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Objective: Scholars are exploring novel diagnostic and prognostic biomarkers with higher sensitivity and specificity for systemic lupus erythematosus (SLE). In this regard, DNA methylation alterations have aroused attention. The association between the dysfunction of MMP9 and TNFAIP3 genes and SLE has been previously demonstrated. Therefore, in this study, we investigated the methylation level of MMP9 and TNFAIP3 promoters in peripheral blood mononuclear cells (PBMCs) of SLE patients and healthy controls., Methods: Eighty Iranian SLE patients and 77 healthy individuals were enrolled. The methylation quantification endonuclease-resistant DNA (MethyQESD) method was used to assess methylation levels of MMP9 and TNFAIP3 in extracted DNA of PBMCs. To quantify the diagnostic utility of the promoter methylation level of these genes, the receiver operating characteristic (ROC) curve was constructed., Results: MMP9 promoter was significantly hypomethylated in SLE patients compared with healthy people ( p < 0.001), while there was no significant difference in terms of TNFAIP3 promoter methylation levels ( p = 0.167). Also, this differential MMP9 methylation was observed in patients with renal involvement and patients without renal involvement (42.07 ± 25.73 vs 56.74 ± 29.71, p = 0.007). ROC analyses indicated that the diagnostic power of the MMP9 promoter methylation level for SLE was 0.839 [95% CI (0.781-0.911)]. Moreover, MMP9 methylation level was negatively correlated with creatinine and anti-dsDNA concentration and positively correlated with C3 and C4 levels., Conclusion: The results of this study highlight the application of MMP9 methylation level in PBMCs of SLE patients as a diagnostic biomarker.

Introduction: The COVID-19 pandemic has considerably affected human beings most of whom are healthcare workers (HCWs) combating the disease in the front line., Methods: This cross-sectional study aims to explore the effects of stress and anxiety caused by COVID-19 on the quality of sleep and life in HCWs, including physicians, nurses, and other healthcare staff. In this global study, we asked 1,210 HCWs (620 and 590 volunteers from Iran and European countries, including Germany, the Netherlands, and Italy, respectively), who age 21-70, to participate in the test. Several measures of COVID-related stress, anxiety, sleep, and life quality, including the 12-item General Health Questionnaire (GHQ-12), Fear of COVID-19 scale (FCV-19S), Beck Anxiety Inventory (BAI), the Pittsburgh Sleep Quality Index (PSQI), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) are recorded., Results: Volunteers reported high rates of stress and anxiety and poor sleep quality as well as lower quality of life. The correlation analysis between the measures is reported. According to the results, regardless of the location, HCWs, predominantly female nurses, developed anxiety and stress symptoms which consequently resulted in lower sleep and life quality. Both for Iranian and the European HCWs, significant differences existed between nurses and the other two groups, with the p -values equal to 0.0357 and 0.0429 for GHQ-12, 0.0368, and 0.714 for BAI measure. Even though nurses reported the most stress, anxiety, fear of COVID-19, lower quality of life and sleep in both countries, and also an increase in other measures as well, there existed no statistically significant difference in FCV-19S, PSQI, and WHOQOL-BREF., Discussion: This study helps to expand our knowledge the effects of pandemics on HCWs and also for healthcare management to predict HCW's mental health conditions in similar situations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zangeneh Soroush, Tahvilian, Koohestani, Maghooli, Jafarnia Dabanloo, Sarhangi Kadijani, Jahantigh, Zangeneh Soroush and Saliani.)

Background/aim: This study aimed to evaluate the demographic, clinical, angiographic and prognostic characteristics of Takayasu arteritis (TA) in Iran., Materials and Methods: A total of 75 patients with TA based on the American College of Rheumatology 1990 criteria for TA classification referred to the Rheumatology Centres, were followed-up from 1989 to 2019. Demographic, clinical, angiographic and prognostic characteristics were collected at baseline and last visit., Results: The mean age was 31.9 ± 9.8 years at the disease onset. Female to male ratio was 14. The median latency in diagnosis was 24 months. Pulse discrepancy in the arms, blood pressure discrepancy in the arms, limb claudication, hypertension and constitutional symptoms were the most common clinical features. The most common angiographic type at the time of diagnosis was Type I (42.7%). The most frequent arterial lesion was stenosis (89.4%). Subclavian, carotid and aortic arteries were the most commonly involved arteries. New lesions developed in 28.6% of patients during the 5.25-year follow-up. Vasculitis-induced chronic damage was observed in all patients. Disease activity decreased and vascular damage remained stable throughout the follow-up period., Conclusions: The clinical features and angiographic type of TA in Iran are different from most Asian countries. Differences in angiographic and clinical features may lead to delayed diagnosis. The issue of delay in diagnosis should create awareness among health care providers that TA is not a very rare disease in Iranians and failure to pay attention to warning symptoms may delay the diagnosis., Competing Interests: The authors declare that they have no conflicts of interest., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Background: Limited studies have reported epidemiologic data on the impact of Iran-Iraq war. This study examines the war casualties for both combatants and civilians on Iranians at national level., Methods: Databases of Veterans and Martyrs Affair Foundation (VMAF), Janbazan Medical and Engineering Research Center (JMERC) and Ministry of Health were used to collect the data. The prevalence of injuries for both civilians and combatants was presented. Casualties were studied based on conventional and unconventional weapons attacks (1980-2018), separately., Results: The Iran-Iraq war led to 183623 lost lives, 554990 injured and 40240 captured. The mean length of captivity was 45.7 months (1 month-19 years) and 2.7% (n = 575) died in captivity. There were 1439180 war related injuries recorded in databanks, mostly affecting men (98.4%). About 1439180 injuries were recorded, most of them related to conventional weapons (938928 [65.24%]). Remaining artillery and mortar fragmentation in the body (39.5%, n = 371236), psychological disorders (15.9%, n = 228944), and exposure to chemical weapons (11%, n = 158817) were the most prevalent war-related injuries., Conclusion: Human casualties of the Iran-Iraq war on the Iranian side and the health care system are huge even after more than three decades., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: To describe the utilization and out-of-pocket (OOP) payments of war survivors receiving health care services and its determinants., Methods: A cross-sectional study was carried out by systematic random sampling at national level (n = 3079) on healthcare utilization in war survivors on their last received services. A validated questionnaire was used to gather the information of inpatient and outpatient healthcare services and OOP payment. The data were analyzed to indicate the determinants of health utilization and expenses., Results: Health care utilization was reported in 91.6% (n = 2822). The majority (82.5%) received one or two services in their last visits, mostly related to physician visits and medications (65.97%). Health care utilization was higher than general population annually, especially in physician visit (6.6 versus 4.89), medication (5.1 versus 3.6), and hospitalization (0.78 versus 0.15). About 20.2% (n = 599) of the study population paid out of their pocket for their last medical care services. The frequency of OOP payment was greater for physician visit and medication. Payment for hospitalization, imaging, and lab tests were more significantly associated with proceeding to reimburse the expenses ( P <0.001). The median OOP payment was US$10.8 (interquartile range US$20.6). Gender (P=0.003), area of residence ( P =0.01) and being war victims ( P =0.005) were the significant determinants for both OOP payments and reclaiming the expenditure. Higher amount of payments ( P <0.001) and more received health services ( P =0.002) were also important factors in reclaiming the expenditure., Conclusion: Both outpatient services and hospital admission are more frequent among war survivors compared to the general Iranian population. Future studies should attempt to explore the reasons., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: Domestic violence against women can lead to short and long term health-related issues. We aimed to estimate the prevalence of domestic violence against married women and its correlates in southwestern, Iran., Methods: A population-based survey was carried out from February 1st to May 30th, 2018 in Shiraz, Iran. Currently married or recently separated/divorced women who visited healthcare centers were voluntarily interviewed. World Health Organization (WHO) standard domestic violence questionnaire was used to measure domestic violence. Hence, its prevalence and correlates were assessed. Data were analyzed using multivariable logistic regression., Results: Lifetime prevalence of overall, mental, physical, and sexual domestic violence were 54.5% (95% CI: 49.6, 59.4), 52.0% (95% CI: 47.1, 57.0), 18.2 % (95% CI: 14.4, 22.0) and 14.0 % (95% CI: 10.6, 17.4), respectively. Living separately, increasing spouse's age, the higher number of children, rental housing, middle to low monthly income, and history of domestic violence in the family of husband and/or wife had a positive correlation with domestic violence in some categories., Conclusions: More than half of the married women in southwestern Iran are experiencing domestic violence, and mental domestic violence is the most common type. Economic instability and witnessing domestic violence in childhood are the most correlates of domestic violence. Family violence preventive services and other population-based measures are highly necessary for this region.

