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Abstract Background To evaluate the additive effect of topical or sub-tenon injection of interferon (IFN)-α 2b in the treatment of refractory diabetic macular edema. Methods In this prospective study patients with center-involved DME who were unresponsive to 3 monthly consecutive IVB injections were recruited. Patients were divided into three groups: group1, received IFN- α 2b topical drop at a dose of 1mIU/ml four times a day for 3 months. Group 2, received a single sub-tenon injection of 1mIU/ml IFN- α 2b at the enrollment. Group 3 received artificial tears four times a day for 3 months (control group). All groups received three consecutive monthly IVB injections and were evaluated monthly up to 1 month following the last IVB injection. Results In this study, 59 eyes of 35 patients with refractory DME were assessed. The final follow-up showed that although CMT decreased in all groups, only patients in Group 2 had statistically significant lower CMT compared to their baseline values (change in CMT: − 117 ± 213 µm; p-value = 0.025). Comparison of CMT changes between three groups showed no statistically significant difference, although it was higher in group 2 (change in CMT: − 117 ± 213 µm (Group2) vs. − 49 ± 173 (Group 1) vs. − 36 ± 86 (Group 3); p-value = 0.085). Considering eyes with baseline CMT > 400 µm, sub-tenon injection of IFN α2b led to a significant reduction of CMT at the first month and final follow-up visit (CMT change: − 166 ± 210, − 145 ± 231 µm; p-value = 0.018 and 0.035, respectively). In this subgroup, eyes in Group 2 had lower CMT at the first month following treatment in comparison with the control group (CMT: 444 ± 123 µm vs. 544 ± 96 µm, p-value = 0.042). Alterations of CDVA were not statistically significant among groups, although patients in Group 1 had a significant improvement in vision at second and last follow up (CDVA change: − 0.23 ± 0.39, − 0.20 ± 0.43 logMAR; p-value = 0.030 and 0.010, respectively). Conclusions In short term, Sub-tenon injection of IFN might have an additive anatomical effect in eyes with refractory DME. Validation of this observation requires further prospective controlled studies.

Critical discourse analysis is a process for the revelation of hidden thoughts and ideologies in a text (discourse). One of the theorists of critical discourse analysis is Theo van Leeuwen, whose theory of "social actors" and "social action-reactions" seeks to legitimize or de-legitimize some actors, their actions and goals. The methods of legitimizing an object or delegitimizing it are the basis of this theory. The four main strategies for legitimizing discourse are: 1) validation, 2) moral evaluation, 3) rationalization, and 4) myth-making. Each of these four methods has various forms and in this research, the poems of Malek al-Sho'ra Bahar and Haji Qader Kooi have been examined from the perspective of approaches for legitimizing discourse. Findings show that in the poems of Bahar and Haji Qader Kooi de-legitimization is more frequent than the legitimization. The models of de-legitimization used by the poets are adopted from Quranic verses, ancient kings of Iran and the glorious history of ancient Persia and some other civilized countries. Following the examples of the Qur'an and the ancient kings and by quoting the words of the Prophet (PBUH) and the elders of ancient Iran, Bahar and Haji Qadir have delegitimized the government of their time through accreditation and mentioning the negative attributes of the dominant system and members of the governing body. Also, both poets allude to the heroic mythology of ancient Persia so as to enthuse the people into action against the government and de-legitimizing that government.

Background: Scoring and analysis of Forced Choice(FC) scale has caused a great deal of controversy among researchers. Most of the discussions are related to the superficiality of the obtained results due to the ipsative nature of FC scale datas. Aims: The aim of this study was to use the Thurstonian Item Response (T-IRT) approach in scoring and examining the factor structure of FC scales. Methods: The statistical population of this study was students of Allameh Tabataba'i University of Tehran. The T-IRT model was used to score and analyze the data obtained from the Kolb Learning Styles Questionnaire (LSI), which is a Forced Choice approach. Results: The results of the T-IRT model in examining the factor structure of the LSI showed that the four-factor model fit well with the data and also, although the correlation structure between the factors in the orthogonal bipolar bifactor model was consistent with the proposed Kolb structure; but this model did not fit well with the data. The results of Multinomial logistic regression model in examining the relationship between learning styles of gender and field of study of students showed that the gender variable has no Share in predicting learning styles (CH:4.87, P>0.05); but the model related to the field of study was significant (CH:305.26, P

Millions of cataract surgeries with intraocular lens (IOL) implantation are performed worldwide. Although cataract surgery brings many benefits to the patients, the risk of various complications is still a concern. One of the infrequent adverse events but potentially affecting on patients' visual acuity and contrast sensitivity is losing the transparency of IOL. IOL opacification may lead to IOL removal or exchange, which is unpleasant to both the patient and the surgeon. Several reports of acute IOL clouding are available in the literature describing various etiologies of this phenomenon, however, the exact mechanism remained unclear in some cases. Herein, we aimed to review the causes and outcomes of intraoperative and early postoperative IOL opacification.

