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This study investigated the impact of Problematic Internet Use (PIU) on Iranian adolescents' Psychological Well-Being (PWB), focusing on the mediating roles of sleep quality and self-regulation. Data was collected from a sample of students (n = 228, girl = 197, boy = 31) aged 12 to 19 years. Participants completed four online questionnaires, including the PIU questionnaire, the Psychological Well-Being Scale (PWBS), the Pittsburgh Sleep Quality Index (PSQI), and the Short Self-Regulation Questionnaire (SSRQ). Results confirmed that while PIU was not directly effective on PWB, it was indirectly effective through the mediation of sleep quality and self-regulation. By gaining such understanding, we can devise interventions to enhance individuals' sleep quality and self-regulatory capacities, thereby improving their PWB.

This study strived to determine the effectiveness of integrative teaching of reading strategies and working memory on basic math and problem-solving skills. It is a quasi-experimental pretest-posttest study carried out on 50 second-graders from Chahashk Shandiz village in the academic year of 2020-2021 who were randomly selected by cluster sampling and randomly divided into experimental and control groups. The intervention was performed by cellphone software through virtual education in two steps. The experimental group underwent integrative training for 20 sessions, but the control group did not receive any intervention. Colored Progressive Matrices (1956) and a researcher-made story problem-solving and arithmetic skills test were used to collect data. Descriptive statistics (mean and standard deviation) and one-way multivariate analysis of covariance were used to analyze the data. The results showed that the integrative teaching of reading strategies and working memory enhanced the basic math skills, with an effect size of 0.67 in second-grade elementary students (P<0.001). According to the results, integrative teaching improved students' problem-solving skills but did not affect their skills in arithmetic operations. Therefore, second-grade elementary teachers can use this method to enhance their story problem-solving skills.

Background: Today, methods that enable students to benefit from online programs to the fullest and learn independently and self-directed are of critical importance. Many scales have been developed to measure self-directed learning in the physical classroom. This study was conducted to design and assess the psychometric properties of an instrument to assess learning process in a virtual environment. Materials and methods: A questionnaire for assessing s learning process in a virtual environment was developed following six steps. The process began with a systematic search for related articles. A qualitative study was then conducted to identify self-directed learning strategies and processes in virtual environments. The identified strategies were then compared with those from a literature review, and the scale items were developed accordingly. Expert validation, exploratory factor analysis, and reliability analysis were conducted to ensure questionnaire validity and reliability. This study included online postgraduate students from Iranian medical science universities in 2019. Results: The scale consisted of 5 factors and 44 items. In exploratory factor analysis, five subscales explained 90% of the total variance. Cronbach's alpha was 0.91 for the total scale. The interclass correlation coefficient between the test and retest was 0.77. Conclusion: A questionnaire designed to assess learning process in a virtual environment for postgraduate virtual students has reasonable psychometric properties, including reasonable internal reliability and construct validity.

Background: The purpose of this study was to evaluate the complexity of malocclusion and existing patterns in children with autism spectrum disorders (ASD) using the index of complexity, outcome and need (ICON). Methods: This cross-sectional study included children diagnosed with ASD, aged 9–15 years. A group of healthy children with the same demographic characteristics was randomly selected as the control group. Malocclusion was assessed according to ICON scoring protocol. The following parameters were recorded: dental aesthetics, upper arch crowding/spacing, presence of crossbite, anterior-vertical relationship (open and deep bite) and buccal segment anterior-posterior relationship. Finally, an overall ICON score was derived and reported for each patient. Descriptive analysis was performed for all investigated variables. Significance level was set at p < 0.05. Results: A total of 324 children, divided into ASD (162) and control (162) groups, comprised the study population. Our results demonstrated that the average overall ICON score was significantly higher in the ASD group compared to the control group (38.77 vs. 27.43, p < 0.001). ASD children also obtained significantly higher scores regarding the dental aesthetics component (3.84 vs 2.78, p < 0.001). Study groups were significantly different in terms of the prevalence of incisor overbite and open bite (p = 0.002 and p < 0.001, respectively). Patients in the ASD group showed a higher prevalence of Class II and Class III malocclusions (p < 0.001). Conclusion: ASD children obtained significantly higher overall ICON scores, indicating more complex and severe malocclusions. These children also exhibited a greater tendency towards Class II and III malocclusions. [ABSTRACT FROM AUTHOR]

This study was designed to study dual risk of MWFs and vibration according to exposure simulation of selected industry. Air samples of two types MWFs were evaluated according to NIOSH 5026. Vibration acceleration exposure was assessed based on the ISO 8041:2005 standard. Cell treatment of both MWF air samples and vibration as the same as dual exposure to MWF airborne and vibration was assessed. There is a potency of nitrosamine formation in airborne samples of ethylamine containing MWF, while heterocyclic including bore is found in airborne bore containing MWF. DNA breaks caused by boron-containing MWF were higher than nitrosamine air samples. Oxidative stress production and chronic inflammation were highlighted in the response to cell treatments. The risk of cell toxicity in machining workers was evaluated at a level lower than the occupational exposure limit for MWFs and vibration. [ABSTRACT FROM AUTHOR]

Introduction: Multiple sclerosis (MS) is a chronic inflammatory disease in which the immune system attacks the myelin sheath of the central nervous system (CNS). It has been proposed that autoimmune conditions may occur together and an individual's immune system may attack more than one system. Autoimmune thyroid disease is one of the most common comorbidities along with MS. Since thyroid hormones are crucial for normal brain function and remyelination, we aimed to determine the prevalence of thyroid dysfunction in a group of MS patients compared with healthy controls. Methods: This cross‐sectional study was conducted in medical clinics affiliated to Shiraz University of Medical Sciences, South of Iran. To prevent the effects of MS modifying drugs on thyroid function, we examined 73 newly diagnosed MS patients, which had not been treated yet, compared to 72 healthy individuals. Results: After measurement of the serum level of TSH, Anti TPO‐Ab, and Anti TG‐Ab, we found a significantly higher prevalence rate of abnormal TSH levels (high or low) in the MS group (p = 0.02). We also found a higher frequency of thyroid dysfunction in the female MS group (p = 0.01). However, there was no significant difference in the two other anti‐thyroid antibodies among the groups. Our results demonstrate a significant and positive linear relationship between age and TSH levels (R = 0.402; p < 0.001) and also age and Anti TPO‐Ab levels (R = 0.397; p < 0.001) among the MS population. Conclusion: We found a higher prevalence of TSH alteration among the MS population. Anti TPO‐Ab and Anti TG‐Ab levels did not differ among groups. These findings suggest that MS patients might be at an increased risk for thyroid dysfunction. However, further studies are required to determine the underlying cause. The linear relationship between age and TSH and Anti TPO‐Ab levels in MS patients suggest that there is an association between TSH dysfunction and age. [ABSTRACT FROM AUTHOR]

Background: Clinical education plays an essential role in shaping the nursing identity and is one of the central elements in the education of nursing students. Today, with the advancement of novel technologies, utilizing mobile phone-based technologies in the education of medical sciences is inevitable. Therefore, this study was conducted with the aim of investigating the impact of the urology educational application on nursing students' cognitive-functional criteria and satisfaction during the internship period. Methods: This experimental educational intervention study was conducted during nursing students' urology internship course at Shahid Beheshti School of Nursing and Midwifery in Rasht. The data collection tools included a demographic characteristics questionnaire, cognitive skills scale, functional skills scale, and satisfaction scale (Stokes, 2001). The data were analyzed using SPSS software version 16, and a significance level was set at 0.05. Results: Out of 48 studied students, 28 (58.3%) were males. The mean age of the students was 20.34 (SD = 1.51) years. In the application group, the mean of students' cognitive skills after the intervention significantly increased by 2.33 units (95% CI: 1.73 to 2.9) (t(23) = 7.97, P < 0.001, d = 1.626). By controlling the scores before the intervention, the adjusted mean score of cognitive skills in the application group was 0.56 units (95% CI: -0.16 to 1.28) higher than the traditional group; however, this difference was not statistically significant (F(1, 45) = 2.42, P = 0.127, η2p = 0.051). There was no statistically significant difference between the mean score of students' functional skills in traditional and application groups (t(46) = 0.63, P = 0.532, d = 0.184). The total mean score of satisfaction with education in the application group was 83.0 (SD: 10.7). According to the values ​​of the quartiles, 75% of the students scored higher than 75.9, 50% scored higher than 83.9, and 25% scored higher than 91.1. Conclusion: According to the results of this study, students' scores of functional and cognitive assessment and satisfaction with the application in urology clinical training were reported as favorable. Therefore, it is recommended that mobile phone-based technologies be used in students' clinical education and internships in combination with the traditional method. [ABSTRACT FROM AUTHOR]

