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Background: Sexual offenses encompass a diverse array of behaviors across various contexts, affecting numerous individuals. Despite the prevalence of sexual offending among adolescents, there is still a limited understanding of this population. To contribute further to the literature in this field, the present study was conducted to compare a group of male adolescents convicted of sexual offenses with a control group in terms of reflective functioning (RF), emotion regulation (ER) strategies, and emotion dysregulation (ED). Methods: 60 male adolescents aged 12 to 18 years (M = 16.90; SD = 0.97) who had been convicted of at least one serious sexual offense were recruited from male adolescents referred by juvenile courts to the Legal Medicine Organization in Mashhad, Iran, and compared with a control group of non-offending adolescents consisting of 60 male adolescents aged 12 to 18 years (M = 16.97; SD = 0.82) who were attending school. The groups were matched on age and education level. Results: A comparison between these two groups revealed that adolescents with a history of sexual offending exhibited poorer RF capacity, greater use of suppression as an ER strategy, and higher scores in all ED domains (p's < 0.001) except non-acceptance of emotional responses compared with the control group. Conclusions: Results suggest that RF, ER strategies, and ED need to be considered as important psychological factors in understanding and treating adolescents with a history of sexual offending. [ABSTRACT FROM AUTHOR]

The current study aimed at diagnosing the language needs of Iranian undergraduate students of computer engineering in order to find out whether there is any significant difference in perceptions between the students and their ESAP (English for Specific Academic Purpose) teachers, concerning their Reading skill needs. To conduct the intended research study, both qualitative and quantitative approaches were taken. The quantitative approach included the use of self-assessment, and two questionnaires, and the qualitative approach included participant observation. The questionnaires were adapted from Atai and Shoja (2009), and were distributed among 500 undergraduate students of computer engineering and 30 ESAP teachers who were chosen randomly through cluster sampling method from thirteen universities. Mann-Whitney U-test results showed that there was a significant difference between perceptions of the students and their teachers about their Reading skill needs and "Reading" was mentioned as one of the most difficult skills for the students. Moreover, it was found that the majority of students suffered from low level of General English Language Proficiency, and also "low motivation" and the "character" of teachers were found to be important factors affecting students' learning.

Background: Cancer is one of the main causes of death in the worldwide. Pancreatic Cancer (PC) is prevalent in developed and increasing in developing countries. PC is important because of its low survival rate, high fatality, and increasing incidence. Therefore, identifying risk factors to prevent its development is necessary. This study aimed to determine incidence of PC and its risk factors in the Golestan Cohort Study (GCS) in Iran. Method: This study is a prospective population-based cohort study in the frame of GCS with 15 years of follow-up for PC. GCS was launched in the Golestan province of Iran with 50045 participants who were 40 to 75 years old. variables included: age, gender, education status, smoking, alcohol consumption, opium usage, type of blood group, dyslipidemia, body mass index (BMI), waist circumference (WC), family history (FH) of PC, ethnicity, and history of diabetes mellitus (DM). Result: Among 50045 participants of GCS during 15 years of follow up, 100 people were diagnosed PC. PC incidence was 0.2%. Age-standardized incidence rate (ASR) of PC in the study population was 11.12 per 100,000 person-years. People with age ≥60 years were 46, in 50–59 years old group were 36, and 18 of them were <50 years (p<0.001). The smoking rate in PC group was 27% (p<0.01). Univariate model of cox regression analysis showed age 50–59, ≥60 years compared to <50 years [HR:3.006, 95%CI (1.707–5.294), p<0.001], [HR: 6.727, 95% CI (3.899–11.608), p<0.001], male gender [HR:1.541, 95%CI (1.041–2.281), p = 0.031], opium use [HR:1.436, 95% CI (0.887–2.324), p = 0.141], and smoking [HR:1.884, 95%CI (1.211–2.929), p = 0.005] were predictors for PC. In the multivariate model after adjusting, age 50–59 [HR:2.99, 95% CI (1.698–5.265), p<0.001], and ≥60 years [HR: 6.564, 95% CI (3.797–11.346), p<0.001] was the only predictor for PC. Conclusion: This study revealed an incidence of PC 0.2% in GCS in Iran. Main risk factor for PC was older age. [ABSTRACT FROM AUTHOR]

Introduction: Managers in the health care sector have the responsibility of accomplishing objectives and guaranteeing the excellence of services. To be chosen as a manager in a health organization, individuals must possess specific qualities and skills. Examining the process of selecting and appointing managers at the highest level of service provision might offer policymakers valuable insights into the importance of considering competences when choosing and appointing leaders of health centers. Hence, this study was conducted to identify the characteristics that influence the selection process of heads of city health centers in Iran. Methods: The present study employed a qualitative and phenomenological approach, utilizing interviews performed in the year 2023. The study sample consisted of health deputy from medical sciences universities, local health network managers, and heads of city health center. The participants were selected using a purposive selection method. A total of 16 male participants were interviewed, and the interviews were then analyzed using MAXQDA-10 software using the usual content analysis method. Results: In this study, the factors affecting the selection of the heads of health care centers were classified into two general topics: individual factors and environmental factors, and eight sub-topics, including health literacy, experience, individual characteristics, communication skills, mental characteristics, legal issues, political factors, and cultural factors. Conclusion: The development of health literacy, specialized knowledge, and communication skills to coordinate and resolve organizational problems helps train competent managers. Top health system managers, who select health center managers, must understand political and cultural variables and regulate and steer their influence to select effective managers. [ABSTRACT FROM AUTHOR]

Background: Specific biomarkers for metabolic syndrome (MetS) may improve diagnostic specificity for clinical information. One of the main pathophysiological mechanisms of MetS is insulin resistance (IR). This systematic review aimed to summarize IR-related biomarkers that predict MetS and have been investigated in Iranian populations. Methods: An electronic literature search was done using the PubMed and Scopus databases up to June 2022. The risk of bias was assessed for the selected articles using the instrument suggested by the Joanna Briggs Institute (JBI). This systematic review protocol was registered with PROSPERO (registration number CRD42022372415). Results: Among the reviewed articles, 46 studies investigated the association between IR biomarkers and MetS in the Iranian population. The selected studies were published between 2009 and 2022, with the majority being conducted on adults and seven on children and adolescents. The adult treatment panel III (ATP III) was the most commonly used criteria to define MetS. At least four studies were conducted for each IR biomarker, with LDL-C being the most frequently evaluated biomarker. Some studies have assessed the diagnostic potency of markers using the area under the curve (AUC) with sensitivity, specificity, and an optimal cut-off value. Among the reported values, lipid ratios and the difference between non-HDL-C and LDL-C levels showed the highest AUCs (≥ 0.80) for predicting MetS. Conclusions: Considering the findings of the reviewed studies, fasting insulin, HOMA-IR, leptin, HbA1c, and visfatin levels were positively associated with MetS, whereas adiponectin and ghrelin levels were negatively correlated with this syndrome. Among the investigated IR biomarkers, the association between adiponectin levels and components of MetS was well established. [ABSTRACT FROM AUTHOR]

Objectives: Previous studies have shown interindividual variation in free thyroxine (FT4) serum levels and thyroid stimulating hormone (TSH) in healthy persons. Genetic factors mainly determine this variation, and genome-wide association studies have increased the number of thyroid function-associated variants. The present study investigates the association of candidate variants with FT4 and TSH in a euthyroid Iranian population. Method: A total of 2931 unrelated euthyroid subjects (FT4 10.29–21.88 pmol/L; TSH 0.32–10 mIU/L, thyroid peroxidase antibody TPOAb < 33 IU/mL in men and < 35 IU/mL in women), with available genotypes were chosen from the Tehran Thyroid Study (TTS), to examine the impact of selected SNPs on thyroid hormone under the additive genetic model. In order to evaluate regional associations with FT4 and TSH levels, a haplotype analysis was done. Results: We identified a strong association between the rs4338740-C allele and TSH in the adjusted model (β = -0.095, P-value = 0.0004). Also, findings indicated that rs4954192 ACMSD and rs4445669 CADM1 correlated with normal TSH levels (P-value = 0.011, P-value = 0.014, respectively). Haplotype analysis revealed that two haplotypes were significantly associated with TSH levels in euthyroid individuals. The ACGA and AC haplotypes on chromosomes 8 and 14 were significantly correlated with normal TSH levels, respectively (P-value = 0.014, P-value = 0.016). Conclusions: This is the first genetic association study with TSH and FT4 reference values in an Iranian population. Our findings indicate that a few gene variants associated with the reference values of TSH in other populations are also associated with the reference values of TSH in Iranians. [ABSTRACT FROM AUTHOR]

