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Given the importance of learning collocations, this study investigated the effectiveness of three types of mind maps, namely, bubble, double-bubble and multi-flow maps, on the comprehension and production of collocations. The participants were 120 upper-intermediate level male learners of English at Qalam institute in Tehran, who ranged from 15 to 18 years of age. This study used convenience sampling based on availability. A pretest was used to ensure the participants' unfamiliarity with the selected items. The participants belonged to four classes, each class being assigned to one treatment condition (one control and three experimental groups). All the groups had 12 treatment sessions, and in each session, eight collocations were introduced to the participants. After the treatment, two posttests of comprehension and production were given to all the participants, and the collected data were analyzed using two one-way analysis of variance (ANOVA) procedures. In both comprehension and production tests, the bubble and double-bubble map groups performed significantly better than the control group. Although there was a meaningful difference between the multi-flow map and the control group in the comprehension of collocations, there was no meaningful difference in the production of collocations. These results can have important implications for language teachers, curriculum designers, and educational policy makers. [ABSTRACT FROM AUTHOR]

Background: Redondoviridae is a newly discovered virus family linked to oral and respiratory conditions in people, while there is still debate about whether it is also coinfected with other respiratory viruses. This study aimed to determine the frequency of Redondovirus (ReDoV) in nasopharyngeal samples and to investigate any possible links to SARS-CoV-2 infections. Methods: A polymerase chain reaction (PCR) test was conducted on 731 nasopharyngeal samples from individuals referred to medical centers in Tehran, Iran, for SARS-CoV-2 testing to investigate the prevalence of ReDoV. An oral interview was performed to complete information on dental issues and the individuals' demographics, symptoms, and vaccination history. Results: The prevalence of ReDoV was 25.99%, and 15.26% had a coinfection with SARS-CoV-2. No notable correlation was found regarding ReDoVs and SARS-CoV-2 infections (p > 0.05). Women had a higher ReDoV positivity rate of 18.47% compared to men at 7.52% (p = 0.12), and there was no significant correlation between age groups and ReDoV presence. Nonetheless, a significant association was noted between ReDoVs and dental/gum issues (p < 0.0001, OR: 13.0326). A phylogenetic analysis showed that ReDoVs originated from various human-related clusters. Conclusions: These results highlight the potential for detecting ReDoVs in nasopharyngeal samples of people with gum or dental issues. Additionally, conducting more ReDoV epidemiological research and proposing oral health as a possible marker for ReDoV infections is important. [ABSTRACT FROM AUTHOR]

The prediction of suspended sediment load (SSL) within riverine systems is critical to understanding the watershed's hydrology. Therefore, the novelty of our research is developing an interpretable (explainable) model based on deep learning (DL) and Shapley Additive ExPlanations (SHAP) interpretation technique for prediction of SSL in the riverine systems. This paper investigates the abilities of four DL models, including dense deep neural networks (DDNN), long short-term memory (LSTM), gated recurrent unit (GRU), and simple recurrent neural network (RNN) models for the prediction of daily SSL using river discharge and rainfall data at a daily time scale in the Taleghan River watershed, northwestern Tehran, Iran. The performance of models was evaluated by using several quantitative and graphical criteria. The effect of parameter settings on the performance of deep models on SSL prediction was also investigated. The optimal optimization algorithms, maximum iteration (MI), and batch size (BC) were obtained for modeling daily SSL, and structure of the model impact on prediction remarkably. The comparison of prediction accuracy of the models illustrated that DDNN (with R2 = 0.96, RMSE = 333.46) outperformed LSTM (R2 = 0.75, RMSE = 786.20), GRU (R2 = 0.73, RMSE = 825.67), and simple RNN (R2 = 0.78, RMSE = 741.45). Furthermore, the Taylor diagram confirmed that DDNN has the highest performance among other models. Interpretation techniques can address the black-box nature of models, and here, SHAP was applied to develop an interpretable DL model to interpret of DL model's output. The results of SHAP showed that river discharge has the strongest impact on the model's output in estimating SSL. Overall, we conclude that DL models have great potential in watersheds to predict SSL. Therefore, different interpretation techniques as tools to interpret DL model's output (DL model is as black-box model) are recommended in future research. [ABSTRACT FROM AUTHOR]

Sudden sensorineural hearing loss (SSNHL) is a condition in which a person experiences a rapid loss of hearing, often in one ear. The cause of SSNHL is not always clear, but it is thought to be related to issues with the inner ear, auditory nerve, or other parts of the hearing pathway. Intratympanic injection is a treatment method for SSNHL in which a medication (corticosteroids) is injected directly into the middle ear space through the tympanic membrane. This randomized clinical trial was conducted in two hospitals in Tehran, Iran. Patients with SSNHL were randomized (using the 4-block method) and included in this study. 0.5 cc of dexamethasone or triamcinolone was injected via a 25-gauge spinal needle into the cone of light of tympanic membrane. This procedure was repeated six times. In the present study, the rate of response to treatment was compared in the two groups of triamcinolone and dexamethasone, which showed that in the group where intratympanic injection of dexamethasone was performed, 70.9% of patients responded to treatment (48.4% had a complete response and 22.5% had a partial response), and in the group receiving intratympanic triamcinolone, 72.5% responded to the treatment and improved, 50% showed a complete response and 22.5% showed a partial response, and no significant difference was found in the statistical analysis of the two groups. Also, the comparison of audiometric parameters (SDS and SRT) did not show any significant difference before and after the treatment based on the treatment group, and the treatment response was found in the same group. No significant differences were noted in terms of outcome. Intratympanic dexamethasone injection was associated with a 70.9% response and triamcinolone injection with a 72.5% response. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to identify the social cognitive predictors of regular dental visits and mouth self-examination behaviors among the elderly population, based on the Health Action Process Approach (HAPA) model. Background: Regular dental visits and mouth self-examination can prevent oral and dental problems among the elders. Little information is available regarding the social cognitive predictive factors of these two behaviors. Materials and methods: A cross-sectional study was conducted in 24 municipality centers in Tehran, Iran in 2021. The centers were selected randomly using a multi-stage cluster sampling method and 301 elderly attendants aged 60≥years participated in the study. Data collection was done using a researcher-made questionnaire including demographic characteristics and the HAPA model constructs for two target behaviors. Data were analyzed using the Smart-PLS version 3.3.9 via correlation and PLS-SEM analysis. Results: The mean age of the participants was 65.3±5.33 years and 79.7% were female. The SEM analysis showed that Action Self-Efficacy [b (SD) = 0.595 (0.065), P< 0.001] and Risk Perception [b (SD) = 0.218 (0.070), P< 0.002] were predictors of Intention for mouth self-examination but only Action Self-Efficacy [b (SD) = 0.651 (0.043), P< 0.001] was predictor of Intention for regular dental visits. Recovery Self-Efficacy and Planning directly contributed to the prediction of Mouth Self-Examination. The relationship between Maintenance Self-Efficacy and both behaviors is mediated by Planning. Also, the mediating role of Planning between Intention and target behaviors was confirmed. Conclusion: Action self-efficacy predicted the intention for regular dental visits and mouth self-examination behaviors. The relationship between intention and both behaviors was mediated by Planning. Emphasis on improving Action Self-Efficacy and Intention formation will enhance the effectiveness of interventions aiming at promoting the oral health of the elderly population. [ABSTRACT FROM AUTHOR]