Background: Interaction between researchers and policymakers is an essential factor to facilitate the evidence-informed policymaking. One of the effective ways to establish this relationship and promote evidence-informed policymaking is to employ people or organizations that can play the role of knowledge brokers. This study aims to analyze the communication network and interactions between researchers and policymakers in Iran's health sector and identify key people serving as academic knowledge brokers. Methods: This study was a survey research. Using a census approach, we administered a sociometric survey to faculty members in the health field in top ten Iranian medical universities to construct academic-policymaker network using social network analysis method. Network maps were generated using UCINET and NetDraw software. We used Indegree Centrality, Outdegree Centrality, and Betweenness Centrality indicators to determine knowledge brokers in the network. Results: The drawn network had a total of 188 nodes consisting of 94 university faculty members and 94 policymakers at three national, provincial, and university levels. The network comprised a total of 177 links, with 125 connecting to policymakers and 52 to peers. Of 56 faculty members, we identified four knowledge brokers. Six policymakers were identified as key policymakers in the network, too. Conclusions: It seems that the flow of knowledge produced by research in the health field in Iran is not accomplished well from the producers of research evidence to the users of knowledge. Therefore, it seems necessary to consider incentive and support mechanisms to strengthen the interaction between researchers and policymakers in Iran's health sector. [ABSTRACT FROM AUTHOR]

Objective According to the World Health Organization (WHO), more than 1 billion people (approximately 15% of world population) live with disability. Also, about half of these people lack access to healthcare facilities. Therefore, providing timely healthcare services, especially rehabilitation, is of great significance for these people. The goal of the study was to determine the objectives and policies in the field of rehabilitation in middle- and high-income countries and compare them with Iran. Materials & Methods Based on available databases, a comprehensive review of documents, papers, and books was performed in the field of rehabilitation related to high- and middle-income countries. Results Due to a lack of coordinated services, inappropriate access, unplanned distribution, unclear service delivery levels, neglect of health promotion and prevention levels, lack of a transparent referral system, unclear insurance system, and weak financial resources, the need for a national program with a service integration approach is strongly felt. The review of the rehabilitation programs and documents in other countries help us to design a conceptual framework of the rehabilitation service model, which is based on three principles: Removing barriers and developing access to healthcare services and programs; strengthening and developing rehabilitation using technology, community-based support, and rehabilitation services; and promoting comparable international data collection on disability and supporting research on disability and related rehabilitation services. Conclusion The national rehabilitation program, with a service integration approach, provides a good platform for fair access to rehabilitation services for all people with disability. In this program, the health system is the most important reference to meet these needs. Therefore, it is suggested that this program pursue three main objectives: Fair promotion of the healthcare services of rehabilitation for recipients, improving the response to the needs of rehabilitation service recipients, and reducing the financial and social risks of service recipients. [ABSTRACT FROM AUTHOR]

In the healthcare sector, organizational identity (OI) and commitment (OCO) are essential in ensuring quality nursing care. Therefore, the relationship between them has been empirically supported in several studies. However, little attention has been paid to how organizational culture (OCU) mediates the relationship between these two constructs. To fill this gap, this research was conducted. Data collected from nurses and paramedics working in Milad hospital, Iran, were examined first to determine the relationship between OI and OCO. Then, we investigated the role that OCU plays in mediating these relationships. The data was collected from 347 nurses and paramedics of Milad Hospital using a single-stage cluster sampling method. The collected data were then analyzed using a causal model. Based on the results of the data analysis, this study's model fits the data well. As a result of the path analysis, it was only membership that had a direct and significant relationship with OI among the three dimensions of OI, including membership, similarity, and loyalty. Additionally, the model determined that OCU mediates the influence of OI on OCO. The study's insights may be helpful for nursing executives and healthcare managers to create specific policies aimed at strengthening feelings of OI and creating a positive hospital OCU so that nurses and paramedics will have a greater sense of commitment in the long run. [ABSTRACT FROM AUTHOR]

Introduction: Substance use can be the source of various disabilities. The purpose of this study is to investigate and compare the disabilities caused by substance use. Material and methods: This is a descriptive-analytical cross-sectional study. The samples studied in this study were 400 people who referred to MMT centers in Hamadan, Iran. Centers were selected by cluster sampling method and samples within the cluster were selected by convenience sampling method. The instrument was the WHODAS2 standard questionnaire designed by the World Health Organization to assess disability. The extracted data were analyzed by SPSS20 software. Result: 64.8% of the participants were opium users, 24.5% amphetamine users and 10.8% were marijuana users. The results showed that age, gender, place of residence and type of substance use were significantly associated with the degree of disability and the highest rate of disability occurred in opium users (p ≤ .01). Conclusion: Different substances differ in the amount and type of disabilities they cause and this difference should be considered in the treatment of people with substance use disorder. [ABSTRACT FROM AUTHOR]

Goodwin's brush‐tailed mouse (Calomyscus elburzensis Goodwin, 1939) is a poorly known small rodent that occupies rocky habitats in Iran, Turkmenistan, Afghanistan, Pakistan, Azerbaijan, and Syria. Herein, a detailed description of the shape, size, and function of the postcranial skeleton of this species is presented for the first time. Trapping was carried out in eastern Iran between the years 2013 and 2015. Skeletal parts of 24 adult male specimens were removed using the papain digestion protocol, and several postcranial morphological characteristics and measurements were examined. We attempted to achieve a morpho‐functional characterization of Goodwin's brush‐tailed mouse and to match morphological specializations with previous information on the ecology, behavior, and phylogenetic inferences of this rodent. Goodwin's brush‐tailed mouse has extended transverse processes and long zygapophyses in the first five caudal vertebrae along with a good innervation of the caudal vertebrae, which has resulted in a well‐developed basal musculature of the tail. It has extended forelimb, long ilium, and short post‐acetabular part of the innominate bone, loose hip joint with high degree of lateral movement of the hindlimb, and long distal elements of the hindlimb. These features have resulted in fast terrestrial movements in open microhabitats, including climbing and jumping. Although superficial scratching of the ground is observed, the species is incapable of digging burrows. Evaluation of postcranial morphological characteristics and character states further indicated the basal radiation of the genus Calomyscus among other Muroidea. Findings constitute a source of information for morpho‐functional and phylogenetic comparisons between Calomyscidae and other mouse‐like muroids. Research Highlights: Postcranial morphological specializations of Calomyscus elburzensis were matched with information on its ecology and phylogeny.Findings constitute a data set for morpho‐functional and phylogenetic comparisons between Calomyscidae and other rodents. [ABSTRACT FROM AUTHOR]

Background: Having meaning in life is a protective factor for psychological well-being. Accurate assessment of this construct needs a valid and reliable tool. Purpose: This study aims to evaluate the psychometric properties of the Farsi version of the meaning of life questionnaire in patients with cancer. Method: In this cross-sectional study, after translating the questionnaire to Farsi, in a sample of 212 patients with cancer, feasibility, content and convergent validity, exploratory and confirmatory factor analysis, internal consistency, stability, and responsiveness were evaluated. Results: The results show that the content validity ratio of all ten items was greater than 0.49. Also, the modified Kappa coefficient of each item was greater than 0.6. The maximum likelihood exploratory factor analysis extracted one factor, which explains 76.13% of the total variance of the sample. Item nine was removed. The confirmatory factor analysis results show that the one-factor model had good fit indices. The Cronbach's alpha, McDonald's omega, composite reliability, MaxR, and intraclass correlation coefficient were 0.96, 0.96, 0.96, 0.96, and 0.98, respectively. The questionnaires had responsiveness and its response time was 3 s. Conclusion and policy summary: The nine-item Farsi version of the meaning of life questionnaire has good validity and reliability and responsiveness. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the antibiotic-susceptibility pattern of Klebsiella pneumoniae causing urinary tract infection (UTI) in two geographical regions of Iran and then compare it to the rest of Iran and other countries. Over a year, from winter 2014 to winter 2015, 80 cases of Klebsiella were isolated from 2584 urine samples and identified using biochemical and microbiological tests. The disk diffusion method was used to determine antibiotic susceptibility based on the standard protocols provided by the CLSIs. The results of this study were compared with several reports from Iran and other countries, before the COVID-19 pandemic from 2007 to 2018. Based on the results of the antibiotic susceptibility of 80 isolated K. pneumoniae, amikacin (AN), Meropenem (MEN), gentamicin (GM), and ciprofloxacin (CP) were identified as the most sensitive antibiotics with 77.5%, 77%, 75%, and 58.75% sensitivity, respectively. A comparison of 17 report results showed imipenem (IPM) is the most sensitive antibiotic against the K. pneumoniae isolates, with a sensitivity range of 85% -100%. Followed by amikacin (AN), which was reported as the first or second antibiotic or third or fourth antibiotic in less than 30% of the cases. CP was reported as a second or third option in 22% of the cases. This study evaluated the sensitivity pattern of K. pneumoniae to antibiotics, and the results show that it has the potential to be applied to further studies and related programs, including periodic screening, regional screening, and revision in therapeutic approaches. [ABSTRACT FROM AUTHOR]