Aim: Our objective was to assess the efficacy and safety of adding alpha-pinene (a herbal terpenoid) to quadruple therapy compared to a placebo in improving symptoms and Helicobacter pylori (H. pylori) eradication rates in Functional dyspepsia (FD) patients. Background: FD is a prevalent upper gastrointestinal condition, and no definitive pharmacological treatment is available for its management. Methods: We conducted a randomized, double-blinded, placebo-controlled trial on FD patients diagnosed with H. pylori infection. We collected baseline demographic data and assessed FD symptoms in the participants. Patients were randomly allocated to receive either standard quadruple therapy with α-pinene capsules (0.25 mg/day) or quadruple therapy with a placebo for two weeks. We employed a validated questionnaire, the Short Form Leeds Dyspepsia Questionnaire (SF-LDQ), to evaluate FD symptoms. The eradication rate of H. pylori was compared between the two groups one month after completing the treatment regimens. Any reported adverse drug reactions (ADRs) were documented throughout the trial. Results: Over four months, a total of 66 patients completed the trial. Notably, there were no significant differences in baseline SFLDQ scores between the two groups (p=0.83); however, a significant divergence emerged at the trial's conclusion (p=0.03). The H. pylori eradication rates did not show notable differences between the two treatment arms (p=0.43). Importantly, there were no dropouts from the trial due to ADRs. Among reported ADRs, participants experienced abdominal pain, headache, diarrhea, and a metallic taste, with no significant variance in incidence rates observed between the two groups (p=0.62). Conclusion: These findings suggest that α-pinene could be an effective and safe agent for reducing FD symptoms. [ABSTRACT FROM AUTHOR]

Purpose: Cutaneous leishmaniasis (CL) is the most common type of leishmaniasis in tropical and subtropical areas. This study investigated the trend of CL changes from 2009 to 2022, and predicted the number of leishmaniasis cases until 2024. Methods: This ecological study was performed on new monthly confirmed CL cases from 2009 to 2022 from the leishmaniasis registration system in southeast Iran. The time series method was used to investigate the trend of changes in CL from 2009 to 2022. SARIMA model was run to predict the number of leishmaniasis cases until 2024 by controlling the effect of climatic variables on the disease process. Results: The analysis showed a significant increase in CL cases in 2015 and from 2021 to 2022. The minimum number of registered cases was observed in 2018, with 81 cases. The maximum number was also observed in 2021, with 318 patients. The leishmaniasis cases decreased from January to June and increased from July to December. According to the results of SARIMA (1, 0, 0) (1, 0, 0) multivariate analysis, the temperature in log 12 has a significant negative correlation with the number of leishmaniasis cases. This model predicted a decreasing trend in leishmaniasis cases until 2024. Conclusion: The southeast region of Fars province is one of the hyper-endemic regions of the disease, and it is prone to periodic outbreaks. An active surveillance system must investigate the CL incidence trend and evaluate the effectiveness of interventions to prevent the occurrence of new outbrea. [ABSTRACT FROM AUTHOR]

The present study was conducted to investigate the concentration of nitrate in drinking water resources and its carcinogenic risk in the southern provinces of Iran in 2020. Raw data of nitrate concentrations were obtained from wastewater and water Company of each province, and Mont Carlo Simulation (MCS) was considered 10‐5 for estimating human carcinogenic risk. Our results demonstrated that in the drinking water resources of Khuzestan and Fars provinces, the nitrate level was 59 and 72 mg/L, respectively, higher than the World Health Organization (WHO) recommendation. The calculated carcinogenic risk of nitrate for Khuzestan and Fars provinces were higher than the range set by WHO and Health Canada, 8.8 × 10−5 and 1.3 × 10−5, respectively. Exposure to an unacceptable nitrate level through drinking water can affect blood carrying oxygen and cause methemoglobinemia and a significant relationship with gastrointestinal cancer spread. [ABSTRACT FROM AUTHOR]

Although, strengthening patient safety competencies in nursing has been emphasized for enhancing quality care and patient safety. However, little is known about the association of nurses' perceptions of patient safety competency with adverse nurse outcomes in Iranian hospitals. This study aimed to measure nurses' levels of patient safety competency in the hospitals of Iran and examines the relationship between patient safety competency with the occurrence and reporting of adverse events (AEs). This cross-sectional research was applied in eight teaching hospitals in Tehran, Iran, between August and December 2021. A sample of 511 nurses was randomly selected using the table of random numbers. The validated Patient Safety Competency Self-Evaluation questionnaire was used. Furthermore, two questions were used to measure the incidence and reporting of AEs. Data analysis was performed using descriptive statistics, independent t-tests, and two binary logistic regression models through SPSS version 24.0. The mean patient safety competency score was 3.34 (SD = 0.74) out of 5.0; 41.5% of nurses rated their patient safety competency as less than 3. Among subscales, "skills of patient safety" scores were the highest, and "knowledge of patient safety" scores were the lowest. Nurses with higher Knowledge and Attitude scores were less likely to experience the occurrence of AEs (OR = 1.50 and OR = 0.58, respectively). Regarding AEs reporting, nurses with higher Skill and Attitude scores were 2.84 and 1.67 times, respectively, more likely to report AEs (OR = 2.84 and OR = 3.44, respectively). Our results provide evidence that enhancing PSC leads to reduced incidence of AEs and increased nurses' performance in reporting. Therefore, it is recommended that managers of hospitals should enhance the patient safety competency of nurses in incidents and reporting of patient safety adverse outcomes through quality expansion and training. Additionally, researchers should carry out further research to confirm the findings of the current study and identify interventions that would strengthen patient safety competencies and reduce the occurrence of AEs, and rise their reporting among nurses. [ABSTRACT FROM AUTHOR]

Economic policies for managing agricultural water use are often complicated by the challenge of using water prices as an efficient economic tool when other non-economic concerns are involved in the decision-making process. This study aims to analyse the impact of water pricing policies on preserving agricultural water resources in Iran. This study applies a system dynamics approach to simulate the system performance and behaviour of stakeholders and the economic implications. Our finding shows that water pricing policies will likely fail due to low water price elasticity and if there are lack of institutional and physical infrastructure, alternative professions, manufacturing technology, education, and training opportunities. The results also illustrate how agricultural water price increase (AWPI) fails to reduce water consumption in the absence of an adequate institutional arrangement. Also, it shows how the lack of advanced institutional infrastructure in the presence of physical infrastructure enhances pervasive overuse and destructive competition among stakeholders by increasing the area under cultivation. In the discussion, the paper portrays a way out of the decision-making body by following AWPI effects on water conservation in the agricultural sector as the most significant water consumer. It investigates the absence and subsequent presence of specific institutional conditions and evaluates training and enhancing farmers' skills and alternative career source with higher income and technology as the architecture of good environmental governance. Finally, it concludes that a series of inclusive measures must be considered to increase the elasticity of the water price. These measures must stimulate farmers towards pursuing the goals of global sustainable development and enhancing social welfare. [ABSTRACT FROM AUTHOR]