Background: The aim of the study was to identify health concerns of veterans with high-level lower extremity amputations., Methods: Through a cross-sectional study, general practitioners, an orthopedic specialist, psychologists, psychiatrists, physiotherapist and prosthetists examined 100 veterans using a short-form health-related quality of life questionnaire (SF-36) that assessed their ability to perform activities of daily living (ADL), instrumental activities of daily living (IADL) and life satisfaction (SWLS) after hip disarticulation or hemi-pelvectomy amputations. The assessment tool was designed to gather statistically useful information about their health needs., Results: The means of the Physical Component Summary (PCS), Mental Component Summary (MCS), SWLS, ADL and IADL were 48.58 ± 29.6, 33.33 ± 22.0, 19.30 ± 7.7, 48.10 ± 10.5 and 5.08 ± 1.8, respectively. Somatization, depression, and anxiety were the most prevalent disorders; among the veterans who were visited by psychiatrists, 11.6% had a history of hospitalization in a psychiatry section, and 53.2% had a psychiatric visit. Regardless of their injury in battle, 34% of veterans were hospitalized. Hearing problems were common, and about four-fifths of the participants suffered from at least one orthopedic condition. Neuroma (49%) was the most common stump-related complication during orthopedic evaluations, though the prevalence of phantom pain was 81% during the pain assessment. A total of 87% of the participants had a history of wearing a prosthesis, but only 29% wore a prosthesis at the time of the present study. The Canadian-type of prosthesis was uncomfortable and not useful (27%) and excessively heavy (10%) according to the amputees., Conclusions: Understanding veterans' characteristics and special needs are important to make sure that enough facilities and services are afforded to them. These findings emphasize the importance of paying close attention to different dimensions of health in veterans and can help health providers identify health needs and make regular assessments.

Objective: The aim of this study was to document long-term symptoms and functional results following war-related knee disarticulation, trans-femoral amputation, and hip disarticulation., Methods: An observational cross-sectional study was conducted in a 7-day recreational camp in Iran. One thousand patients with unilateral hip disarticulation, trans-femoral amputation and knee disarticulation due to war-related injuries were invited to undergo a thorough physical examination. Among the invited persons, 58.7% (587 subjects) responded to our invitations. A complete examination related to phantom pain, phantom sensation, stump pain, back pain, and sound limb joints pain with a self-constructed questionnaire was performed. In addition, Amputee Mobility Predictor (AMP) instrument with a prosthesis was completed to assess the function of patients., Results: The mean duration of time since amputation was 22 years. The most common symptoms reported by participants were phantom sensation (82%), back pain (69%), and phantom pain (63%). In addition, total scores of AMP with a prosthesis in persons with knee disarticulation and trans-femoral amputations were 20.8 and 28, respectively. The knee disarticulation was associated with higher scores of AMP with a prosthesis compared to transfemoral amputation (p < 0.01)., Conclusion: The results of this study showed that patients with lower limb amputation suffer from significant clinical and functional problems. The findings may be useful to adopt new strategies in planning rehabilitation programs to improve quality of life and health status of patients with war-related lower limb amputation., Level of Evidence: Level IV, Therapeutic study., (Copyright © 2018. Production and hosting by Elsevier B.V.)

Purpose: To evaluate quality of life (QOL) of caregivers of severely disabled war survivors and identify variables threatening caregivers' QOL., Methods: A cross-sectional study was performed on 532 caregivers of Iran-Iraq war related injured survivors by using Persian version of 36-item Short Form Health Survey (SF-36)., Findings: Caregivers had lower QOL compared to the Iranian female population (p < .001). Caregivers of amputees had better SF-36 scores compared to caregivers of two groups of chemical warfare survivors (p ranging from .01 to <.001). Caregiving to chemical warfare and being married at the time of trauma were the independent predictors of poor QOL in both the physical component summary (OR = 5.08, 95% CI = 3.35-7.7; OR = 0.57, 95% CI = 0.37-0.89) and the mental component summary (OR = 4.12, 95% CI = 2.68-6.32; OR = 0.63, 95% CI = 0.40-0.98)., Conclusion and Clinical Relevance: Caregivers of war veterans suffer from poor QOL. Chemical warfare agents contribute to more persistent poor QOL in caregivers than the injuries caused by conventional weapons., (© 2014 Association of Rehabilitation Nurses.)

During January 2013-August 2014, a total of 1,800 patients in Iran who had respiratory illness were tested for Middle East respiratory syndrome coronavirus. A cluster of 5 cases occurred in Kerman Province during May-July 2014, but virus transmission routes for some infections were unclear.

This study addresses the problem of psycho-verbal violence experienced by women seeking divorce in Tehran (Iran's capital) and aims to investigate the influence of cultural capital on the occurrence of this form of violence. The study surveyed 207 women aged 20 to 60 seeking divorce in Tehran using random sampling. The data were collected using questionnaires developed by the researchers and focused on cultural capital and cases of psycho-verbal violence against women. Pearson's correlation coefficient test and regression multivariant analyses were used for statistical analysis. The results indicate a significant inverse relationship between women's cultural capital and psycho-verbal violence against women, encompassing embodied cultural capital, objectified cultural capital, and institutionalized cultural capital (p < 0.001). Regression analyses revealed that the incidence of psycho-verbal violence experienced by women decreases when embodied cultural capital increases first, followed by objectified and institutionalized capital. Conversely, an increase in the number of children correlates with an increase in psycho-verbal violence. [ABSTRACT FROM AUTHOR]

Background and Aims: Ocular trauma (OT) is a a major cause of ocular morbidity and blindness. This study was systematically conducted to determine the factors contributing to OT in Iran. Methods: In this study, a systematic review of all published articles in Persian and English languages from 2000 to 2023 was conducted to investigate the factors affecting OT in Iran. The included studies encompassed cross‐sectional, cohort, and case‐control designs. Articles were selected from internationally recognized databases, including PubMed, Web of Science, Scopus, and Google Scholar, as well as Persian databases such as SID and Magiran. The search strategy involved using keywords aligned with the (MeSH) terms, such as "oculars," "trauma," and "Iran." Initially, 403 articles were identified, and ultimately, 14 articles met the inclusion criteria. To ensure the prevention of bias and assess the quality of the selected articles, the Newcastle‐Ottawa Scale was utilized. Result: In the present study, the majority of individuals in the reviewed articles were categorized as having mild eye injuries (13.8%). A higher percentage of injuries was observed in males compared to females, and a higher prevalence of injuries was also observed in the age group of over 30 years compared to other age groups. Among the mechanical causes, sharp trauma had the highest prevalence rate (72.5%), while falls had the lowest prevalence rate (14%), followed by sport‐related injuries (29%). Non‐mechanical injuries were mentioned in only one article and had a prevalence rate of 1.5% Conclusion: The results of the current research have shown that among the mechanical injuries, accidents involving motorcycles and sharp objects are the leading causes of OT in Iranians. Therefore, the use of protective equipment such as goggles and adherence to traffic laws play a particularly important role, especially in men higher the age of 30. These findings highlight the necessity for targeted educational and preventive measures to reduce OT in Iran. [ABSTRACT FROM AUTHOR]

To estimate the years of life lost (YLL), registered deaths due to Iraq-Iran war (1980-2005) were identified considering ICD10 codes of Y36.0 to Y36.9. Estimated YLL was calculated by taking age-weighting options and discount rates. Population life expectancy in each corresponding year was retrieved from the national health database. During 1980-2005, 178,298 Iranian men and 5325 Iranian women died in war. The mean death age was 22.8 ± 9 years, 96.6% occurred during the years of war (September 1980-August 1988). In the years after the war (1988-2005) 6243 (3.4%) of deaths occurred as the result of complication of the war-related injuries or implanted landmines/unexploded ordnances (ICD10 code: Y36.8). YLL in Iraq-Iran war among Iranian victims were calculated as 10,479,405.0 years considering the age weighting and discount rate equal to 0. Age-adjusted YLL were estimated as 10,169,546.2 years in males. Female cases that comprised 2.9% of total victims lost 309,858.8 years. The mean YLL was calculated as 57.1 years for each Iranian victim killed in Iraq-Iran war. The war-related YLL was estimated more than 10 million years that comprised a majority of young men. This study is the first step in estimation of disability adjusted life year (DALY) of Iraq-Iran war on Iranian side.