Three ladybird (Coleoptera: Coccinellidae) species, Coccinella septempunctata L., C. undecimpunctata L. and Hippodamia variegata (Goeze), were recorded as hosts of Dinocampus coccinellae (Schrank, 1802) (Hymenoptera: Braconidae) in the Khuzestan and Kurdistan provinces of Iran. Coccinella undecimpunctata is a new host of this parasitoid in the country and both provinces are its new distribution records. The rates of emergence of D. coccinellae from field-collected C. septempunctata and H. variegata were very low (below 1%), while C. undecimpunctata was parasitized to a much higher degree (26.7%). [ABSTRACT FROM AUTHOR]

An important principle of forest management worldwide is the sustained conservancy of regional biodiversity. The aim of this study was to investigate the effects of climate and climate change on biodiversity in several uneven-aged, mixedwood stands in the world-heritage, Hyrcanian forest of northeastern Iran. The study involves the analysis of site-specific biodiversity records amassed from inventory plots distributed across three distinctive sub-regions of the Hyrcanian forest. In the current study, indices of species richness and evenness were assessed using both parametric and nonparametric techniques, i.e., generalized linear models (GLM) and artificial neural networks (ANN). Both methods employed physiographic, historical biometric and climatic data sourced from the three sub-regions as input to model development and validation. Results showed that ANN with R2-values of 0.68 and 0.57 was better skilled at predicting the indices of species richness and evenness than regression with GLM, yielding R2-values of 0.13 and 0.10. Climate and physiographic variables were determined as the more important explanatory variables in both models. As per climate scenarios, representative concentration pathways (RCP) 4.5 and 8.5, biodiversity was predicted to stay mostly unchanged by 2070. These results suggest that management and conservation decisions made today can help ease the potential, undesirable effects of future climate change. Understanding the future distribution of key Hyrcanian forest tree species is critical for effective conservation planning. [ABSTRACT FROM AUTHOR]

The present study was done to evaluate the prevalence of intestinal parasitic infections (IPIs) in patients with COVID-19 in health care centers (Imam Reza and Golestan hospitals), Tehran, capital of Iran. By designing a matched case-control study, 200 fecal samples were collected for each of the COVID-19 patients and healthy individuals. Nasopharyngeal/oropharyngeal swab samples were collected from all participants for the diagnosis of COVID-19. RNA extraction was performed, and then real time reverse-transcription polymerase chain reaction (rRT-PCR) assay was applied to detect viral RNA. Considering the lung complications, 25%> lung complications was detected in 49 patients, 25–49% in 42 patients, and 50%≤ in 109 patients. Fecal samples were examined using different parasitological techniques. After nested-PCR, sequencing was applied to identify Cryptosporidium spp. and microsporidia spp. A relatively lower prevalence of IPIs was detected among control group (7.5%), than in COVID-19 patients (13%), though not significant P = 0.13 . The most prevalent parasite among patients was Blastocystis sp. (6%). Also, 13.76% of IPIs were detected in inpatients with more than 50% lung complication. As well, a remarkably significant difference in IPIs was observed among diarrheic COVID-19 patients, in comparison with nondiarrheic patients P < 0.00001 . Moreover, the isolated sequences in the present study belonged to C. parvum subtype IIa and Enterocytozoon bieneusi genotypes D and Peru 8. In conclusion, more epidemiological and clinical research studies are needed to better understand the status and interaction of IPI in COVID-19 in Iran and other countries. [ABSTRACT FROM AUTHOR]

Background: Oral mucositis (OM), an acute inflammation of the oral cavity, is a common complication in patients undergoing invasive myeloblastic chemotherapy or radiation therapy. 5-fluorouracil (5-FU) is one of the most effective therapeutic drugs, but one of the common side effects of 5-FU administration is OM. Unfortunately, no suitable treatment has been found, so far to control its side effects. Studies showed that herbal medicine like Punica granatum var pleniflora (PGP) has medicinal properties such as anti-inflammatory and antibacterial and can be an alternative for the treatment of fungal infection. Accordingly, we decided to investigate the therapeutic effect of PGP in the treatment of OM caused by 5-FU in golden hamsters. Methods: Sixty male golden hamsters were divided into six main group. Chemotherapy with 5-FU at dose of 60 mg/kg was performed at a ten-day duration. Then, cheek pouches of the hamsters were scratched with an 18-gauge sterile needle to induce oral mucositis in animals. On the twelfth day, as a day of intensification of OM, treatment with PGP including topical gel with concentrations of 5% and 10% and oral administration of hydro-alcoholic extract with doses of 125 mg/kg and 250 mg/kg for three- and five-day therapeutic duration were separately started. Finally, samples of cheek pouches in hamsters were collected on 14th and 17th days and histopathologic score (HPS), malondialdehyde (MDA), and myeloperoxidase (MPO) levels were assayed. Results: A significant (p < 0.05) decrease in histopathologic score was observed in G10%−, P125-treated groups in comparison to the Ctrl group. Our data showed that treatment with G10% is more potent than P125-treated group. In contrast, histopathologic score in G10%, P125, and P250 treated groups demonstrated almost similar values On the 17th day. However, the levels of MDA and MPO in the treatment groups were enhanced compared with control group (p < 0.05). Conclusions: It is possible that PGP can play protective role in the healing of tissue damage caused by chemotherapy with 5-FU due to the presence of its natural compounds and antioxidant properties. [ABSTRACT FROM AUTHOR]

Background: There are various approaches in primary health care regarding the key role of nurses. This systematic review investigates the roles of nurses, as part of the family medicine team. Materials and Methods: All published articles related to the role of nurses in the family medicine team from January 2000 to March 2022 were the subjects of this study. The eligibility criteria included original articles published in English or Persian in the last two decades. International credible scholarly databases (PubMed, Scopus, Magiran, IranMedex, and SID) were searched using keywords and syntax. Some of the keywords included "Family Health Nurse," "Nurses in Primary Care," "Family Medicine," "Family Physician Care Program," "General Physician Program," "Role," and "Nurse." Data were extracted based on Sample, Phenomenon of Interest, Design, Evaluation, Research type (SPIDER) technique and reported based on the structure of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Of 147 identified publications by the search strategy, eight eligible empirical studies were included. The results showed that besides providing nursing care, nurses play vital roles in communication and teamwork, assessment, securing health services relevant to communities' needs, education, empowerment, clinical practice, health promotion, prevention, reflective research practice, and counseling. Conclusions: This study identified different roles nurses could play in providing primary health care. These findings are helpful for the replanning or reform of primary health care in countries, which aimed to expand the Family Physician Program (FPP) in their countries, including Iran. [ABSTRACT FROM AUTHOR]