Background. Diabetes mellitus (DM) is one of the most common chronic diseases, the main manifestation of which is hyperglycemia, and is accompanied by many complications. Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, several studies have reported the occurrence of various complications associated with different degrees of hyperglycemia in COVID-19 patients. The aim of the present study was to investigate the glycemic characteristics and clinical outcomes in patients with COVID-19. Methods. In this cross-sectional study, 418 patients with COVID-19 were evaluated in terms of hyperglycemia and its related factors, as well as the relationship between hyperglycemia and the outcome of the disease. Data were statistically analyzed using SPSS software. Results. In the present study, 350 (83.7%) out of 418 hospitalized patients with COVID-19 had hyperglycemia and 193 (55.1%) of the patients with hyperglycemia were women. 169 (48.4%) of patients with hyperglycemia during hospitalization were already diabetic. The mean age was higher in COVID-19 patients with hyperglycemia (P < 0.001), and systolic blood pressure and respiratory rate were also higher in them (P = 0.005 and P = 0.013, respectively). In patients with hyperglycemia, oxygen saturation (SpO2) at the time of admission and discharge was lower than other patients (P < 0.001). The frequency of hypertension in the patients with hyperglycemia was significantly higher than in nonhyperglycemic patients (P < 0.001 vs. 0.014). The estimated glomerular filtration rate (eGFR) of hyperglycemic patients was significantly lower than other patients (P < 0.001). Also, there was a significant inverse relationship between eGFR values and fasting (FBS) and random blood sugar (BS) (r = 0.328 and r = 0.310, P < 0.001). On the other hand, there was a direct relationship between FBS and random BS in patients with hyperglycemia with the dose of corticosteroids (r = 0.146 and r = 0.158, P < 0.01). In total, 8.2% of the patients died, although the FBS and random BS and a history of DM were not risk factors for the death of patients (P < 0.05). Conclusion. The findings of our study showed that hyperglycemia is highly prevalent in hospitalized patients with COVID-19. Hyperglycemia in previously nondiabetics appears to be associated with decreased eGFR in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: Infections with herpes simplex virus type 2 (HSV-2) and varicella-zoster virus (VZV) are associated with serious maternal and neonatal health consequences. The literature review reveals a research gap regarding the seroprevalence of HSV-2 and VZV among women of reproductive age in Mashhad, Northeast of Iran. The present study aims to evaluate the seroprevalence of these viruses among a group of women in Mashhad, Iran. Methods: Sera were collected by health center personnel using a cluster sampling method from healthy women with specific age characteristics residing in three distinct socioeconomic regions of the city. The participants, aged 20-35, were divided into three groups (20-25, 26-30, and 31-35 years). The levels of VZV and HSV-2 IgG antibodies were evaluated using commercial ELISA kits. Subsequently, the results were analyzed using SPSS software. Results: A total of 93 women were included in the study. Anti-HSV-2 IgG antibody was detected in 3 out of 93 participants (7.5%), while anti-VZV IgG antibody was found positive in 80 out of 93 individuals (83.3%). The HSV-2 positive cases were concurrently positive for the VZV antibody. There was no significant difference in the positivity of anti-HSV-2 and anti-VZV antibody positivity within age groups or socioeconomic status (P > 0.05). Conclusions: The high seroprevalence of VZV among nonvaccinated participants indicates a widespread presence of the virus and underscores its potentially serious impact on community health. Therefore, it is recommended that a VZV vaccination program be considered by the health system. Furthermore, the reactivation of latent HSV-2, whether symptomatic or asymptomatic, during pregnancy should not be disregarded as a life-threatening threat. [ABSTRACT FROM AUTHOR]

Background and Aim: Viral infections are associated with augmented morbidity and mortality risk in Hemodialysis (HD) patients. Materials and Methods: In this investigation, we have scrutinized the presence of hepatitis B virus (HBV), and occult hepatitis B virus infection (OBI), in HD patients. In this cross-sectional study, the blood samples and data from 200 hemodialysis patients referred to a dialysis center in Kerman, from January 2022 to March 2023 were collected. Anti-HBV antibodies and HBs Ag were analyzed in the specimens using an enzyme-linked immunosorbent assay (ELISA). All samples were tested for OBI by using a real-time polymerase chain reaction (PCR) assay. Results: Of the 200 patients considered, 4 (2%) for HBs Ag were positive. Real-time PCR demonstrated OBI in 2 (1%) patients. The majority presence of viral infection was in the age group 50≥ years, self-employment, low education level, and diabetic patients. Furthermore, our study revealed that a higher percentage of HD patients were associated with low educational levels, self-employment, urban residence, and comorbidities such as diabetes and hypertension. Conclusion: In this study, HBV antigen prevalence was 2%, and OBI prevalence was 1%, indicating a low HBV incidence in HD patients. Our study underscores the importance of lifestyle improvement, increased awareness among lower-educated and lower-skilled individuals, and rigorous disinfection practices in managing risk factors for hemodialysis patients, including HBV and OBI. [ABSTRACT FROM AUTHOR]

In face of climate change and global scale biodiversity loss, assessing the relationship between biodiversity and forest ecosystem functioning is essential, but poorly investigated in temperate forests of Iran. We examined plant diversity aboveground biomass relationships in unmanaged, and forests managed with a single-stem selection system in the Hyrcanian forests ecoregion in Northern Iran. Also, the effect of single-stem selection system on soil nutrient and plant species diversity of tree layer was investigated. Linear models were used to analyze the effect of management and soil characteristics on aboveground biomass and tree layer attributes. Moreover, the relationships between aboveground biomass and plant species diversity metrics and soil characteristics were investigated using simple linear and multiple linear regression analysis by using regression analysis. We found that tree layer species richness and Shannon diversity were significantly higher in managed forests compared to unmanaged forests. While simple regression analysis revealed no effect of tree layer diversity and soil characteristics on aboveground biomass, multiple regression analysis showed that the main positive driver of aboveground biomass was soil nitrogen content (or its equivalent soil organic carbon). These findings indicate that from a biodiversity point of view, the single-stem selection system can be considered a sustainable forest management approach in Hyrcanian forests because it has positive effects on tree layer diversity. This is probably driven by increased habitat heterogeneity and light availability at forest floor through cuttings, while keeping cutting intensity at a level that is too low to significantly affect tree biomass. While the relationship between soil nitrogen and biomass was positive, we found no relationship between species diversity and biomass. Finally, assessment of relationship between biomass and plant species diversity and other underlying factors such as soil nutrients can be considered an important tool to conserve and manage ecosystem services. [ABSTRACT FROM AUTHOR]

Access to sufficient and safe water particularly in vulnerable countries is one of the most important goals targeted by the United Nations for 2030. The agricultural water supply is crucial in arid areas such as Iran. In water supply projects, employers usually seek less duration and cost, and higher quality, however, contractors seek a reduction of fluctuations in project resources, especially human resources, and these goals may be in conflict with each other. Therefore, finding an optimal project schedule considering different project objectives is vital for managers to achieve stakeholders' satisfaction. In this study, the four main project objectives including time, cost, quality, and resource leveling as well as the activity dependencies and resource constraints are addressed through fuzzy optimization. The proposed model was first implemented on a small-sized project instance for validation; then, the model was solved by the Nondominated Sorting Genetic (NSGA-II) and Multi-objective Particle Swarm Optimization algorithms using the information of a real-world agricultural water supply project. The results of the first Pareto set for different alpha-cuts in relation to the fuzzy quality factor show a set of solutions and different alternatives for project implementation which leads to a number of execution modes each of which may result in achieving the project objectives. Finally, the most ideal solution with a duration of 178 days was selected using the fuzzy TOPSIS method. The findings demonstrate the validity of the proposed model concerning the needs of agricultural water supply organizations. [ABSTRACT FROM AUTHOR]

Despite the importance of the prediction of land susceptibility to gully erosion, there is a lack of research studies adopting the deep‐learning approach. This study aimed to predict gully susceptibility hotspots using hybridized deep‐learning models and evaluate their efficiency. Field records of gully occurrences in a gully‐prone region, the Talwar watershed (6468 km2), eastern Kurdistan province, Iran, were used to generate a gully inventory dataset. A total of 14 geomorphometric, environmental, and topo‐hydrological gully drivers were selected as predictor variables. The hybridized models were developed using convolutional neural network (NNC) and metaheuristic procedures, including the gray wolf optimizer (GWO) and the imperialist competitive algorithm (ICA). The validity of the resulting outputs was investigated based on the area under the receiver operating characteristic (ROC) curve. Results revealed that the NNC‐GWO had the highest efficiency in the validation step (AUC = 97.2%), whereas the NNC‐ICA was the second‐best model (AUC = 95.1%). The standalone NNC model showed the lowest accuracy (AUC = 91.2%) in predicting gully susceptibility hotspots compared to NNC‐GWO and NNC‐ICA. Thus, both hybridized models had better predictive performance for identifying gully susceptibility in comparison with the standalone NNC model. Furthermore, according to the NNC‐GWO model, about 0.2% (1294.8 ha) and 0.05% (235.2 ha) of the study area were identified as high and very high gully susceptibility classes. In addition, the application of the standalone NNC led to an overestimation of the susceptibility degree for gully initiation. This study supports researchers efforts to increase the model's performance when working in the land degradation domain. [ABSTRACT FROM AUTHOR]

The purpose of this study is to propose a framework to evaluate the entrepreneurship intensity (EI) of Iranian state universities. In order to determine EI, a hybrid multi-method framework consisting of Delphi, Analytic Network Process (ANP), and VIKOR is proposed. The Delphi method is used to localize and reduce the number of criteria extracted from a deep literature review, according to the social and economic conditions of Iranian state universities by using an expert panel, including sixty-eight country-wide academicians and practitioners. After that, a group approach to ANP was utilized as an evaluation method to derive the weights of each criterion. Next, the evaluation data were gathered through a questionnaire, and, finally, the compromise ranking of universities was calculated using the VIKOR method. Moreover, this study applies weight-variance analysis (WVA) to suggest improvement actions. The paper proposes an evaluation framework for determining the performance of entrepreneurship development initiatives in universities. By using this framework, twenty-two Iranian state universities are evaluated in terms of their EI, and the results are discussed.