Purpose: To determine the impact of pain in the vertebral column on the activities of daily living (ADL) level of war victims with bilateral lower limb amputation., Method: All the war-related bilateral lower limb amputees were invited. More than half of them (n = 335) participated and underwent a thorough assessment after giving informed consent., Results: The majority of the participants were male (97.6%). Their mean age was 42 years and 97.6% of them were married. The most common causes of injury leading to amputation were shells of artillery and mortar (56.7%). The most common level of amputation was bilateral transtibial (37.6%) and 64% were wearing the prosthesis of both sides. The most ADL dependency were transfer activities (27.8%) and bathing (23.3%) and the most independent functioning was eating (97.6%). Upper cervical vertebral pain was associated with dependency in the bowel and bladder management and dressing (p < 0.03 and p < 0.04, respectively). Pain in the lower cervical vertebrae was associated with dependency in toileting and dressing (p < 0.01 and p < 0.01, respectively). There were significant relationships between pain in the thoracic vertebrae and dependency in bathing, transfer activities and toileting (p < 0.02, p < 0.003 and p < 0.03, respectively). Pain in the lumbosacral region had a relationship with the level of amputation, transfer activities and toileting (p < 0.006, p < 0.03 and p < 0.05, respectively)., Conclusions: Vertebral pain in bilateral lower limb amputees, especially lumbosacral pain, was accompanied with higher dependency in ADL. Therefore, a multidisciplinary approach to the management of pain is required to minimize disability and maximize functioning.

Background: Since the declaration of a swine flu pandemic by the World Health Organization (WHO), the Islamic Republic of Iran has launched a surveillance system to test all suspected cases, both in community and hospital settings., Methods: From June 1st to November 11th, 2009, there were 2662 (1307 females and 1355 males) RT-PCR confirmed cases of pandemic influenza A (H1N1) detected in Iran. Of these cases, 75% were 5-40 years-old. During this period, 58 patients (2.18%) died. Of the total number of cases, 33 were pregnant women with no reported mortalities amongst them. The prevalence of death had no significance correlation with sex and age (P=0.720 and 0.194, respectively)., Results: Geographic distribution of the reported cases showed the highest rates in central and eastern provinces of Iran. There were two disease phases until November 2009, including an initial exogenous wave which blended into a second wave of indigenous disease, with a peak of cases after the start of the educational year. A review of the epidemiology of these initial phases of disease in Iran can help for better planning and more efficient action in future phases of the disease., Conclusion: It is of utmost importance to strengthen the surveillance system for this disease and appropriately transfer the resultant knowledge to the medical professionals, stakeholders and the general population, accordingly.

Background: In view of lack of comprehensive data on landmine casualties that lead to amputation in Iran, we conducted this study to determine the pattern and demographic features of landmine explosions that result in amputation of the victims., Methods: To define the pattern of landmine- and unexploded ordinances-induced amputations and to understand the most common types of underlying activities at the time of the blast, a retrospective study was conducted among the victims in 5 western provinces of Iran, West Azerbaijan, Kermanshah, Kurdistan, Ilam, and Khuzestan between 1988 and 2003., Results: Of a total of 3713 victims, 1499 had undergone amputations. The mean age of the victims at the time of accident was 23 years; 92% of the victims were male, 48.4% of them were of very poor education and all were civilians. Below knee amputation was the commonest type of amputation., Conclusion: The occurrence of lower limb amputations from landmine injuries in Iran is a significant burden on the healthcare system; rendering allocation of more resources to provide preventative and rehabilitation measures is therefore a must.

Introduction: Women with breast cancer often face deep spiritual challenges that affect their performance and spiritual health. This qualitative study was conducted to investigate the spiritual experiences of women with breast cancer and the role of spirituality in the cancer experience. Methods & Materials: This study was conducted with a qualitative research method and a contractual content analysis approach in 2024 at the Chemotherapy Center of Peymaniyeh Hospital in Jahrom City under the supervision of Jahrom University of Medical Sciences. To collect information, 13 patients with breast cancer were selected by targeted sampling and a semi-structured interview was conducted with them. Interviews were recorded, handwritten, and analyzed by Granheim and Lundman method. Lincoln and Cuban criteria were used to ensure the accuracy and reliability of the data. Data were analyzed using MAXQDA 2020 software (VERBI). Results: Information in 3 levels of spiritual needs, including 4 sub-levels of communication with God, in search of awareness, hope in overcoming suffering, finding meaning in suffering, and spiritual and spiritual synergy; The category of factors of fear and suffering of the patient includes 3 sub-categories in the clutches of poverty and time, double suffering and silent battle, and the category of spirituality results in patients includes 2 sub-categories in the arms of God in overcoming cancer and recovery and healing pains. The average age of the patients was 44.30 years. Finally, 10 subcategories and 3 main categories (spiritual needs, factors of fear and suffering, and results of spirituality in patients) were extracted. Conclusion: The results of the present study showed that living with breast cancer can change the path of life, beliefs and spiritual attitudes of patients. In addition, it will cause their spiritual growth and excellence. Also, the findings of this study showed the importance of addressing the spiritual needs of breast cancer patients as part of comprehensive and patient-centered care. It is recommended to conduct more studies on meeting the spiritual needs of cancer patients as a part of spiritual care. [ABSTRACT FROM AUTHOR]

Mehr Housing now deals with a serious quality of residence, which is rooted in its planning system. The housing planning approach in Iran-the custodial approach-that emerged in the frame of a comprehensive plan influenced by the modernism movement in Europe is the reason for this crisis due to its specific attitude towards the space and atomist worldview. On the contrary, the landscape approach with its "holistic" attitude considers the improvement of residence quality depending on a system of space that guarantees the quality improvement in the frame of dual perceptual-physical criteria. This study aims to compare those components that affect the quality of residence within two "planning" and "landscape" approaches and asks what kind of relationship exists between components affecting the quality of residence within two landscape and planning approaches at different levels in Iran. The purpose of this study is to achieve a strategy to improve the quality of residence in Mehr Housing through a comparative analysis of the theoretical foundations of "planning approach" as the custodial approach of Mehr Housing and the landscape approach. The research method of this study is qualitative based on the theoretical analysis of two landscape and planning approaches. The comparison between components affecting the quality of residence in these two approaches was made through logical reasoning. The assessment of data obtained from other studies was done by comparing them with previous components and comparison between them. Due to its sectoral and partial view on some components of quality in the residence environment, the "planning approach" could not guarantee the quality of the environment despite the importance of these components. This is the incident that has responded to the different needs of occupants by improving the quality of residence within the landscape approach in the frame of "spatial arrangement" and creating a "whole" that is simultaneously perceptual and functional. Hence, it is possible to revive the potential social capital in the Mehr Housing Project by "modifying" the conditions of the environment with an idealistic attitude-adopting a landscape approach. [ABSTRACT FROM AUTHOR]

Introduction: Intimate partner violence (IPV) against women is a serious public health issue and refers to physically, sexually and psychologically harmful behaviors as well as emotionally controlling behaviors and financial abuse that occur in the form of marriage or cohabitation. Knowing the current situation of the IPV prevalence against women and high-risk areas in the Zanjan city, Iran, can help policymakers to establish better health programs for risk reduction. Methods: This population-based cross-sectional study consisted of married women aged 18-55 years living in Zanjan city in 2021. 760 married women covered by 19 urban comprehensive health service centers (UCHSCs) were selected by the stratified systematic random sampling method. The prevalence of IPV against women was measured in four types: psychological, physical, sexual, and economic. Results: Mean (SD) age of the women was 35.49 (8.76) years. 606 women (79.7%) experienced one type of IPV. The highest and lowest IPV prevalence against women were psychological (76.6%) and economic (12%), respectively. The highest and lowest prevalence of psychological violence were observed in CUHSCs 2 and 17, physical violence in CUHSCs 1 and 14, sexual violence in CUHSCs 2 and 17, and economic violence in CUHSCs 2 and 8, respectively. The severity of violence was higher among self-employment or workers husbands, with low monthly household income, and among younger women. Discussion: The IPV rate in the target population is high, and the highest rate is related to psychological violence. These results highlight the need to intervention in the society and high-risk women for policymakers of the health system. [ABSTRACT FROM AUTHOR]

Approximately 34,000 Iranians known to have sustained mustard agent exposure during the Iran-Iraq war of 1980-1988 and survived over a decade afterwards were screened for distribution of the most commonly occurring medical problems. In order of greatest incidence, these include lesions of the lungs (42.5%), eyes (39.3%), and skin (24.5%). Within each subpopulation, patients were ranked according to severity of lesions. Twenty-three percent to 37% of patients exhibited at least mild coverage, with 1.5% to 4.5% classed as moderate, and a much smaller population (0.023-1.0%) of the 34,000 patients exhibiting extensive (severe) lesional coverage. These results provide a comprehensive overview of the medical problem most common among mustard victims and could serve as a predictor of the likely impact of these weapons on health status of populations exposed to them during ongoing military conflicts.