Background: To date, no specific medication has been shown to be effective in treating COVID-19. Objectives: Due to the role of medicinal plants in reducing the symptoms of viral diseases, the present study aimed to assess the efficacy of an herbal medicine package (anti-flu Pulmo-Health), prepared based on Persian traditional medicine instructions and bioinformatics studies, in reducing the symptoms of COVID-19 in outpatients. Methods: This double-blinded randomized controlled trial was conducted on 60 COVID-19 outpatients referred to the Emergency Department of Baqiyatallah Hospital in Tehran (Iran) in July-Sep. 2020. The patients were randomly assigned into two groups, the control group (receiving routine treatment and a placebo) and the intervention group (receiving routine treatment plus anti-flu Pulmo-Health syrup and supplementary drops). The intervention continued for 10 days. The primary outcomes were oxygen saturation level, respiratory rate, heart rate, frequency of coughs during day and night times, shortness of breath score (based on the SOBDA questionnaire), expectoration, as well as the frequency of dry and productive coughs. Secondary outcomes were systolic and diastolic blood pressure, body temperature, headache, nausea, and chills. Results: In this study, 55 COVID-19 patients (27 cases in the control group and 28 subjects in the intervention group) were analyzed. The mean age of the patients was 46.25 ± 12.84 years, and 65% of them were female. The two groups of patients were homogenous in terms of demographic characteristics. The results showed that COVID-19 patients who received routine treatment plus the herbal syrup and supplementary drops revealed significantly better therapeutic responses in terms of respiratory rate, oxygen saturation, expectoration (P < 0.001), frequency of dry and productive coughs (P < 0.001), frequency of coughs, and shortness of breath (P < 0.001). Conclusions: As evidenced by the results of this study, the higher therapeutic response of COVID-19 outpatients to the anti-flu herbal syrup, this medicine is recommended as a supplement to improve respiratory symptoms in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Hospital-treated intentional self-poisoning is common. The possibility of changed (increased) suicidal behaviors during the COVID-19 pandemic has been raised. To compare frequencies in self-poisoning events (SPEs) and the proportions with in-hospital mortality, in the year prior to and following the official onset of the COVID-19 pandemic, in a population of hospital-treated self-poisoning patients in Iran. All self-poisoned patients admitted to Loghman-Hakim Hospital, a clinical toxicology specialty hospital in Tehran, were included. The frequency of SPEs was compared between the one-year periods immediately before and after the onset of COVID-19 pandemic using Poisson regression. Differences in proportions of in-hospital mortality were also compared using logistic regression. A total of 14,478 patients with 15,391 SPEs (8,863 [61.2%] females) were evaluated in the study. There was no difference in the overall frequency of SPEs (relative risk [RR] of 0.99 [CI95% 0.96–1.03]), but a small increase in males (RR 1.07; 1.02–1.13) and a minor decrease in females (RR 0.95; 0.91–0.99). In total, 330 patients died (2.3% of all SPEs). There was no difference in overall in-hospital mortality odds ratio (OR: 0.98 [0.79–1.22]), in females (OR = 1.14 [0.80–1.60]) or males (OR = 0.92 [0.69–1.23]). There was no change in the frequency of SPEs and no difference in the in-hospital mortality proportions, suggesting that the COVID-19 pandemic had little or no effect on these aspects of suicidal behavior in Iran. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the association between dietary patterns, derived through latent class analysis (LCA), with visceral adiposity index (VAI), Triglyceride-Glucose Index (TyG), inflammation biomarkers, and body composition in overweight and obese Iranian women. For this cross-sectional study, dietary exposure was assessed using a validated 147-item semi-quantitative food frequency questionnaire (FFQ). Dietary patterns were derived through LCA. Binary logistic was performed to test the associations of dietary patterns with VAI, TyG, inflammation biomarkers, and body composition. Health centers in Tehran, Iran. 376 obese and overweight women, aged > 18 years. Two dietary patterns were identified using LCA modeling: healthy and unhealthy. Women in the unhealthy class were characterized by higher consumption of fast food, sweetened beverages, grains, unhealthy oils, butter and margarine, and snacks. Compared with the healthy class, the unhealthy class was associated with an increased risk of higher fasting blood sugar (FBS) (OR = 6.07; 95% CI: 1.33–27.74, P value = 0.02), c-reactive protein (CRP) (OR = 1.72; 95% CI: 1.05–2.80; P value = 0.02), and lower fat free mass index (FFMI) (OR = 0.56; 95% CI: 0.35–0.88, P value = 0.01), after adjusting for confounders. We found that adherence to an unhealthy dietary pattern was associated with decreased FFMI and increased FBS and CRP using LCA, but not with the rest of the variables. Further studies should be conducted to confirm the veracity of these findings. [ABSTRACT FROM AUTHOR]

The widespread inappropriate use of intravenous (IV) pantoprazole, due to its high cost, is a substantial issue. To improve its rational use, an order entry form (OEF) based on the institutional guideline, was implemented. Physicians were required to fill an OEF upon administration of IV pantoprazole. We aimed to evaluate the compliance of physicians as well as the accuracy of filled OEFs six months after the implementation. The study was conducted in a tertiary care teaching hospital in Tehran. Chart review was performed for all patients with an IV pantoprazole order. IV pantoprazole OEFs received by the hospital pharmacy for these patients were evaluated in terms of quantity and quality (e.g., completeness, accuracy of filled items, etc.). Only for 270 (62%) patients, OEFs were received by the hospital pharmacy. Indications were specified in 199 (73.5%) forms, and their agreement with the forms filled by the researcher was 37.8%. The most frequent indication specified in OEFs was stress ulcer prophylaxis (40.7%). IV pantoprazole administration was rational only in 15.9% of cases. The emergency ward had the highest frequency of orders (57.9%), while having the lowest fill rate (56.7%) among the wards with the highest number of orders. The disagreement between the researcher and the OEFs regarding the need for IV medication was 39.5%. This study demonstrated that the compliance of physicians with the accurate completion of OEFs was suboptimal. It seems that for long-lasting changes in IV pantoprazole utilization patterns, barriers should be determined, and additional methods such as ongoing educational seminars or feedback might be needed along with OEF. [ABSTRACT FROM AUTHOR]

Introduction. Medications such as antioxidants and recombinant FSH are prescribed to improve sperm DFI (DNA fragmentation index) and treat infertility. Due to the high cost and duration of medications, in this study, we decided to investigate the effectiveness of combining these two medications with lower doses and in less time, compared to previous studies prescribing them individually, to reduce sperm DFI in infertile men. Methods. This study, a retrospective observational before and after trial, included a group (n = 94) of men aged 18-50 years with DFI > 20 % suffering from male factor infertility in an andrology clinic in Tehran, Iran, from 2019 to 2020. Patients received the combination of two medications, recombinant FSH every 5 days (75 IU subcutaneously) and an antioxidant every day (selenium, vitamin E, CoQ10, and folic acid) for 2 months. The patient's sperm DFI and sperm parameters have been measured before and after the medication and were reported in patient's files. In all patients, we compare the sperm DFI and sperm parameters before and after the treatment to evaluate the effect of the combination therapy. Results. The sperm DFI was significantly reduced (p value ≤0.001) in the patients treated by the combined medication. The sperm DFI improvement was 50.16% in the total population. However, there were no significant changes in other sperm parameters such as sperm concentration, total motility, progressive motility, immotile sperms, and abnormal morphology. Total sperm count and nonprogressive motility had significant changes statistically. Conclusion. Sperm DFI is an important indicator for evaluating the quality of semen. In this study, we demonstrate that the combination of recombinant FSH and antioxidants in a shorter time and with lower doses is effective in reducing DFI significantly. But in terms of other sperm parameters, it does not make a significant difference. [ABSTRACT FROM AUTHOR]

Background and Purpose: Dental treatment under general anesthesia (GA) is one of the common treatment methods today for dental treatment in children, so dentists’ point of view in this field is very important. Therefore, the purpose of this study was evaluation the awareness and attitude of pediatric dentists and final‑year dental students about dental treatment for children under GA. Methods: To conduct this study, 150 people, including 75 general dentists (GD) and 75 final‑year dental students (FYDS), were randomly selected in Tehran. In this study, a researcher‑made questionnaire containing 15 questions (7 awareness questions and 8 attitude questions) was used to evaluate the awareness and attitude of the participants. After extracting the raw results, statistical analysis of the results was done using SPSS‑Ver. 22 software. Results: 60% of the participants (90 people) were men and the remaining 40% (60 people) were women. The results showed that the level of awareness of male dentists was significantly higher than that of female dentists (P = 0.015). In addition, although the awareness level of FYDS was lower than GD, this difference was not statistically significant (P = 0.130). The average level of awareness among different age groups had a significant difference (P = 0.009), so the age group of 36‑45 years compared to the younger age groups (25‑35 years) and the older age groups (36‑45 and 55 ‑46 years), had a higher level of awareness. Conclusion: According to the findings, it can be concluded that it is necessary to use appropriate educational methods to improve the level of awareness and attitude of children’s dentists. [ABSTRACT FROM AUTHOR]

The spatial models dealing with urban growth dynamics have been widely studied, while rare works have considered under-developed countries. Several problems have been detected in creating, calibrating and applying urban growth models and changing land use. The present work aims the modelling land-use changes through the CA-GA model in which a frame is provided for analysis and producing a map of growth patterns in urban areas in different spatial scales to study and analyse the increasing urban growth in Tehran. To consider the land-use changes in Tehran, ETM+TM images of 1985, 1992, 2000, and 2020 were selected to be analysed by the CA-GA algorithm to model the growth of the urban areas. The total kappa of results in Tehran is about 0.93, indicating the required precision and confidence of applied combinative genetic-Cellular automata modelling methods to model urban development. [ABSTRACT FROM AUTHOR]