Climate change and rising global average temperatures across the year may strongly affect olive fruits' development process and their oil yield and quality. There is therefore an urgency to take immediate actions to characterize the wide variability of cultivars in order to identify those with a stable response to high temperatures, particularly in areas like the west of Iran, which is characterized by a warm summer continental climate. The objective of this study is to investigate the process of fruit development and oil accumulation in response to high summer temperature conditions in a set of four Iranian olive cultivars (Shengeh, Roughani, Zard Aliabad, and Dezful) in comparison with four foreign olive cultivars (Konservolia, Sevillana, Manzanilla, and Mission) in seven various harvesting times (20 July, 5 and 20 August, 5 and 20 September, 6 and 21 October). The obtained results evidence a significant positive correlation between fruit dry matter and oil content. High temperatures reduced the oil and dry matter accumulation in the second half of the summer, with severe thermal conditions adversely affecting oil synthesis. Paramount variations were observed among the cultivars regarding oil accumulation, dry matter, and pomological attributes. All of them showed the highest oil content at the last harvest. Among all analyzed varieties, Roughani showed the highest tolerance and adaptive capacity to high temperatures as it accumulated the greatest amount of dry matter as well as oil content in all of the harvesting times, demonstrating a positive correlation between these two traits. Although Shengeh showed the lowest oil content on a dry and fresh weight basis at the first harvesting time, this cultivar generally presented higher fruit development attributes than the other cultivars, highlighting that it benefits from a high temperature. [ABSTRACT FROM AUTHOR]

Carbapenemases-producing K. pneumoniae are challenging antimicrobial therapy of hospitalised patients, which is further complicated by colistin resistance. The aim of this study was to investigate the molecular epidemiological insights into carbapenemases-producing and colistin-resistant clinical K. pneumoniaeA total of 162 colistin resistant clinical strains of K. pneumoniae were collected during 2017–2019. Antimicrobial susceptibility and the colistin minimum inhibitory concentration were determined. Using PCR assay, the prevalence of resistance-associated genes including blaKPC, blaIMP, blaVIM, blaOXA-48, blaNDM-1 and mcr-1 to -9 was examined. Additionally, a PCR assay was used to examine the mgrB gene in colistin-resistant bacteria. 94.4% of the tested strains were resistant to imipenem and 96.3% were resistant to meropenem. Colistin resistance (MIC > 4 µg/L) was observed in 161 isolates (99.4%) by Colistin Broth Disk Elution method. The KPC enzyme was the most common carbapenemase and was identified in 95 strains (58.6%), followed by the IMP, VIM and OXA-48 detected in 47 (29%), 23 (14.2%) and 12 (7.4%) isolates, respectively. However, no NDM-1 gene was detected. Additionally, none of the studied isolates harbored mcr variants, while mgrB gene was observed in 152 (92.6%) isolates. Colistin resistance of K. pneumoniae isolates may be associated with mgrB gene mutation. To stop the spread of resistant K. pneumoniae, surveillance must be improved, infection prevention protocols must be followed, and antibiotic stewardship must be practised. [ABSTRACT FROM AUTHOR]

The concept of common morality is fundamental in medical ethics, and lack of universal content and characteristics of common morality is a product of its multifaceted nature. This study aimed to identify the ideas and experiences of academic faculties regarding common morality in a pluralistic setting to promote conceptual knowledge and strengthen moral reasoning and ethical decision-making. The study was conducted using a qualitative method, employing semi-structured in-depth interviews with thirteen faculty members who were selected purposively. In order to assess their ideas and experiences, the transcripts of the interviews were analyzed using the content analysis method through directed and conventional approaches. The interviews were coded manually. Two themes were reflected in the interviews: ontology and epistemology of common morality. The study indicates that the debate about the subjective or objective dependence of common morality questions the coherence of Beauchamp and Childress' common morality (CM) theory, as common morality is the result of various individual and social factor that influence moral thinking and decision-making in pluralistic environments. Additional studies are needed in order to investigate the effect of cultural, social, theoretical, ideological and individual factors on promoting clinical ethical reasoning and decision-making skills. [ABSTRACT FROM AUTHOR]

Introduction: Cardiac complications are the leading cause of death in thalassemia patients. It is assumed that progressive iron accumulation results in myocyte damage. Myocardial T2* measurement by cardiac MRI quantifies iron overload. We aimed to study the association between left and right ventricular (LV and RV) function and iron deposition estimation by cardiac MRI T2* in a sample of Iranian patients. Methods: Cardiac MRI exams of 118 transfusion-dependent thalassemia major patients were evaluated retrospectively. Biventricular function and volume and myocardial and liver T2* values were measured. The demographic and lab data were registered. Poisson and chisquare regression analyses investigated the correlation between the T2* value and ventricular dysfunction. Results: The study participants' mean (SD) age was 32.7y (9.02), and 47.46% were female. Forty-nine cases (41.52%) revealed at least uni-ventricular dysfunction. LV dysfunction was noted in 20 cases, whereas 47 patients revealed RV dysfunction. The risk of LV dysfunction was 5.3-fold higher in patients with cardiac T2* value less than 10msec (RR = 5.3, 95% CI = 1.6, 17.1, P < 0.05). No association was found between age, liver T2* value, serum ferritin level, and chelation therapy with the risk of LV and RV dysfunction. Conclusion: Cardiac MRI T2* measure is a good indicator of LV dysfunction. Moreover, MRI parameters, especially RV functional measures, may have a substantial role in patient management. Therefore, cardiac MRI should be included in beta-thalassemia patients' management strategies. [ABSTRACT FROM AUTHOR]

The depletion of fossil fuel sources has encouraged the authorities to use renewable resources such as wind energy to generate electricity. A backup/storage system can improve the performance of wind turbines, due to fluctuations in power demand. The novelty of this study is to utilize a hybrid system for a wind farm, using the excess electricity generated by the wind turbines to produce hydrogen in an alkaline electrolyzer (AEL). The hydrogen storage tank stores the produced hydrogen and provides hydrogen to the proton-exchange membrane fuel cell (PEMFC) to generate electricity once the power demand is higher than the electricity generated by the wind turbines. The goal of this study is to use the wind profile of a region in Iran, namely the Cohen region, to analyze the performance of the suggested integrated system on a micro scale. The output results of this study can be used as a case study for construction in the future, based on the exact specification of NTK300 wind turbines. The results indicate that, with the minimum power supply of 30 kW from the wind turbines on a lab scale, the generated power by the PEMFC will be 1008 W, while the maximum generated hydrogen will be 304 mL/h. [ABSTRACT FROM AUTHOR]

Background & Objective: Occurrence of Hepatitis E Virus (HEV) infection may be common in Human Immunodeficiency Virus (HIV-1) patients and may lead to chronic infection as well as cirrhosis. We intended to determine the incidence of HEV infection among HIV-1 patients in comparison to individuals without HIV-1 infection. Methods: In our cross-sectional study, 87 HIV-1-positive patients were compared to 93 healthy individuals in Kerman, Iran. Plasma and peripheral blood mononuclear cells (PBMCs) were obtained from all the participants. Plasma samples were evaluated for HEV IgM and IgG using the ELISA kit. Then, reverse transcriptase-nested polymerase chain reaction (RT-nested PCR) was used in RNA extractions from PBMCs to check for the presence of HEV RNA. Results: Among the subjects examined in our study, 61 (70.1%) and 71 (77.4%) out of patients with HIV-1 infection and healthy individuals were male, respectively. The average ages of patients with HIV-1 and the control group were 40.2 years and 39.9 years, respectively. No discernible differences were found between the two groups based on IgM and IgG seropositivity against the HEV. However, HEV-RNA was found in 8% of patients with HIV-1 and 1.1% of HIV-1-negative individuals (P=0.03). There was also an association between the HEV genome and anti-HEV and anti-HCV antibodies in HIV-1-positive patients (P=0.02 and P=0.014, respectively). Conclusion: HEV infection may be more common in HIV-1 patients and may develop a chronic infection in immunocompromised individuals. Molecular-based HEV diagnostic tests, including RT-PCR assays, should be performed in HIV-1 patients with unknown impaired liver function tests. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to investigate the prevalence, risk factors, endoscopic findings, and outcome of gastrointestinal bleeding in COVID-19 hospitalized patients. Materials and Methods: This study is a retrospective review of COVID-19 hospitalized patients with gastrointestinal bleeding from a large university hospital in southeast Iran. This study was conducted over one year from April 2020 to March 2021. Results: Out of 3563 COVID-19 inpatients with approximately equal sex distribution (52.5% of men and 47.5% of women), 80 (2.24%) patients with a mean age of 58.01±20.71 were identified with signs of gastrointestinal bleeding, including; melena (48.8%), hemoglobin drop (42.5%), fresh blood hematemesis (31.3%), rectorrhagia (20%) and coffee ground emesis (10%). 52 patients (65%) had signs of gastrointestinal bleeding on admission, and 28 patients (35%) developed gastrointestinal bleeding during their hospital admissions, most of whom were men (63.8%). Endoscopic characteristics were; gastric erosion (27.7%), gastric ulcer (23%), duodenal ulcer (21.5%), esophageal ulcer (12.3%), and esophageal erosion (6.1%) in upper gastrointestinal endoscopy. On colonoscopy, hemorrhoids (25%), mass lesions (16%), fissures (8.3%), diverticular lesions (8.3%), and polyps (8.3%) were the most common findings. The overall mortality of the patients in the present study was 36.2%. However, gastrointestinal bleeding related deaths were 7.5%. Conclusion: Gastrointestinal bleeding was identified in 2.24% of hospitalized COVID-19 patients, with gastroduodenal ulcers and erosions as the most common symptoms. [ABSTRACT FROM AUTHOR]