Introduction Finding biomarkers for highly lethal cancers is a priority. Objective The current study was designed to understand the clinical significance of vascular endothelial growth factor (VEGF), latent membrane protein 1 (LMP1), and tumor necrosis factor-α (TNF-α) expression as the biomarkers, and evaluate their correlation with each other, in nasopharyngeal carcinoma (NPC) in the province of Guilan, North of Iran. Methods Gene expression was evaluated in 25 formalin-fixed paraffin-embedded (FFPE) blocks from cases of confirmed NPC and 20 FFPE samples of non-NPC by quantifying messenger ribonucleic acid (mRNA) and protein levels, using real-time polymerase chain reaction (PCR) and immunohistochemistry (IHC) methods, respectively. Furthermore, the correlations among the protein levels of different genes, along with the patients' demographic characteristics were assessed. Results Our findings on mRNA and protein levels demonstrated that the expression of the LMP1 gene in the NPC group was significantly elevated compared with that of the non-NPC group. In addition, the protein levels in the NPC group indicated a positive and significant correlation between LMP1 and VEGF expression. It was noted that both protein and mRNA levels showed no significant differences in the expression of TNF-α and VEGF genes between the NPC and control groups. Furthermore, there was no significant relationship between the expression of these proteins and the demographic characteristics of NPC patients. Conclusion Overall, a significant increase in LMP1 expression was observed in NPC patients, which may serve as a diagnostic biomarker for NPC. Also, LMP1 might be involved in NPC progression by inducing VEGF gene expression. [ABSTRACT FROM AUTHOR]

Aim: The current study purposed to evaluate the autologous platelet-rich plasma (PRP), and platelet-rich fibrin glue (PRFG) effect on the treatment of complex, and recalcitrant anal fistula (AF) which was not cured by several surgeries. Background: AF has remained one of difficult challenges for centuries. Surgery is the common treatment method for it, but the risk of fecal incontinence and recurrence is still a distressing complication for patients and surgeons. New procedures were published in the scientific literature, each with advantages and disadvantages. According to reports, an effective therapy option is the autologous fibrin glue that is rich in platelets. Methods: Autologous PRP and PRFG were prepared from 10 patients' own blood. The surgeon curetted the tract of anal fistula for the deepithelialisation till hemorrhage occurred; PRP was injected around the fistula into the tissue, and PRFG was interpositioned in the tract. Age, number of previous surgeries, complications, number of PRP and PRFG administrations, and duration of halting the discharge were among the information gathered. Patients were followed up between 10 months to 84 months after treatment. Results: No complications were observed during and after the injection. During the period of follow-up, AF leakage was stopped for 6 patients, but not for 4 patients. Conclusion: Since autologous PRP injection, and PRFG interposition is a safe, effective, and minimally invasive procedure for resistant AF to surgeries; it can be used, along with surgery to increase the healing rate of complex anal fistula. [ABSTRACT FROM AUTHOR]

Background: This study investigated the association between internalized stigma and hope, self-esteem, self-efficacy, and treatment adherence and explored the most influential and predictive factor of internalized stigma among patients with severe mental disorders. Materials and Methods: This correlational descriptive study was conducted on 257 outpatients diagnosed with severe mental illness according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) diagnostic criteria. The participants were seeking treatment at outpatient and affiliated clinics of Razi Hospital, Iran, from October 2018 to May 2019. We used a convenient sampling design. Internalized Stigma of Mental Illness scale, Dispositional Hope Scale, Rosenberg's Self-Esteem Scale, General Self-Efficacy Scale, and Drug Attitude Inventory were used to gather data. The data were analyzed using inferential statistics (Pearson correlation, coefficient logistic, and regression analyses) at a 0.05 significance level. Results: The mean (standard deviation) score of internalized stigma was 1.57 (0.49), and 58% of the participants reported moderate to high internalized stigma. A negative significant relationship was found between internalized stigma and hope (r = -0.55, p < 0.05), self-esteem (r = -0.66, p < 0.05), and self-efficacy (r = -0.64, p < 0.05). Treatment adherence was not found to be significantly associated with the internalized stigma. In the final regression model, self-esteem and self-efficacy significantly predicted internalized stigma. Conclusions: Given the crucial role of self-esteem and self-efficacy in predicting internalized stigma, nurses should devote special attention to these factors and use strategies to improve individuals' self-esteem and self-efficacy. [ABSTRACT FROM AUTHOR]

Background: Informal care can reduce hospitalization frequency and time, elevate bed turnover, and increase the health systems' capacity. This type of care has shown meaningful value in managing many cases through the COVID-19 pandemic. The present study aimed to identify determinants of monetary valuation of informal care and the burden of this care on the COVID-19 patients' caregivers. Methods: Through a cross-sectional phone survey from June to September 2021 in Sanandaj city, the west of Iran, COVID-19 patients and their caregivers (Each Group No. 425) were separately interviewed. A simple probabilistic sampling method was applied. Two questionnaires were developed and used after validation. Monetary valuation of informal caregivers was done using Willingness to pay (WTP) and willingness to accept (WTA). Double hurdle regressions were used to determine related variables to WTP/WTA. R software was used for the data analysis. Results: The total mean (Standard Deviation) of WTP and WTA were $12.02(28.73), $10.30(15.43) USD. Most respondents put a zero value on informal care by WTA (243(57.18%) and WTP [263 (61.88%)]. Caregivers' Employment, and being spouse/child of the care recipient increased the probability of reporting a positive value for WTP (p-value < 0.0001, p-value = 0.011 respectively) and WTA (p-value = 0.004, p-value < 0.0001 respectively). An increase in the number of caring days decreased the probability of reporting positive WTA (p-value = 0.001) and increased the mean of lnWTP (p-value = 0.044). Perceived difficulty in doing indoor activities and perceived difficulty in doing outdoor activities decreased lnWTA mean (p-value = 0.002) and lnWTP mean (p-value = 0.043) respectively. Conclusions: Increasing caregivers' self-efficacy and facilitating their involvement in the caring process could be facilitated through flexible work status, educational programs, and interventions on decreasing their burnout. [ABSTRACT FROM AUTHOR]

Background: Librarians need to provide innovative services to different target groups. Objectives: This study aimed to determine the innovation status in the central libraries of Iranian medical universities. Methods: This cross-sectional study was conducted in 2020. The study population consisted of 67 managers of the central libraries in Iranian medical universities. Data were collected using a researcher-made questionnaire whose validity was confirmed by experts; its reliability was also confirmed with an alpha coefficient of 0.98. The data analysis was performed with descriptive and inferential statistics using SPSS version 24 software. Results: The mean innovation score in the studied libraries was 3.5 ± 0.74 in the dimension of organizational innovation and 3.2 ± 0.73 in service innovation, both of which were relatively desirable. However, the innovation level in the technological dimension was 2.7 ± 0.54, which was a relatively unfavorable situation. There were no significant relationships between gender (P = 0.88, 0.16, 0.17), age (P = 0.287, 0.708, 0.981), education degree (P = 0.561, 0.943, 0.935), work experience (P = 0.284, 0.656, 0.782), and education level (P = 0.605, 0.122, 0.033) and the types of innovation in medical libraries. Conclusions: In the digital era, libraries need to focus on innovation, redefine their plans, do strategic planning to change their roles, and take practical steps to provide services for their users' needs. [ABSTRACT FROM AUTHOR]

This study aims to explore the perceptions of nurses providing care to coronavirus disease 2019 (COVID-19) patients about barriers to teamwork. The qualitative study was carried out using a content analysis method. Individual and semi-structured interviews were conducted with 28 nurses in Iran. Conventional content analysis was used to categorize the data. The barriers to teamwork in caring for COVID-19 patients were divided into two categories including individual problems and organizational challenges. Individual problems were subcategorized into inadequate education, lack of motivation, inexperience, and misconceptions. Organizational challenges were subdivided into lack of organizational support, poor organizational communication, and inadequate infrastructure. The results of this study highlighted barriers that led to poor teamwork in caring for these patients. These results can be employed to develop a model to eliminate or reduce barriers such as individual problems and organizational challenges of caring for patients with COVID-19. [ABSTRACT FROM AUTHOR]