The aim of this study is to compare experiential avoidance, resilience, and emotional regulation difficulties in adolescent students with narcissistic and histrionic personality traits. The research is descriptive and of a comparative nature. The study population consists of adolescents seeking counseling and psychotherapy services affiliated with the Welfare Organization in Regions 10, 11, and 12 of Tehran. Among the individuals seeking assistance, a total of 100 participants (50 with narcissistic traits and 50 with histrionic traits) were selected using convenience sampling as the research sample. The research instruments included standardized questionnaires for acceptance and action, resilience, and emotional regulation difficulties. Multivariate analysis of variance (MANOVA) was employed for data analysis. The findings indicated a significant difference in experiential avoidance, resilience, and emotional regulation difficulties among adolescents with narcissistic and histrionic personality traits (P < 0.01). The results showed that the levels of experiential avoidance were higher among individuals with narcissistic personality traits, while the average scores of resilience and emotional regulation difficulties were higher among individuals with histrionic personality traits. [ABSTRACT FROM AUTHOR]

Constipation is a common reason for children seeking medical care worldwide. Abdominal complaints and constipation are also common in lead-poisoned children. This study evaluates the prevalence of abnormal blood lead levels (BLL) among pediatric and adolescent patients and examines the association of constipation with elevated BLL. This was a prospective data collection of patients younger than 18 years old with the chief complaint of constipation seen in the Mofid Children's Hospital gastroenterology clinic and Loghman Hakim pediatric and pediatric gastroenterology clinics were eligible for enrollment in this study. Constipation was defined as infrequent or difficult defecation according to ROME IV criteria lasting 2 months or more. BLL was measured with a fresh capillary whole blood capillary sample. The LeadCare II device assays BLL using an electrochemical technique (anodic stripping voltammetry). A total of 237 patients were enrolled in the study. 122 (51.48%) were female and 115 (48.52%) were male. About one fifth of patients (49; 20.67%) had BLL ≥ 5 µg/dL. The mean BLL in the sample was 3.51 µg/dL. Abdominal pain was the most common symptom accompanying constipation (134; 56%). Multivariate analysis found endoscopic evaluation (P values 0.024, OR 3.646, 95% CI 1.189–11.178), muscle pain (P values 0.020, OR 24.74, 95% CI 1.67–365.83), and maternal education (P values 0.02, OR 4.45, 95% CI 1.27–15.57) with significant differences in groups of patients with normal and elevated BLL. Elevated BLL necessitates an assessment and plans to reduce childhood lead exposure. BLL screening in childhood constipation with refractory chronic abdominal pain may also eradicate the need for invasive procedures like endoscopic evaluation. [ABSTRACT FROM AUTHOR]

Background and Aim: Telemedicine can be considered a primary modality of patient care for non-emergent conditions in the COVID-19 era. The usage and expansion of telemedicine are important and inevitable issues. We decided to investigate the neurosurgeons' perspective on telemedicine in the treatment and follow-up of neurosurgical patients during the COVID-19 period. Methods and Materials/Patients: This cross-sectional study was carried out in the Department of Neurosurgery, Tehran, from June 2021 to July 2021. An internet-based questionnaire was distributed among all postgraduate and assistant neurosurgeons at the Tehran University of Medical Sciences. Statistical analysis was performed using SPSS software, Version 24.0 (IBM SPSS statistics for windows, IBM corp; 2016). Results: This study was performed among 74 neurosurgeons who were mainly male (89.2%). Their mean age was 33.16±5.69 years (ranging from 27 to 62 years), and telemedicine has not been used previously in 37 precipitants (50%). Most precipitants preferred telemedicine for follow-up (93.24%). The common reasons for unimplemented telemedicine were determined by insurance and repayment obstacles (58.11%). Most of the participants believed that telemedicine should first be adapted to working condition and local setting, then it can be applied more in the future. Eventually, the effectiveness of telemedicine was controversial, according to most neurosurgeons' replies. Conclusion: This study indicated neurosurgeons' preference for telemedicine. They considered it a comfortable alternative. However, the effectiveness of telemedicine is controversial as it should be adapted first and then used extensively for future purposes. It is also suggested that future studies compare the results of this research with those of studies performed after the COVID-19 outbreak. [ABSTRACT FROM AUTHOR]

The toxic air pollutants such as benzene, toluene, ethylbenzene and xylene (BTEX) as well as asbestos are considered hazardous because of their role in adverse impacts on human health. Accordingly, this research was conducted to evaluate the levels, seasonal variations, spatial mapping, potential sources, and health risk assessment of BTEX compounds as well as asbestos fibres in the ambient air of Tehran. Air samples were collected by the NIOSH1501 method at 15 different sample stations from March 2018 to February 2019. Charcoal glass tube was used to collect samples and BTEX concentration was further determined using GC-FID method. The sampling of asbestos fibres was carried out via a low volume peripheral pump with analysis performed according to the NIOSH 7400 method via phase contrast microscopy (PCM). The findings showed that the mean±SD concentrations of ∑BTEX were 33.44 ± 11.77 and 59.97 ± 33.76 µg/m3 in warm and cold seasons, respectively. It was 1.46 × 10−3 and 2.31 × 10−3 fibre/ml for asbestos in the warm and cold seasons, respectively. The spatial mapping indicated that the maximum levels of both pollutants were observed in sampling sites S1, S11, and S15, which were located close to factories downtown (S1) and heavy traffic roads (S11 and S15). The mean inhalation lifetime cancer risk (LTCR) value for benzene was 1.64 × 10−5, which was higher than US EPA and WHO recommended limits. Further, the excess lifetime cancer risk (ELCR) suggested that the exposure to asbestos fibre in Tehran would cause the risk of developing cancer in 0.5 to 3.53 people per every 1000 individuals. Hence, much suitable managing strategies are required to control the concentration of these pollutants in the ambient air of Tehran. [ABSTRACT FROM AUTHOR]

Objectives By the rapid growth of the elderly population, the need to pay attention to this group becomes more obvious. General self-efficacy, self-control and self-esteem are the effective individual factors for the empowerment of the elderly. This study aims to examine the relationship between these individual aspects of empowerment and general health in older adults attending neighborhood houses in Tehran, Iran. Methods & Materials In this descriptive-analytical study with cross-sectional study design, 320 older men and women over 60 years of age participated who were selected by a cluster sampling method. Data were collected using a demographic form, the 28-item general health questionaire, 10-item general selfefficacy scale, Rosenberg self-esteem scale, and Tangney's brief self-control scale. Data was described using mean and standard deviation, and analyzed using chi-square test, Spearman correlation test, oneway-ANOVA, and linear regression in SPSS sofwtare, version 22. Results The mean age of the elderly was 68.42±8.3 years. Their mean score of general health was 21.95±13.4. A significant negative correlation was found between general health, general self-efficacy, self-esteem and self-control (P<0.001). Their general health had a significant relationship with their educational level (P<0.001), years of employment (P=0.002) and housing status (P<0.001). The multivariate regression Results showed that housing status (P=0.156), self-esteem (P<0.001), self-control (P<0.001), and general self-efficacy (P<0.001) were the significant predictors of general health in the elderly. Conclusion There is a relationship between general health, general self-efficacy, self-esteem, and selfcontrol of the elderly in Tehran. Their general health is related to their educational level, years of employment, and housing status. Housing status, self-esteem, self-control and general self-efficacy are predictors of their general health. Attention should be paid to these factors in developing health promotion programs for the elderly. [ABSTRACT FROM AUTHOR]

Background and Aims: The Healthy Beverage Index (HBI) is a valuable technique to estimate the synergistic effects of overall beverage consumption. Several studies have evaluated the associations between HBI and beneficial changes in the health status. however, there is no study on the association between patterns of beverage consumption and mental health status. Therefore, this study sought to examine the association between HBI and psychological disorders among overweight and obese women.Methods: 199 overweight and obese women, between the ages of 18 and 55 y, were enrolled in this cross-sectional study in Tehran, Iran. To collect beverage dietary data, a validated semi-quantitative food-frequency questionnaire (FFQ) was used. Furthermore, the DASS-21 questionnaire was used to assess psychological profile states.Results: The association of total depression anxiety stress (DASS) score with healthy beverage index (HBI) tertiles in models was marginally significant (OR =: 0.78; 95% CI 0.30-2.02; P-value = 0.074; (OR = 0.77; 95% CI 0.28-2.16; P-value = 0.062), respectively. In terms of stress, anxiety, and depression, after adjusting for confounders, participants with higher HBI in the third tertile had lower odds of depression vs. the first tertile (OR = 0.99; 95% CI 0.35-2.81; P-trend = 0.040).Conclusion: We demonstrate that the total DASS score was associated with HBI tertiles. We also found that participants with higher HBI had lower odds of depression. However, additional well-designed studies are needed to confirm the veracity of these findings. [ABSTRACT FROM AUTHOR]

