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The central aim of this study is to evaluate the effectiveness of the recently revised elementary curriculum for arts education in Iran. The study employed an educational criticism method and was conducted in two elementary schools. Data were collected by observation, semi-structured interviews and curriculum documents over a four-month period. The research participants consisted of 12 professionals (teachers, coordinators and principals), and 30 students (8-12 year-olds from different cultural backgrounds). According to the results of this study, the schools' architecture and environment do not promote creativity, active participation and engagement in the learning process. The general and specific objectives, the content areas, the time allocated to the teaching of each area, teaching methods and assessment procedures have been clearly defined in the official curriculum documents for arts education. Nevertheless, the areas of painting and occasionally handcrafts are the content areas which are taught to students using direct methods of teaching and students' performance is often evaluated by traditional tests. The study concludes that the current arts curriculum has not been successful, or not as successful as it was intended to be. The most common obstacle to effective arts teaching, however, is the lack of a place for arts within the school programme similar to that of science and mathematics. Lack of enough well-trained teachers with an educational background in arts education is another obstacle that needs to be addressed in future revisions of the curriculum.

Background/Objectives: Celiac disease (CD) is a systemic and autoimmune enteropathy of the gastrointestinal tract with malabsorption characteristics. The only effective treatment for CD is adhere strictly to a gluten-free diet (GFD) throughout life. We evaluated the dietary patterns in celiac disease patients and their association with dietary intakes and anthropometric measurements in Iran. Subjects/Methods: This is a case-control study on 182 participants who were referred to the Khuzestan Celiac Association, Iran. Nutritional information was collected using a validated 147-item semi-quantitative food frequency questionnaire (FFQ). The software Stata (StataCorp, Version 14.0) was used to analyze the data. Principal component analysis (PCA) was used to obtain participants' dietary patterns. Results: A significant relationship was observed between age and body mass index (BMI) across quartiles of the healthy dietary pattern score (P < 0.001, P = 0.001, and P = 0.001, respectively), indicating that as age and BMI increased, participants demonstrated greater adherence to the healthy dietary pattern. Individuals with the highest adherence to the healthy dietary pattern had the lowest odds ratio for celiac disease (CD) (Q1: reference; Q2: 1.96, 95% CI: 0.84–4.55; Q3: 0.61, 95% CI: 0.27–1.42; Q4: 0.10, 95% CI: 0.03–0.33, P trend < 0.001), and this association remained significant after adjusting for BMI (adjusted P trend = 0.003) and energy intake (adjusted P trend < 0.001). Moreover, there was a significant association between the lowest odds ratio for CD and the highest adherence to the unhealthy dietary pattern after adjustment for energy intake (Q1: reference; Q2: 0.38, 95% CI: 0.13–1.12; Q3: 0.21, 95% CI: 0.06–0.71; Q4: 0.07, 95% CI: 0.02–0.29, adjusted P trend < 0.001). Additionally, a significant association was observed between the odds ratio for CD and the mixed dietary pattern score (Q1: reference; Q2: 6.01, 95% CI: 2.29–15.72; Q3: 2.47, 95% CI: 0.93–6.55; Q4: 4.84, 95% CI: 1.84–12.66, P trend = 0.02), and this association remained significant after adjustment for energy intake (adjusted P trend < 0.001). Conclusions: The findings of the present study indicate that individuals who adhere to healthy dietary patterns have a lower incidence of celiac disease. [ABSTRACT FROM AUTHOR]

Background: Numerous factors are likely to result in poor treatment adherence, which is one of the important factors contributing to increased complications and the low efficacy of hemodialysis (HD), particularly inadequate knowledge of patients. This study aimed to compare the effects of a mobile health (mHealth) app (the Di Care app) use and face-to-face training on the clinical and laboratory parameters of dietary and fluid intake adherence in patients undergoing HD. Methods: This single-blinded, two-stage/two-group randomized clinical trial was fulfilled in 2021-22 in Iran. Seventy HD patients were recruited, using the convenience sampling method, and were then randomized into two groups: mHealth (n = 35) and face-to-face training (n = 35). ​ The patients in both groups received the same educational materials via the Di Care app and face-to-face training for one month. Before and 12 weeks after the intervention, the mean interdialytic weight gain (IDWG), potassium (K), phosphorus (P), total cholesterol (TC), triglyceride (TG), albumin (AL), and ferritin (FER) levels were measured and compared. The data were analyzed using the SPSS via descriptive statistics (mean, SD, frequency, and percentage) and analytical tests (independent-samples t-test, paired-samples t-test, Wilcoxon signed-rank test, Mann-Whitney U test, Chi-square test, and Fisher's exact test). Results: ​Prior to the intervention, the mean IDWG and the K, P, TC, TG, AL, and FER levels, were not significantly different in both groups (p > 0.05). The mean IDWG (p < 0.0001), and the K (p = 0.001), P (p = 0.003), TC/TG (p < 0.0001), and FER (p = 0.038) levels in the HD patients in the mHealth group decreased. ​As well, the mean IDWG (p < 0.0001), and the K (p < 0.0001) and AL (p < 0.0001) levels showed a descending trend in the face-to-face group. The fall in the mean IDWG (p = 0.001) and the TG level (p = 0.034) in the patients in the mHealth group was significantly greater than that in the face-to-face group. Conclusions: The Di Care app use and the face-to-face training could improve dietary and fluid intake adherence in patients. However, mHealth could have more effect on the laboratory parameters than face-to-face training, largely reducing the IDWG. Trial registration: This study was registered in the Iranian Registry of Clinical Trials (No. ID IRCT20171216037895N5). [ABSTRACT FROM AUTHOR]

Background: The incessant and stressful nature of providing care to patients with chronic diseases can cause fatigue in caregivers. Caregivers' fatigue and reduced quality of life can reduce the patient's quality of care. Since it is important to pay attention to the mental health of family caregivers, this study investigated the relationship between fatigue and quality of life and their related factors in family caregivers of patients on hemodialysis. Methods: This cross-sectional descriptive-analytical study was performed in 2020–2021. One hundred seventy family caregivers were recruited by convenience sampling from two hemodialysis referral centers in the east of Mazandaran province, Iran. The data collection tools were the Family Caregiver Quality of Life questionnaire and Krupp's fatigue severity scale. Results: The majority (88%) of caregivers had moderate to severe fatigue. Caregivers' fatigue was a major factor influencing their quality of life. There was a significant fatigue difference between some categories of kinship and the caregiver's income level (P < 0.05). Caregivers with lower income and education levels, those who were the patient's spouse, and those who could not leave the patient alone had significantly worse quality of life than other caregivers (P < 0.05). Also, caregivers living with the patient in the same house had a worse quality of life than those living separately (P = 0.05). Conclusion: Considering the high prevalence of fatigue among family caregivers of patients on hemodialysis and its adverse effect on their quality of life, it is recommended to perform routine screenings and implement fatigue alleviation interventions for these caregivers. [ABSTRACT FROM AUTHOR]