Background: Global estimates showed an estimate of up to 650,000 seasonal influenza-associated respiratory deaths annually. However, the mortality rate of seasonal influenza is unknown for most countries in the WHO Eastern Mediterranean Region, including Iran. We aimed to estimate the excess mortality attributable to seasonal influenza in Kerman province, southeast Iran for the influenza seasons 2006/2007-2011/2012., Methods: We applied a Serfling model to the weekly total pneumonia and influenza (PI) mortality rate during winter to define the epidemic periods and to the weekly age-specific PI, respiratory, circulatory, and all-cause deaths during non-epidemic periods to estimate baseline mortality. The excess mortality was calculated as the difference between observed and predicted mortality. Country estimates were obtained by multiplying the estimated annual excess death rates by the populations of Iran., Results: We estimated an annual average excess of 40 PI, 100 respiratory, 94 circulatory, and 306 all-cause deaths attributable to seasonal influenza in Kerman; corresponding to annual rates of 1.4 (95% confidence interval [CI] 1.1-1.8) PI, 3.6 (95% CI 2.6-4.8) respiratory, 3.4 (95% CI 2.1-5.2) circulatory, and 11.0 (95% CI 7.3-15.6) all-cause deaths per 100,000 population. Adults ≥75 years accounted for 56% and 53% of all excess respiratory and circulatory deaths, respectively. At country level, we would expect an annual of 1119 PI to 8792 all-cause deaths attributable to seasonal influenza., Conclusions: Our findings help to define the mortality burden of seasonal influenza, most of which affects adults aged ≥75 years. This study supports influenza prevention and vaccination programs in older adults., (© 2022 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

The social audit approach is proposed under the ongoing evaluation and monitoring. In this approach, there are policy inputs and processes, including resources diversion and transformation. This article evaluates the impact of the Youthful Population and Protection of the Family law on the childbearing attitudes and willingness to have children according to this model. The qualitative method and in-depth interviews with the audience of the law was used. Findings indicated that under"inappropriate policy inputs" the sub-categories of insufficient incentives compared to economic conditions, not including the basic needs of having children, and The inefficient content of cultural policies, have reduced the effects of the law. In the under"policy processes"there has been the resources deviation due to the taste of executive agencies and "resource transformation"due to negative behaviours against granting facilities. Distrust in government incentives, the failure to provide an efficient solution in the face of the complexities and structural conditions of executive institutions have reduced the effects of the law. [ABSTRACT FROM AUTHOR]

Background and objective: The needs and characteristics of veterans with post-traumatic stress disorder (PTSD) create significant challenges in family life, particularly for spouses. Identifying the nature of these challenges from the perspective of spouses leads to a more comprehensive and profound understanding of their existing problems and can be used for targeted interventions. Therefore, this research was conducted to explore the challenges of living with veterans suffering from PTSD from the perspective of their spouses. Methods: This qualitative study used conventional content analysis to explore Challenges of spouses of veterans with post-traumatic stress disorder. Fifteen spouses of veterans with PTSD from the Veterans Affairs Center in Iran between June 2022 and January 2023, were purposively selected to participate in the study. Semi-structured in-depth interviews were conducted to collect data. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using the method proposed by Graneheim and Lundman content analysis method with the support of MAXQDA 2020 software. Results: The mean age of the participants was 56.74 ± 6.43 years. Through data analysis, seven main categories and sixteen subcategories were identified. These categories included burnout (sleep disturbances, feelings of exhaustion), apathy towards self-care and caring for the veteran (neglecting self-care, lack of interest in continuing care), depression (feelings of hopelessness and being at the end of the line, decreased self-confidence (Crushed and ignored (being mistreated, having multiple roles), relationship disturbances (Dissatisfaction with marital relationship,isolation and limited social interactions, disconnection from God), financial burden (heavy costs of care, lack of insurance support), and declining social status (negative attitude of the society, suffering from discrimination and inequality). Conclusion: The consequences of PTSD-related injuries in veterans directly and indirectly affect the overall living conditions of their spouses. These spouses experience emotional detachment and constant rejection, leading to a decrease in their resilience against existing stressors and exposing them to disruptive and challenging issues in individual, family, and social dimensions of life that affect their physical and mental well-being. Therefore, these spouses require empowerment and access to social support in dimensions of educational, caregiving, therapeutic, and supportive. It is recommended that health policymakers pay special attention to designing up-to-date interventions to enhance the health of these spouses in physical, mental, spiritual, and social dimensions. [ABSTRACT FROM AUTHOR]

Background: Psychiatric wards are one of the most stressful medical centers. Apprenticeship in mental health can cause feelings of stress and anxiety among nursing students. Investigating nursing students' beliefs about mental illnesses is very important to improve nursing education. The present study aimed to identify nursing students' metaphors for their first clinical experiences of encountering patients with mental disorders. Methods: This descriptive qualitative study was conducted on 18 undergraduate nursing students studying in two nursing colleges at Guilan University of Medical Sciences, in the north of Iran, in 2022. The data were collected through semi-structured interviews and analyzed using Critical Metaphor Analysis by the MAXQDA 2007 software. Results: The analysis of nursing students' metaphors led to the emergence of 36 metaphors and 5 categories. These categories were "experience of dealing with a mental patient is similar to fear mixed with excitement", " patient is similar to an errant human", " psychiatric hospital is similar to a prison", "nurse is similar to a prison guard", and "clinical instructor is similar to a supporter, sympathetic and knowledgeable friend". Conclusions: The results showed their negative attitude towards the psychiatric hospital and health care providers. It is suggested that the findings of this study be taken into consideration in the planning of clinical education of nursing students. [ABSTRACT FROM AUTHOR]

This research was conducted with the aim of investigating the effect of a spiritual care program (SCP), on the body image and resilience of second-degree burn patients in Iran. In this semi-experimental study, 60 patients with second-degree burns were selected in the Tehran Mottahari Burns Hospital, Iran in 2022. These patients were divided through random allocation into two intervention and control groups. The patients of both groups filled out Beck's self-esteem Test (BSCT) and Connor-Davidson Resilience Scale (CD-RISC) before, immediately, and 3 months after the intervention. In the intervention group, SCP was performed for eight sessions over two weeks. Firstly, the 4D Model of Spiritual Health and Well-Being was examined, then two one-hour sessions were held with each patient about each dimension, with a total of four dimensions including eight sessions, in which these dimensions were examined and discussed. There was no difference in the score of body image (P = 0.326) and resilience (P = 0.597) before intervention in the control and intervention groups. However, the mean of body image score in the intervention group immediately (109.56 ± 4.86) and 3 months after (109.16 ± 6.06) the intervention was significant, respectively. Also, the mean of resilience score in the intervention group was significant immediately (85.86 ± 6.78) and 3 months after the intervention (85.73 ± 6.27). It is suggested for healthcare providers to use the SCPs to reduce the recovery time of burned patients and reduce complications and treatment costs. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to investigate women's reproductive health challenges during floods. Design: This study is qualitative, specifically employing content analysis with an inductive approach. Methods: Data were collected through in‐depth, semi‐structured individual interviews between July and December 2021. The study involved 13 women affected by floods in Golestan province, Aq Qala Township, and also included seven healthcare providers and officials. Before the interviews, informed and written consent was obtained from all participants. The sampling process continued until data saturation was achieved. Results: The analysis of the participants' experiences in this study revealed four main categories of requirements, which were as follows: Maternal and Child Health with four subcategories, Essentials of Women's Health Care with two subcategories, Problems of Relationships with two subcategories, and Aggression and Physical Violence with two subcategories. In conclusion, during floods, women encounter numerous challenges in preserving their reproductive health. Recognizing and understanding these challenges can be instrumental in effectively planning measures to prevent or address them during disasters like floods. Implications for the profession and/or patient care impact: Every disaster has unique conditions and challenges. The health requirements of individuals impacted by floods differ from those affected by other natural disasters. By identifying the specific reproductive health needs of women affected by floods, midwives and other healthcare providers can enhance their planning efforts, enabling them to better address and fulfil these needs during such critical situations. Patient or public contribution: Thirteen women were affected by floods, and seven healthcare providers and officials were interviewed. [ABSTRACT FROM AUTHOR]

