionnaire with 18 items was developed. The total score ranged from 18 to 54; a higher score indicated a higher level of COVID-19 related stigma. An expert panel assessed the face and content validity. Of 1637 randomly recruited Tehran citizens without a history of COVID-19 infection, 1064 participants consented and were interviewed by trained interviewers by phone., Results: Item content validity index (I-CVI), Item content validity ratio (I-CVR), and Item face validity index (I-FVI) were higher than 0.78 for all 18 items. The content and face validity were established with a scale content validity index (S-CVI) of 0.90 and a scale face validity index (S-CVI) of 93.9%, respectively. Internal consistency of the questionnaire with 18 items was confirmed with Cronbach's alpha of 0.625. Exploratory factor analysis revealed five latent variables, including "blaming", "social discrimination", "dishonor label", "interpersonal contact", and "retribution and requital attitude". The median of the stigma score was 24 [25th percentile: 22, 75 the percentile: 28]. A large majority (86.8%) of participants reported a low level of stigma with a score below 31. None of the participants showed a high level of stigma with a score above 43. We found that the higher the educational level the lower the participant's stigma score., Conclusion: We found a low level of stigmatizing thoughts and behavior among the non-infected general population in Tehran, which may be due to the social desirability effect, to the widespread nature of COVID-19, or to the adaptation to sociocultural diversity of the large city., (© 2022. The Author(s).)

Background: Sexual and reproductive health (SRH) is an important aspect of women's health. Polycystic ovary syndrome is a common disease among women and has long-term negative effects on women's health. Evidence shows that polycystic ovary syndrome has different impacts on SRH needs among women. The aim of this study is to design and validate an SRH services guideline for healthcare providers in treating women with polycystic ovary syndrome., Methods: The guideline will be developed and validated using an exploratory sequential mixed-methods approach in three phases based on the National Institute for Health and Care Excellence (NICE) model: (1) scoping phase (describing the SRH needs of women with polycystic ovary syndrome from the results of both review and qualitative studies); (2) development phase (developing a primary guideline for SRH services); (3) validation phase (validation of the guideline will be performed by a panel of experts and stakeholders using the AGREE [Appraisal of Guidelines for Research and Evaluation] tool)., Discussion: A specific and practical guideline on the SRH of Iranian women with polycystic ovary syndrome will be developed, which will be compatible with their specific needs and culture, considering the limited resources available. It will help service providers identify and address the specific needs of women with polycystic ovary syndrome., (© 2021. The Author(s).)

Background: Previous observational studies have highlighted the negative effects of serum hormone levels at the minimum threshold during frozen embryo transfer (FET) cycles. However, still the questions regarding the maximum threshold level, and the highest allowed dosage of hormonal medications remain unresolved. The present study was conducted to determine whether there is any relationship between the serum progesterone and estradiol levels on the day of ET, and live birth rate (LBR) in patients receiving HRT in FET cycles., Methods: In this prospective cohort study, eligible women who were undergoing their first or second FET cycles with the top graded blastocyst stage embryos were included. All patients received the same HRT regimen. FET was scheduled 5 days after administration of the first dosage of progesterone. On the morning of ET, 4-6 h after the last dose of progesterone supplementation, the serum progesterone (P 4, ng/ml) and estradiol (E 2 , pg/ml) levels were measured., Results: Amongst the 258 eligible women that were evaluated, the overall LBR was 34.1 % (88/258). The serum P 4 and E 2 values were divided into four quartiles. The means of women's age and BMI were similar between the four quartiles groups. Regarding both P 4 and E 2 values, it was found that the LBR was significantly lower in the highest quartile group (Q 4 ) compared with the others, (P = 0.002 and P = 0.042, respectively). The analysis of the multivariable logistic regression showed that the serum level of P 4 on ET day, was the only significant predictive variable for LBR. The ROC curve revealed a significant predictive value of serum P 4 levels on the day of ET for LBR, with an AUC = 0.61 (95 % CI: 0.54-0.68, P = 0.002). The optimum level of serum P 4 , with 70 % sensitivity and 50 %specificity for LBR, was 32.5 ng/ml., Conclusions: The present study suggests that a serum P4 value at the maximum threshold on the day of FET is associated with reduced LBR following blastocyst transfer. Therefore, measuring and monitoring of P 4 levels during FET cycles might be necessary. However, the results regarding the necessity for the screening of serum E 2 levels before ET, are still controversial, and further prospective studies are required.