Abstract To present long-term visual and structural outcome of treatment in two forms of flat irregular pigment epithelial detachment (FIPED): avascular (aFIPED) and vascularized (vFIPED) in eyes within pachychoroid spectrum. Prospective interventional case series. FIPED were classified into two subgroups; aFIPED and vFIPED based on OCTA. aFIPED underwent PDT, and vFIPED underwent either PDT, IVB, or combination of PDT&IVB. Vision, subretinal or intraretinal fluid, and choroidal biomarkers such as choroidal thickness, area, choroidal vascular index (CVI), and PED area were measured at baseline and last follow-up. Fifteen eyes with aFIPED were followed for a mean of 14.7 ± 10.8 months. Their vision improved, (0.44 ± 0.37–0.33 ± 0.40 LogMAR, p = 0.009) with significant reduction of fluid, choroidal area, thickness, PED area and increase in CVI. Twenty eyes with vFIPED were followed for a mean of 16.5 ± 8.2 months. The same pattern of choroidal alterations without visual improvement was observed in eyes underwent PDT alone. Combination therapy resulted in improvement of vision (0.38 ± 0.10–0.23 ± 0.17 LogMAR, p = 0.006) with reduction of choroidal area and thickness, with an increase in CVI. IVB alone could not change vision or choroidal structure. Single session PDT may lead to sustained visual improvement and structural change in eyes with aFIPED. Combination of PDT and IVB may be a better choice in eyes with vFIPED.

The prevalence of suicide attempts and suicidal ideation among university students is a global concern. Cultural values, social determinants, religion, and especially growing stress all play an important role in this. This systematic review aimed to identify potential protective and risk factors thought to be associated with suicidal ideation among students in the Eastern Mediterranean region and highlight the importance of developing an effective health care response. MEDLINE, CINAHL, Embase, PsycINFO, WHO Global Health Library, IMEMR, Web of Science Core Collections and Farsi and Arabic databases were searched for papers in English, Farsi, and Arabic. A combination of validated filters, free text keywords, and Mesh and Non-Mesh terms were used to retrieve relevant literature. A total of 2774 papers were found after the search, 257 selected for full-text review, and 72 papers included in the final review. Family and peer support play a potential protective role in the development of suicidal ideation among university students, while adverse life events, bullying, depression, anxiety, and other mental health conditions were identified as risk factors. Suicidality was likely under-reported due to stigma around social and cultural factors. Factors involving religion and culture may act as both protective and risk factors and require more in-depth investigation. The student population in the Eastern Mediterranean region face many challenges. The common theme of suicidality emerged as an indicator of an imbalance of resources and stress, which needs to be addressed proactively, given a most likely underreporting of suicidal ideation and attempts due to stigma.

Abstract The Eurasian lynx (Lynx lynx) is one of the widespread felids in Eurasia; however, relatively little is known about the Asian subspecies, and especially the Iranian populations, which comprise the most southwestern part of its range. The current study aimed to assess the phylogenetic status of Iranian populations relative to other populations of Eurasia, by sequencing a 613 bp fragment of the mitochondrial control region. In total, 44 haplotypes were recorded from 83 sequences throughout Eurasia, two of which were found in Iran. The haplotype (H1) is dominant in all Iranian lynx populations and identical to specimens from SW Russia and central China. The second haplotype (H2) is unique and was recorded only from Ghazvin Province in the central Alborz Mountains. Both haplotypes occur in Ghazvin Province. The phylogenetic tree and a median-joining network identified four clades (i.e., East, West 1, West 2, and South). These results are congruent with previous studies and suggest that Eurasian lynx was restricted to the southern part of its range during the glacial maxima and expanded from there to East Asia and to Europe during several independent re-colonization events. The Caucasus region most like plays an important role as a refugium during glacial cycles.