In recent years, the use of fuzzy linear regression has expanded significantly in economics, accounting. and financial mathematics. In this type of regression, for data analysis, there is no need to meet the prerequisites that are required in normal linear regression. In addition, it is necessary to solve a linear programming problem to find coefficients of this type of regression. Since, in examining the status of stability and the cash and accrual components of companies' profits, the calculation of accruals is based on forecasts and estimates and is measured by less reliability, so implied greater stability of profit due to its cash component. Among the cases that have an accrual basis, the non-objectivity of the amount, especially the cash amount of the earnings, is very important for the future profitability. In this study, focusing on profit cash components, and the stability, the profitability of the company and its efficiency compared to the accrual basis are investigated using fuzzy linear regression. In the issue of technical analysis and to check profits sustainability, a sample of four selected industries, vehicle manufacturing, pharmaceuticals, basic metals, and ceramic tiles during the years 2011-2016, has been selected in the Tehran Stock Exchange market. In this study, sign constraints are added to the set of constraints in the main linear programming problem so obtained solutions can be interpreted and justified. The results confirmed the hypothesis "cash components of profit have more stability of profit than accrual components", but the hypothesis "more stability of profit due to cash components of profit has a greater impact on the amount of cash and the rights Stockholders" and also the hypothesis "the profit expectations implicit in the stock price fully reflect the stability of the profit related to the cash components of the profit", was not confirmed. [ABSTRACT FROM AUTHOR]

The present study investigated the concentration, spatial distribution, seasonal changes, potential sources, and bioaccessibility-based risk assessment of Particulate Matter2.5-bound heavy metals in seven regions of Tehran city with three different uses. A total of 64 samples were collected from high-traffic, low-traffic and industrial areas, whereby the concentration of Particulate Matter2.5-bound heavy metals was analyzed by Inductively Coupled Plasma device. Unmix 6 software was used to determine the source of pollution emission, in this study. Moreover, bioaccessibility-based risk assessment of ParticulateMatter2.5-bound heavy metals was done for inhabitants of Tehran city. The results indicated that the concentration of ∑heavy metal High-traffic, Low-traffic and Industrial areas was obtained as 2709.53 ± 172.91, 1981.136 ± 158.46, and 1047.28 ± 81.26 ng/m3, respectively. Based on Anmix analysis, 3 sources of heavy metals were found: source 1 mostly resulting from industrial sources, source 2 mainly from natural sources, and source 3 emanating from vehicles (both heavy and light). Bioaccessibility-based risk assessment also indicated that the risk of carcinogenicity of the studied metals exceeded the limit proposed by Environmental Protection Agency and World Health Organization (1 × 10–4). Thus, in order to maintain the health of Tehran citizens, proper managerial strategies are required to control the concentration of these pollutants in the ambient air of Tehran. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak affected mental health globally. One of the major concerns following the COVID-19 pandemic was increased incidence of risky behaviors including alcohol consumption. This study evaluates the trend of alcohol poisoning in Loghman-Hakim Hospital (LHH), the main referral center of poisoning in Tehran, during the 2-year period from 1 year prior to 1 year after the onset (February 23rd, 2020) of the COVID-19 epidemic in Iran. All patients admitted with alcohol intoxication from February 23rd, 2019 to February 22nd, 2021 were evaluated and patient data extracted from LHH electronic hospital records. Alcohols were categorized as toxic (methyl alcohol) and non-toxic (ethyl alcohol). Of 2483 patients admitted, 796/14,493 (5.49%) and 1687/13,883 (12.15%) had been hospitalized before and after the onset of the COVID-19 epidemic in Iran, respectively. In total, 140 patients did not survive, of whom 131 (93.6%) were confirmed to have methanol intoxication. Mortality was significantly higher during the outbreak (127 vs 13; P < 0.001; OR: 4.90; CI 95%: 2.75 to 8.73). Among the patients, 503 were younger than age 20. Trend of alcohol intoxication showed increases in children (57 vs 17) and adolescents (246 vs 183) when compared before and after the COVID-19 epidemic outbreak. A total of 955 patients were diagnosed with methanol toxicity which occurred more frequently during the COVID-19 era (877 vs 78; P < 0.001; OR: 10.00; CI 95%: 7.75 to12.82). Interrupted time series analysis (April 2016–February 2021) showed that in the first month of the COVID-19 epidemic (March 2020), there was a significant increase in the alcohol intoxication rate by 13.76% (P < 0.02, CI = [2.42–24.91]). The trend of alcohol intoxication as well as resulting mortality increased in all age groups during the COVID-19 epidemic in Iran, indicating urgent need for the prevention of high-risk alcohol use as well as improved treatment. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorders (ASD) are a set of developmental, psychological, and neurological disorders that occur in early childhood. The most important characteristic of individuals with autism is difficulty in social interactions and communication. Researchers in the field of oral health have not paid enough attention to these individuals due to their specific behavioral characteristics. Therefore, due to the limitations of the studies in this field in Iran, increasing prevalence of autism, and importance of oral health in people with ASD, this study was conducted to evaluate the oral health status of primary school students with autism (7-15 years old) in autism schools in Tehran.Methods: Students from seven governmental special primary schools in Tehran were selected for this study. Data about oral health behavior and the presence of each of the seven barriers of tooth brushing task was collected via questionnaires completed by parents. During the dental examination, the cooperation level according to the Frankle Index, oral hygiene status according to the Simplified Oral Hygiene Index, and caries experience (DMFT) of the students were recorded by a calibrated dentist. A psychologist assessed the level of ASD using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM5). Data analysis including descriptive and regression analysis was done using the SPSS software version 24.Results: Two hundred and seventeen students aged 7-15 years participated in this study, of whom 65.4% brushed their teeth once or more every day, 85.7% had sugary snacks twice or less per day, 73.7% used fluoridated tooth paste, and 80% brushed their teeth with parents' help. The most common barrier to tooth brushing was difficulty in brushing (51.6%). The cooperation level was definitely positive in 46.1%. The mean Simplified Oral Hygiene Index (OHI-S) and caries experience (DMFT) scores were 1.92 ± 0.55 and 2.36 ± 2.38, respectively.Conclusion: The clinical indices of OHI-S and caries experience (DMFT) were used to evaluate the oral health status in the students with ASD in Tehran, Iran. A better oral hygiene status was related to higher brushing frequency and lower sweet snack consumption. The findings of the present study indicate that educational interventions regarding oral hygiene and healthy diet may improve oral self-care in individuals with ASD. [ABSTRACT FROM AUTHOR]

In the present study, PM2.5, volatile organic compounds (VOC), heavy metals, and polycyclic aromatic hydrocarbons (PAHs)-bonded PM2.5 as well as asbestos fibers were investigated in two cities in the east of Tehran, Iran. To this end, 72 samples were collected from six stations located in the cities of Varamin and Pakdasht from March 2018 to March 2019. The concentration of BTEX compounds, PAHs, and heavy metals were measured using gas chromatography-flame ionization detector (GC-FID), gas chromatography-mass spectrometry (GC-Mas), and inductively coupled plasma atomic emission spectroscopy (ICP-OES), respectively. In addition, phase contrast microscopy (PCM) method was used to identify the properties of asbestos fibers. The results obtained from the present showed that the mean concentrations of PM2.5, heavy metals, PAHs, BTEX, and asbestos fibers were 52.05 µg/m3, 319.08 ng/m3, 3.97 ng/m3, 40.58 µg/m3, and 2.84 f/L, respectively. In addition, the results obtained from PCA and heavy metals sources showed that transport fleets were the natural source of most of these pollutants. In case of PAH sources, transport and incineration of coal had the highest contribution in the emission. Furthermore, the risk assessment showed that most of the compounds have a higher risk value than the guideline value spatial distribution and also showed that stations close to airports, city terminals, and highways were more polluted than other parts of the city. Therefore, in order to have healthy air and with the least pollution, it seems necessary to formulate the necessary strategies in the cities of Varamin and Pakdasht. [ABSTRACT FROM AUTHOR]