Background: Osteoporosis is a systemic bone disease which leads to a reduction in bone mass. Many studies have shown that up to 80% of bone mineral density (BMD) variations are attributed to genetic factors. Arachidonate 12-lipoxygenase enzyme, encoded by the ALOX12 gene, produces lipid peroxides as reactive oxygen species (ROS), leading to oxidative stress and the development of osteoporosis. Selenium (Se) is incorporated into selenoproteins, which may reduce the risk of osteoporosis., Objectives: We aimed to investigate the association of 2 ALOX12 single nucleotide polymorphisms (SNPs) and serum Se level with lumbar spine and femoral neck BMD among elderly individuals living in Amirkola, Iran., Material and Methods: The study consisted of 180 individuals aged ≥60 years (90 healthy and 90 osteoporotic patients). We examined the effect of 2 ALOX12 SNPs (rs2292350 and rs9897850), using the polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) on both BMD regions measured by dual energy X-ray absorptiometry (DXA). Serum Se level was measured using an atomic absorption spectrophotometer PGG990 AAS (PG Instruments Ltd., Luterworth, USA)., Results: The rs2292350 SNP showed a significant association with femoral neck BMD (p = 0.04). Moreover, in terms of serum Se level, a significant difference was found between the patient group (57.58 ±25.54 μg/L) and the control group (81.09 ±25.58 μg/L) (p < 0.001). In addition, individuals with higher serum Se levels also had higher BMD of the lumbar spine (r2 = 0.392; p < 0.001) and the femoral neck (r2 = 0.478; p < 0.001)., Conclusions: The results suggested that genetic variation in ALOX12 might influence BMD variations in our recruited participants. As for the patients with lower serum Se levels, it was observed that serum Se deficiency was accompanied by some ALOX12 variation, contributing to the development of osteoporosis.

Value-based choices are influenced both by powerful counterfactuals, such as regret, and also by risk in potential outcomes. Culture can profoundly affect how humans perceive and act in the world, but it remains unknown how regret in value-based choice and key aspects of risk-taking may differ between cultures. Here our computational approach provides precise and independent metrics, grounded in extensive neurobiological evidence, for the influences of risk and regret on choice. We test for commonalities and differences across three diverse cultures: Iran, China and the UK. Including Iran matters because cross-cultural work on value-based choice is lacking for this key 21 st Century culture, and also because patterns across the three cultures arbitrates between explanations for differences. We find commonalities, with regret influencing choice across cultures and no consistent cultural difference seen. However, for risk, unlike in both Chinese and Westerners' choices, Iranians are risk-seeking - findings consistent across two task variants and further explained by Iranians showing less subjective impact of negative, but not positive, outcomes of risky choices. Our computational approach dissects cultural impacts on two key neurobiologically-grounded quantities in value-based choice, showing that neuroscientific accounts cannot a priori isolate such quantities from culture in the cognitive processes underlying choice.

Telemedicine projects are aimed at offering medical services to people who do not have access to direct diagnosis and treatment services. As a powerful tool for analyzing the performance of complex systems and taking probable events into consideration, systemic simulation can facilitate the analysis of implementation processes of telemedicine projects in real-life-like situations. The aim of the present study was to propose a model for planning resource capacities and allocating human and operational resources to promote the efficiency of telemedicine project by investigating the process of teleradiology. In this article, after verification of the conceptual model by the experts of this field, the computerized simulation model is developed using simulation software Arena. After specifying the required data, different improvement scenarios are run using the computerized model by feeding the data into the software and validation and verification of the model. Fixing input data of the system such as the number of patients, their waiting time, and process time of each function, for example, magnetic resonance imaging or scan, has been compared with the current radiology process. Implementing the teleradiology model resulted in reduction of time of patients in the system (current: 1.84 ± 0.00, tele: 0.81 ± 0.00). Furthermore, through this process, they can allocate the lower resources to perform better functions of staff. The use of computerized simulation is essential for designing processes, optimal allocation of resources, planning, and making appropriate decisions for providing timely services to patients.