Aim: Little has been studied about the transition from initial smoking experimentation to future regular smoking in adolescents. We therefore aimed to describe the stages of the transition to smoking process in adolescents using growth mixture models (GMMs). Subject and methods: In this two-phase cohort study, a representative sample of 4903 10th-grade students was assessed using multistage sampling in Tabriz, Iran. The main outcomes comprising smoking status, intention to start smoking, and smoking during the past week/month, were collected in addition to the predictors, using valid and reliable instruments. The optimal number of classes was determined, and GMMs were conducted with covariates. Results: Decisively, GMMs emerged as a three-class optimal model comprising "Smokers and intending smokers" (5.5%), "Occasional smokers" (17.7%), and "Non-smokers" (76.8%). GMMs lead in significant intercepts (range over 1.3 to 37.8) and significant and positive slopes (range over 0.32 to 1.44) for the change in outcomes (all p < 0.05). Higher age, being male, higher socio-economic status, having a smoker friend, having a smoker in the family, substance abuse, and self-injury, higher attitude toward smoking, and general risk-taking behavior were directly related to a positive change in outcomes (all p < 0.05). Conclusions: The GMMs, highlighted two substantial initiations and transitions through smoking stages in adolescents with effective and directed programs, and second, the importance of implementing educational campaigns, public-awareness initiatives, and targeted interventions in the future. [ABSTRACT FROM AUTHOR]

The family physician program (FPP) is one of the most significant health care reforms in Iran; however, many studies showed that this program has not been able to achieve its intended objectives because of a variety of challenges. This program, despite the existing challenges, is going to be expanded across the country. To improve the likelihood of its success, identification of the structural and infrastructural challenges is necessary. This systematic review was conducted to assess the structural and infrastructural challenges of FPP in Iran. This systematic review of the literature was conducted in order to investigate the infrastructure and structure needs of the current program in Iran. All published articles related to the FPP in Iran were the subject of this study. The eligibility criteria included original articles, reviews, or case studies published in English or Persian during 2011-2021 related to the challenges in the referral system of FPP in Iran. Data were extracted based on Sample, Phenomenon of Interest, Design, Evaluation, Research type technique and were reported based on the structure of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. International credible scholarly databases were searched. The search strategy was defined based on keywords and the search syntax. This study identified different challenges of the referral system in the areas associated with legal structure, administration, and social structure. The identified challenges in this program should be addressed in order to ensure that this program will lead to improved quality of care and equity in Iran health care system. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to estimate the effect of potential risk factors on survival of human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS) patients using censored quintile regression model. Material and methods: We used a dataset from a (registry-based) retrospective cohort study conducted in Tehran (from April, 2004 to March, 2018). Demographic information, such as age, sex, marital status, and educational level as well as behavioral information, including being-in-prison, drug/alcohol abuse and smoking, antiretroviral therapy, co-infection with tuberculosis (TB), and CD4+ cell count, were investigated as potential risk factors for AIDS progression. Censored quintile regression was used to estimate and investigate these factors for AIDS progression. Results: Mean age of patients was 33.93 years. Time to progression ranged from 0.01 to 223.17 months, and mean of time to progression was 40.55 months. A total of 1,249 (50.5%) patients experienced an event by end of the study. Impact of age, gender, prison, being addicted, being infected with tuberculosis, and using highly active antiretroviral therapy (HAART) were significant for most of quintiles (p < 0.05). Conclusions: It was shown that age, being prisoned, TB infection, and HAART were significantly associated with a lower time in AIDS progression. Censored quintile regression could be an appropriate choice for considering time-varying effects and easy interpretation of regression coefficients in analyzing AIDS progression data. [ABSTRACT FROM AUTHOR]

The contamination of milk and its products with heavy metals has toxic and dangerous effects on human health. This study aimed to determine the heavy metal concentration and health risk assessment resulting from them in four different brands of Pasteurized milk consumed in Gorgan city, Iran. This study was performed during three seasons (summer, autumn and winter). Sixty different samples of pasteurized milk of four common brands were selected and analysed. Samples were digested in the laboratory by using nitric acid method digestion, and the heavy metal concentration was measured by using the linear regression based on the height of the peaks of the voltammograms. Also, health risk assessment was analysed by Oracle® Crystal Ball. According to the results, the overall mean (n = 60) concentration of Pb, Cd, Cu and Zn in all of the analysed milk samples was 0.02, 0.023, 0.97 and 4.31 µg/g, respectively. Based on these results, about 67% had Pb content lower than the codex limits, almost 70% of all milk samples had Cd content higher than the permissible limit, and Cu concentration in all milk samples was under the mentioned permissible limits. Zn concentrations in all samples were exceeded the permissible limits. HRI values in adults and children via consumption of pasteurized milk in all of the analysed samples were within the safe limits (HRI < 1). Based on these findings, monitoring of contaminants in milk and other dairy products prevented the probably side effects of these heavy metals on human health. [ABSTRACT FROM AUTHOR]

Objective: Nurses are considered key members to respond to incidents and disasters. As many patients are hospitalized during the coronavirus disease (COVID-19) pandemic, and nurses are directly in contact with these patients; their preparedness enables them to respond to this situation more effectively and protects their health. Therefore, the present study aimed to design and validate a questionnaire to measure the nurses' preparedness in response to COVID-19 in Iran in 2020. Methods: This study was a mixed research aiming to develop and validate a psychometric research instrument in 2020. Based on the review of the literature regarding COVID-19 and other viral respiratory infections, the items were extracted, rewritten, and validated. In the quantitative phase, the validity of the questionnaire was evaluated in terms of face, content, and construct validity, and its reliability was evaluated based on internal consistency and stability (Cronbach's alpha and Intra-class Correlation Coefficient [ICC]). To fill out the questionnaire, the nurses were selected by random sampling. Data analysis was done by the SPSS software, version 23 (IBM Corp, Armonk, NY). Results: The designed questionnaire included 9 dimensions and 50 items. The dimensions included (1) Incident Command System (ICS); (2) risk assessment and management; (3) information and communication management; (4) psychological approaches; (5) personal protective equipment; (6) prevention of contamination, isolation, and quarantine; (7) education and training; (8) patient management; and (9) features of the new coronavirus. The content and face validity of the questionnaire were approved by the specialists and experts of nursing and health in disasters and emergencies. The content validity ratio was > 0.7 for all items. The content validity index was also approved for all items. The Cronbach's alpha coefficient and ICC were respectively 0.71 and 0.72 for the total questionnaire. The total score was determined based on 5 ranges, including 50–89 (very low preparedness), 90–129 (low preparedness), 130–170 (medium-level preparedness), 171–210 (high preparedness), and 211–250 (very high preparedness). Conclusion: Nurses' preparedness to respond to this pandemic requires multilateral measures. Measuring the nurses' preparedness can clarify the challenges in hospital measures taken to respond to this crisis. Evaluating the nurses, determining the challenges and priorities, and finding solutions to resolve them can improve the nurses' performance in providing health care services. Preparation of nurses during pandemics can reduce the damages to this group and maximize their efforts to protect the patients. Thus, health planners and policy-makers should try to promote the nurses' awareness and preparedness. [ABSTRACT FROM AUTHOR]

Livestock husbandry exerts major pressures on wildlife across the world. Large carnivores are particularly at risk because they are often killed by pastoralists as a preventive or precautionary response to livestock depredation. Minimizing the overlap between pastures and carnivore habitat can thus be a conservation strategy, but it remains often unclear which pastures should be targeted to maximize conservation benefits given a limited budget. We addressed this question for the last viable population of the Asiatic cheetah (Acinonyx jubatus venaticus) in northeastern Iran. By combining species distribution modeling with a spatial prioritization framework, we aimed to identify where grazing right buyouts should take place to reduce cheetah killing by herders and their dogs. We assessed the Asiatic cheetah habitat using species distribution models, highlighting large, contiguous areas that overlap with livestock pastures (5792 km2, equaling 72% of the total predicted suitable habitat). Subsequently, we used data on the number and distribution of livestock (~47,000 animals in 80 pastures) and applied a spatial prioritization method to identify pastures for grazing right buyouts for a range of budget scenarios (US$100,000–600,000). Pastures selected had a high level of irreplaceability and were generally stable across budget scenarios. Our results provide a novel approach to minimize encounter rates between cheetah and livestock, and thus the mortality risk, for one of the world's most endangered felids and highlight the potential of spatial prioritization as a tool to devise urgent conservation actions. [ABSTRACT FROM AUTHOR]