Trichoderma species are known to have a high potential for biotechnological applications. β-glucosidase enzyme is an important component of cellulase enzyme complex of Trichoderma with a crucial role in enzymatic degradation which is inhibited by glucose. The purpose of this study was to find the Trichoderma strains with high cellulase activity and tolerance to glucose. Therefore, 77 Trichoderma isolates were obtained from forest soils in Iran. Ten of them, had high cellulase activity, and the H1N44 isolate showed the highest activity of cellulase as well as high tolerance to glucose. In addition using FPAse assay, the level of cellulase activity was 0.66 U/mL in H1N44 and this result was 4-fold higher than β-glucosidase activity in Trichoderma reesei QM6a in the absence of glucose. Then, 10 representative cellulolytic isolates were sequenced in three genomic loci, including ITS, tef-1 and rpb-2 and H1N44 isolate was recognized as Trichoderma koningiopsis. As a result of this study, H1N44 was identified as a novel cellulolytic and glucose-tolerant strain with high potential for biotechnological utilization. [ABSTRACT FROM AUTHOR]

Pomegranate has been considered a medicinal plant due to its rich nutrients and bioactive compounds. Since environmental conditions affect the amount and composition of metabolites, selecting suitable locations for cultivation would be vital to achieve optimal production. In this study, data on the diversity of targeted metabolites and morphological traits of 152 Iranian pomegranate genotypes were collected and combined in order to establish the first core collection. The multivariate analyses were conducted including principal component analysis (PCA), and cluster analysis. In addition, the current and future geographical distribution of pomegranate in Iran was predicted to identify suitable locations using the MaxEnt model. The results showed high diversity in the studied morphological and metabolic traits. The PCA results indicated that FFS, NFT, JA, and AA are the most important traits in discriminating the studied genotypes. A constructed core collection using maximization strategy consisted of 20 genotypes and accounted for 13.16% of the entire collection. Shannon-Weaver diversity index of a core collection was similar or greater than the entire collection. Evaluation of the core collection using four parameters of MD, VD, CR, and VR also indicated the maintenance of the genetic diversity of the original set. According to the MaxEnt model, altitude, average temperature of coldest quarter, and isothertmality were the key factors for the distribution of pomegranate. The most suitable areas for pomegranate cultivation were also determined which were located in arid and semi-arid regions of Iran. The geographic distribution of pomegranate in the future showed that the main provinces of pomegranate cultivation would be less affected by climatic conditions by the middle of the century. The results of this study provide valuable information for selection of elite genotypes to develop the breeding programs to obtain the cultivars with the highest levels of metabolic compounds for pharmaceutical purposes, as well as identification of the most suitable agro-ecological zones for orchard establishment. [ABSTRACT FROM AUTHOR]

Background: Evolving evidence indicates the role of vitamin D deficiency in the progression of IBD and its impact on the severity of the disease, but it remains unclear whether vitamin D deficiency causes IBD or vice versa. Methods: This cross-sectional study was conducted to determine the serum levels of vitamin D and its effects on the severity of disease in patients with inflammatory bowel disease in the Imam Khomeini Hospital complex. A questionnaire containing demographic information, records on the use of supplements and medications, disease complications, and criteria for determining the severity of the disease based on the Mayo score and Crohn's Disease Activity Index (CDAI) and 25 hydroxy vitamin D levels was completed and evaluated. Results: Of the 101 participants, 21 were with Crohn's disease and 80 had ulcerative colitis. The mean age of Crohn's patients was 33.80±9.5 years and ulcerative colitis was 38.43±10.2 years. Among patients with ulcerative colitis, 37 (46.8%) had a mayo score less than 3 and 42 (53.2%) were 3 and more. Mean vitamin D in the mayo score less than 3 was 32.14 and the mayo score 3 and more was 23.99. Of the Crohn's patients, 12 (57.1%) were in the recovery phase and 9 (52.9%) were in a non-recovery phase. The mean of vitamin D in the recovery phase was 29.10 and in the others was 27.04 Conclusion: There is a significant relationship between the level of vitamin D supplementation, the final value of CDAI, and the identification of the patients with the Mayo score. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic caused by the newly emerged Coronavirus was first detected in China in December 2019 and rapidly spread throughout the world. With the rapid spread of the disease, all countries involved in accordance with their capacities took necessary measures to identify and manage the disease. The first patient was diagnosed with COVID-19 in Iran in February 2020. Considering the significant role of the laboratory services in detection and management of the disease, planning and programming to provide access to these services was considered as a top priority for healthcare system in Iran. Adopting all existing laboratory capacities and providing necessary infrastructures for expanding COVID-19 laboratory diagnostics, resulted in establishment of a nationwide network of COVID-19 molecular diagnostic laboratories within the shortest possible time. In addition to expanding the capacity of laboratory services, improving the laboratory network's performance have been taken into serious consideration. In spite of the strict sanctions, the COVID-19 molecular diagnostic laboratories scaled up to more than 430 laboratories currently (September 2021), mostly are operating in the private sector. With considerable efforts, COVID-19 molecular laboratory network was established to provide nationwide diagnostic services. Taking into account the capacity for performing SARS CoV-2 Rapid Antigen testing, at the moment, we are able to provide more than 100,000 COVID-19 diagnostic tests per day. However, due to continuation of the pandemic and in accordance with the needs of the health system, it is necessary to plan and carry out more activities for diagnostic testing of COVID-19. The purpose of this paper is to introduce the process of establishing the COVID-19 laboratory diagnostic network to manage the COVID-19 pandemic in Iran. [ABSTRACT FROM AUTHOR]

Intestinal parasitic infections (IPIs) are still a serious public health problem worldwide, particularly in developing countries. The COVID-19 pandemic has affected people's lifestyles and quality of life. Besides, the prevalence of IPIs is directly associated with environmental sanitation, overcrowding, and personal hygiene. Therefore, the current study aimed to determine the prevalence of IPIs among patients referred to hospitals affiliated to Shiraz University of Medical Sciences by reviewing the available data of hospital information system database in the pre- and post-COVID-19 pandemic. The total data of 13,686 patients referred to hospitals affiliated to Shiraz University of Medical Sciences, southern Iran were collected from March 2019 to March 2021. The overall prevalence of IPIs was found to be 4.4%, and Blastocystis spp. was the most common parasite. The prevalence of protozoan parasites (4.4%) was significantly higher than helminthic parasites (0.04%, P < 0.001). A significant association was observed between IPIs with age, gender, and year (P < 0.05). The prevalence of IPIs among those referred to hospitals before the COVID-19 pandemic was higher than those referred to hospitals during the COVID-19 pandemic (5.8% vs 2.8%), and the differences were statistically significant (P < 0.001). The odds of infection among people investigated during the COVID-19 pandemic was about 40% lower than those investigated before the COVID-19 pandemic (AOR: 0.60, 95% CI: 0.49–0.73, P < 0.001). Our results showed that the prevalence of IPIs has decreased during the COVID-19 pandemic. Improved sanitation, personal hygiene, and health education can be effective in reducing parasitic infections in the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Iran's nursing education has undergone significant modifications in the last decades, especially following the Islamic revolution and the Iran-Iraq war. This review outlined changing trends in Iran's nursing education and evaluate its status compared to other developing and developed countries. Methods: Six international and two national electronic data sources were searched up to May 2021, using relevant keywords and terms. The studies were included if they addressed history, development, or evolutionary aspects of Iran's nursing education or evaluated its status by comparing it with developing or developed countries, using Bereday's model. To obtain more relevant information, the organizational documents of the Iranian Ministry of Health and Medical Education and the Iranian Ministry of Culture and Higher Education were searched. Of 753 evidence found in the initial search, 73 were considered eligible for this review. A systematic and unbiased data synthesis was performed and a narrative and tabulated summary was presented. Results: The evolution in Iran's nursing education has resulted in the establishment of Bachelor, Master, and Ph.D. programs. Iran's nursing education system plays an important role in fulfilling the healthcare system's mission, and it does not hold a dissatisfactory position in comparison with other developed and developing countries. However, this system is expected to be more versatile for the upcoming changes and advancements. Conclusion: Iran's nursing education has a moderate rating despite recent changes. Hence, this system has to be modified in some aspects by adopting experiences of other countries, with an appropriate and successful education system, to prepare future highly competent nurses. [ABSTRACT FROM AUTHOR]