Background: Lead exposure is one of the most menacing of environmental exposures, particularly in children. Children are more susceptible to the effects of lead which manifest in many organ systems, including interference with mental and motor development. Lead poisoning can cause colicky abdominal pain. In this study, the authors sought to evaluate the prevalence of elevated blood lead level (BLL) and its contributing factors among pediatric patients presenting with abdominal pain. An epidemic of lead poisoning in adults was previously uncovered, and thus a concern for pediatric lead poisoning was raised.Methods: Pediatric patients presenting to two pediatric clinics in Tehran with abdominal pain were eligible for enrollment in a descriptive prospective cross-sectional study. A predesigned questionnaire was filled for each patient by their consenting parents. The questionnaire queried demographic information, environmental, social, and other relevant parameters for lead exposure. After completion of the questionnaire, biometrics were obtained, and a blood sample was taken from each patient for measurement of BLL and complete blood count.Results: A total of 187 patients were enrolled in the study. Of them, almost 20% had BLL ≥ 5 µg/dL. Univariate analysis showed that age (p = 0.002, OR 3.194, CI 95% 1.504-6.783), weight (p = 0.009, OR 2.817, CI 95% 1.266-6.269), height (p = 0.003, OR 3.155, CI 95% 1.443-6.899), and playing with both plastic and cotton toys (p = 0.03, OR 2.796, CI 95% 1.072-7.295) were significant predictors of high BLLs. Maternal level of education correlated with blood lead concentrations (p = 0.048, OR 2.524, CI 95% 1.006-6.331).Conclusions: A clinically significant number of cases of abdominal pain may have high BLLs. Specific attention should be paid to children presenting with abdominal pain, especially due to the detrimental effects of lead on their mental and motor development. [ABSTRACT FROM AUTHOR]

Background: Granulomatosis with polyangiitis (GPA), also known as Wegener's granulomatosis, is an idiopathic systemic disease typically affecting the lungs, although other organs may also be involved.Case Presentation: A 28-year-old male was admitted to Baqiyatallah university hospital in Teheran (Iran) after a 3-week history of fever and productive cough. The patient gradually developed fatigue, arthralgia, hematuria, nausea, vomiting, dyspnea, hemoptysis, weight loss, oliguria and then anuria. Chest-X-ray (CXR) and computerized tomography scan revealed cavitating nodular opacities in the right lung lobe. Furthermore, plasma creatinine increased from 2.2 to 4 mg/dl in a few days. Histopathological examination of kidney biopsy revealed peri-glomerular and peri-vascular inflammation, degeneration and necrosis of the tubular epithelial lining, red blood cell casts, distorted glomerular structure, fibrin thrombi, segmental breaks of the glomerular basal membrane, disruption of Bowman's capsular membrane and crescent formation of the affected glomeruli. An abnormal CXR, an abnormal urinary sediment and a typical kidney histology were used as criteria to diagnose glomerulonefritis with poliangiitis (GPA). Bronchoalveolar lavage smear and PCR turned out positive for mycobacterium tuberculosis. After 3 months of treatment for (GPA) and tuberculosis the patient developed headache and seizure. Cerebral Magnetic Resonance Venography revealed cerebral venous thrombosis of the sinus transverse and sigmoid.Conclusions: Tuberculosis may coexist with GPA, as it occurred in our patient. Since a crescentic glomerulonephritis can progress to renal failure, clinicians should always be aware of potential multiple conditions when considering differential diagnoses. [ABSTRACT FROM AUTHOR]

Background and Objectives: Sexual satisfaction is one of the important and influential factors in the couples' stability and quality of marital life. Therefore, it is important to study the factors affecting it (such as; mindfulness, marital forgiveness, & mental well-being). Accordingly, the purpose of the present study was to investigate the mediating role of marital forgiveness and mental well-being in the relationship between mindfulness and sexual satisfaction. Materials and Methods: The present study is descriptive. The sample size included 300 married men and women in Tehran in the period of 2020-2021who were selected through the accessible sampling method.To collect the data, the Larson's Sexual Satisfaction Questionnaire (LSSQ), the Freiburg Mindfulness Inventory (FMI-SH), the Warwick-Edinburg Mental Well-being Scale (WEMWBS), and the Paleari et al.'s Marital Offence-Specific Forgiveness Scale (MOFS) were used. Data were analyzed by using Pearson's correlation coefficient and path analysis. Results: The results of the mediation analysis indicated that the direct effect of mindfulness on sexual satisfaction was significant (β=0.136, p=0.043). The indirect effect of mindfulness on sexual satisfaction through both marital forgiveness and mental well-being was also significant (β=0.056, p=0.017, β=0.289, p=0.010, respectively). Therefore, marital satisfaction and mental well-being had a partial mediating role in the relationship between mindfulness and sexual satisfaction. Conclusion: The results obtained in this research can help mental health researchers and therapists in both the theoretical (expanding and enriching the theoretical concepts in the field of couple therapy) and practical (developing therapeutic and educational programs) aspects. [ABSTRACT FROM AUTHOR]

Many historic city centers around the world have begun a process of regeneration in recent decades after years of stagnation and decline. Numerous factors play a role in the transformations of the historic center, including cultural tendencies, urban public policies, real estate market trends, and tourism. This study investigates the transformations of the historic neighborhoods of Kashan in Iran, during which private investors began to buy, restore, and reuse the historic houses since the 1990s. We applied a qualitative research approach, focusing on face-to-face semi-structured interviews and observations. The findings of this study revealed four groups of investors with different backgrounds and motivations: (1) rich pioneers from Tehran fascinated by architectural heritage, (2) Iranian expatriates influenced by nostalgia for authenticity, (3) European professionals interested in Iranian art and aesthetics, and (4) local investors mostly aiming to revitalize their childhood memories and introduce their cultural heritage to tourists. This study also shows that different urban transformation processes overlap and occur simultaneously in the historic neighborhoods of Kashan, generated by different investors. [ABSTRACT FROM AUTHOR]

The present study evaluated the concentrations, spatial distribution, seasonal variations, potential sources, and risk assessment of organic/inorganic pollutants in ambient air of Tehran city. Totally, 180 air samples were taken from 9 sampling stations from March 2018 to March 2019 and were analyzed to determine the concentrations of organic pollutants (BTEX compounds and PM2.5-bound PAHs) plus inorganic pollutants (PM2.5-bound metals and asbestos fibers). The results revealed that the mean concentrations of ∑ PAHs, BTEX, ∑ heavy metals, and asbestos fibers were 5.34 ng/m3, 60.55 µg/m3, 8585.12 ng/m3, and 4.13 fiber/ml in the cold season, respectively, and 3.88 ng/m3, 33.86 µg/m3, 5682.61 ng/m3, and 3.21 fiber/ml in the warm season, respectively. Source apportionment of emission of the air pollutants showed that PAHs are emitted from diesel vehicles and industrial activities. BTEX and asbestos are also released mainly by vehicles. The results of the inhalation-based risk assessment indicated that the carcinogenic risk of PAHs, BTEX, and asbestos exceeded the recommended limit by The US environmental protection agency (US EPA) and WHO (1 × 10–4). The risk of carcinogenesis of heavy metal of lead and chromium also exceeded the recommended limit. Thus, proper management strategies are required to control the concentration of these pollutants in Tehran's ambient air in order to maintain the health of Tehran's citizens. [ABSTRACT FROM AUTHOR]

Background: Motivation triggers all human activities including learning and lack of career motivation can lead to decreased efficiency. This study assessed the association between academic burnout and career choice motivation in senior dental students. Methods: This cross-sectional study was performed on senior dental students of all four dental schools in Tehran in 2017. Dental students voluntarily filled out a 33-item questionnaire that comprised three sections. The first section included the Burnout Clinical Subtype Questionnaire (BCSQ-SS) with 12 questions addressing academic burnout. The second section consisted of 8 questions about career choice motivation, and the third section concentrated on 13 questions dealing with demographics. The individual scores of each section and the total scores were reported. The factor analysis of 8 questions about dental career choice motivation yielded 3 factors of social status and security, altruism, and others' advice motivations. The data were analyzed using regression test. Results: Totally, 131 students filled out the questionnaire (response rate = 86%). The total score of academic burnout was 38.89% ± 1.13%. The highest and the lowest burnout scores belonged to the domains of "overload" (46.69%± 1.46%) and "neglect" (31.98%± 1.32%), respectively. The most and the least frequently mentioned source of motivation for choosing dentistry were high income and failing to enter other fields, respectively. The burnout score was higher in students with altruism motivations (P = 0.007) and lower in students with others' advice motivations (P = 0.004). The burnout score was higher in students with inadequate or moderate financial support from the family and lower in students whose mothers' educational level was high-school diploma or lower. Conclusion: Senior dental students in Tehran encountered different levels of academic burnout. In the present study, low financial support and altruism as career choice motivations were associated with higher level of academic burnout. [ABSTRACT FROM AUTHOR]