Background: Purpose: This study intended to investigate the prevalence of anemia and its associated factors among patients with type 2 diabetes mellitus (T2DM) in Gorgan, Iran. Methods: This cross-sectional study was conducted on 415 (109 men) patients with T2DM referred to the referral diabetes clinic of Sayad Shirazi Hospital in Gorgan in 2021. Demographic information, anthropometric indices, past medical history, and some laboratory data on cell counts, serum blood glucose, HbA1c, creatinine, lipid/iron profiles, and urinary albumin were collected. The univariable and multivariable logistic regression analysis was applied to compute odds ratios (ORs) and 95% confidence intervals (CI) for potential associated factors, using SPSS version 21. The multivariable Model was adjusted for obesity, Hb A1c, T2DM duration, using glucose-lowering drugs (GLDs), chronic kidney disease (CKD), albuminuria, hypertriglyceridemia, and hypercholesterolemia. Results: The prevalence of anemia was 21.5% [95%CI: 17.6-25.7] among our total participants. The corresponding values for men and women were 20.2 (13.1-29.0) and 21.9 (17.4-27.0), respectively.The adjusted model revealed that obesity (OR, 1.94 [95% CI, 1.17–3.23]), T2DM duration for more than five years (OR, 3.12 [1.78–5.47]), albuminuria (OR, 6.37 [3.13–10.91]), chronic kidney disease (OR, 4.30 [ 2.83–7.29]) and hypertriglyceridemia (OR, 1.72 [ 1.21–2.77]) were significantly associated with prevalent anemia among patients with T2DM. Moreover, using insulin separately or in combination with oral GLDs associated positively with the prevalence of anemia with ORs of 2.60 [1.42-6.42] and 1.87 [1.30-4.37] , respectively. Conclusion: Anemia had a high prevalence among patients with T2DM in the north of Iran (about 22%), which is associated with obesity, hypertriglyceridemia, duration of T2DM, and diabetic kidney disease. [ABSTRACT FROM AUTHOR]

An efficient method to instantly assess drought-tolerant plants after germination is using osmoregulation in tissue culture media. In this study, the responses of three Iranian melon genotypes to sorbitol (0.1, 0.2, and 0.4 M) or polyethylene glycol (PEG) (0.009, 0.012, and 0.015 M) were evaluated as drought stress simulators in MS medium. 'Girke' (GIR), 'Ghobadloo' (GHO), and 'Toghermezi' (TOG) were the genotypes. GIR is reputed as a drought-tolerant genotype in Iran. The PEG or sorbitol decreased the coleoptile length, fresh weight, and photosynthetic pigments content while enhancing proline and malondialdehyde (MDA) contents. Protein content and antioxidant enzyme activity were utterly dependent on genotype, osmotic regulators, and their concentration. Coleoptile length, root and shoot fresh weight, root dry weight, proline and MDA content, and guaiacol peroxidase (GPX) activity can be used as indicators for in vitro screening of Cucumis melo L. genotypes. The results showed that sorbitol mimics drought stress better than PEG. Overall, our findings suggest that in vitro screening could be an accurate, rapid, and reliable methodology for evaluating and identifying drought-tolerant genotypes. [ABSTRACT FROM AUTHOR]

A new species belonging to the genus Laimydorus , and a known species of the genus Labronema , collected from the rhizosphere of grassland plants in West Azarbaijan province, Iran, are presented. The new species is characterized by its body length (1.56–1.81 mm in females and 1.39–1.57 mm in males), lip region offset by weak constriction and wider than adjacent body (11–14 μm), odontostyle 17–20 μm long, neck length 312–434 μm, vulva longitudinal (V = 42.2–46.5), uterus well-developed and with Z-differentiations, tail long (219–237 μm, c = 6.9–8.3, c´ = 8.2–10) in females, short and convex-conoid with blunt terminus (19–22 μm, c = 68–72.5, c´ = 0.77–0.84) in males, spicules 40–45 μm long, and 18–20 contiguous ventromedian supplements with hiatus. Molecular analyses, using Bayesian inference based on D2-D3 expansion segments of the 28S rRNA (LSU), placed the new species in a clade comprising representatives of the genera Nevadanema , Dorylaimus , Labronema , Calcaridorylaimus , Mesodorylaimus , and Prodorylaimus , which all belong to Dorylaimidae. In addition, new data (molecular, morphometrics, images, and geographic distribution) are presented for the Iranian population of Labronema vulvapapillatum. [ABSTRACT FROM AUTHOR]

Collective trauma is the outcome of traumatic incidents that necessitate collective self‐reflection and create a need for public discourse. Access to social media allows individuals to shape event coverage beyond what is put forth by mainstream media through hashtag‐based communities. The death of Sahar Khodayari, or "Blue Girl," an Iranian woman who committed suicide after being sentenced to prison for appearing in a sports stadium dressed as a man, is one such event that became a collective trauma. The current study sought to examine the collective trauma reaction among Farsi‐speaking Twitter users in response to Khodayari's death as represented in public tweets. The overall pool of data consisted of 8,653 tweets containing at least one of four hashtags (i.e., #BlueGirl, #Blue_Girl,, # #), posted September 9–24, 2019, as well as 603 tweets posted on the anniversary of the event 1 year later. Using thematic analysis, we identified three main themes within these public tweets representing different responses to Khodayari's death: social justice, awareness, and process. In undemocratic countries, like Iran, where there are limited free physical spaces for public gatherings, social media provides a platform for people to come together after tragic events to express emotions and discuss thoughts and actions. The present findings demonstrate that Twitter allowed Farsi‐speaking users to demand social justice, share awareness about #BlueGirl, and process their emotions and thoughts accordingly. Therefore, social media may provide a window into the collective trauma experience, and it may also serve as a new mode of studying trauma on new platforms. [ABSTRACT FROM AUTHOR]

Background: Type 2 Diabetes mellitus (T2DM) is one of the most common endocrine diseases that weakens the immune system. Candida albicans, is part of the natural oral flora and increases in cases of compromised immune systems. The exact cause of the increased prevalence of candidiasis in patients with T2DM is still unclear. The study aimed to correlate serum interleukin 10 (IL-10) and interferon-gamma cytokines (IFN-γ) with oral candidiasis in T2DM. Methods: In this case–control study, 81 patients with T2DM and 41 non-diabetic individuals aged 30 to 70 years participated. Demographic information, a Blood sample (for blood glucose and cytokine tests), and an oral cotton swab sample from each individual were obtained. The samples were then incubated in a Sabroud dextrose agar medium. Colony growth was calculated and the type of yeast species in individuals with oral candidiasis was identified by culture in CHROMagar Candida medium. IL-10 and IFN-γ were measured by ELISA kit and the data were analyzed using SPSS-18. Results: An overall of 122 participants comprised 73.77% females and 26.22% males. An increase in interleukin-10 by 40% and a decrease in IFN-γ by 6% can increase oral candidiasis prevalence among diabetic patients. Candida albicans was the most prevalent Candida species (spp.) in the diabetic and non-diabetic groups. The presence of oral candidiasis was not associated with HbA1c or FBS levels in both groups. Conclusion: In the diabetic population, an increase in IL-10 or a decrease in IFN-γ may be associated with an increased risk of oral candidiasis. [ABSTRACT FROM AUTHOR]