Medicinal plants have a special place in Iranian people's culture, and they show a growing tendency to use natural, harmless products daily. Understanding consumers' tastes and attitudes can contribute to proper planning for the production, marketing, and use of medicinal plants. This study aimed at determining factors affecting the consumption of medicinal plants in urban communities in the north of Iran. The instruments used in the study were a questionnaire and a face-to-face interview. The study population included 384 households selected from three districts of Gorgan City, Iran, using the simple sampling method (equal chance to select samples from the community). The collected data were analyzed using an ordinal logit model in SPSS software. The dependent variable was the monthly consumption of medicinal plant products, and the independent variables were household costs, household income, education, advertisement, plant prices, and availability. The results showed that financial power, medicinal plant quality, awareness and knowledge of medicinal plants, and preference of medicinal plants over chemical drugs with a significance level of 95% (p value < 0.05) affected the consumption of medicinal plants in the study area. The study's results can be used for successful planning in this area based on producers, processors, and marketers of medicinal plants. [ABSTRACT FROM AUTHOR]

Objective: The actual impact of the pandemic on COVID-19 specific mortality is still unclear due to the variability in access to diagnostic tools. This study aimed to estimate the excess all-cause mortality in Iran until September 2021 based on the national death statistics. Results: The autoregressive integrated moving average was used to predict seasonal all-cause death in Iran (R-squared = 0.45). We observed a 38.8% (95% confidence interval (CI) 29.7%–40.1%) rise in the all-cause mortality from 22 June 2020 to 21 June 2021. The excess all-cause mortality per 100,000 population were 178.86 (95% CI 137.2–220.5, M:F ratio = 1.3) with 49.1% of these excess deaths due to COVID-19. Comparison of spring 2019 and spring 2021 revealed that the highest percent increase in mortality was among men aged 65–69 years old (77%) and women aged 60–64 years old (86.8%). Moreover, the excess mortality among 31 provinces of Iran ranged from 109.7 (Hormozgan) to 273.2 (East-Azerbaijan) per 100,000 population. In conclusion, there was a significant rise in all-cause mortality during the pandemic. Since COVID-19 fatality explains about half of this rise, the increase in other causes of death and underestimation in reported data should be concerned by further studies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Irritable bowel syndrome (IBS) is the most frequent functional gastrointestinal (GI) disorder. In this study, we aimed to evaluate the different aspects of IBS among Middle Eastern residents. METHODS: During the study period, patients attending gastroenterology clinics of nine tertiary referral centers in four Middle Eastern couturiers (Iran, Egypt, Kuwait, and Turkey) were evaluated by Rome IV diagnostic criteria, and those who fulfilled the diagnostic criteria of IBS were asked to fill in a questionnaire covering different demographics and clinical aspects. RESULTS: Overall, during a 6-month period, 509 patients with IBS were included. 41.3% of the participants were male (210 patients), and 37.4% of them had academic education. 50% of the participants were Caucasian, and 34% were Arab, and originally, they were citizens of 18 countries. 77.4% of the participants were residents of subtropical areas, while 22.2% were living in temperate regions. The average age of the participants during the first presentation in subtropical and temperate areas were 38.4 ± 12.19 and 38.06 ± 12.18 years, respectively (P = 0.726). The most common subtypes of IBS in subtropical areas were unclassified (IBS-U, 44.4%), constipation dominant (IBS-C, 27.6%), mixed pattern (IBS-M, 21%), and diarrhea dominant (IBS-D, 6.8%) in descending order while in temperate areas the most common subtypes were IBS-U (43.3%), and IBS-D (22.1%), respectively (P < 0.001). Besides abdominal pain, the most common symptom of patients in each region was bloating (62.2% and 68.1%, respectively, P = 0.246). The rate of depression and anxiety were significantly higher among the residents of temperate areas in comparison with subtropical regions (41.6% vs. 16.5% and 80.5% vs. 58.4%, respectively, P < 0.001). CONCLUSION: Although the average age of IBS presentation is the same in subtropical and temperate areas, it seems that in temperate areas, the rate of IBS-D is more prevalent than in subtropical regions. The rate of anxiety and depression are significantly higher among those who searched social media and the internet to get information about their problems. [ABSTRACT FROM AUTHOR]

Introduction: The only way to limit the prevalence of COVID-19 is to adhere strictly to health protocol. In this regard, WHO has provided the information needed to prevent and deal with this disease on its website. To investigate the Impact of Internet Health Information on Adherence to COVID-19 Protocols, in Iran. Material and Methods: This is a cross-sectional survey and structural equation modeling which is done by students of at the Kerman University of Medical Science, Iran. The data collection tool was a questionnaire. SPSS 22.0, and SmartPLS 3software were used to analyze the data. Results: The present study investigated the impact of health information on the WHO website on adherence to COVID-19 protocols among the students of the Kerman University of Medical Sciences. The bootstrapping results indicate relationships between health information seeking constructs and information quality, satisfaction, and reputation. Regarding the other six hypotheses in the present study, it is predicted that they will be rejected in a larger sample. Conclusion: Online information is now available more easily, quickly, and at a lower cost compared to other sources, it should be constantly monitored and constantly improved in quality. Its usefulness, ease of use, accuracy, recency, and simplicity should be constantly investigated. [ABSTRACT FROM AUTHOR]

The study described here is the process of caring for patients in a coma following a traumatic brain injury (TBI) in Iran. The data that were analyzed come from in-depth semistructured interviews of 20 key participants and associated memos and field notes. The MAXQDA 10 qualitative analysis software was used to assist with the coding of the data. Ten catagories and 26 subcategories were identified from the primary analysis, which fit well into four themes. The main themes that were identified were chaos and confusion, inconsistent quality, multilateral support, and improving care. The processes of caring for persons in a coma following a TBI were found to be an ever-changing, multidimensional, context-dependent process. [ABSTRACT FROM AUTHOR]