Objectives: Quantitative ultrasound (QUS) is a bone densitometry method that is less expensive and more portable than DXA. It is also noninvasive. QUS parameters include speed of sound (SOS), broad band ultrasound attenuation (BUA), and stiffness index (SI). This study defined normal values of QUS parameters in Iranian men and women. Methods: QUS of heels measured in 258 Iranian men and women, aged 20–76 y/o. They were participants of Iranian Multicenter Osteoporosis study (IMOS), selected by randomized sampling. QUS device was an Achilles+ (GE-Lunar) device. Results: Percentiles of SI (2.5%, 50%, and 97.5%) determined. We found a good agreement between the Iranian reference values and western reference (used by device) value in defining normal and osteoporotic people (κ = 0.875). Conclusion: Results from this study suggest that QUS of the heel may be a good method for diagnosis of low bone mass in different regions. [ABSTRACT FROM AUTHOR]

Background/purpose: Due to the importance of social support in pregnant women, especially those with gestational diabetes that cause anxiety and stress in them and requires effective and enough attention, this study aims to assess perceived social support of pregnant women with gestational diabetes in western Iran compared to healthy controls and its relationship with their perceived anxiety. Methods: This is a descriptive/analytical study with a cross-sectional design conducted on 180 pregnant women with gestational diabetes (n = 89) and without gestational diabetes (n = 91) referred to the obstetrics and gynecology clinics of two hospitals (Asalian and Shahid Rahimi) in Khorramabad, western Iran. Data collection tools were a demographic checklist, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Beck Anxiety Inventory (BAI). Collected data were analyzed in SPSS v.20 software using chi square test, independent t-test, one-way ANOVA, and Pearson correlation test. Results: The difference between the two groups was significant in terms of perceived support from family (p = 0.001), perceived support from friends (p = 0.006), and anxiety (p = 0.047). Pearson correlation test results showed a significant negative relationship between the scores of MSPSS and BAI in patients (r= -0.329, p = 0.001) and controls (r=-0.204, p = 0.006). There was a significant difference in the MSPSS score among diabetic women in terms of having fetal macrosomia (p = 0.005), occupation (p = 0.003), education (p = 0.001), and frequency of pregnancy (p = 0.010). Conclusions: The perceived social support level is higher in diabetic pregnant women compared to healthy peers in western Iran. Improvement of social support from family and friends can reduce the anxiety of pregnant women with/without diabetes. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to develop a framework for nursing managers to participate in the health policy‐making process. Background: Nursing managers must be involved in the health policy process to provide appropriate health services, focus on nursing professional excellence, and improve the performance of the health system. Methods: This multimethod research was based on the Delphi study and experts' panel. Faculty members of the nursing, health policy, health services management, and nursing managers working at hospitals were selected via purposive sampling. The data collection tool was a demographic form and an open‐ended questionnaire in the first round and a structured questionnaire in the next round. In the two rounds of Delphi, experts discussed and rated items of nursing managers' participation framework in the health policy‐making process. At the expert panel session, the framework was finalized with a 12‐part checklist. The data were analysed quantitatively using SPSS software version 22. Results: A total of 28 items were entered into the Delphi study. Experts who met the inclusion criteria responded to rounds 1 (n = 20) and 2 (n = 16). Following the two rounds of the Delphi study, 27 items were selected and discussed by experts using a 12‐part checklist related to the framework. The final participation framework was divided into five sections: Barriers, facilitators, advantages, disadvantages, and factors affecting the participation of nursing managers in the health policy‐making process. Conclusion: In our findings, the relationship between the components of the framework and policy cycle was shown, which should be considered to lay the groundwork for participation. This can lead to health promotion, accountability, and financial participation in the health system, which can improve the proactive involvement of nursing managers in the health policy‐making process. Implications for Nursing Management: The proposed framework can be utilized across the spectrum of nursing, including practice, leadership, and education to enhance the participation of nursing managers in health policy activity. [ABSTRACT FROM AUTHOR]

Climate change has significant effects on forest ecosystems around the world. Since tree diameter increment determines forest volume increment and ultimately forest production, an accurate estimate of this variable under future climate change is of great importance for sustainable forest management. In this study, we modeled tree diameter increment under the effects of current and expected future climate change, using multilayer perceptron (MLP) artificial neural networks and linear mixed-effect model in two sites of the Hyrcanian Forest, northern Iran. Using 573 monitoring fixed-area (0.1 ha) plots, we measured and calculated biotic and abiotic factors (i.e., diameter at breast height (DBH), basal area in the largest trees (BAL), basal area (BA), elevation, aspect, slope, precipitation, and temperature). We investigated the effect of climate change in the year 2070 under two reference scenarios; RCP 4.5 (an intermediate scenario) and RCP 8.5 (an extreme scenario) due to the uncertainty caused by the general circulation models. According to the scenarios of climate change, the amount of annual precipitation and temperature during the study period will increase by 12.18 mm and 1.77 °C, respectively. Further, the results showed that the impact of predicted climate change was not very noticeable and the growth at the end of the period decreased by only about 7% annually. The effect of precipitation and temperature on the growth rate, in fact, neutralize each other, and therefore, the growth rate does not change significantly at the end of the period compared to the beginning. Based on the models' predictions, the MLP model performed better compared to the linear mixed-effect model in predicting tree diameter increment. [ABSTRACT FROM AUTHOR]

It has been postulated that a palliative approach in psychiatric ward has the potential to increase the quality of care for people with severe mental illness (SMI). This study aimed to explain nurses' perception about barriers to provision of palliative care for people with SMI. In this qualitative content analysis study, semi-structured interviews have been conducted with 26 Iranian nurses. Two categories and four subcategories were formed. The categories included poor organizational and professional infrastructure, and inadequate patient/family follow-up system. The first category includes lack of specialists who provide palliative care, lack of palliative wards, and lack of teamwork. The second category contained erroneous cultural beliefs and lack of attention to the role of family. The society must deal with the cultural taboos associated with mental illness through cultural-based interventions. Furthermore, attention should be paid to the role of families in palliative care. The health system should try to build relevant palliative care units to facilitate the provision of it for people with SMI. [ABSTRACT FROM AUTHOR]

Background: Accurate information on the cost determinants in the COVID-19 patients could provide policymakers a valuable planning tool for dealing with the future COVID-19 crises especially in the health systems with limited resources. Objectives: This study aimed to determine the factors affecting direct medical cost of COVID-19 patients in Hamadan, the west of Iran. Methods: This study considered 909 confirmed COVID-19 patients with positive real-time reverse-transcriptase polymerase-chain-reaction test which were hospitalized from 1 March to 31 January 2021 in Farshchian (Sina) hospital in Hamadan, Iran. A checklist was utilized to assess the relationship of demographic characteristics, clinical presentation, medical laboratory findings and the length of hospitalization to the direct hospitalization costs in two groups of patients (patients with hospitalization ≤ 9 days and > 9 days). Statistical analysis was performed using chi-square, median test and multivariable quantile regression model at 0.05 significance levels with Stata 14 software program. Results: The median cost of hospitalization in patients was totally 134.48 dollars (Range: 19.19–2397.54) and respectively 95.87 (Range: 19.19–856.63) and 507.30 dollars (Range: 68.94–2397.54) in patients with hospitalization ≤ 9 days and > 9 days. The adjusted estimates presented that in patients with 9 or less hospitalization days history of cardiovascular disease, wheezing pulmonary lung, SPO2 lower than 90%, positive CRP, LDH higher than 942 U/L, NA lower than 136 mEq/L, lymphosite lower than 20% and patients with ICU experience had significantly positive relationship to the median of cost. Moreover, in patients with more than 9 hospitalization days, history of cardiovascular disease and ICU experience was statistically positive association and age older than 60 years and WBC lower than 4.5 mg/dL had statistically negative relationship to the median of hospitalization cost. Conclusion: As the length of hospital stay, which can be associated with the severity of the disease, increases, health systems become more vulnerable in terms of resource utilization, which in turn can challenge their responsiveness and readiness to meet the specialized treatment needs of individuals. [ABSTRACT FROM AUTHOR]