Aims Burns and wounds caused by it are a global injury. Finding natural ingredients to accelerate wound healing in patients with fewer side effects could be valuable. This study aimed to determine the effect of oral Centella asiatica extract on the healing of pain and wound of burn in patients. Materials & Methods This study is a clinical trial in which 76 patients hospitalized in the burn department were randomly divided into two intervention (n=38) and control (n=38) groups. The intervention group, in addition to the usual antibiotic treatments, received capsules containing 200mg of Centella asiatica twice daily, and the control group received capsules containing 200mg of starch twice daily. Data collection tools were Bates-Jensen Wound Assessment tool and Visual Analog Scale. Patients' pain and wound healing status were examined at different time of the study. Findings The mean burn pain score showed a significant improvement in the intervention group compared to the control group (p<0.001). The average wound healing score did not show significant improvement in the intervention group compared to the control group (p=0.561). However, size (p=0.023), the degree of destruction of the underlying tissues (p=0.032), the amount of necrotic tissue (p=0.015), and the amount of granulation tissue (p=0.001) improved significantly in the intervention group. In addition, the peripheral tissue edema in the control group decrease significantly compared to the intervention group (p=0.008). Conclusion Oral extract of Centella asiatica reduces pain in burn patients. However, it does not affect wound healing, although it improves some wound healing indicators. [ABSTRACT FROM AUTHOR]

Aims Iraq used chemical weapons in the war with Iran, in military and civilian areas. Due to the long-term effects of these weapons, Considering over 35 years after this eight-year war, the number of chemical warfare victims is increasing. This research aimed to investigate the spatial distribution of chemical warfare victims by province. Instrument & Methods This descriptive-analytical research study was done using data obtained from the General Department of Statistics and Information Technology of the Martyr and Veteran Affairs Foundation. The data of chemical casualties includes the number; place of residence, gender, and type of injury in 2021 that were analyzed using SPSS 20 and ArcGIS software and Moran's test. Findings The total number of veterans in 2021 was 601330; 10.7% of them were chemical victims. Tehran (11%), Isfahan (9.67%), and Khorasan-Razavi (6.92%) provinces had the highest, and Hormozgan (0.39%), South-Khorasan (0.66%), and Sistan & Baluchistan (0.77% provinces) had the lowest. The spatial distribution of chemical warfare victims showed a cluster pattern. Conclusion The consequences of Iraq's use of chemical weapons can be seen in all of Iran's provinces, and all provinces have chemical victims. Tehran, Isfahan, Khorasan Razavi, Kerman, West-Azerbaijan, and Khuzestan have more chemical victims than other provinces. [ABSTRACT FROM AUTHOR]

Despite Iran's longstanding reputation for sustainable water management, the country currently faces mounting water-related challenges caused by population growth, industrial development, urban sprawl, lifestyle changes, climate change, territorial conflicts, poor management, and insufficient public participation. Since past and present water-related challenges share similar origins and patterns, addressing the past is imperative. After gathering, contextualizing, verifying, clustering, coding, and corroborating sources, we conducted a historical study to examine the relationship between water and Iranians from prehistoric times to the Islamic Golden Age (1219 AD). According to the findings, in prehistoric Iran, drought, flooding, river course changes, and the absence of a central government severely impacted water development. Despite doubts about the qanat's origin, archaeological investigations indicate in the proto-historical period, qanat systems existed in Iran and the Arabian Peninsula. In 550 BC, the Achaemenids initiated a fundamental transformation in Iran's water history by building dams, qanats, and water canals under a centralized administration. After a slump during the Seleucids (312–63 BC) and the Parthians (247 BC–224 AD), Iranians practiced water governance reborn under the Sassanids (224–651 AD). The Sassanids, like the Achaemenids, formed a powerful statement of unity, cooperation, and support among people for implementing their major water-related plans after enhancing institutions, laws, and communications. Chaotic Iran, however, endured severe water-related weaknesses in the Late Sassanids. Throughout the Islamic Golden Age, Iranians successfully traded water knowledge with other nations. As seen today in Iran, the Iranians have been unable to thrive on their resources since the Mongol invasion due to weak water governance, political tensions, and poor public support. The water sectors face more severe challenges when ancient water systems are ignored, applied without enhancement, or blindly adopted from other nations. Therefore, before current problems worsen, it is essential to integrate traditional and modern water cultures, technology, and management techniques. [ABSTRACT FROM AUTHOR]

The Persian Qanats, ancient underground aqueduct systems that have provided irrigation water to arid regions in Iran for over 3000 years, are recognized as a vital element of the country's cultural heritage. Eleven of these impressive structures have been included on the UNESCO World Heritage List, underlining their cultural, social, political, and physical significance. As these underground heritage sites offer a unique opportunity for fostering territorial collaboration and social capital between tourists and the local community, it is important to develop a comprehensive model to influence the behavior of tourists, officials, and natives in their treatment of these invaluable sites. This study aimed to design a sustainable behavior model for underground heritage tourism management in Persian Qanats that have been listed as UNESCO World Heritage properties. The research employed a theme analysis approach, utilizing a statistical sample of 22 base managers and Qanat tourism experts. The study used content and thematic analysis to develop a research model that guarantees the sustainable protection of these valuable underground heritage sites by shaping the behavior of tourists, officials, and natives. The proposed model serves as a guideline for effective behavior management, leading to the preservation of these significant underground heritage sites for future generations. In conclusion, this study provides valuable insights into the sustainable management of Persian Qanats and the promotion of a strong sense of territorial collaboration and social capital between tourists and the local community. [ABSTRACT FROM AUTHOR]

Context: One of the changes that occur in a person and lead to a change in the patient's sexual desire is chronic diseases, including spinal cord injury (SCI). Objectives: This study aimed to evaluate the epidemiology of sexual dysfunction (SD) in patients with SCI in Iran by a systematic review and meta-analysis. Methods: In the present systematic review and meta-analysis, using the keywords "spinal cord injury", "sexual dysfunction", and "Iran" a list of related articles were extracted from national and international databases. The search was conducted by two researchers in the national databases (SID, Magiran, and Irandoc) and international databases (Web of Science, PubMed, and Scopus). The necessary data were collected using a specialized checklist and analyzed using CMA v.2.0 software. Results: The result showed 183 articles were extracted in the initial search, and after reviewing the articles, six articles were included in the systematic review and meta-analysis stage. The prevalence of SD in patients with SCI was equal to 45.9%, 95% (CI: 30.2 - 62.4). Conclusions: The prevalence of SD and sexual dissatisfaction in patients with SCI was reported to be high. For this reason, it is suggested to do necessary interventions to improve the sexual satisfaction of these patients. [ABSTRACT FROM AUTHOR]

Aims: Patient experience, along with clinical performance and safety, is known as a critical criterion for improving healthcare performance. This study aimed to assess the validity of the Persian version of the Picker Patient Experience Questionnaire. Instruments & Methods: This descriptive cross-sectional study was condcted in Nikan Gharb and Nikan Aqdasiyeh hospitals in Tehran from April to May 2022. The Persian version of the Picker Patient Experience Questionnaire was prepared based on the translation-retranslation method. The face and content validity of the questionnaire was evaluated with the opinions of 10 experts. To check the tool validity, all patients discharged from the two hospitals were interviewed by phone from April 21 to May 21, 2022. The main dimensions and constructs of the questionnaire were determined by the exploratory factor analysis method. The questionnaire reliability was evaluated using the test-retest method by participation of 30 subjects. Findings: By checkingthe validity of the questionnaire, the items were included in 7 aspects which were in accordance with the main sections of the questionnaire (information and education, coordination of care, emotional support, respect for patient preferences, physical comfort, involvement of family and friends, and continuity and transition). The tool reliability for the 7 aspects by Cronbach's alpha was in the range of 0.744 to 0.911, and for the whole questionnaire was 0.804. Conclusion: The Persian version of Picker Patient Experience Questionnaire has the necessaiy validity to evaluate the experience of hospitalized patients in Iranian hospitals. [ABSTRACT FROM AUTHOR]