Background: Drought stress is among the most serious threats jeopardizing the economic yield of crop plants in Iran. In particular, in response to withholding irrigation, the reduction in performance and quality of a precious plant such as the olive tree is remarkable. Therefore, the selection of cultivars that are resistant or tolerant to drought has been recognized as one of the most effective long-term strategies for sustainably alleviating the adverse effects of this stress. In this view, our study evaluated the response of 8 olive cultivars including 4 elite native cultivars (Zard Aliabad, Roughani, Dezful, and Shengeh) and 4 foreign cultivars (Manzanilla, Sevillana, Konservolia, and Mission) to water shortage in the Dallaho Olive Research station of Sarpole-Zahab in Kermanshah province in 2020. Olive trees underwent 3 levels of irrigation treatment including 100% full irrigation (control), 75%, and 50% deficit irrigation. Results: Based on the results, 50% deficit irrigation decreased both growth and pomological traits, but determined the highest dry matter percentage. As the severity of drought stress increased, with an accumulation of sodium and malondialdehyde, an incremental increase in osmolytes was observed, as well as an enhancement of the activity of antioxidant enzymes (peroxidase and catalase). In contrast, full irrigation led to an increase in photosynthetic pigments, calcium, and potassium. Dezful and Konservolia cultivars revealed a significantly higher growth rate, correlated in the former to higher levels of chlorophyll, compatible compounds, total phenolic content, relative water content, potassium to sodium ratio, catalase, and peroxidase activities compared with other cultivars. Konservolia showed the best yield parameters under 75% and 100% irrigation regimes, correlated to higher chlorophyll, potassium, and total phenolic content (in particular at 75% ET). Conclusions: Generally, the selection of more resilient or tolerant cultivars to sustain water scarcity stress is a widely operative solution to extend rainfed orchards in semi-arid environments. Our study showed that Dezful and Konservolia had the best adaptive mechanisms to cope with the detrimental effects of drought stress. [ABSTRACT FROM AUTHOR]

Background: Gastrointestinal (GI), liver, and pancreaticobiliary diseases, in addition to the high health care utilization, account for a significant proportion of disability and death in Iran. We aimed to assess the incidence of in-hospital mortality for the total GI, liver, and pancreaticobiliary diseases in all hospitals in Kerman, Iran. Methods: In a cross-sectional study from May 2017 to April 2018, we collected the data of in-hospital death records due to GI, liver, and pancreaticobiliary diseases in all hospitals in Kerman city. GI and liver diseases were classified into three main categories: 1. Non-malignant GI diseases, 2. Non-malignant liver and pancreaticobiliary diseases, and 3. GI, liver, and pancreaticobiliary malignancies. All data were analyzed using SPSS software, version 22 (IBM). Results: Of 3427 in-hospital mortality, 269 (7.84%) deaths were due to GI, liver, and pancreaticobiliary diseases, of which 82 (30.48%) were related to non-malignant GI disorders, 92 (34.20%) to the non-malignant liver and pancreaticobiliary diseases, and 95 (35.31%) were associated with GI, liver and pancreaticobiliary malignancies. Most patients were male (62.08%), and the most common age was between 60-80 years (40.5%). GI bleeding occurred in 158 (58.73%) patients, and variceal bleeding was the most common cause (28.48%). Additionally, cirrhosis was reported in 41 out of 92 (44.56%), and hepatitis B virus (HBV) was the most common cause of cirrhosis among 17 out of 41 (41.46%). Conclusion: Our results show that gastric, colorectal, and pancreatic cancers and cirrhosis due to HBV were the most common causes of mortality associated with GI, liver, and pancreaticobiliary diseases in the hospitals of Kerman. [ABSTRACT FROM AUTHOR]

Objective: Nowadays, loneliness is one of the foremost common issues among university students that may negatively affect their physical and mental states and academic performance. Accordingly, this research project intended to investigate the incidence of loneliness and its related risk factors among students studying at universities of medical sciences. Method: The participants in this cross-sectional study were 538 Tabriz University of Medical Sciences students, selected using a simple random sampling method. Loneliness was measured using the UCLA Loneliness questionnaire with 20 questions. Descriptive statistics, multiple logistic regression, and Chi-square were used to identify factors affecting loneliness. Results: The results showed that the mean loneliness score and the magnitude of the students' loneliness were 41.42 and 26.4%, respectively. The magnitude of loneliness was higher among female respondents (OR = 1.86, P = 0.005), cigarette smokers (OR = 0.39, P < 0.001), freshman students (OR = 2.76, P = 0.021), sophomore students (OR = 2.36, P = 0.040), those with low financial status (OR = 1.80, P = 0.037), and those residing in dormitories (OR = 1.73, P = 0.013). Conclusion: In general, loneliness was widespread among the students. Based on the findings, the magnitude of loneliness was higher among the first-year student group, female students, students with poor economic status, and those who smoked and lived in dormitories. Therefore, this study's findings underline the significance of making students aware of loneliness, investigating the circumstances and factors that exacerbate this sensation among first-year students (mainly between 18-21 years old), and devising intervention to alleviate it. [ABSTRACT FROM AUTHOR]

Introduction Mortality due to carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection has increased worldwide in recent years. The risk factors associated with hospital settings in Iran and the role of strain resistance mechanisms in many studies are unclear. Methods A retrospective study was conducted on consecutive non-repetitive patients with CRPA infections isolated from seven major hospitals from northwest of Iran. We evaluated different risk factors and characteristics of bacteria for the death or survival of patients. Results In this study, 116 CRPA isolates were obtained from patients admitted to seven hospitals. Forty-one (35.3%) patients were enrolled in the study of mortality risk factors. Significant risk factors associated with mortality included the site of infection, hospitalization in different wards, the use of invasive devices, and the type of carbapenem resistance mechanisms. Conclusions ICU admission, the use of mechanical ventilation and chest tube and infection with pandrug-resistant strains were the most important factors in increasing mortality due to CRPA infection. These results suggested that the clinicians should emphasize the proper use of antibiotic and invasive procedures. [ABSTRACT FROM AUTHOR]

Background: Self-medication in students, as educated people, is one of the most important health issues. It is known that inappropriate self-medication is harmful for individuals as it has potential risks, disrupts the drug market and increases the per capita financial drug consumption. Thus, the aim of this study is to investigate the habits related to drug use and the prevalence of self-medication practices among university students. Methods: This cross-sectional study was conducted in 2021 at Jahrom universities/Iran, using an electronic "self-medication practices and medication habits" questionnaire. A total of 848 students from four healthcare and non-healthcare universities participated in the study. Results: The prevalence of self-medication among students was 44.8%. The most common medicines used for self-medication included cold remedies and sedatives that were used by 33% of the students. About 47% of students stated that they have used antibiotics without a physician's prescription. The internet and social networks were the source of information on self-medication in about 40% of students. There was no significant difference in self-medication between medical and non-medical students (OR = 0.865, 95% CI: 0.659–1.134). Self-medication in students with underlying disease was higher than students without underlying disease (OR = 2.8, 95% CI: 1.39–5.60). Conclusions: Self-medication had a high prevalence among students. The best strategy to reduce or eliminate self-medication is to raise students' awareness and knowledge about potential risk of self-medication practices. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a prevalent multifactorial disorder that can increase the risk of developing diabetes, cardiovascular diseases, and cancer. We aimed to compare different machine learning classification methods in predicting metabolic syndrome status as well as identifying influential genetic or environmental risk factors.Methods: This candidate gene study was conducted on 4756 eligible participants from the Tehran Cardio-metabolic Genetic study (TCGS). We compared predictive models using logistic regression (LR), Random Forest (RF), decision tree (DT), support vector machines (SVM), and discriminant analyses. Demographic and clinical features, as well as variables regarding common GCKR gene polymorphisms, were included in the models. We used a 10-repeated tenfold cross-validation to evaluate model performance.Results: 50.6% of participants had MetS. MetS was significantly associated with age, gender, schooling years, BMI, physical activity, rs780094, and rs780093 (P < 0.05) as indicated by LR. RF showed the best performance overall (AUC-ROC = 0.804, AUC-PR = 0.776, and Accuracy = 0.743) and indicated BMI, physical activity, and age to be the most influential model features. According to the DT, a person with BMI < 24 and physical activity < 8.8 possesses a 4% chance for MetS. In contrast, a person with BMI ≥ 25, physical activity < 2.7, and age ≥ 33, has 77% probability of suffering from MetS.Conclusion: Our findings indicated that, on average, machine learning models outperformed conventional statistical approaches for patient classification. These well-performing models may be used to develop future support systems that use a variety of data sources to identify persons at high risk of getting MetS. [ABSTRACT FROM AUTHOR]