Abstract The purpose of current study was to evaluate different optical coherence tomography angiography (OCTA) metrics in eyes with diabetic retinopathy with and without diabetic macular edema (DME). In this retrospective study, macular OCTA images of eyes with non-proliferative or proliferative diabetic retinopathy were evaluated. Vascular density, vascular complexity and non-perfusion densities were compared between eyes with and without DME. One-hundred-thirty-eight eyes of 92 diabetic patients including 49 eyes with DME were included. In multivariate analysis, the presence of DME was positively associated with geometric perfusion deficit (GPD) in superficial capillary plexus (SCP), capillary non-perfusion (CNP) of SCP, and GPD in deep capillary plexus (DCP) (all P

Abstract Background To assess the impact of brachytherapy on macular microvasculature utilizing optical coherence tomography angiography (OCTA) in treated choroidal melanoma. Methods In this retrospective observational case series, we reviewed the recorded data of the patients with unilateral extramacular choroidal melanoma treated with ruthenium − 106 (106Ru) plaque radiotherapy with a follow-up period of more than 6 months. Automatically measured OCTA retinal parameters were analysed after image processing. Results Thirty-one eyes of 31 patients with the mean age of 51.1 years were recruited. Six eyes had no radiation maculopathy (RM). From 25 eyes with RM, nine eyes (36%) revealed a burnout macular microvasculature with imperceptible vascular details. Twenty-one non-irradiated fellow eyes from the enrolled patients were considered as the control group. Foveal and optic disc radiation dose had the highest value to predict the burnout pattern (ROC, AUC: 0.763, 0.727). Superficial and deep foveal avascular zone (FAZ) were larger in irradiated eyes in comparison to non-irradiated fellow eyes (1629 μm2 vs. 428 μm2, P = 0.005; 1837 μm2 vs 268 μm2, P = 0.021; respectively). Foveal and parafoveal vascular area density (VAD) and vascular skeleton density (VSD) in both superficial and deep capillary plexus (SCP and DCP) were decreased in all irradiated eyes in comparison with non-irradiated fellow eyes (P

Abstract Combining genetic data with ecological niche models is an effective approach for exploring climatic and nonclimatic environmental variables affecting spatial patterns of intraspecific genetic variation. Here, we adopted this combined approach to evaluate genetic structure and ecological niche of the Indian gray mongoose (Urva edwardsii) in Iran, as the most western part of the species range. Using mtDNA, we confirmed the presence of two highly differentiated clades. Then, we incorporated ensemble of small models (ESMs) using climatic and nonclimatic variables with genetic data to assess whether genetic differentiation among clades was coupled with their ecological niche. Climate niche divergence was also examined based on a principal component analysis on climatic factors only. The relative habitat suitability values predicted by the ESMs for both clades revealed their niche separation. Between‐clade climate only niche comparison revealed that climate space occupied by clades is similar to some extent, but the niches that they utilize differ between the distribution ranges of clades. We found that in the absence of evidence for recent genetic exchanges, distribution models suggest the species occurs in different niches and that there are apparent areas of disconnection across the species range. The estimated divergence time between the two Iranian clades (4.9 Mya) coincides with the uplifting of the Zagros Mountains during the Early Pliocene. The Zagros mountain‐building event seems to have prevented the distribution of U. edwardsii populations between the western and eastern parts of the mountains as a result of vicariance events. Our findings indicated that the two U. edwardsii genetic clades in Iran can be considered as two conservation units and can be utilized to develop habitat‐specific and climate change‐integrated management strategies.

Abstract Background The islands in the Persian Gulf are home to several species of gazelles, i.e., Gazella bennettii, G. subgutturosa, and a new subspecies of Mountain gazelles which was discovered on Farur Island and described for the first time in 1993 as Gazella gazella dareshurii. Later, phylogenetic analyses showed that the Mountain gazelles consist of two species: G. gazella and G. arabica. As the Farur gazelles are more closely related to the Arabian forms of the Mountain gazelles, this subspecies is regarded to be G. arabica dareshurii. Until now, the origin of this subspecies has been an enigma. Results Here, we used mitochondrial cyt b, two nuclear introns (CHD2 and ZNF618), and morphological data to address this question by investigating the taxonomic position of the Farur gazelles. The results show that this population is monophyletic and split from other G. arabica populations probably 10,000 BP. Conclusions It is a natural relict population that was trapped on the island due to the rising sea levels of the Persian Gulf after the Last Glacial Maximum. Intermittent drought and flooding are suggested to be the main factors balancing population growth in the absence of natural predators on this monsoon-influenced island. Conservation actions should focus on preserving the natural situation of the island (cease introducing mesquite tree and other invasive species, stop building new construction and roads, and caution in providing water sources and forage), and possibly introducing individuals to other islands (not inhabited by gazelles) or to fenced areas on the Iranian mainland (strictly isolated from other gazelle populations) when the population reaches the carrying capacity of the island.