Background: Child laborers are often defined as work that deprives children of their childhood, their potential and their dignity, and that is harmful to physical and mental development. Child laborers are one of the most vulnerable groups in domestic violence. Domestic violence severely affects the physical and mental health, and consequently affects substance dependence and resilience to suicide of these children. Accordingly, it is essential to examine domestic violence, substance dependence, and suicidal ideation in working children. Objectives: the present study aimed to investigate the relationship between exposure to domestic violence and substance dependence and suicide resilience on the other among child laborers in Iran. Methods: This study employed cross-sectional research. 600 child laborers were selected via convenience and snow ball sampling from one rehabilitation and welfare center and three charity organization societies in the west of Iran, from January to August 2022. They completed questionnaires. Data were analyzed by SPSS software version 22 and with using descriptive statistics (frequency, percentage, mean and standard deviation) and ANOVA, independent t-test and the multiple linear regression model with a backward strategy. Results: Findings showed that exposure to domestic violence has a strong and direct correlation with substance dependence (r = 0.94, p < 0.001) and strong and indirect correlation with suicide resilience (r =- 0.91, p < 0.001). Also substance dependence has a strong and direct correlation with suicide resilience (r = -0.87, p < 0.001) in child laborers. Variables of substance dependence, suicide resilience, gender, guardian's disease status, living status and age can predict 76.51% of the variance in domestic violence in these children. Conclusion: Child laborers experience a lot of domestic violence, which severely affects their suicide resilience and substance dependence in them. Therefore, there is an urgent need for systematic support programs with content (teaching self-care behaviors, stress management, avoiding tense and violent environments) in order to support of these children and reduce domestic violence against them and subsequently reduce substance improve abuse resilience to suicide in these children. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aims to investigate whether a relationship is observed between spiritual health and health literacy among female teenagers, especially in terms of their attitudes toward breast self-examination. Methods: This study was a cross-sectional survey. Using multi-stage cluster sampling, 600 female students in grades 10 and 11 were chosen. A standard health literacy questionnaire created by Montazeri et al. and a 20-item spiritual health questionnaire created by Paloutzian and Ellison were used. Data were analyzed using SPSS software, version 22. Results: Most respondents had moderate health literacy and spiritual health with a positive and significant correlation (r=0.32). Health literacy has also been linked to maternal education and lower social class affiliation. Spiritual health was shown to be the vital variable in explaining health literacy in the regression. Conclusion: The research results showed the importance of spiritual health in health literacy and attitude towards health and preventive behaviors. Policymakers should give much more importance to spiritual health, especially in existential and non-ritual religious forms, in designing preventive interventions. [ABSTRACT FROM AUTHOR]

Objectives. To investigate the prevalence, pattern, and socioeconomic risk factors of intimate partner violence (IPV) before and 6 months after the pandemic onset among a cohort of Iranian women. Methods. We conducted a population-based IPV survey among 2502 partnered Iranian women aged 18 to 60 years before (n = 2502) and 6 months after (n=2116) the pandemic's onset. We estimated prevalence and incidence of psychological, physical, and sexual IPV, and the odds of different forms of IPV associated with main exposure variables, adjusted for participant relationship factors. Results. Pandemic prevalence of IPV (65.4%; 95% confidence interval [CI] = 63.4%, 67.4%) was higher than prepandemic prevalence (54.2%; 95% CI = 52.2%, 56.3%). At follow-up, the incidence of IPV was 25.5% (95% CI = 22.9%, 28.4%). The highest incidence was in cases of physical and sexual IPV. Women whose partners lost their employment were at significant risk of new exposure to IPV. Highest socioeconomic status (SES) was associated with less physical IPV (odds ratio = 0.03; 95% CI = 0.01, 0.14). Conclusions. IPV prevalence has risen since the COVID-19 epidemic began with many women who had never experienced IPV now facing it. Unemployment of women or their partners and prepandemic lower socioeconomic status are risk factors of IPV. Monitoring programs should target these populations. (Am J Public Health. 2023;113(2):228–237. https://doi.org/10.2105/AJPH.2022.306839) [ABSTRACT FROM AUTHOR]

Aims Amputation makes a person susceptible to postural deviation and compensatory movements and causes reduced performance, biocompatibility, pain, and dissatisfaction. This study aimed to investigate the effect of eight weeks of a comprehensive rehabilitation protocol on indicators of postural control, back pain, quality of life, and gait speed in adults with unilateral lower limb amputation. Materials & Methods This Quasi-experimental study was carried out on 23 subjects with transtibial amputations at K2 level and above who could walk with the help of a prosthesis. The subjects were selected by purposive sampling and were assigned into training and control groups. The training group received proper posture, correcting daily life activities, teaching the correct use of prosthesis, and mirror therapy for eight weeks. However, the control group followed their routine daily life activities. A dynamic computer posturography machine was used to evaluate the postural control indicators. Low back pain was measured bj a visual analog scale. The quality of life was evaluated using TAPES and CLASS questionnaires. And the gait speed was checked by a 2-minute gait test. Findings Eight weeks of the comprehensive corrective protocol had a significant effect on the indicators of postural control, low back pain, quality of life, and gait speed, in the training group (p<0.05). Conclusion Implementing a comprehensive program of correctional protocol leads to improvement of balance and postural control indicators, quality of life and gait speed, and reduction of low back pain intensity in unilateral lower limb amputees. [ABSTRACT FROM AUTHOR]

Background: Respiratory diseases are the leading cause of morbidity and mortality in the survivors exposed to Sulfur Mustard (SM). The late abnormalities can be present as chronic bronchitis, tracheobronchial stenosis, asthma, bronchiectasis, airway narrowing, lung fibrosis, and lung cancers. This study aims to investigate the association between radiological findings and lung cancer development in patients exposed to sulfur mustard gas. Methods: We entered 719 victims exposed to SM during the Iran–Iraq war into our follow-up study in a consensus manner. They were periodically followed with Chest HRCT scans from 2001 to an interval of 2014–2019. The mean year interval between exposure and the last follow-up was 38 years. For confirming the lung cancer in those with evidence of malignancy in their imaging, fine needle aspiration/biopsy and/or surgical intervention were done. Results: Among 719 patients, 57% were free from any pathologic findings in their HRCT scan. Among the subjects who had the abnormal radiologic findings, Air Trapping (AT), Lung Fibrosis (LF), Bronchiectasis (B), and the evidence of lung cancer were found in 265 (36.9%), 207 (28.8%), 151 (21.0%), and 42 (5.8%), respectively. Adenocarcinoma (38.1%) was the most common type of cancer. The right lung was involved more than the left one regarding LF, B, and cancer (p value < 0.05). Considering the laterality, a significant correlation was found between the side of LF and B and the tumor side. Furthermore, it was shown that the lung lobes with LF were statistically correlated to tumor-involved lobes. The relative risk of AT and B existence for tumor development was 11.73 [4.87–28.26] and 10.14 [5.12–20.090], respectively. The most predictive finding was LF which caused the risk of developing tumor 17.75 [7.35–42.86] times higher in the patient with this pathology. By each increment of the number of LF and B, the risk of developing tumors increased by 51% and 76%, respectively. Conclusion: In survivors exposed to Sulfur Mustard, those with bronchiectasis and lung fibrosis have a significantly higher risk of developing lung cancers, so a close follow-up of these victims is recommended. Trial registration This study was confirmed by the institutional review board and ethics committee at Shiraz University of Medical Sciences (SUMS) with the ethical code IR.SUMS.MED.REC.1399.637. [ABSTRACT FROM AUTHOR]