Background: Family caregivers of hemodialysis patients are the first and most crucial source of care at home. They experience many problems in the care of hemodialysis patients, which can affect their quality of life and hope, affecting the quality of care provided to patients. This study aimed to determine the relationship between quality of life and hope in family caregivers of hemodialysis patients.Methods: A cross-sectional (descriptive-analytical) study performed on 300 family caregivers in the east of Mazandaran province in Iran. Data were collected using the Family Caregiver Quality of Life (FQOL), SF8 and adult hope scale. Data analysis was performed in SPSS version 16, and a P-value of below 0.05 was considered statistically significant.Results: The results showed that, there was a direct and significant relationship between hope and quality of life. However, the quality of life was significantly lower in suburban residents, the unemployed, spouses, people with lower education and income levels, caregivers who cannot leave their patients alone, those living with their patients in the same house, and those taking care of male patients, compared to other participants (P < 0.05). Suburban residents, the unemployed, people with an insufficient level of income, and those living with their patients in the same house had significantly lower hope, compared to other subjects.Conclusion: Since an increase of hope and quality of life of caregivers can cause improved quality of patient care, it is recommended that hope-based educational programs and interventions be implemented for caregivers. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) has severely influenced various aspects of human life, particularly education. This study aimed to explain the impact of the COVID-19 pandemic on nursing education from administrators, educators, and students' perspectives. Methods: This qualitative study with a conventional content analysis approach was conducted from June to October 2020 at a nursing school in Tehran. Thirteen participants were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. Nursing administrators, educators, and students constructed interviews to understand nursing education changes during the pandemic. All interviews were recorded, transcribed, reviewed, coded, and analyzed using the Graneheim and Lundman methods. Results: Interviewed respondents included administrators and professors (n = 6) and nursing students (n = 7). The respondents reported five main topic areas: (1) safe management in ambiguous situations; (2) perceived situations; (3) adaptive coping; (4) educational facilitators and challenges, and (5) continuing education in an uncertain context. The central theme was "close conflict of education with COVID-19". Conclusions: The current study noted instability and challenges placed on nursing education during the pandemic. Opportunities were addressed during the pandemic to improve the nursing training process using planning, scientific management, emerging technology, innovative educational opportunities, and comprehensive support from institutional stakeholders. Clear guidelines and recommendations are needed to ensure medical education safety during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, causing a significant public health disaster. Objectives: The present study aimed to evaluate the clinical features and laboratory data of neonates born to mothers with COVID- 19. Methods: A retrospective multicenter cohort study was conducted from March 20 to September 5, 2020, on all neonates born to mothers with positive real-time reverse transcriptase-polymerase chain reaction for SARS-CoV-2 or clinically suspected COVID-19. Neonates enrolled in this study were from five different hospitals affiliated with the Tehran University of Medical Sciences. All the newborns were tested for SARS-CoV-2 using nasopharyngeal swabs during the first 24 - 48 hours of life, and a second-time swabbing was performed as indicated at subsequent visits. All categorical data were manifested as frequency (%), and continuous data were shown as mean±SD. Results: Forty-four neonates born to 39 infected mothers were evaluated during the study period. Nineteen women had complications during pregnancy, including hypertensive disorders, gestational diabetes, preterm labor, etc. Besides, 54.5% of the neonates were born preterm. The mean gestational age and birth weight were 35.11 ± 4.01 weeks and 2,567 ± 898 g, respectively. Fifteen (34.1%) neonates were symptomatic at birth, and during the observation, more neonates became symptomatic. Finally, 27/44 (61.3%) neonates became symptomatic, and 17/44 remained asymptomatic. The most common clinical manifestations were respiratory distress (77.7%), followed by fever or hypothermia (18.5%), gastrointestinal problems (14.8%), and neurologic findings (3.7%). Also, the most common clinical feature of eight neonates with positive RT-PCR was respiratory distress, followed by neurologic symptoms, temperature instability, and gastrointestinal disorder, in sequence. Few abnormalities were seen in laboratory findings. Chest Xrays were abnormal in 22.2% of the neonates. Conclusions: The SARS-CoV-2 infection during pregnancy may cause severe maternal and neonatal morbidities. Neonates with positive SARS-CoV-2 may demonstrate a spectrum of clinical features. The most common feature of neonates born to mothers with COVID-19 was respiratory distress. [ABSTRACT FROM AUTHOR]

Iran is one of the origins of some Salicornia species. Nevertheless, comprehensive research has not been conducted on genetic potential, distribution, selection of populations, and the economic utilization of Salicornia in Iran. In the current study, Salicornia was collected based on the previous data available for 26 different geographical locations of provinces in Iran. We examined Salicornia plants' universality DNA barcodes, including rbcL, matK, trnH-psbA, and ITS, and their species identification abilities and identified six species groups. Subsequently, accurate modeling of distributed areas was provided with MAXENT and highlighted the valuable information on the diversity of specific geographical regions, conservation status of existing species, prioritization of conservation areas, and selection of Agro-Ecological areas. Together, this type of integrative study will provide useful information for managing and utilizing Salicornia genetic resources in Iran. [ABSTRACT FROM AUTHOR]

Prior research highlighted the importance of an organisational context stimulating autonomous behaviour when trying to increase levels of corporate entrepreneurship. From a social exchange perspective, we argue that firms in developing countries need to complement such supportive practices with performance-oriented practices. Our findings indicate that Iranian firms with an organisational context characterised by an interaction of social context and performance management have more engagement in corporate entrepreneurship, and that corporate entrepreneurship mediated the relationship between the organisational context and firm performance. This provides a better understanding of the way firms in developing economies can shape their organisational context to promote corporate entrepreneurship in order to achieve better firm performance. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the correlation of the visual acuity and diabetic retinopathy stage using optical coherence tomography and optical coherence tomography angiography metrics. Methods: In this prospective study, optical coherence tomography and optical coherence tomography angiography images of patients with different stages of diabetic retinopathy were obtained. In optical coherence tomography angiography images, the size of foveal avascular zone, central macular thickness, and vessel density at superficial and deep capillary layers of the macula were measured. In optical coherence tomography images, the presence of intraretinal cyst, disorganization of retinal inner layer, and ellipsoid zone and external limiting membrane disruption were evaluated. The associations between the variables with visual acuity and diabetic retinopathy stage were analyzed. Results: In total, 68 eyes of 38 patients with a mean age of 58.96 ± 10.59 years were included. In total, 34 eyes were categorized as non-proliferative diabetic retinopathy, 14 as active, and 20 as regressed proliferative diabetic retinopathy. Univariate analysis showed deep parafoveal vessel density, central macular thickness, ellipsoid zone disruption, disorganization of retinal inner layer, and external limiting membrane disruption had a significant relationship with visual acuity. However, in multivariate analysis, only central macular thickness and ellipsoid zone disruption had significant association with visual acuity (p = 0.02 and p = 0.01, respectively). There was a significant difference in deep parafoveal vessel density (p = 0.04), but not in foveal avascular zone area, between different stages of diabetic retinopathy. Conclusion: In this study, the foveal avascular zone area did not correlate with visual acuity and different stages of diabetic retinopathy. Structural abnormalities on optical coherence tomography images with especial focus on outer retinal disruption provided more reliable predictors for visual acuity outcomes in patients with diabetic retinopathy. [ABSTRACT FROM AUTHOR]

Acute gastroenteritis is one of the most important causes of death in children in developing countries which cause by different enteropathogens, including bacteria, viruses, and parasites. Among these, most of the acute gastroenteritis in children are caused by viral infections mainly by rotavirus and norovirus. This study aimed to study the epidemiological and clinical status of acute gastroenteritis resulting from rotavirus and norovirus in children between June 2015 and June 2016 in Iran. A total of 211 stool specimens were collected from Ali Asghar Children's Hospital and Bahrami Children's Hospital in Tehran, from June 2015 to June 2016. The samples were screened by commercial enzyme immunoassay (EIA) Ridascreen kit and real time RT-PCR to detect rotavirus and norovirus genogroups I and II, respectively. The information on demographic and clinical manifestations was collected, and data analyzed using IBM SPSS statistics version 22. Overall, the detection rate of rotavirus was 25.6%, and for norovirus infection, it was 17.5%. All norovirus positive specimens belonged to genogroup II. Higher rates of rotavirus infections were observed in children from 7 to 24 months, and higher rates of norovirus infections were detected in children from 1 to 12 months. Clinical symptoms were not different between rotavirus and norovirus case-patients. The present study not only highlights the importance of rotavirus and norovirus infections in Iran but also verifies the relevance of norovirus as the cause of severe gastroenteritis in children. [ABSTRACT FROM AUTHOR]