Industrial growth and development are among the integral components of economic development in developing countries such as Iran. Markazi province in the central part of Iran is one of the most prone areas for industrial progress due to its geopolitical location, proximity to the capital and major cities, and access via Iran's western corridor. Over the last few decades, the concentration of major industries in combination with a lack of environmental safeguards have led to major environmental concerns, such that the province's industrial development faces serious challenges going forward. This paper analyzes how to resolve these challenges through strategic analysis of stakeholder interactions using a Graph Model for Conflict Resolution, i.e., a non-cooperative model of game theory. Results indicate that, from a strategic point of view, the main cause of the conflict is over physical industrial land development in Markazi province by way of rationality and organizational benefits from stakeholders. It was shown that the insistence from the Industry and Mining Organization on industrial development and the Department of Environment on the preservation of natural resources and the environment, on the one hand, and the prevention of their further destruction, on the other, have made it difficult to find a cooperative solution. The findings further unveiled that in a non-cooperative scenario (i.e., the current situation), the equilibrium point of the conflict is status 16 (i.e., among the 18 situations) and no unilateral progression from either party can be detected. Via the equilibrium point, if the current preferences of the parties cannot be resolved, the conflict will remain at a deadlock leaving the environment at risk of further degradation. [ABSTRACT FROM AUTHOR]

A new species of the genus Willinema, collected in two locations from north-west Iran, is described and illustrated. Willinema persicum sp. nov. is characterised by its 1.42–1.89 mm long body, lip region offset by weak constriction and 10–13 μm broad, odontostyle 14–18 μm long, neck 270–306 μm long, pharyngeal expansion 110–137 μm long, female genital system mono-opistho-ovarian, anterior genital branch 41–133 μm long or 0.8–2.9 times the corresponding body diameter, posterior uterus tripartite, vulva a pre-equatorial (V= 39–44) transverse slit, tail short and convex conoid to rounded (19–27 μm, c= 61–84, c′ = 0.7–1.0), spicules 36–41 μm long, and 7–9 ventromedian supplements with hiatus. The taxonomy of the genus is updated, including an emended diagnosis, list of species, key to their identification, and compendium of their main morphometric traits. Eudorylaimus brunettii apud Andrássy (1967), nec Meyl (1953), is renamed Willinema chilense sp. nov. The phylogeny of the group is briefly addressed also. [ABSTRACT FROM AUTHOR]

Markazi Province has high potential for residential development due to its geopolitical location in the central part of Iran. This study investigated the possibility of residential area development in Markazi Province using a GIS‐based analytic network process. ArcGIS Version 10.6.1 and Super Decision Version 3.2 software were utilized for the zoning and assessment of criteria. All criteria, and their sub‐criteria, and limitations were gathered using national standards, literature review, and experts. According to the final residential area land suitability map, 16.74% of Markazi Province is highly or very highly suitable for urban development, even though 57.55% of the province's area (i.e., 30% of its current cities) are located in the exclusion zone. Results suggested that most parts of the province do not have desirable conditions for residential zoning. Further attention and deepened GIS monitoring over an extended period would be beneficial before future development is considered. In particular, the natural limitations in the region—such as slope—impede development potential. The study provides an alternative quantifiable and verifiable approach for sustainable urban planning from a land use policy perspective. [ABSTRACT FROM AUTHOR]

The production of seafood, particularly in areas far from coastlines, makes aquaculture an optional farming alternative. Case research from the semi-arid Markazi province, Iran, is examined as a viable aquaculture location for Oncorhynchus mykiss (rainbow trout). ArcGIS Version 10.6.1 and Super Decision Version 3.2 software are utilized for the zoning and assessment of criteria maps. All criteria, i.e., sub-criteria and limitations, were gathered through the academic literature, qualitative interviews via expert opinion, national data, and guidelines. By imposing constraints on the premier aquatic potential map, the final map of the aquaculture potential of Markazi province was obtained. The results indicated that 40.79% of Markazi province has a high potential for aquaculture development. According to the sensitivity analysis, changes in criterion value (i.e., increase or decrease) in weight corresponded with the rate of change. Aquaculture development would require large-scale investment and make Markazi province a major seafood producer in the region. [ABSTRACT FROM AUTHOR]

The costs of gas transportation and its environmental/security impacts in Iran have led to evaluating geothermal/solar renewable sources instead. Regarding the high potential of geothermal/solar in Sistan/Baluchestan province, Iran, which have still no access to the global gas network, these resources create a desirable plan. This paper attempted to present/compare four possible solar-assisted ground source heat pumps to supply four purposes of electricity demand, heating/cooling, and domestic hot water. First, the energy needed in the region was designed with DesignBuilder. Then, each proposed system was modeled in Polysun software using a photovoltaic-thermal and a vertical geothermal heat exchanger. Afterward, all probable plans were evaluated and compared technically, economically, and environmentally. The results indicated that the maximum/minimum values of the coefficient of heat pump performance for direct heat exchanger and series systems were 4.39/3.87. Also, the optimal plan was introduced with 4957/10667 kWh electricity consumption/production. Besides, an economic analysis was estimated for the optimal strategy with an investment return of 7years. The designed system prevented 5089kgCO 2 emissions annually. By means of this integrating hybrid system, Sistan/Baluchestan province would become a significant renewable power plant globally, and a considerable techno-economic and environmental challenge would be dissolved in Iran. • A novel geothermal/solar hybrid system was introduced and analyzed technically, economically and environmentally. • The proposed hybrid system could supply heating/cooling/electricity demands. • One of significant challenge, non-renewable resources usage, would be dissolved in Iran by using a renewable hybrid system. • The proposed plan could reduce CO2 emissions significantly. [ABSTRACT FROM AUTHOR]

The environmental taxes, such as carbon tax, also affect other economic variables in a different way in addition to the main goal of politicians. The carbon tax aims to reduce energy consumption and pollutant emissions, while it can also reduce labor tax and labor costs which are incentives to create new jobs. It is necessary to evaluate the carbon taxation policy in Iran due to the special circumstances of the budget deficit mainly caused by the decline of exports and oil revenues. The present study is based on a general equilibrium model in the form of a nonlinear equations system. The model has been calibrated for the 2017 reference year using the data table adopted from Iran's economy. It has been shown that if the carbon tax revenue is employed to decrease the labor income tax, the environmental quality will be improved by reducing pollutant emissions on the one hand, and it will lead to positive effects on the welfare and employment on the other hand. In the present paper, the effect of applying this tax on two policies with redistribution (compensation) and without redistribution (no compensation) of income tax among the households is examined. Maximum, minimum, and optimal values of pollutant emissions reduction under the influence of carbon tax policies were calculated in both scenarios. The simulation results show that the taxation without redistribution of tax revenues decreases the welfare and household's actual consumed budget by 6.2%, but in policy with compensation of tax revenue, these indices will increase by 0.8%. The gross domestic product (GDP) decreases by about 1.7% and 2.1% in both policies, respectively, while the consumer price index (CPI) in both scenarios will increase by about 6.4% and 8%, respectively. According to this research findings, carbon taxation with the redistribution of revenue is a suitable policy to reduce greenhouse gas emissions and adhere to international commitments at the same time. [ABSTRACT FROM AUTHOR]