This study was carried out in order to determine the cost and benefit of investment, cost price, margin safety ratio, gross margin, benefit-cost ratio, and economic value of the wheat seed losses in processing lines of domestic systems of Ar-Mashin, Arvin-Sanat, Ramsanat Bhareh, and Azaran Boojar lines, located in Fars, Khorasan Razavi, Khouzestan and Golestan provinces, respectively in 2018. In this case, profitability analysis and engineering economic indicators were considered to achieve the research objectives. According to results, the average cost price of wheat seed (per kg) in target processing lines and provinces was estimated to be 19633.9 Iranian Rials, which was lower than selling price in most of the provinces. Average gross margins for processing lines in Jovein Cultivation and Industry, Fars Thousand Khoosheh Talayehdaran, Amiran Zagros Taha, Army Sample, Sabz Dasht Sorkheh, and Razmandegan Companies in target provinces were positive and was 11.2 billion Iranian Rials, but, this gross margins in Marvdasht Rural Cooperative Company, Rural Cooperative Company of Gonbad, and Zarrin Daneh Benvar Company in Khouzestan were negative. Average benefit-cost ratio in domestic processing lines was 1.05 during the analysis period. Also, average useful waste separated from the seed processing line was 20.2%, and the value of lost seeds was 958.6 million Iranian Rials. Therefore, it is recommended that profitable companies continue their activities by increasing the amount of purchased inbound seeds to minimize losses and receive positive economic benefits. [ABSTRACT FROM AUTHOR]

Groundwater resources play a crucial role in supplying water for domestic, industrial, and agricultural use. In this study ACCESS-CM2, HadGEM3-GC31-LL, and NESM3 were selected for validation from Coupled Model Intercomparison Project Phase 6 (CMIP6). In the following, the feedforward neural network was employed to predict monthly groundwater level (GWL) based on the emission scenarios of the sixth IPCC report (SSP2-4.5 and SSp5-8.5) for the next two decades (2021–2040) in the Sari-Neka coastal aquifer near the Caspian Sea, Iran. In this regard, the monthly maximum and minimum temperature, precipitation, and water table of previous month from four piezometers from 2000 to 2019 were used as input variables to forecast GWL. The evaluation of the three GCM models demonstrated that the ACCESS-CM2 provided the best values of the R2 and RMSE with observation parameters. The results of r, R2, RMSE, and MAE were evaluated for the model and indicated good performance of the model. The results also illustrated that under such mentioned scenarios, the mean monthly temperature would rise approximately from 0.1–1.2 °C. In addition, the mean monthly precipitation is likely to witness changes from -10% to 78% in the next two decades. As a result, this seems to lead to improvement and recharge of groundwater level for the near future. The results can help managers and policymakers to identify adaptation strategies more precisely for basins with similar climates. [ABSTRACT FROM AUTHOR]

Natural resources development cooperatives (NRDCs) are leading enterprises that develop sustainable community‐based solutions. Basically, such cooperatives attempt to engage beneficiaries in environmental conservation through collective action. However, there exist remarkable shortcomings in administering these types of cooperatives. This paper aims to investigate beneficiaries' willingness to participate and invest in NRDCs based on three educational, economic, and social sections, each represented by their corresponding components, which represent the variables (sub‐factors) of each section. The current research was performed using a descriptive‐survey approach. Semi‐structured interviews were conducted with 63 cooperatives' board members located in Ardabil Province in Iran. Results discovered that three variables of information, participation acceptance rate and top‐down planning from educational factors alongside those of conservation effectiveness and projected outlook from the economic factor significantly affect participation levels in NRDCs. Similarly, the lack of rangeland ownership, cooperatives' limited problem‐solving capabilities, and concerns about environmental conservation of formerly demolished lands, all components of the social section investigated in this study, highly influenced beneficiaries' participation in cooperatives. Correlation coefficient analysis between the efficient factors showed that education levels have no significant relationship with the two remaining factors; however, the economic and social factors positively and significantly (p < 0.01) relate to beneficiaries' participation level. Nonparametric correlation analysis determined that variables from the economic factor analysis, such as the financial capital size, awareness levels, indigenous culture, people's experiences interacting with the administrative bodies of NRDCs, the state‐run economy, and the lack of support for beneficiaries by cooperatives from the social factor analysis each have independent and distinct relationships that affect participation in cooperatives. However, from the educational factor analysis, all variables were influenced reciprocally and were of inferior importance to participation in NRDCs. [ABSTRACT FROM AUTHOR]

Birds of prey feed mainly on small vertebrates and regurgitate indigestible remains, such as hair and bones of their prey, as pellet. Hence, the analysis of pellets provides valuable information on the distribution of the prey species. In this paper, we used elements of the postcranial skeleton for the identification of gerbilline rodents in pellets of birds of prey in Iran for the first time. These pellets were collected during several field campaigns in 11 regions of North, Razavi, and South Khorasan provinces (Iran), and supplemented with museum data from 13 regions in Razavi Khorasan, Golestan, and Chaharmahal and Bakhtiari provinces (Iran). A total of 320 rodent individuals from 102 different pellets were identified, of which 44 (13%) rodent specimens belong to Gerbillinae. The gerbilline species Meriones crassus, M. zarudnyi and Tatera indica were recognized based on diagnostic traits of their postcranium. Identification based on postcranial traits was confirmed by skull and tooth identifications. Using pellet remains, the record of Zarudny's jird (M. zarudnyi) expanded the distribution range of the species. We also provided some notes on the shape and size of the pellets of birds of prey. Further studies are necessary to evaluate the role of postcranial elements in identification of rodents. [ABSTRACT FROM AUTHOR]

The current study aims at presenting a model to investigate the feature selection of health services website and its effect on increasing the role of Myocardial Infarction prediction and online health marketing through the case study of the Shahid Rajaee Heart Specialized Hospital, Iran. Considering research objectives, this study is a practical research and regarding the data collection method, it is a descriptive-survey one. The statistical population of this study included all clients of Shahid Rajaee Heart Specialized Hospital. Due to the unlimited and unavailability of the sample, the Cochran formula was used to determine the sample size and 384 people were selected. A questionnaire was distributed among them in a convenient way. Finally, all research hypotheses were confirmed; results showed that visual aesthetics has the most and user friendliness least effect on participation of heart diseases, respectively. In addition, visual aesthetics is an effective and direct stimulator for health marketing on the health services website. Finally, there are some suggestions and solutions to improve and enhance the role of Myocardial Infarction prediction and health marketing in the mentioned hospital. [ABSTRACT FROM AUTHOR]

Poaching is driving many species toward extinction, and as a result, lowering poaching pressure is a conservation priority. This requires understanding where poaching pressure is high and which factors determine these spatial patterns. However, the cryptic and illegal nature of poaching makes this difficult. Ranger patrol data, typically recorded in protected area logbooks, contain information on patrolling efforts and poaching detection and should thus provide opportunities for a better understanding of poaching pressure. However, these data are seldom analyzed and rarely used to inform adaptive management strategies. We developed a novel approach to making use of analog logbook records to map poaching pressure and to test environmental criminology and predator–prey relationship hypotheses explaining poaching patterns. We showcase this approach for Golestan National Park in Iran, where poaching has substantially depleted ungulate populations. We digitized data from >4800 ranger patrols from 2014 to 2016 and used an occupancy modeling framework to relate poaching to (1) accessibility, (2) law enforcement, and (3) prey availability factors. Based on predicted poaching pressure and patrolling intensity, we provide suggestions for future patrol allocation strategies. Our results revealed a low probability (12%) of poacher detection during patrols. Poaching distribution was best explained by prey availability, indicating that poachers target areas with high concentrations of ungulates. Poaching pressure was estimated to be high (>0.49) in 39% of our study area. To alleviate poaching pressure, we recommend ramping up patrolling intensity in 12% of the national park, which could be achievable by reducing excess patrols in about 20% of the park. However, our results suggest that for 27% of the park, it is necessary to improve patrolling quality to increase detection probability of poaching, for example, by closing temporal patrolling gaps or expanding informant networks. Our approach illustrates that analog ranger logbooks are an untapped resource for evidence‐based and adaptive planning of protected area management. Using this wealth of data can open up new avenues to better understand poaching and its determinants, to expand effectiveness assessments to the past, and, more generally, to allow for strategic conservation planning in protected areas. [ABSTRACT FROM AUTHOR]