Objective: This study aimed to explain the parents’ attitude towards their children with disabilities based on religious belief and social support through the mediating role of marital satisfaction. Method: This was a descriptive cross-sectional study. The statistical population included 200 parents of the students in the schools and care centers for the students with disabilities in Tabriz. The parents were selected through the available sampling method. They completed the questionnaires on parental attitude, marital satisfaction, social support, and religious belief. The software of SPSS-25 and AMOS-18 was used to analyze the data. Findings: The findings of the correlation coefficient showed that there was the highest correlation (0.59) between the positive parents’ attitude towards the children with disabilities and religious belief. Furthermore, the findings of path analysis showed that the highest path coefficient was related to the effect of parents’ attitudes through religious belief (0.38), as well as marital satisfaction, and social support (0.20) respectively. Conclusion: According to these findings, the strong religious belief of people in the society and marital satisfaction and social support will cause the parents to have positive attitudes towards their children and accept them better.

Abstract Background Quantitative assessment of vascular density (VD) of retinal and choriocapillaris (CC) in various stages of diabetic retinopathy (DR) using spectral domain optical coherence tomography angiography (SD OCTA). Methods 188 eyes of 97 participants were recruited in this cross-sectional study. The macular OCTA (3x3mm) scan was performed and the computer algorithm assessed VD at the level of superficial capillary plexus (SCP), deep capillary plexus (DCP) and CC. Results All measured parameters were decreased in retinal VD at the more extreme stages of DR, with the exception of SCP foveal VD. There was a constant pattern of decrease in VD of CC from normal cases to cases of NDR and NPDR and then a slight increase occurred in the PDR stage but never touching the normal quantities. Age, fasting blood sugar, and years of diabetes mellitus were correlated with reduced VD in different segments. Multivariate linear regression analysis showed that best-corrected visual acuity (BCVA) was positively correlated with parafoveal VD at SCP and VD of foveal area at CC. VD of all subfields of macular area except foveal DCP VD showed reduced levels in diabetic macular edema (DME) patients compared to those without DME. Conclusions The findings of the study endorse retina VD changes as a potential biomarker for DR development before retinopathy becomes clinically evident. It seems that parafoveal VD of SCP and foveal VD of CC are good biomarkers to predict VA in the diabetic patients.

Abstract Background To describe the features of multimodal imaging and the diagnostic role of en face OCT in the paracentral acute middle maculopathy (PAMM) spectrum. Methods In this observational case series, 5 eyes of 5 patients with acute PAMM were identified. Demographic characteristics as well as data regarding the underlying disease, presenting visual acuity (VA) and ophthalmic examination results were recorded. All patients underwent multimodal imaging within 3 days after symptom onset. Results The mean age of patients was 52.2 (range, 33–67) years. Systemic comorbidities including diabetes mellitus and hypertension were identified in two patients. Except for one patient diagnosed with isolated PAMM, other patients had signs of retinal vascular disease such as a cilioretinal artery or branch retinal artery obstruction, non-ischemic central retinal vein occlusion, or a combination of these vascular disorders. The central vision was preserved in two cases; however, the remaining cases presented with profound VA reduction. Different patterns of PAMM including arterial, globular, and fern-like were observed in en face OCT at deep capillary plexus (DCP) level. En face OCT images could precisely delineate the margin of the PAMM area. Optical coherence tomography angiography (OCTA) showed decreased vascular density in DCP. Unresolved projection artifact by conventional OCTA software was observed in DCP and choriocapillaris slabs in all cases. Conclusion En face structural OCT in PAMM can delineate the area of ischemia and the degree of foveal involvement. Unresolved projection artifact by conventional OCTA software in the PAMM area can be seen in DCP and choriocapillaris layers.

Abstract Interspecific hybridization increasingly occurs in the course of anthropogenic actions, such as species translocations and introductions, and habitat modifications or occurs in sympatric species due to the shortage of conspecific mates. Compared with anthropogenically caused hybridization, natural hybridization is more difficult to prove, but both play an important role in conservation. In this study, we detected hybridization of two gazelle sister species, Gazella bennettii (adapted to dry areas) and Gazella subgutturosa (adapted to open plains), in five habitat areas, where G. bennettii naturally occur in central Iran. The hybrids have a nuclear genomic identity (based on two introns), habitat preference, and phenotype of G. bennettii, but the mitochondrial identity (based on cyt b) of G. subgutturosa. We suggest that natural hybridization of female G. subgutturosa and male G. bennettii happened twice in central Iran in prehistoric times, based on the haplotype pattern that we found. However, we found indications of recent hybridization between both species under special circumstances, for example, in breeding centers, due to translocations, or in areas of sympatry due to the shortage of conspecific mates. Therefore, these two species must be kept separately in the breeding centers, and introduction of one of them into the habitat of the other must be strictly avoided.