Background: The ongoing COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to high morbidity and mortality worldwide. Vaccination against SARS-CoV-2 is a leading strategy to change the course of the COVID-19 pandemic. Aims of the study: Our aim was to investigate the efficacy and side effects of the Sinopharm vaccine in patients with hemoglobinopathies in Iran and the frequency of breakthrough infection after a full course of vaccination. Methods: A multicenter cross-sectional study of 434 patients with hemoglobinopathies (303 ß-thalassemia major, 118 ß-thalassemia intermedia, and 13 sickle-thalassemia) were conducted from March to July 2021 in IRAN. All patients have received the first dose of the China Sinopharm vaccine and received the second dose of the vaccine 28 days apart. Antibody testing: Detection of immunity after vaccination was evaluated by commercial enzymelinked immunosorbent assay (Pishtazteb ELISA commercial kit), including a surrogate virus neutralization test (sVNT), for detection of SARS-CoV-2 immunoglobulins (IgA, IgM, IgG), total neutralizing antibody (NAb). Results: The mean age of patients was 35.0 ± 8.5 (from 18 to 70) years, and 55.6% were positive for the antibody. Overall, 48.2% of the studied population had at least one side effect after vaccination. The most frequent side effects were fever and chills, dizziness, and body pain. A total of 90 (20.7%) vaccinated patients developed breakthrough infections after two doses of Sinopharm vaccination. Disease severity was recorded, and it was classified as mild in 77.8%, moderate in 13.6%, and severe in 7.4% of patients. One 28-year-old woman with ß-thalassemia major died eight days after diagnosing a breakthrough SARS-CoV-2 infection. Conclusion: No safety concerns were identified in patients who received two doses of the Sinopharm vaccine. Its efficacy was not optimal due to the lack of effect on new variations of the virus. However, our data show that it seems to be protective against the severity of COVID-19 infection in patients with hemoglobinopathies. The frequency of breakthrough infections after two doses of Sinopharm vaccination supports the evolving dynamic of SARS-CoV-2 variants requiring special challenge since such infection may represent a risk for vulnerable patients. [ABSTRACT FROM AUTHOR]

We studied the distribution of chigger mite species over mammal hosts, attachment sites on the host body, habitats, and seasons in Iran. The study was based on 2155 specimens of 36 chigger species collected from 10 species of Muridae, Cricetidae, and Soricidae across six provinces of northern Iran. A high level of mixed infestation by chiggers was recorded—76% of hosts parasitized by chiggers were infested by more than one (2–8) species. Statistically significant differences in the preference for anterior and posterior parts of the host body were found. Three species—Neotrombicula lubrica, N. delijani, and Cheladonta firdousii—preferred the posterior part of the host body; 12 species were characterized by the occurrence in the anterior part and differed from one another by the frequency of presence in the posterior part. One species, Hirsutiella alpina, was found only in the anterior part of the host body (inside the ears of rodents). The most diverse chigger fauna was on the fringe of Golestan National Park (species richness = 21, Shannon–Wiener index = 2.823). The chigger fauna of the high-mountain localities on the Alborz Range was the least diverse (species richness = 16, Shannon–Wiener index = 2.439). The seasonal aspect of activity was evident for Neotrombicula elegans, which exposed the autumn–winter period of the occurrence on hosts, and N. vernalis, with the winter-spring peak of abundance. [ABSTRACT FROM AUTHOR]

Medical ethics faces several challenges in different aspects of education, research, and treatment in medicine and healthcare practice. Design and implementation of a national strategic plan can pave the way for the development of a roadmap in various countries to strengthen ethics and address these challenges. To create a comprehensive plan compatible with the Iranian healthcare system, a multidisciplinary team of main stakeholders compiled a national strategic plan of medical ethics following several focus group discussion sessions and two workshops (2014-2017). Ultimately, the plan was confirmed by the Supreme Council for the Medical Ethics of the Ministry of Health and Medical Education. The current paper is a national report of the process and the medical ethics strategic plan in Iran. We have also tracked signs of progress and achievements in the country. In conclusion, this valuable effort has led to significant success in the implementation of medical ethics in clinical medicine, medical research, and education by using all the resources in our country. The participation of all the stakeholders, especially healthcare professionals in this way is required. [ABSTRACT FROM AUTHOR]

This study aimed to compare the cost-effectiveness of these two regimens in hemophilia A patients, under-12-years-old in southern Iran. A cost-effectiveness study comparing prophylaxis versus on-demand was conducted on 34 hemophilia patients (24 and 10 patients were on the prophylaxis and on-demand regimens respectively) in 2017. The Markov model was used to estimate the economic and clinical outcomes. The costs were collected from the societal perspective, and the utility criterion was the 'quality adjusted life year (QALY)' indicator. The required data were collected using a researcher-made cost checklist, the EQ5D standard questionnaire and Hemophilia Joint Health Score. The probabilistic sensitivity analysis (PSA) was performed to determine the robustness of the results. The means of costs, joint health score and QALY in the prophylaxis regimen were $478,963.1 purchasing power parity (PPP), 96.67, and 11.98 respectively, and in the on-demand regimen were $521,797.2 PPP, 93.46 and 10.99 respectively. The PSA confirmed the robustness of the model's results. The results of the scatter plots and acceptability curves showed that the prophylaxis regimen in 97% of the simulations for the thresholds below $20950 PPP was more cost-effective than on-demand regimen. Prophylaxis regimen showed the lower costs and higher effectiveness and utility in comparison with the on-demand regimen. It is recommended that prophylaxis should be considered as the standard care for treatment of hemophilic patients. [ABSTRACT FROM AUTHOR]

Background and Aim: The healthy people’s fecal flora in the community represents a large potential reservoir. Therefore, the current study aimed to detect antibiotic resistance patterns and virulence factors in Klebsiella pneumoniae isolated from healthy volunteers’ feces. Materials and Methods: Three hundred and fifty stool specimens were collected from sales rep healthy individuals referring to the Northwest Tehran Health Centers to get a health card. Bacterial isolation, identification, and antimicrobial susceptibility testing were conducted according to the routine instructions. In addition, polymerase chain reaction (PCR) was used to detect the genetic factors responsible for producing extended-spectrum β-lactamases (ESBLs: SHV, TEM, and CTX-M) blaKPC and other virulence genes. Results: Among fecal samples analyzed, 60 (17.1%) K. pneumoniae were isolated. The results demonstrated that the highest resistance rate was related to piperacillin-tazobactam (n=25, 41.6%), followed by and meropenem (n=17, 28.8%) and cotrimoxazole (n=11, 18.3%), respectively. Also, all strains were susceptible to amikacin, gentamicin, and imipenem. The PCR results of the virulence gene showed that 95% (n=57) of isolates were positive for fimH gene, 93.33% (n=56) for BssS gene, 27 (45%) for rmpA gene. The PCR results for antibiotic resistance genes showed that 41.66% (n=25) had blaTEM gene, 38.33% (n=23) blaCTX-M gene, 35% (n=21) blaSHV gene and 3.33% (n=2) isolates had blaKPC gene, and none of these isolates carried magA gene. Conclusion: Antibiotic resistance was common among K. pneumoniae isolated from healthy volunteers’ feces who participated in this study. Transmission of resistant bacteria and plasmids through oral-fecal sources threats to the public, which could complicate treatment options for community-acquired infections caused by K. pneumoniae. [ABSTRACT FROM AUTHOR]

Background: We examined and estimated the trend of breast cancer incidence in Kerman, the largest province in Iran. Method: Having compiling the data of new cases from three sources (cancer registry, pathology, radiotherapy) in this longitudinal study, the number of untouched cases was estimated using log-linear model. We estimated the annual age-standardized rate (ASR) per 100,000 women in 2001-2015. We utilized joint point regression method to estimate the trend of breast cancer incidence during the examined years. Results: The ASR of breast cancer increased from 25 in 2001-2005 to 37 in 2011- 2015, showing that the annual average percentage increased by 5.9% (95% Confidence Interval: 3.5, 8.4, P<0.001). Moreover, during this period, the completeness of the cancer registry increased from 16% in the first five years to 70% in the last five years. Conclusion: Our findings revealed that the coverage of the cancer registry increased significantly. It seems that part of the increasing trend of the reported cancer incidence was attributed to the enhancement of the cancer registry scheme, but our findings suggested that the real incidence of breast cancer had a growing trend. [ABSTRACT FROM AUTHOR]

BACKGROUND Functional dyspepsia is a common, troubling, and usually chronic disorder. Although the merit of using pathological assays has not been confirmed, medications affecting eosinophils may result in some improvements. Disseminated distribution of mast cells may also be an essential factor. Given the probable associations and lack of evidenced-based data, this study was conducted to comparatively investigate the number of eosinophils and mast cells in the duodenum in functional dyspepsia patients and healthy controls. METHODS In this case-control study, 150 consecutive subjects in Kerman, Iran, were enrolled in 2015 and 2016; the subjects consisted of 100 patients with functional dyspepsia and 50 asymptomatic healthy controls. Samples from the two groups were compared for the number of eosinophils, mast cells, and Helicobacter pylori presence by grasp biopsy. RESULTS The mean number of mast cells significantly differed between the groups (P = 0.001), but the eosinophil count was similar (p > 0.05). Female gender, no opioid use, and H. pylori may increase mast cell count (p < 0.05). CONCLUSION Overall, the mast cell count was significantly different between people with functional dyspepsia and people without it, but the eosinophil count in the two groups was similar. [ABSTRACT FROM AUTHOR]