In World War I, sulfur mustard or mustard gas was used as a chemical weapon for the first time. Years later, during the imposed war (eight years of holy defense) against the Islamic Republic of Iran, Iraq used this poisonous gas against the soldiers and people of Iranian cities. Many years after the war, many chemical veterans still suffer from its effects. Mustard gas is a strong alkylating substance with cytotoxic and mutagenic properties, which causes blisters in mucous membranes and skin when it comes in contact with the skin. It is usually a colorless or amber-yellow oily liquid. In high concentrations, it has a disgusting smell similar to horseradish, onion, or garlic, which is mostly due to contamination with ethyl sulfide and other byproducts of its synthesis. Various studies have proven that long-term exposure to this toxic gas can lead to respiratory disorders and lung cancer. Considering the drug resistance and special conditions of chemical veterans with lung cancer, one of the new methods proposed for their treatment is the use of oncolytic viruses. The purpose of this study is to review the therapeutic potential of oncolytic viruses in the treatment of lung cancer caused by chemical warfare agents. [ABSTRACT FROM AUTHOR]

This research paper reports the process and results of a project to automatically classify historical and non-historical buildings using airborne and satellite imagery. The case study area is the center of Yazd, the most important historical site in Iran. New computational scientific methods and accessibility to satellite images have created more opportunities to work on automated historical architecture feature recognition. Building on this, a convolutional neural network (CNN) is the main method for the classification task of the project. The most distinctive features of the historical houses in Iran are central courtyards. Based on this characteristic, the objective of the research is recognizing and labeling the houses as historical buildings by a CNN model. As a result, the trained model is tested by a validation dataset and has an accuracy rate of around 98%. In Sum, the reported project is one of the first works on deep learning methods in historical Iranian architecture study and one of the first efforts to use automated remote sensing techniques for recognizing historical courtyard houses in aerial images. [ABSTRACT FROM AUTHOR]

During Iraq-Iran conflict, chemical weapons, particularly SM gas, were used numerous times, whose aftereffects are still present. This study aimed to compare serum proteome in the chronic ML (n = 10) and HC (n = 10). TMT label-based quantitative proteomics was used to examine serums from two groups. Among total significant proteins, 14 proteins were upregulated (log2 ≥ FC 0.5, p 0.05), and 6 proteins were downregulated (log2 ≤ FC - 0.5, p 0.05). By helping PPI network, and EA, 11 main pathways connected to significantly different protein expression levels were discovered, including inflammatory and cell adhesion signaling pathways. It may be deduced that the wounded organs of exposed individuals experience poor repair cycles of cell degeneration and regeneration because certain repair signals were elevated while other structural and adhesion molecules were downregulated. The systems biology approach can help enhance our basic knowledge of biological processes, and contribute to a deeper understanding of pathophysiological mechanisms, as well as the identification of potential biomarkers of disease. [ABSTRACT FROM AUTHOR]

Background and Aim: Iranian veterans have suffered spinal cord, chemical, psychological, and amputation injuries due to the eight-year war in Iraq, which has necessitated long-term care. Most caregivers are their spouses. In this study, the overall quality of life score of the wives of Iranian veterans has been estimated. Methods: In this systematic review and meta-analysis, the databases of Scientific Information Database (SID), MagIran, PubMed, ISI and, Scopus were searched with the keywords war veteran, quality of life, Iran, and their combinations without time limit. Data were analyzed using meta-analysis and random-effects model. Heterogeneity between studies was assessed by I² test. Meta-regression was used to investigate the relationship between quality of life score with the year of publication and sample size of articles. Results: Fourteen studies with a sample size of 2905 people were analyzed. The pooled score of quality of life of veterans' wives was 59.86% (95% CI: 48.20-71.51) in the physical dimension and 57.67% (95% CI: 46.81-68.53) in the psychological dimension. The highest and lowest scores of quality of life of veterans' spouses in the physical dimension were related to the subscales of physical function (58.72%, 95% CI: 42.74-50.94)) and pain (43.55, 95% CI: 34.69-52.42), respectively; and in the psychological dimension were related to the subscales of social performance (53.56%, 95% CI: 42.43-64.70) and psychological role limitation (41.52%, 95% CI: 36.52-46.29). Conclusion: Veterans' wives have a relatively low quality of life due to intensive and long-term care of veterans, and it seems necessary to pay more attention to this group. [ABSTRACT FROM AUTHOR]

Despite growing attention to the relationship between social cohesion and health outcomes, very few studies have focused on correlates of social cohesion especially in developing countries. This study sought to identify the factors related to neighborhood social cohesion among the older adults in Tehran, Iran. The sample consisted of 1280 community-dwelling older adults aged 60 and over. Face-to-face interviews were administrated to gather data from residents of selected neighborhoods. Bivariate analyses and hierarchical regression analysis were done to reveal the relations between perceived neighborhood social cohesion and independent variables. The mean age of the participants was 70.90 years (SD = 8.07 years) and more than half of them (57.9%) lived in the mid-advantage areas. The mean social cohesion score was 7.32 (SD = 2.13) and the mean percentage score was 61.08 (SD = 17.75). Results showed that marital status, employment status, independent daily living, and perceived health status, availability of shopping center, cleanness of the neighborhood, security for walking and area-level advantage, significantly related to higher neighborhood social cohesion (F = 10.382, R2 = 14.8). Environmental characteristics included cleanness, security, and advantage of the neighborhood had the greatest effect on the neighborhood social cohesion. The significant change in R Squared showed that the addition of environmental characteristics accounted for an amount of variance in neighborhood social cohesion (∆F = 11.46, ∆R2 = 0.054), after controlling for confounding variables. The study findings underscore the importance of improving environmental aspects of neighborhood to develop older adults' social cohesion. Developing the infrastructures for neighborhood accessibility, cleanliness, and security can lead to higher levels of social cohesion. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is the most common type of domestic violence often used by men against their wives. Due to the destructive and widespread social and health consequences of IPV, the present study aimed to investigate the prevalence and related factors of IPV among married women in Garmsar, Iran. Methods: Using multi-stage clusters sampling method, this cross-sectional study included 400 married women in Garmsar, Iran. The data collection process was conducted during October and December 2019 using a researcher-made questionnaire. The content validity of the questionnaire was confirmed using content validity ratio (CVR) and content validity index (CVI) indicators (0.85 and 0.88, respectively). Also, the reliability was confirmed by examining the internal consistency and obtaining a score of 0.93 for Cronbach's alpha. Descriptive and analytical statistics were performed using t-test, analysis of variance (ANOVA), and Tukey's post-hoc test. Results: Most participants were in the age range of 20-40 years (mean age: 34.9 years). The overall exposure of women to IPV was 56.11%. In addition, the most prevalent types of IPV included legal (24%), social (24%), financial (22%), verbal (16%), physical (13%), emotional (12%), and sexual (11%). The effective factors on the prevalence of IPV included number of children, education level, occupation, and age (P less than 0.05). Conclusions: We witnessed that women living in Garmsar faced different types of IPV and their overall exposure to this phenomenon was higher than the national and global average. To resolve the problem, the following measurements are recommended: a careful investigation of the reasons for the spread of IPV, implementing interventions based on reliable evidence, and serious cooperation of the experts and relevant governmental and non-governmental institutions, particularly citizens. [ABSTRACT FROM AUTHOR]

Background: Disclosure of HIV-positive status in women is associated with many factors. Consequently, status disclosure remains a challenge for Iranian women living with HIV. This study aimed to assess the prevalence, related factors, and reflections of HIV-positive status disclosure to a sexual partner(s) among Iranian women living with HIV. Methods: A cross-sectional study was conducted on 170 HIV-seropositive women. Participants were selected from patients registered in the largest HIV clinic and HIV-positive club of Iran. The "HIV disclosure" questionnaire had 38-items and all the interviews were administered by the researcher. Data were analyzed using SPSS version 21.0 software. We used a logistic regression method to calculate the crude odds ratio (COR) and the adjusted odds ratio (AOR) for self-disclosure as the independent predictor variable and the dependent variable, respectively. Results: One hundred and seventy HIV-positive women were enrolled. Most of them had disclosed their HIV status to at least one person (94.1%) and their sexual partners (86.5%). In the univariate analysis, being married (COR = 18.66, 95% CI 5.63–61.87), living with a sexual partner (COR = 4.72, 95% CI 1.92–11.62), being aware of sexual partners' HIV status (COR = 6.20, 95% CI 1.79–21.49), and gaining the support of sexual partner (COR = 9.08, 95% CI 3.48–23.64) were associated with higher odds of HIV status disclosure. In the multivariate analysis, being aware of sexual partners' HIV status, and gaining the support of sexual partners remained associated with HIV status disclosure. Most women reported a positive reflection from their sexual partners after disclosure, however, negative reflections from society were more common compared to sexual partners and family members. Conclusion: This study shows high overall HIV disclosure proportions. It should be noted that a large number of women were infected by their sexual partners, especially by their spouses. The high rate of transmission in married people indicates an urgent need for more emphasis on appropriate prevention behaviors by infected partners. [ABSTRACT FROM AUTHOR]