• Relative impacts of human activities and climate change on river flow are assessed. • The proposed methodology is a stochastic version of the fixing-changing method. • The uncertainties of the models' parameters are analyzed using the DREAM algorithm. • To evaluate the methodology, it was applied to the Zayandehrud basin in Iran. • Results show the applicability and efficiency of the proposed methodology. Climate change and human activities are two important factors affecting surface runoff. In water resource planning and management, it is usually important to separate the contribution of the mentioned factors to the runoff change. In this paper, a new methodology is proposed to obtain the relative impact of human activities and climate change on streamflow under uncertainty. In this methodology, the breakpoint of the annual time series of the observed runoff is estimated and the time series is divided into two study periods; before and after the breakpoint, namely the "natural" and "impacted" periods. The Jazim monthly water balance model is used for monthly runoff simulation. To incorporate the effect of snow in simulating runoff, two Jazim-based monthly water balance models with Rao and Al Wagdany (1995) and McCabe and Markstrom (2007) snow modules are used. Then, the monthly water balance models are calibrated and verified for the natural and impacted periods. The main parameters of the water balance models are optimized using the Genetic Algorithms. The uncertainty of the parameters of the models is analyzed using differential evolution adaptive Metropolis (DREAM) algorithm, which is based on the Markov Chain Monte Carlo (MCMC) algorithm. This algorithm provides the posterior probability distribution functions (PDFs) of parameters of the runoff simulation models. Next, the PDFs of the contribution rate (CR) of the climate change and human activities to runoff are determined using the fixing-changing method by taking into account the PDFs of the models' parameters. To show the applicability and efficiency of the proposed methodology, it is applied to the Zayandehrud sub-basin in Iran. Using the Standard Normal Homogeneity Test (SNHT), Pettitt and Buishand range tests, one breakpoint at 2006 is detected in runoff time series. Through the monthly rainfall-runoff simulations and the fixing-changing method, it is estimated that decrease in the runoff after the breakpoint can be attributed to climate change by 57.8% and 45%, using the Jazim-Rao & Al Wagdany model and the Jazim-McCabe & Markstrom model, respectively. The results of the uncertainty analysis of the parameters of the water balance models show that the parameters of LSMX (maximum moisture capacity of the lower soil layer) and K 3 (deep percolation coefficient) are the most significant parameters in the uncertainty of runoff simulated by both the models. According to the PDFs of contribution rate (CR) of climate change and human activities which are obtained using each rainfall-runoff model, it can be inferred that the Jazim-McCabe & Markstrom model significantly decreased the uncertainty of estimations. [ABSTRACT FROM AUTHOR]

Iran is among the countries which change official time, every year according to their constitutions. Studies have shown an increase of incidence ratio (IR) of acute myocardial infarction by these time transitions. Despite annual time changes in Iran, there is no published data to prove this among the Iranian. This retrospective study examined the IR of patients with AMI, who were admitted to the Emergency Department (ED) of 5 teaching hospitals during the week just after the time transitions (observed period), with two weeks before and after the time transitions (expected period), both in spring and fall. In total, 11051 patients were admitted during the ten weeks (observed and expected), in both spring and fall time transitions. The IR of AMI during both observed and expected period did not show any significant difference (p > 0.05); however, the incidence of AMI was increased during the first week after the transition in spring (p > 0.05). Although the results of the present study did not prove the relation between time transitions and incidence of AMI, a slight increase existed for IR of AMI during three days after spring shift. This increase in IR of AMI can be due to Nowrooz, the national holidays which lasts four days after turning clocks forward in Iran. [ABSTRACT FROM AUTHOR]

Objective: Many people who access mental health services usually do not seek treatment to avoid the consequences of stigma and label of mental illness. Thus, determining each aspect related to stigma reduction barriers seems necessary. This qualitative study was conducted to investigate stigma reduction barriers towards mental disorders in Iran. Method: In this study that was conducted from 2013 to 2015, content analysis was used and all stakeholders were selected by purposive sampling technique. All data were obtained through 16 individual interviews, 2 focus groups, and 6 written narratives. The data were collected, coded, and analyzed accordingly . Results: The major themes were as follow: The universality of stigma, beliefs, attitudes and lack of awareness, mental health providers and other specialists, cultural barriers, structures and policymakers, and insufficient financial resources. Conclusion: It is necessarily to identify the barriers of stigma reduction programs in Iran to increase the quality of life of patients with mental disorders. In the present study, due to the presence of mental health stakeholders, the main barriers were obtained. [ABSTRACT FROM AUTHOR]

Background: Stigma affects all aspects of mental disorders, and is the most important risk factor for promoting mental health. The aim of this study was to explore strategies effective in reducing the stigma toward people with mental disorders in Iran. Methods: This qualitative study was conducted from 2013 to 2016. All participants were recruited by purposive sampling method. The majority of them were stakeholders of mental health in Iran. Data were collected through eight individual interviews, two focus groups, and six written narratives. The data were collected, coded and analyzed simultaneously. Content analysis was employed to analyze the qualitative interview data. Results: The major themes that emerged were: "Emphasis on education and changing attitudes", "Changing the culture", "Promoting supportive services", "Role of various organizations and institutions", "Integrated reform of structures and policies to improve the performance of custodians", and "Evidence-based actions". Conclusions: This study did not investigate the extent of stigma or its origins, rather it examines strategies appropriate for implementation in Iran. Additional studies are needed to evaluate the effectiveness of strategies for reducing the stigma attached to patients with mental disorders. [ABSTRACT FROM AUTHOR]

This paper presents a novel combination of transcritical carbon dioxide refrigeration with Boosted-MED (Multi-Effect-Desalination) system to provide cooling and fresh water simultaneously. In the combined system a part of gas cooler in refrigeration system is replaced by the first effect and Booster module of Boosted-MED; so that a significant amount of waste heat would be recovered. Thermodynamic and economic analyses are carried out in order to investigate the proposed system’s performance. Since institution of CO 2 as a heating medium in MED systems is a novel topic; so, the heat transfer process between CO 2 and seawater is studied. Results show that the supercritical CO 2 presents an effective heat exchange process. Therefore, the specific heat transfer area would be reduced 135% and 25% compared to conventional MEDs and sensible heat source MEDs, respectively. The proposed combined system can save 57% of energy and 37.8% and 29.1% of total annual cost in Iran and Toronto respectively, compared to a stand-alone CO 2 refrigeration system and an MED-Boosted. [ABSTRACT FROM AUTHOR]

Background: Some studies have shown that patients with cancer may experience significant spiritual distress as well as spiritual growth, that there is a positive association between spirituality and coping, and that positive religious coping predicts enhanced health outcomes. Purpose: This study was designed to help explain how the meaning of disease and spiritual responses to threatening stressors influence the final experiential outcomes of adults with leukemia undergoing hematopoietic stem cell transplantation in Iran. Methods: This grounded theory study conducted in-depth interviews between 2009 and 2011 on 10 adults in Iran with leukemia undergoing hematopoietic stem cell transplantation. Recorded audio interviews were transcribed verbatim in Persian and coded and analyzed using Corbin and Strauss (2008)'s approach. Results: Main categories that emerged from data included ''experiencing the meaning of cancer''; ''changing perceptions of death, life and health''; and ''moving toward perfection and sublimity.'' ''Finding meaning'' was the main concept that defined the final outcome of the experience of participants. Conclusions/Implications for Practice: Understanding the meaning to patients of disease and treatments may help healthcare providers better appreciate the patients' perspective and improve the physician--patient relationship. Nurses are well positioned to play a decisive role in helping patients cope effectively with their treatment process and in helping ensure positive outcomes for treatments through their helping patients find the unique meaning of their experience. [ABSTRACT FROM AUTHOR]