Polycyclic aromatic hydrocarbons (PAHs) have aroused considerable concern over their ubiquitous presence and potentially hazardous effects on the environment. This research provides the data on PM2.5-bounded PAHs distribution in the ambient air of areas with different land uses of Tehran, Iran. A total of 64 air samples - 16 samples in the industrial area (IS), 24 samples in high traffic areas (HTS), and 24 samples in low traffic areas (LTS) - were taken and analyzed by gas chromatography-mass spectroscopy (GC-MS). The results of this study showed that the mean concentration of ΣPAHs in the air of IS, HTS, and LTS regions was 13.58 ± 18.58, 22.45 ± 33.32, and 33.90 ± 65.006 ng/m3, respectively. The mean concentration of ΣPAHs in samples taken from the IS region was significantly (p < 0.05) higher than that taken from HTS and LTS regions. The source apportionment of PAHs in the air of Tehran was performed using the Unmix.6 EPA receptor model. The results of this model indicated that 41%, 34%, and 26% of PAHs were due to industrial activities and diesel vehicles, traffic and transportation sources, and burning coal and heating appliances, respectively. The total incremental life time cancer risk (ILCR) caused by exposure to PAHs through airborne-PM2.5 of Tehran city was 1.03 × 10−6, 1.51 × 10−6 and 3.23 × 10−6 for LTS, HTS and IS areas, respectively. Estimated results of ILCR indicate that the carcinogenesis risk values in the study area are at an acceptable level (between 10−6–10−4). [ABSTRACT FROM AUTHOR]

Background: Vitamin D is an essential element for body health with its supplements generally administered to prevent vitamin D deficiency. Since these supplements are available in domestic settings, vitamin D toxicity may happen in children.Methods: All children younger than 12 years who presented to the pediatric emergency department of Loghman Hakim Hospital, Tehran, Iran with history of ingestion of more than 1500 IU/day of vitamin D supplements were enrolled. Patients' demographic data, on-presentation signs and symptoms, laboratory findings, treatments given, and outcome were evaluated.Result: Fifteen patients presented during the study period. Their mean age was 46.53 ± 10.14 months and 12 (80%) were girls. All of them had unintentionally ingested vitamin D. Mean ingested dose was 406700.7 ± 227400.1 IU. In eight patients (53.3%), 25 hydroxy vitamin D level was more than 100 ng/mL. One patient experienced hypercalcemia while all of them were asymptomatic and discharged without complications. There was no significant difference between patients with and without high levels of 25 OH vitamin D regarding lab tests, toxicity course, and outcome.Conclusions: It seems that acute vitamin D toxicity is a benign condition in our pediatric population which may be due to high prevalence of vitamin D deficiency in Iran. [ABSTRACT FROM AUTHOR]

Objective: Numerous studies demonstrated the effect of grape on memory improvement. According to Iranian traditional medicine, "maviz" as a specific type of dried grapes can effectively improve memory. However, there is no reported clinical trial on the effect of "maviz" on memory improvement in humans. Hence, this study was conducted to investigate "maviz" effect on memory in university students. Materials and Methods: This randomized open-label clinical trial was conducted on a total number of 53 students of Shahed University, Tehran, Iran, from November 2017 to February 2018. The participants were randomly allocated into an intervention group (receiving "maviz", 25 g in the morning for 4 weeks) or a control group (who did not take "maviz"). The Digit Span Task and the NBack Task were used for the measurement of working memory at the pre- and post-intervention stages. Results: According to the results, no significant differences were found between the two groups regarding age, gender, marital status, and initial working memory test scores. "maviz" consumption produced a highly significant improvement in total working memory score in the Digit Span Task (5.18 vs. 2.35, p<0.001) and Acoustic Memory Span (1.29 vs. 0.62, p=0.021). Moreover, "maviz" consumption significantly increased the percentage of true responses in the N-Back Task and reduced the mean reaction time in the first level of the task. Conclusion: "maviz" consumption was improved working memory in young healthy adults. [ABSTRACT FROM AUTHOR]

Background: The Coronavirus disease 2019 (COVID-19) outbreak quickly has spread and became a pandemic. However, no approved therapeutics or effective treatment is available for the treatment of these patients. The present study was done to retrospectively assess the treatment strategies (e.g., pharmaceutical care services) for COVID-19 patients in selected hospitals and highlight the importance of such services in the management of a pandemic. Materials and Methods: Data from a series of COVID-19 patients (978 patients; 658 males [66.9%] and 324 females [33.1%]) admitted to the selected hospitals in Tehran from 20 February to 19 March 2020 were retrieved retrospectively from the Health Information System (HIS) of the hospitals. The statistical tests were used for analyzing the effect and correlation of the variables (drugs) with the average length of stay (ALOS) in the hospital. Results: Diverse medication classes and old drugs with or without strong evidence of therapeutic effects against the novel coronavirus, some previously tried as a treatment for SARS-CoV and MERS-CoV, were mostly used for the treatment of patients in the hospitals. Many medications (broad-spectrum antibiotics and antivirals) or combination therapies are used without evidence of their therapeutic effects during pandemics. Conclusion: Therefore, guidelines should be provided for the off-label use of these drugs by policymakers and stakeholders during a pandemic emergency due to high demands. Also, monitoring of the HIS data can play an important role in improving public health response to emerging diseases. [ABSTRACT FROM AUTHOR]

Aim: To assess dental fear and its determinants in 7–11-year-old children. Methods: In this cross-sectional (descriptive-analytical) study, the standard Persian version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire was completed by 240 parent–child (children aged 7–11 years) pairs referred to dental clinics in Tehran city, Iran. Background characteristics were also inquired. Results: An equal number of boys and girls participated in the study. The mean score of fear among the children was 21.66 ± 8.33. The causes of fear among the children were, first, injection, and then, seeing the dentist's drill, choking feeling, and finally, filling the tooth. There was a significant correlation between the scores of children's dental fear and their experience of meeting with the dentist (p = 0.001). The result of the regression test showed that the age of the children (p = 0.022) and high levels of dental fear among their fathers (p < 0.001) was related to high levels of dental fear among the children. Conclusions: The present children revealed a moderate level of dental fear. Taking children's age into account in behavioural management and challenging father's fear seemed to play a key role to reduce the child's fear and prevent its long-term consequences. [ABSTRACT FROM AUTHOR]

Skylines are a prominent part of most cities. The natural landscapes surrounding cities make up their natural skylines, while the general shape formed by the silhouette of buildings and other urban features comprises their built skylines. This study sought to determine whether the natural skylines of cities affect residents' preferences for the shape and height variation of built skylines. To answer this question, the authors selected three cities in Iran with different natural skylines (mountainous-desert, mountainous, and desert). Based on the Cochran formula, the authors selected a sample of 384 participants from each city. Next, they created nine images using different combinations of two variables representing the general shape of the skyline (concave, convex, or flat) and the variation in building height (low, medium, or high). The authors analyzed the collected data using SPSS 19 software. They examined the significance of differences in public preferences in the three cities with regard to variations in building height and the general shape of the skyline using inferential statistics (Kruskal-Wallis, Mann-Whitney U, and chi-square tests). The results showed that participants preferred a degree of building height variation that was consistent with the shape of the surrounding natural environment. However, in terms of the general shape of the skyline, participants preferred the opposite, favoring a general shape that contrasted with the natural environment. Respondents from the mountainous-desert city, Tehran, preferred a flat skyline due to the varied terrain of the natural environment. Similarly, respondents from Hamedan preferred a concave skyline, which contrasted with the shape of their mountainous natural skyline. Finally, respondents from the desert city, Yazd, preferred the contrast of the convex skyline. [ABSTRACT FROM AUTHOR]

Background and Aim: Blood gas analysis is an important laboratory test for diagnosis and treatment of a variety of medical conditions in emergency rooms. Inaccurate sample collection is one of the reasons for errors in blood gas analysis. This study was conducted to evaluate different volumes of heparin in syringes and the effect of sample dilution on blood gas analysis as one of the main factors affecting the results of blood gas analysis. Methods: One hundred children (4 months to 12 years) who presented to Loghman Hakim Hospital, Tehran, Iran, were enrolled in this study. Two samples were taken from each patient. For the first sample, the syringes were filled with heparin sodium and then emptied completely to achieve a very thin layer anticoagulant coating. For the second sample, the syringes were filled with 0.1 mL of liquid heparin sodium 5000 U/mL (5%). The blood gas parameters including pH, PO2, PCO2, HCO3 and BE (base excess) were measured. Data were analyzed using SPSS version 18. Results: All parameter had lower levels in second samples (0.1 mL heparin 5%) except for PO2 compared to the first samples (P < 0.001). Conclusion: This study found that a small amount of heparin in the syringe changed the result of blood gas analysis. [ABSTRACT FROM AUTHOR]