By exposing individuals to trauma, wars can cause a host of psychiatric disorders. This study aimed to collect and compare the studies conducted to estimate the prevalence of depression among veterans, former prisoners of war (POWs) and military personnel in the Iran–Iraq war (1980–1988). In this systematic review, a search was conducted using relevant keywords in major national and international databases, personal archives and national academic libraries. We screened 135 records using their abstracts and selected a total of 56 studies for full‐text review. Eventually, 19 studies were included in our systematic review and meta‐analysis. The estimated pooled prevalence of depression among Iranian veterans and POWs was 22.4% (95% confidence interval = 15.0–32.0). Although the results indicated disparities in the prevalence of depression among veterans and POWs, the aggregate estimated prevalence was much higher than what has been reported for military personnel. Effective policies and strategies are required for prevention and treatment of depression and related psychiatric complications among veterans and former POWs. [ABSTRACT FROM AUTHOR]

Introduction: A great number of Iranian military forces have sustained sulfur mustard gas exposure during the Iran-Iraq war of 1980-1988 and have survived with dental care needs. Accordingly, this study aimed to discover the prevalence of intraoral lesions and periodontal diseases associated with the percentage of being chemical veterans. Methods: This cross-sectional study was conducted in the summer of 2009 on 40 chemical veterans. The patients were examined using dental mirrors under dental unit light, as well as a periodontal probe, to evaluate soft tissue attachment. The clinical results were then documented on medical records. Data were analyzed using the Chi-square test and two independent sample t-tests in SPSS software (version 19). A p-value less than 0.05 was considered statistically significant. Results: The study population was composed of 40 patients with a mean age of 50.7±9.32 years, mean pocket depth of 1.47±0.31 mm, and mean bleeding on probing of 0.35±0.24 mm. Furthermore, 55% and 27.5% of the patients had xerostomia and temporomandibular joint dysfunction, respectively. However, no significant association was found between these factors and the percentage of being veterans. Conclusion: The study findings showed that 96.7% of the patients had bleeding on probing problem. The mean score of plaque index that is a practical measurement on evaluating oral hygiene was 2.06±0.99. Therefore, informing chemical veterans about their periodontal health by performing regular dental assessments by dental specialists and instructing oral hygiene seem to be this group's need. [ABSTRACT FROM AUTHOR]

The number of older people living in urban environments is growing dramatically. Adhering to a set of standards is essential to achieve a desirable living setting. In order to assess strengths and deficiencies, older people described how the checklist of essential features of age-friendly cities matches their own experiences. The descriptive study was conducted with the participation of 384 older people from Tabriz, Iran, who were selected randomly, from all over the city. The degree of conformity of city characteristics was described with the standards with a score of 0–100. The mean age of participants was 68.2 ± 0.35 years. More than half of the respondents (56.5%) were men and approximately one-third of the participants were illiterate and 80% were married respectively. The most satisfying dimension was the outdoor spaces and buildings (32.06 ± 11.94) and the least one was the communication and information (9 ± 0.27). Fragmented systems and services were a general challenge. Inadequate coordination between the public service organizations and consumers prevented the area's wealth of resources from reaching their full potential. [ABSTRACT FROM AUTHOR]

Oseltamivir and antiviral agents are frequently used for the prevention and treatment of influenza infection. However, resistance to oseltamivir has been reported globally due to a mutation in the Influenza virus neuraminidase gene. Such resistance will be detected by genotyping and phenotyping studies of viral isolates. The recent study aimed to determine the genetic mutation of neuraminidase gene in influenza A (H1N1) viruses isolated from children referred to Shiraz tertiary hospitals during 1 year (2015–2016) with influenza‐like symptoms. A total of 300 patients were registered and throat samples were taken. The throat swabs were used for viral RNA extraction. Detection of influenza A (H1N1) was performed using the one‐step real‐time polymerase chain reaction (qRT‐PCR) method. From positive isolates for H1N1, 51 random samples were evaluated for neuraminidase gene mutation with the nested PCR‐sequencing method. Of 300 cases, 102 (34%) isolates were detected as influenza A (H1N1) pdm09. Based on sequencing results, 2 of the 44 sequenced isolates exhibited H275Y substitution, which presented oseltamivir resistance. In comparison with reference strain, the phylogenetic analysis of sequenced isolates was classified in genogroup 6B. While this result is the first report of emerging oseltamivir‐resistant in the southwest of Iran, it is highly recommended to perform these evaluations on the different geographical regions in any prevalence area to plan treatment strategies for influenza. Highlights: oseltamivir‐resistant A(H1N1) pdm09 virus was detected in south Iran. oseltamivir‐resistant A(H1N1) pdm09 viruses may re‐emerge in future seasonal outbreaks. Constant monitoring of oseltamivir‐resistant viral variants is essential for the implementation of the viral treatment strategy. [ABSTRACT FROM AUTHOR]

Aim: Work-related musculoskeletal disorders (WMSDs) associated with patient mobility are one of the most common occupational hazards to which the nursing staff are exposed. Therefore, the present study aimed to investigate nurses' performance relative to the risk factors for musculoskeletal disorders associated with patient mobility in the Teaching Hospitals across Kermanshah in 2018. Methods: In this cross-sectional descriptive study, 270 nursing staff were studied in 2017. As for data collection, the valid questionnaire of nurses' performance was used. Then, after data collection, the data were entered into SPSS Statistical Software Version 16.0 and analyzed using the descriptive and inferential statistics such as chi-square, independent t-test, analysis of variance, and Pearson correlation coefficient. Results: The results of the present study revealed that the average working time per week was 54.14 ± 13.17 h, regardless of the promotion and productivity rules. It was also found out that the most painful parts of the body identified by the nursing staff were the lumbar spine and neck. The mean score of nurses' performance relative to the risk factors for musculoskeletal and skeletal disorders associated with patient mobility was 7.75 out of 18. Conclusion: Given the level of nurses' performance relative to the risk factors for musculoskeletal disorders associated with patient mobility, it is necessary to carry out further studies so as to figure out how to prevent and reduce such disorders. [ABSTRACT FROM AUTHOR]

Introduction. Klebsiella pneumoniae (K. pneumoniae) is one of the leading causes of hospital-acquired and community-acquired infections in the world. This study was conducted to investigate the molecular epidemiology of drug resistance in clinical isolates of K. pneumoniae in Azerbaijan, Iran. Materials and Methods. A total of 100 nonduplicated isolates were obtained from the different wards of Azerbaijan state hospitals, Iran, from 2019 to 2020. Antibiotic susceptibility testing was done. The DNA was extracted, and the PCR for evaluation of the resistance genes was carried out. Results. The highest antibiotic resistance was shown to ampicillin (96%), and the highest susceptibility was shown to tigecycline (9%), and 85% of isolates were multidrug resistant. The most frequent ESBL gene in the tested isolates was blaSHV-1 in 58%, followed by blaCTXM-15 (55%) and blaSHV-11(42%). The qepA, oqxB, and oqxA genes were found to be 95%, 87.5%, and 70%, respectively. We detected tetB in 42%, tetA in 32%, tetD in 21%, and tetC in 16%. Seventy isolates were resistant to co-trimoxazole, and the rate of resistance genes was sul1 in 71%, followed by sul2 (43%), dfr (29%), and sul3 (7%). The most common aminoglycoside resistance genes were ant3Ia, aac6Ib, aph3Ib, and APHs in 44%, 32%, 32%, and 31.4%, respectively. The most frequent resistance gene to fosfomycin was fosA (40%) and fosX (40%) followed by fosC (20%). Conclusion. The results of this study indicate the high frequency of drug resistance among K. pneumoniae isolated from hospitals of Azerbaijan state. The present study shows the presence of high levels of drug-resistant genes in various antibiotics, which are usually used in the treatment of infections due to K. pneumoniae. [ABSTRACT FROM AUTHOR]