Persian ironwood (Parrotia persica) is native species from Iran and covers 10,54% of the commercial volume. Its wood structure and its chemical composition are affected by growth conditions. The aim of the study was to assess the variation of mineral content (Ni, Fe, Cu, Zn, Pb, Cd), wood density and chemical properties (cellulose, lignin, ash and extractive) of ironwood in relation to altitude above sea level (100, 500 and 700 meter) and pith distance within stem (near to pith and bark and middle point). In addition was investigate the relationship between mineral content with oven-dried density and chemical properties. Results showed that Cd, Cu, Fe, Ni and Zn content (except Pb concentration) increased by increasing of altitude and decreased along radial position within stem from the pith to the bark. Lignin, ash and extractive content increased by increasing altitudes from 100 to 700 meter while cellulose decreased. Radial position had not significant impact on the chemical properties. There are significant relationships between mineral content-chemical properties and between mineral content-wood density (except Cu - density). Forward stepwise regression showed that ash and lignin content had important role on the variation of all of mineral content except on Cd. [ABSTRACT FROM AUTHOR]

Correction to: Environment, Development and Sustainability https://doi.org/10.1007/s10668-021... The original version of the article unfortunately contained an error in one of the author name. The original article can be found online at https://doi.org/10.1007/s10668-021-01698-1. [Extracted from the article]

Complications of total laryngectomy can have serious implications for the final outcome of treatment, including pharyngocutaneous fistula. We conducted a retrospective study of surgical techniques to determine how to best prevent or decrease the incidence of pharyngocutaneous fistula following total laryngectomy. We reviewed the hospital records of all patients who had undergone total laryngectomy for laryngeal carcinoma at Ghaem Hospital in Mashhad, Iran, from March 1989 through February 2005. We identified 88 such patients-80 men and 8 women. We divided this cohort into two groups according to the type of pharyngeal defect closure they received. A total of 37 patients-31 men and 6 women (mean age: 61.4 ± 5.9 yr) underwent primary closure along with a sternocleidomastoid muscle (SCMM) flap (flap group). The other 51 patients-49 men and 2 women (mean age: 61.3 ± 4.4 yr)-underwent standard primary closure without creation of an SCMM flap (nonflap group). Overall, postoperative pharyngocutaneous fistula occurred in 9 of the 88 patients (10.2%)-1 case in the flap group (2.7%) and 8 cases in the nonflap group (15.7%). The difference between the two groups was statistically significant (p < 0.001; odds ratio = 0.612, 95% confidence interval = 0.451 to 0.832), independent of other factors. We found no correlation between fistula development and age (p = 0.073), sex (p = 0.065), or tumor location (p = 0.435). Likewise, we found no correlation between tumor location and either sex (p = 0.140) or age (p = 0.241). We conclude that including an SCMM flap in the surgical process would significantly decrease the development of fistula, regardless of age, sex, and tumor site. [ABSTRACT FROM AUTHOR]

Endometriosis is a gynecological disorder. One of the most disabling clinical problems of affected women is pain syndrome which presenting with dysmenorrhea and dyspareunia. Sexual dysfunction is one of the health problems is these women which is not regarded as it should be. The goal of this study was to evaluate sexual function in Iranian women with endometriosis in comparison with healthy controls. Forty-six married women with confirmed endometriosis and 80 healthy subjects enrolled. Participants were asked to answer the valid and reliable Persian version of Female Sexual Function Index (FSFI) questionnaire. The most common clinical symptom were dysmenorrheal and dyspareunia. The mean Visual Analogue Scale for pain during sex was 37.4 ± 35.7 and mean sexual activity satisfaction was 64.4 ± 33.6 %. Total FSFI score and scores of three out of six subscales (arousal, orgasm and pain) were significantly different between patients and controls. By considering 26.55 as cut off point, we found that education level and body mass index (BMI) were significantly different in patients with and without sexual dysfunction. BMI was the independent predictor for total FSFI score in both case and control groups. Iranian women with endometriosis exhibited significant dysfunction in most domains of FSFI questionnaire. So, sexual dysfunction should be considered in Iranian women with endometriosis. [ABSTRACT FROM AUTHOR]

BACKGROUND Celiac disease presents with a wide spectrum of symptoms. This study clarifies different aspects of celiac disease along with the most common patterns of celiac presentation in Khuzestan Province, Iran. METHODS Patients’ information was obtained by evaluation of their files from the archives of the Khuzestan Celiac Society and records at gastroenterologists’ offices in this province. RESULTS Overall, there were 103 (40 males, 63 females) patients included in this study. Patients’ mean ages were 33 ± 11 years (males) and 31.6 ± 11.7 years (females). In terms of geographic distribution, 54.1% resided in the center of the province followed by 26.5% who were residents of the northern area. The rate of employment among men was 70.6% whereas it was 8.3% for women. In terms of education, 21.9% of men and 33.3% of women had academic educations. The rate of matrimony was 80.6% (n=29) for men, 65.4% (n=38) for women and 3.4% (n=2) who were divorced. Mean height was 164 ± 14 cm in men and 157.5 ± 10 cm in women. Mean BMI at the time of presentation was 22.7 in men and 22.6 in women. The most common gastrointestinal (GI) complaints in male patients were diarrhea (35%), reflux (20%), bloating (17.5%), abdominal pain (15%), vomiting (15%) and constipation (7.5%). Female patients experienced diarrhea (49.2%), abdominal pain (31.7%), bloating (31.7%), vomiting (19%), constipation (9.5%) and reflux (7.9%). The most common concomitant non-GI disorders among male patients were anemia (17.1%), thyroid disease (14.3%), and weight loss (14.3%); women experienced anemia (33.9%), thyroid disease (12.5%), and weight loss (7.1%). Approximately half of the patients exhibited symptoms for more than five years prior to diagnosis and 90% were diagnosed by gastroenterologists. Of these, 43% had normal endoscopy results. The most common serologic markers were anti-TTG (69.9%), anti-EMA (27.7%). CONCLUSION Physicians, prior to attributing patients’ symptoms to irritable bowel syndrome (IBS), should be aware that patients who present with long-term nonspecific symptoms might possibly have celiac disease. During endoscopy, the threshold for obtaining biopsies should be low. [ABSTRACT FROM AUTHOR]

Corn is the third important agricultural product. It is an important input in the poultry production and the basic elements of edible oil, starch, glucose, and raw material in industrial production of ethanol and some other products. The aim of this study is to find strategies to avoid price volatility, hence, the harmonic method has been used to investigate the corn price cycle and the GARCH model has been used to investigate its fluctuation. The harmonic method results showed long-term cycles in the period of 21 months in analyzing the period and the GARCH model result indicated that the corn price fluctuations causes more fluctuations in the corn future prices, in addition the error terms that have less contribution in the conditional variance. Based on the characteristics of the corn price variation obtained in this study, the policymakers should provide a proper condition to encourage sellers and buyers to deal in the Agricultural Mercantile Exchange and use future and option contract to control the price volatilities. [ABSTRACT FROM AUTHOR]