Background. Given the current prevalence of COVID-19, the World Health Organization has ordered the implementation of health protocols and social distancing, as well as home quarantine as a way to control and manage the disease. Athletes' physical activity has been affected due to quarantine conditions, so this research was done to evaluate the physical activity of amateur athletes of Tehran National Gas Company in an attempt to provide a solution to maintain physical fitness. Methods. This study was a descriptive-survey research and the data collection tool utilized in this study was a researcher-made questionnaire consisting of 15 questions. The validity and reliability of the questionnaire were checked by experts and provided online questionnaire by the google form software and was available to individuals. The variables examined in the questionnaire were: current status of athletes physical fitness, relationship with the coach, place of residence, physical activity at home, athletes' feelings, training programs, level of family support for Athletes' sports activity, number and duration of training sessions, training intensity, and diet. The statistical population of this study was 100 people. The sample size was determined based on Morgan table, and 70 people were finally selected through easy sampling method and entered the study. Results. The results showed that most athletes were in the age range of 51-60 years. Most of the participants were active in the field of mountaineering. The majority of participants in the study had moderate physical fitness compared to the pre-quarantine period. Conclusion. According to the findings of this study, most athletes in this study had a moderate level of physical fitness. The study suggests that we increase the intensity of physical activities under supervision of coaches to maintain the fitness and increase the health and immunity. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effectiveness of an intervention called 'Organ donation, Life donation' on increasing the number of signed donor cards among employees. A randomized controlled trial study was conducted in Hamadan, Iran, among employees of two‐branch offices from February to July 2019. We randomly assigned 14 two‐branch offices (n = 324 participants) to the multi‐component intervention (i.e., providing training and materials, engaging participants' families and providing immediate opportunity to register for organ donation) or control groups. We used the Extended Organ Donation Model to guide the intervention development. Data were collected using a 46‐item self‐administered questionnaire at pre‐test, 1‐month follow‐up and 6‐month follow‐up. Descriptive statistics, Chi‐square test and analysis of variance (ANOVA) change score analyses were used to describe studied variables and investigate changes in outcome variables (i.e., signed donor card and constructs of Extended Organ Donation Model. A higher proportion of the participants in the intervention group signed a donor card than the control group (73.2% vs. 17.9%, respectively). After follow‐ups, the two groups had statistically significant differences in knowledge, perceived behavioural control, anticipated regret, descriptive norms, non‐cognitive beliefs, Islamic beliefs and intention. This study provides evidence of the effectiveness of a brief theory‐based intervention combining different strategies to increase the registration rate in workplaces. It appears that using a multi‐component intervention and taking into account cultural and religious contexts will encourage people to sign donor cards in different communities. [ABSTRACT FROM AUTHOR]

Background. Stachys L. (Lamiaceae) includes more than 300 annual or perennial species growing in temperate regions of Southern Africa, the Mediterranean, America, and Asia. Stachys pilifera Benth (S. pilifera), also known as Marzeh Kuhi, is an endemic species from Iran. It is found in the mountainous habitats of the Zagros area. It has various traditional uses, and the phytochemical ingredients and some biological activities of this species have been examined in previous studies. Methods. PubMed, Science Direct, Google Scholar, Scopus, and Science Web databases were used to gather the data. The purpose of this review is to consolidate the scattered knowledge reported in the literature about botany, traditional uses, phytochemistry, pharmacological properties, and safety of S. pilifera and suggest its potential medicinal properties. Key Findings. In traditional Iranian medicine, S. pilifera manages various illnesses, such as rheumatoid arthritis, common cold, infections, asthma, and tussive. More than 30 compounds have been identified in S. pilifera essential oil. The compounds found in S. pilifera are phenolic compounds, monoterpenes, sesquiterpenes, flavonoids, alkaloids, and terpenoids, which have various properties such as antioxidant, nephroprotective, anti-inflammatory, antimicrobial, hepatoprotective, and anticancer properties. Conclusions. The literature reveals that S. pilifera is an essential source of bioactive phytochemicals and illustrates the unknown area of this plant for new investigations. Moreover, we recommend that future research focus on toxicology and quality control studies for S. pilifera to fill the knowledge gap and provide theoretical support for the plant's possible functional and clinical uses. [ABSTRACT FROM AUTHOR]

Background. Quality of sleep and stress level can affect the health, capacity of learning, and academic performance of the students. This study aimed to investigate the association between stress and sleep quality with academic performance among undergraduate clinical dental students in Shiraz, Iran. Methods. This cross-sectional study was conducted during the second semester of the academic year 2020–2021 among clinical dental students at Shiraz Dental School, Iran. A total of 138 students completed Pittsburgh Sleep Quality Index (PSQI) and dental environment stress (DES) questionnaire. The grade point averages (GPAs) of the previous terms of the participants were also collected. Data analysis was performed using Kolmogorov–Smirnov test, the one-way ANOVA, post hoc Duncan's test, nonparametric Kruskal–Wallis H test, Wilcoxon–Mann–Whitney test, and the chi-squared test. The p values of less than 0.05 were considered statistically significant. Results. Clinical dental students participated in this study experienced moderate levels of stress and poor sleep quality. Mean total DES and PSGI scores did not differ by sex, year of study, marital status, and place of residence (p values >0.05). Most of the students (52.9%) had moderate GPAs. A significant relationship was observed between sex and GPA as well as between place of residence and GPA (p values <0.05). No significant differences were found between DES total score or PSQI score and GPA categories (p values >0.05). A significant direct relationship between DES total score and PSQI score was observed (p < 0.05). Conclusion. Dental undergraduates in Shiraz, Iran, experienced moderate levels of stress and poor sleep quality. The results showed no significant difference between sleep quality or DES and academic achievement. However, a significant direct correlation was observed between sleep quality and dental environment stress. [ABSTRACT FROM AUTHOR]

The overall objective of this study was to investigate urban infill development policies as a good solution to counteract urban sprawl and protect the peri-urban area of Ardabil in Northwestern Iran. In this context, we used a mixed methodology (two quantitative methods). Landsat imagery, including a patchy Landsat ETM+ for the year 2000 and a Landsat 8 for the year 2020, was used to map and assess land use to investigate sprawl and land-use change, and ArcGIS was used to investigate the potential for infill development in this city. The results show that between 2000 and 2020, 967 hectares of peri-urban land was lost to urban expansion. CA-Markov projections also showed that 452 hectares will be lost by 2030. The assessment of the city's internal capacity for infill development showed that more than 999 hectares of land within the city are suitable to support this strategy and provide the land needed for urban expansion over the next decade. Finally, the study of the city's master plan, which applies to all Iranian cities, discovered that there is a lack of adequate outlook regarding the amount of land available for future urban development, leading to misuse of urban land and urban sprawl in Iranian cities, suggesting that an infill development strategy could be a good way to address this issue. [ABSTRACT FROM AUTHOR]

The present study aimed at presenting the elements and characteristics of human resources' supply and recruitment at fourth generation universities, through a mixed method and the meta-synthesis approach. The qualitative part included all related scientific works (212 retrieved works). Adopting Sandelowski and Barroso's (2007) method, the initial screening availed 52 works, and after the second screening based on CASP, 39 documents were finally entered into meta-synthesis coding. The conceptual modeling and opinion polling stages included 12 experts and managers in the field of human resource management. Main categories' reliability was 0.64 based on Kappa formula. The relative content validity coefficients for the categories of recruitment based on value creation for internal capacities, value increase for external talents, and cyberspace of recruitment were 1, 1, and 0.66, respectively; all greater than the minimum value (0.79). In the quantitative process that was based on descriptive and documentary methods, the analytical model of the study was proposed using the opinions of experts and evaluation of CVI-CVR. The findings confirmed the study model with 3 sub-categories, 9 concepts, and 76 codes. Finally, we maintain that the recruitment function at fourth generation universities of Iran, in accordance with the indicators of the proposed model, should be one of the priorities of the application of recruitment in the human resource management process at claimed fourth generation universities our country. [ABSTRACT FROM AUTHOR]

This study aimed to provide an overview of obstacles of medical tourism development in Iran. In a systematic review through searching online database including PubMed, EMBASE, SCOPUS, and Persian databases using related keywords, all qualitative and mix method studies published in English and Persian were selected, and the data were analysed using content analysis. Fourteen studies were analysed, and main obstacles were categorized into three main themes and 12 sub-themes including infrastructure factors (4 sub-themes), government-related or inter-sectoral factors (5 sub-themes) and health sector related or intra-sectoral factors (3 sub-themes). Developing marketing, improving international relations, supporting the capabilities of private sectors, and developing guidelines for insurance and tariffs are suggestions that can be helpful in reducing existing problems. [ABSTRACT FROM AUTHOR]