Study Design: Descriptive cross-sectional study. Purpose: To validate the Persian version of the Million Visual Analogue Scale Questionnaire (MVAS), a self-administered low back pain (LBP) questionnaire. Overview of Literature: The majority of LBP questionnaires translated into Persian evaluate the impact of LBP on daily living. The MVAS is one of the most commonly used self-administered LBP questionnaires, and was developed to assess a different direction and effect of activities of daily living on LBP intensity. Methods: The questionnaire was translated into Persian with the forward-backward method and was administered to 150 patients randomly sampled from an occupational medicine clinic in Tehran in 2017. Results: Cronbach’s alpha for all subscales ranged between 0.670 and 0.799. Confirmatory factor analysis showed adequate construct validity of the Persian version of the MVAS, with root mean square error of approximation 0.046, goodness of fit index 0.902, and comparative fit index 0.969. Other indexes were satisfactory. Conclusions: The Persian MVAS is a valid and reliable instrument that can assess the effect of various daily activities on the intensity of LBP. [ABSTRACT FROM AUTHOR]

Background: Cryptosporidium is known as an opportunist disease-causing agent in man in recent decades .It causes diarrhea and intestinal disorders in the immune deficit and immune competent individuals .This study was aimed to investigate the clinical characteristics of HIV/AIDS patients with cryptosporidiosis infection. Methods: This cross-sectional descriptive study was performed on 53 HIV/AIDS patients referred to the Behavior Disease Consultation Center of Imam Khomeini Hospital in Tehran ,Iran in .2013 First ,the patients were studied clinically and the context data were recorded in a questionnaire for parasitological examination and referred to the laboratory for eosinophil count ,and CD4 count per ml of blood. Results :Cryptosporidiosis was observed in )7.6%( 4 of the total 53 HIV/AIDS patients .The highest prevalence of infection was observed in the age range of 30-39yr .It was observed in different sexes as 5.7% of male and 1.9% of female ,but statistically was insignificant( P=0.163).75% of patients had no intestinal symptom, 11.4% with acute diarrhea and 3.8% with chronic diarrhea. Cryptosporidiosis cases were observed in 5.7% of patients without intestinal symptom. Conclusion: Practitioners in the clinical examination for the detection of the opportunistic intestinal protozoan infection should use clinical and paraclinical characteristics of the HIV/AIDS patients for the diagnostic of Cryptosporidium and other opportunistic parasitic diseases. [ABSTRACT FROM AUTHOR]

Background: Training sessions are the most common framework used to provide self-management for patients with multiple sclerosis. Objective: This study was conducted to determine the effect of life skills training on the self-management of patients with multiple sclerosis. Findings showed that life skills training had a significant effect on the overall self-management score; thus, self-management of patients increased after training life skills (F = 25.1821, P <0.01). Materials and Methods: This semi-experimental study was conducted on 80 subjects with MS in the MS Society in Tehran (Iran) in 2016. The experimental group received four one-hour sessions of life skills training. The control group received routine care. Patients of both groups filled MS self-management (MSSM) scales at baseline and a month after the last training session. Independent t-test was used to compare findings between the two groups; pairwise t-test was used to compare results before and after the test. Covariance test was used to present the research results and data was analyzed by using SPSS21. Findings: Mean and standard deviation of age were 32.22±8.88 and 33.02±10.34 in the control and experimental groups, respectively. Results: Comparison of total self-management showed a significant difference between the control and experimental groups after receiving life skill training (P<0.01). Moreover, there was a significant difference in the mean of total self-management in the experimental group before and after the intervention; self-management increased after intervention (p-value<0.001). Conclusion: This study showed the positive effect of life skills training because its main goal is to prepare and help patients solve problems and deal with difficulties resulting from the disease. Therefore, life skill training is suggested for patients suffering from MS. [ABSTRACT FROM AUTHOR]

Background: Burden of adverse drug reactions (ADRs), in home-environment and domestic settings, is unknown. Objective: To discuss the epidemiology of reported ADRs to 13-Aban drug and poison information center (DPIC) and to discuss the burden of hospitalization caused by these ADRs from commonly implicated therapeutic groups. Methods: A retrospective analysis of the yellow card schemes of suspected ADRs reported to the 13-Aban DPIC was conducted from 21 March 2013 to 21 November 2016 inclusive. Main outcome measures: Characteristics of the ADRs, such as the sex and age of the patient, the therapeutic group involved, and the medical outcome of the exposure, were examined. ADR Hospitalization (ADRH) index was calculated for each drug group by dividing the number of ADR-related hospitalizations with total number of reported ADR cases (n = 748), and then multiplying by 100. Results: ADRs were reported for 748 patients representing 5 cases per 1000 enquiries to the 13-Aban DPIC over almost 4-years of the study period. Public were responsible for reporting every 4 out of 5 ADR cases (n = 651, 87%) and the remaining 1 out of 5 ADR cases was reported by the health care professionals (n = 97, 13%). Most of the ADRs had a medical outcome documented as having a minor effect or were minimally bothersome to the patients (n = 509, 68%), and less than 4.9% (n = 37) were documented as having a major effect or were life-threatening. Overall, 7.4% (n = 55) of ADRs were resulted in hospitalization. Antibacterials for systemic use represented the therapeutic group with the highest hospitalization index (1.7%). Conclusions: The study concluded that ADRs to antibiotics are common and some of them resulted in hospitalization. [ABSTRACT FROM AUTHOR]

Background: Increasing the accessibility of antiretroviral therapy (ART) has caused the emergence of drug resistance in patients receiving ART and in naïve patients. The aim of this study was to evaluate HIV subtype and drug resistance between naïve patients and ART-experienced patients. Methods: Blood samples were collected from 78 antiretroviral and naïve HIV-1 patients; antiretroviral-resistant mutations and subtyping were then determined by sequencing pol regions. Results: Phylogenetic analysis revealed that 96.1% of sequences belong to the CRF35-AD subtype. Transmitted drug resistance was determined in 14% of drug-naïve patients and 40% of ART-experienced patients. Conclusion: The findings of this study illustrated the importance of resistance testing before and during ART treatment. This study can be used to set up a best medicine strategy in Iranian guidelines. [ABSTRACT FROM AUTHOR]

Considering their features, tall building are of high importance in the view of a city. Among their important features are height, top and color which are also some of the most important factors in their effectiveness. In the present study we assessed the effectiveness of these physical features in the overall visual impact of these tall buildings and determined the significance of each of these features in the visual impact of the tall buildings. To this end, we examined a tall building in the largest city of Iran (Tehran). We altered the physical features (its height, top, and color) of the building, providing nine images for each variable element. Combining these pictures, 27 trio pictures were eventually prepared and assessed by a sample of 384 people randomly selected from the population of Tehran. Then, the data were analyzed. The results indicated that height was the most effective factor in the eyes of the citizens, followed by top and, then, color with the least effect among the three factors. In a more thorough analysis of the interactive effect of the factors on each other, we reached the conclusion that height can affect the visual impact of top and color but top can only affect the visual impact of color and slightly the impact of height. However, the effect of color on the other two factors was insignificant. [ABSTRACT FROM AUTHOR]

Implementing a combined cooling, heating and power system(CCHP) to cool, heat and produce electricity is growing rapidly due to its efficiency and low emissions. In this paper, using economic analysis, the size and operation detail of the required gas engine and the specific electricity, cooling and heating load curves for a one year operating period has been determined. The proposed CCHP system meets thermal demands of the facility and has been evaluated under such strategy. Net Annual Profit (NAP) has been introduced as an objective function to be maximized through a developed nonlinear mixed integer programming software. The operation strategy and the payback period of the chosen system have also been determined. A study with the purpose of including or excluding subsidy prices has been carried out. Furthermore, a sensitivity analysis was elaborated in order to show the dependency of optimal solutions to some key contributing factors such as fuel price, electricity buying price and electricity selling price. Results show that, these parameters have significant effect on the system's performance. [ABSTRACT FROM AUTHOR]

Background: Clinical guidelines have increasingly been used as tools for applying new knowledge and research findings. Although, efforts have been made to produce clinical guidelines in Iran, it is not clear whether they have been used by physicians and what factors are associated with them?. Methods: Four hundred and forty three practicing physicians in Tehran were selected from private clinics through weighted random sampling. The data collection tool was a questionnaire on familiarity and attitude toward clinical guidelines. The descriptive and analytical findings were analyzed with t tests, Chi2, logistic and linear multivariate regression by SPSS, version 16. Results: 31.8% of physicians were familiar with clinical guidelines. Based on the logistic regression model physicians' familiarity with clinical guidelines was positively and significantly associated with 'working experience in a health service delivery point' OR = 2.13 (95% CI, 1.17 3.90), 'familiarity with therapeutic protocols' OR = 2.09 (95% CI, 1.22 3.57) and 'holding a specialty degree' OR = 2.51 (95% CI, 1.24 5.07). The mean overall attitude scores in the 'usefulness', 'reliability', and 'problems and barriers' domains were, respectively, 78.9 (SD = 16.5), 78.9 (SD = 19.7) and 50.4 (SD = 15.9) out of a total of 100 scores in each domain. No significant association was observed between attitude domains and other independent variables using multivariate linear regression. Conclusions: Little familiarity with clinical guidelines may represent weakness in of production and distribution of domestic evidence. Although, physicians considered guidelines as useful and reliable tools, but problems such as difficult access to guidelines and lack of facilities to apply them were stated as well. [ABSTRACT FROM AUTHOR]