Background: Accidental exposure to blood and body secretions is frequent among health care workers (HCWs). They are at risk of acquiring blood-borne diseases. In this study, we have investigated the prevalence and risk factors of occupational exposure among the HCWs of the Emergency Departments (ED) at three teaching hospitals in Tehran. Materials and Methods: We conducted this observational, descriptive, cross-sectional study using a self-reporting 25-question survey, related to occupational exposures, in February 2010. It was carried out among 200 HCWs (specialist physicians, residents, medical interns, nurses, laboratory personnel, housekeepers, cleaners, and others), who were working in the EDs of the three teaching hospitals of the Tehran University of Medical Sciences. The age, sex, and job category of the HCWs suffering from the injury were determined, as also the risk factors responsible for the exposure of the HCWs. Results: One hundred and fifteen (57.5%) of the 200 HCWs had had at least one episode of blood or body fluid exposure in their professional life. Hollow-bore needles accounted for the highest amount of injuries, with 41.5%, followed by suture needles (18.5%). The most prevalent procedures associated with injuries were suturing (17.5%) and recapping used syringes (16.5%), respectively. All the specialist doctors in this study reported at least one exposure. The percentage of exposure in the other participants of our study was 74.3% for ED residents, 61.1% for laboratory technicians, 51.9% for nurses, and 51% for medical interns. Binary logistic regression analysis revealed that male gender, recapping needles, and job profession were independently associated with exposure to blood or body fluids. Conclusion: High prevalence of occupational exposure in this study emphasized the importance of promoting awareness, training, and education for the HCWs, for preventive strategies, and also reporting of occupational exposure to blood and body secretions. [ABSTRACT FROM AUTHOR]

Background: The increasing numbers of leukemia cancer survivors treated with hematopoietic stem cell transplantation (HSCT) face numerous challenges after their transplant procedure. Little information has been published regarding the coping process of this population. Understanding how they cope with this life-threatening disease can assist healthcare professionals to provide holistic care. Purpose: This study was designed to elicit the coping process of adults experiencing acute leukemia who underwent HSCT therapy. Methods: This longitudinal qualitative study and grounded theory took place during 2009-2011. Ten adults with acute 'leukemia scheduled for HSCT were recruited from Shariati Hospital in Tehran, Iran. A series of pretransplant and post- transplant interviews were held in the hospital's HSCT units. Final interviews took place 2-6 months posttransplant in the hospital's outpatient clinic. Results: The five categories that emerged from the data included perceived threat, suspension between fear and hope, rebirth, contextual factors, and coping strategies. Although patients vacillated within the coping spectrum (i.e., the "buffer zone" between fighting and acquiescing), "finding meaning" was identified as the final outcome of their experience that indicated effective coping. Conclusions/Implication for Practice: Each patient perceives leukemia and HSCT therapy uniquely. This life-threatening disease can significantly affect patient perception and change patient lives both temporarily and permanently. Nurses can apply effective interventions to help patients cope with their unique situation, find meaning and hope, and allay fear and stress. [ABSTRACT FROM AUTHOR]

Hematopoietic stem cell transplantation (HSCT) causes significant physical, social, psychological, and emotional stress in patients with leukemia. This qualitative study using semi-structured interviews explored the coping strategies of 10 adults with acute leukemia who were undergoing this form of treatment in transplantation units in a major hospital in Tehran, Iran, from 2009 to 2010. A content analysis identified eight themes and 13 subthemes that described the participants' coping strategies. The major themes were: attribution, denial and avoidance, connection with divine purpose, organizing treatment, seeking social support, modifying, reflection, and patience and resignation. A deeper understanding of the coping strategies that are used by patients with leukemia undergoing HSCT can help healthcare providers to encourage patients to use strategies that are likely to be more effective. Such coping strategies also can help patients to achieve a greater sense of empowerment. [ABSTRACT FROM AUTHOR]

• Prediction of oil flow through orifice plate meters based on multiple input variables. • Comparison of machine-learning-optimizers to predict oil flow through orifice plates. • Two-stage DWKNN-ABC Plus MLP-FF model yields most accurate flow predictions. • Machine-learning-optimizer algorithms avoid problematic discharge coefficients. • Nearest-neighbor model assigns high weights to some poorly correlated variables. Flow measurement is an essential requirement for monitoring and controlling oil movements through pipelines and facilities. However, delivering reliably accurate measurements through certain meters requires cumbersome calculations that can be simplified by using supervised machine learning techniques exploiting optimizers. In this study, a dataset of 6292 data records with seven input variables relating to oil flow through 40 pipelines plus processing facilities in southwestern Iran is evaluated with hybrid machine-learning-optimizer models to predict a wide range of oil flow rates (Qo) through orifice plate meters. Distance-weighted K-nearest-neighbor (DWKNN) and multi-layer perceptron (MLP) algorithms are coupled with artificial-bee colony (ABC) and firefly (FF) swarm-type optimizers. The two-stage ABC-DWKNN Plus MLP-FF model achieved the highest prediction accuracy (root mean square errors = 8.70 stock-tank barrels of oil per day) for oil flow rate through the orifice plates, thereby removing dependence on unreliable empirical formulas in such flow calculations. [ABSTRACT FROM AUTHOR]

• A methodology for detecting breakpoints in runoff time series considering uncertainties is developed. • An optimal set of breakpoint locations are found for several generated runoff time series. • The objective function based on the MDL is minimized. • Corresponding breakpoints are estimated and the PDF of breakpoint locations is derived. • The results are analyzed by investigating the remote sensing data and the impacts of inter-basin water transfer projects. Most conventional hydrological time series models, used for forecasting or synthetic data generation, are based on the stationary hypothesis. Hydrologic variables such as surface runoff discharge exhibit non-stationary behavior due to the effects of climate change or human activities. In this paper, a new methodology is proposed to analyze the uncertainty of the number and location of breakpoints in runoff time series. The non-stationary runoff time series is simulated by segmenting the series into stationary pieces, which follow an Auto-Regressive Moving Average (ARMA) process, based on the minimum description length (MDL) principle. The length of each piece and the order of the piecewise ARMA model are optimized using the Genetic Algorithm (GA). Several runoff time series with variable lengths are generated based on the observed data and the probability distribution function(s) (PDFs) of breakpoint location(s) are constructed. An optimal set of breakpoint locations are found for each generated runoff time series by minimizing the objective function based on the MDL. Finally, the PDF(s) of breakpoint location(s) is (are) constructed using the results of the mentioned optimization model. To evaluate the proposed methodology, it is applied to the case study of Zayandehrud River in Iran. According to the obtained breakpoint PDF for the runoff time series, three breakpoints around years of 1987, 1996 and 2006 are identified. The results are analyzed by investigating the time series of agricultural lands derived using remote sensing data and studying the impacts of interbasin water transfer projects implemented in the study area. Overall, investigating human-induced changes in the study area confirms the obtained shape of the PDF of runoff breakpoint and shows the good performance of the developed method for finding the number and location of breakpoints in the runoff time series. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To determine epidemiology and antimicrobial susceptibility patterns of Vibrio (V.) cholerae O1 biotype EL Tor in summer outbreak of 2008 in Iran. Methods: Stool samples were collected from patients suspected to have cholera admitted to hospitals and clinics. Specimens examined by conventional bacteriological methods. All isolates were sent to cholera reference laboratory for further confirmation, stereotyping and susceptibility testing. Results: A total of 220 patients were diagnosed as cholera. All cases confirmed by Iranian reference health laboratory. One hundred ninety nine of 220 V. cholerae serotypes were Inaba and 21 serotypes were Ogawa. All cases were reported from thirteen provinces. The majorities of cases were from Tehran, Qum and Zahedan provinces with 56, 26 and 25 cases respectively. 24(11%) of patients were under 15 years old and 196 (89%) of patients were older than 15 years.149 (68%) of patients were male and 71 (32 %) were female. 129(59%) of patients had Iranian nationality,79 (36.5%) were from Afghanistan and, 12 (5%) were from Pakistan. All isolates were resistant to co-trimoxazole, nalidixic acid, furazolidone, and intermediate to chloramphenicol and were susceptible to tetracycline, ciprofloxacin, and erythromycin. Conclusion: Our study reveals that in recent outbreak caused by V. cholerae EL Tor serotype Inaba is the predominant serotype. All isolates are resistant to cotrimoxazole, nalidix acid and furazolidon. [ABSTRACT FROM AUTHOR]

Background: Developing interventions that improve deep sleep and quit awake is important to improve the quality of care that is provided to preterm infants. Purpose: The aim of this study was to compare the effects of kangaroo care and in-arms-holding on the sleep and wake states of preterm infants. Methods: A randomized controlled trial design was employed in 2011-2012. Seventy-two stable preterm infants with gestational ages of 32-37 weeks and their mothers were recruited from the neonatal intensive care unit of Valiasr Hospital in Tehran, Iran. Seventy participants completed the trial. In the preintervention phase, nurses placed all of the infants, clad only in diapers, in supine position in their incubator for 20 minutes. Next, the infants in the kangaroo care group were placed onto their mothers' bare chest, whereas those infants in the in-arms-holding group were cradled in their mothers' arms, with the head and back supported by the mother's left arm. The intervention period lasted for 70 minutes. In the postintervention phase, the infants were returned to their incubators and placed in supine position for 20 minutes. The observer recorded the status of the infants during the three phases of study. Results: There were no significant differences between the two groups in terms of state distribution in the preintervention phase. However, the kangaroo care group had longer periods in deep sleep (p < .001) and in the quiet awake/alert state (p = .004) during the intervention phase and less time in the light sleep or drowsy state (p < .001) and in the actively awake state (p = .02) than the in-arms-holding group. No significant group differences were found in terms of crying. Conclusions: Kangaroo care appears to increase the length of time that preterm infants spend in deep sleep and quiet awake states as compared with simply being held in their mothers' arms. Replication of this research will strengthen the results. [ABSTRACT FROM AUTHOR]

The present research evaluated the diversity of a number of Iranian pomegranate cultivars using fruit morphological characteristics and AFLP markers. Thirty-one pomegranate cultivars were collected from Yazd Pomegranate Collection in Iran to study their diversity. Seven AFLP primer combinations were used to amplify a total of 112 polymorphic fragments (47.26%). By use of AFLPs, a low genetic diversity level was detected among cultivars. The relationship between fruit characteristics was analyzed using the principal component analysis (P C A). The cluster analysis based on both fruit characteristics and AFLP data indicated that cultivars were not grouped according to their geographic origins. Moreover, the correlation between the diversity matrix based on fruit characteristics and Dice's genetic similarity coefficient was insignificant (r = 0.06). The results obtained from this study can improve the conservation and management of pomegranate germplasm resources and could be helpful in optimizing breeding programs. [ABSTRACT FROM AUTHOR]

In this paper, the effect of different thicknesses of Deconstructed Tires Under Sleeper Pads (DT-USP) and different Unconfined Compressive Strength (UCS) values of mother rocks of ballast aggregates were studied in the degradation of railway ballast. For this purpose, in the first step, both static and dynamic bedding modulus of DT-USP's were extracted in the laboratory according to DIN standard requirements. In continuation, the physical and mechanical properties of the three different ballast types taken from Shahriar, Anjilavand, and Kouhin quarries in Iran were obtained via a series of standard lab tests. The UCS of core specimens taken from the mother rocks of the mentioned queries were ranked as low (159 MPa), medium (216 MPA), and high (285 MPa) respectively. Finally, 36 ballast box test experiments with and without the presence of DT-USPs in three thicknesses of 7, 11, and 13 mm were carried out and their results were compared up to 200,000 loading cycles to investigate the cyclic behavior of ballast samples. Experiment results were elicited in the form of settlement, Hardin breakage index (Br), ballast stiffness, and ballast Damping Ratio (DR). The results demonstrate for ballast of Shahriar quarry by increasing of the DT-USP's thickness from 7 to 13 mm, settlement, Br, and stiffness have decreased by 38.4%, 6.9%, and 80.5% respectively and DR has increased by 199.2% while these reported percentages, i.e. settlement, Br, and Stiffness have decreased and DR has increased after strengthening the ballast mother rock in the cases of Anjilavand and Kouhin quarries. On the other side, based on the achieved results for all three categories of ballast strengths, the DT-USP with 11 mm thickness has shown the most suitable performance. • Effect of deconstructed tire under sleeper pad is investigated on ballast cyclic behavior. • The ballast breakage and settlement is monitored in ballast box test. • Three types of stiff, medium and soft ballast rock is investigated in the tests. • By testing various DT-USPs thicknesses, an optimum thickness is introduced for all ballast types. • A logarithmic equation is proposed for ballast settlement relating to the load cycles and DT-USP stiffness. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is one of the health system problems and important diseases that is rising in developing and advanced countries. Objective: This study aimed to determine the difference of Magnetic Resonance Mammography (MRM) findings versus mammography in detecting multifocal, multi-centric and malignant bilateral lesions in patients with known breast cancer in Tehran. Methods: This cross-sectional study was conducted in Iran and Tehran among breast cancer patients between January 2015 and February 2016. Patients were included in the study prior to surgery, at the request of a surgeon with the aim of detecting multifocal, multi-centric and bilateral lesions. Demographic information was also collected from patients. The results for quantitative variables were expressed as mean and standard deviations, and for qualitative variables, were expressed as relative and absolute frequency. Chi-square test was used to compare the two methods. SPSS Ver.24 (IBM) software was used to analyze the data. Results: Thirty-nine patients were enrolled in the study. The mean age of patients in this study was 48.46±6.836. In mammography, 13 (33.3%) had Composition C and 26 (66.7%) had Composition D according to the type of Composition. In total, 25 patients (89.3%) had one lesion and 3 patients (10.7%) had more than two lesions. In MRM, all lesions observed were mass (54 masses). The number of lesions found in MRM was 27 patients with one lesion (58.9%), 6 patients with two lesions (20.5%) and 5 patients with three lesions (20.6%). MRM detected more lesions compared to mammography (p<0.0001). The value of Chi-square test with a degree of freedom and error level of 0.05 was 3.71 and p<0.0001 that showed a significant relationship between the number of MRM findings in comparison with mammography. Conclusion: The results of our study showed that two or more lesions and bilateral lesions in MRM were more than mammography in women with B Breast Composition C, D; the findings showed that MRM has a better ability to detect breast masses, and can affect the patient's surgical procedure. [ABSTRACT FROM AUTHOR]