Purpose: Studies indicate that milk intake is associated with insulin-like growth factor 1 (IGF-1) concentrations and height in childhood, whether milk and other dairy products promote puberty remains unclear. This study aimed to investigate influences of pre-pubertal intakes of milk, yogurt and cheese on menarcheal age in Tehranian girls. The associations of total dietary calcium (Ca), magnesium (Mg), and phosphorus (P) with menarcheal age were also examined. Methods: This prospective study was conducted on 134 pre-pubertal girls, aged 4-12 years at baseline, who participated in the Tehran Lipid and Glucose Study (TLGS), and were followed for a median of 6.5 years. Dietary intakes were determined at initiation of the study using two non-consecutive 24-h dietary recalls and the age of menarche was documented during the follow-up. Logistic regression was used to calculate the risk of reaching menarche ≤ 12 years according to pre-pubertal levels of dairy or mineral intakes. Results: The risk of earlier menarche was higher in girls with higher intakes of milk [OR: 2.28 (95% CI: 1.03–5.05)], Ca [OR: 3.20 (95%CI: 1.39–7.42)], Mg [OR: 2.43 (95% CI: 1.12–5.27)] and P [OR: 3.37 (95 % CI: 1.44–7.87) after controlling for energy and protein intake, interval between the age at study initiation and the age of menarche, and maternal age at menarche (Model 1). Girls in the middle tertile of cheese intakes had a lower risk of reaching menarche ≤ 12 years than those in the lowest tertile after controlling for covariates in model 1. These associations remained significant after further adjustment of BMI Z-score at baseline. The relationship of Ca, Mg, and P with menarche remained after further adjustment for height Z-score at baseline, whereas the association between milk and cheese intakes became non-significant. Conclusions: Pre-pubertal intake of milk, but not cheese and yogurt, may hasten age at menarche. [ABSTRACT FROM AUTHOR]

Timely notification is of great importance in health emergencies. So identifying the most important sources of information used by people in emergencies seems necessary. The objective of this study was to assess peoples' level of awareness concerning the symptoms, routes of transmission, prevention, and treatment of H1N1 at the time of the pandemic and also to identify their most important source of information. Two telephone surveys were performed at the beginning of levels five and six of the pandemic at a four-month interval on two populations. Using a questionnaire, random phone numbers were called and 662 and 701 individuals from Tehran were surveyed at the two phases. Peoples' level of awareness concerning the disease, symptoms, its routes of transmission, prevention, and treatment of H1N1 had increased in the second phase of the study. At the same time, people were less afraid of the disease in the second phase. The most important sources of information used were TV, newspapers, and radio, respectively. Mass media including TV and newspapers were recognized as the most important sources of information used by the people in emergencies. It seems that designing educational programs and synchronizing the media's policies with health authorities can help fight future health emergencies and prevent delays in notifying people. [ABSTRACT FROM AUTHOR]

Background: Adverse drug reactions (ADR) are ranked as some of the major causes of patient morbidity and mortality. Spontaneous reporting of ADRs has remained the cornerstone of pharmacovigilance and is important in maintaining patient safety. This study was conducted to assess the nurses' knowledge and attitude towards pharmacovigilance, reasons for not reporting ADRs, and their pharmacovigilance practice. Materials and Methods: A questionnaire was prepared to investigate knowledge, attitude and practice (KAP) of nurses regarding ADR reporting. In November 2009, the questionnaires were given to 500 nurses of a teaching hospital in Tehran. Findings: Knowledge and practice of participants were not satisfying; however, their attitude towards pharmacovigilance was at a high level. About 91% of the nurses had never reported an ADR. Most nurses liked to report the ADRs to the physicians (87.1%) and pharmacists in hospital's ADR center (1.8%) rather than the ADR National Center. The main cause of under-reporting of the suspected ADRs was unawareness about the existence of such a national center. Among nurses who had reported ADR for at least once, the majority preferred using phone (10 out of 50) or Yellow Cards (7 out of 50). Only 1 person out of 50 preferred using internet for submitting the reports Conclusions: Since the nurses in this study had little knowledge and poor practice regarding the pharmacovigilance and spontaneous reporting system, interventions such as holding pharmacovigilance workshops in the hospitals focusing on the aims of pharmacovigilance, completing the Yellow Card and clarifying the reporting criteria are strongly recommended. [ABSTRACT FROM AUTHOR]

The goal of this study was to evaluate the pattern and the suitability of the human Albumin usage according to the available and reliable guidelines. A concurrent, cross-sectional study was performed in Shariati Hospital (associated with Tehran University of Medical Sciences, Tehran, Iran). All inpatient adults that were prescribed albumin during the study period were evaluated to register the indications for albumin usage and specific patient information. The total 1281 vials of Albumin were presribed for 135 patients during the study period. The most common reasons to prescribe albumin were volume expansion after the heart surgery (53.3%), nutrition source in malnourished patients (19.3%), paracentesis (12.9%), plasmapheresis (9.6%), hypoalbuminemia (3%) and the others (2.1%). Only 411 vials (32.1%) prescribed with 34 prescriptions (25.2%) were utilized appropriately based on the guidelines. The results showed that based on the guidelines, the most prescriptions of albumin in this hospital have not been written appropriately. Therefore, educational programs on using guidelines may help reduce albumin usage and treatment costs. [ABSTRACT FROM AUTHOR]

Objectives: Preparedness and response at the time of pandemic range from writing programs to conducting procedures as well as informing the target population. The present study was conducted to evaluate the awareness of general practitioners in Tehran, at the time of H1N1 pandemic. It also aimed to identify the main sources used for gathering information at each alert level. Methods: Two telephone surveys were conducted with a 4 month interval, at the beginning of H1N1 pandemic alert level 5 and 6, on 90 and 100 general practitioners, respectively. The knowledge of these physicians on the symptoms of H1N1 flu, the transmission methods, the preventative measures, and existing treatments along with the sources used for gathering information were assessed. Results: While mass media was the main source of gathering information in the H1N1 pandemic alert level 5, more professional sources were used at the H1N1 pandemic alert level 6. Despite the acceptable improvement noted in the knowledge of the physicians during the two phases of the study, their understanding of the disease was believed to be less than the expected level based on H1N1 pandemic alert level. Conclusions: The routine use of mass media as one of the main sources of information gathering at the two stages of the study points out its importance in providing physicians with the required information at the time of H1N1 pandemic. Using adequate, up-to-date, but non-specialized media can fill the gap in information gathering, required for fighting pandemic. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis is the most common form of arthritis in the world. This study presents the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. To add to the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. Methods: Inhabitants (age≥15 yrs) in 22 randomly selected districts (Tehran) participated in a Community-Oriented Program for Control of Rheumatic Diseases (COPCORD) evaluating major rheumatic disorders, including osteoarthritis. Eventually, 10, 291 inhabitants completed a Questionnaire (75% response-rate). Trained interviewers asked participants whether they had had any pain, swelling, tenderness, or morning stiffness in the right/ left hand during previous seven days. Participants underwent a complete physical examination if they had any musculoskeletal complaint or extraarticular manifestation of rheumatic disease. Osteoarthritis was defined as presence of palpable nodules (Heberden's/ Bouchard's nodes, CMC1's squaring), pain, tenderness, swelling, or a combination of them on that joint (DIP-PIP-MCP-CMC1). Clinical hand osteoarthritis was positive if at least one joint showed osteoarthritis. Results: Symptomatic hand osteoarthritis was present in 2.8%(CI; 2.3-3.4) (52.6% female, mean age; 37.1±16.3). Prevalence was higher in females (4.3% vs. 1.3%, p=0.000) and increased with age (0.1% in people <30 versus 23% in people >70, p=0.000). The most common signs in the DIP, PIP and CMC1 joints were bony enlargement, followed by tenderness and pain on movement. Conclusions: our study confirms the evidence of high prevalence of symptomatic hand osteoarthritis in an urban community. The prevalence, pattern of hand joints involvement and relationship with age and sex in this study performed in an Eastern community resemble those in Westerners, which calls for further attention by appropriate services. [ABSTRACT FROM AUTHOR]