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Based on investigations, there exist tight correlations between neurodegenerative diseases' incidence and progression and aberrant protein aggregreferates in nervous tissue. However, the pathology of these diseases is not well known, leading to an inability to find an appropriate therapeutic approach to delay occurrence or slow many neurodegenerative diseases' development. The accessibility of induced pluripotent stem cells (iPSCs) in mimicking the phenotypes of various late-onset neurodegenerative diseases presents a novel strategy for in vitro disease modeling. The iPSCs provide a valuable and well-identified resource to clarify neurodegenerative disease mechanisms, as well as prepare a promising human stem cell platform for drug screening. Undoubtedly, neurodegenerative disease modeling using iPSCs has established innovative opportunities for both mechanistic types of research and recognition of novel disease treatments. Most important, the iPSCs have been considered as a novel autologous cell origin for cell-based therapy of neurodegenerative diseases following differentiation to varied types of neural lineage cells (e.g. GABAergic neurons, dopamine neurons, cortical neurons, and motor neurons). In this review, we summarize iPSC-based disease modeling in neurodegenerative diseases including Alzheimer's disease, amyotrophic lateral sclerosis, Parkinson's disease, and Huntington's disease. Moreover, we discuss the efficacy of cell-replacement therapies for neurodegenerative disease., (© 2020 Wiley Periodicals LLC.)

Background: Rapid increasing pharmaceutical spending on the one hand and limited budgets on the other hand are problems confronting health expenditure. Policymakers have realized that without the negative effect on quality of care, they can control pharmaceutical spending., Methods: The study methodology involved a targeted review of the literature on cost containment policies, their implementation issues, advantages, and disadvantages. Then, all proposed strategies were investigated through interviewing insurance experts. Finally, these policies were prioritized with respect to their adherence to the main issues of performance., Results: Considering implementation costs, durability, and feasibility, six policy options have been proposed as follows: stopping non-prescription medicine reimbursement, using a tiered-coinsurance mechanism, establishing prescription-guidelines, implementing cost-effectiveness-studies, employing scientific bargaining methods, and using different levels of reference pricing., Conclusions: Despite the possibility of some physicians' resistance, preparing prescription guidelines and their gradual enforcement is considered as the first choice. Next, it seems that reference pricing is the most feasible policy. It is in spite of some confusion and dissatisfaction, which might arise due to lack of knowledge and an increase in out-of-pocket expenses. Then, all pricing methods, including cost-effectiveness studies and internal and external reference pricing, should be used as negotiation leverage with pharmaceutical companies. Afterward, stopping non-prescription medicine reimbursement should be implemented by good media communication in view of its effects on a wide range of population. Finally, implementation of tiered-coinsurance mechanism should be considered with special attention to some inherent technical complexity., (© 2020 John Wiley & Sons, Ltd.)

For many years, researchers were looking for new antibacterial substances to deal with hospital infections and especially resistant infections. Nanoparticles attracted much attentions because of their very small size that increases the surface to capacity ratio and consequently increase chemical activity. In this study, the antibacterial effects of silver, copper oxide, nickel oxide, and titanium dioxide nanoparticles were studied on Proteus vulgaris, as a bacterium involved in the resistant hospital infections. The capability of nanoparticles to inhibit the growth of bacteria was assessed via 9 different methods including cylinder, disk, and well-diffusion, spot test, MBC, MIC, liquid inhibitory action test, diffusion, and assessing the effects of nanoparticles on a 24-h culture. Based on the results, copper oxide and silver nanoparticles had high antibacterial effects on P. vulgaris in both liquid and solid cultures, respectively. However, nickel oxide and titanium dioxide nanoparticles only had a weak effect on the inhibition of bacterial growth in the liquid culture. CuO and Ag NPs could release ions and consequently produce free radicals, disturb the equilibrium of electrons between electron donor groups and inactivate enzymes and DNA of the organisms. Moreover, they triggered holes in the bacterial membrane to disturb cellular ion equilibrium. So, they can be used to inhibit the growth of pathogens. Besides, further studies have shown that they could be used as a supplementary treatment and/or in combination with other drugs to cure infections caused by P. vulgaris.

Background: DNA repair pathways, cell cycle arrest checkpoints, and cell death induction are present in cells to process DNA damage and prevent genomic instability caused by various extrinsic and intrinsic ionizing factors. Mutations in the genes involved in these pathways enhances the ionizing radiation sensitivity, reduces the individual's capacity to repair DNA damages, and subsequently increases susceptibility to tumorigenesis., Body: BRCA1 and BRCA2 are two highly penetrant genes involved in the inherited breast cancer and contribute to different DNA damage pathways and cell cycle and apoptosis cascades. Mutations in these genes have been associated with hypersensitivity and genetic instability as well as manifesting severe radiotherapy complications in breast cancer patients. The genomic instability and DNA repair capacity of breast cancer patients with BRCA1/2 mutations have been analyzed in different studies using a variety of assays, including micronucleus assay, comet assay, chromosomal assay, colony-forming assay, γ -H2AX and 53BP1 biomarkers, and fluorescence in situ hybridization. The majority of studies confirmed the enhanced spontaneous & radiation-induced radiosensitivity of breast cancer patients compared to healthy controls. Using G2 micronucleus assay and G2 chromosomal assay, most studies have reported the lymphocyte of healthy carriers with BRCA1 mutation are hypersensitive to invitro ionizing radiation compared to non-carriers without a history of breast cancer. However, it seems this approach is not likely to be useful to distinguish the BRCA carriers from non-carrier with familial history of breast cancer., Conclusion: In overall, breast cancer patients are more radiosensitive compared to healthy control; however, inconsistent results exist about the ability of current radiosensitive techniques in screening BRCA1/2 carriers or those susceptible to radiotherapy complications. Therefore, developing further radiosensitivity assay is still warranted to evaluate the DNA repair capacity of individuals with BRCA1/2 mutations and serve as a predictive factor for increased risk of cancer mainly in the relatives of breast cancer patients. Moreover, it can provide more evidence about who is susceptible to manifest severe complication after radiotherapy., Competing Interests: Competing interestsNot applicable, (© The Author(s) 2020.)

We respond to the comments of Ma et al. and clarify the rationale behind our methodology and why it is suitable for our work.

Background: The aim of this study was to investigate the removal of Cr (VI) using Green-Graphene Nanosheets (GGN) synthesized from rice straw., Methods: Synthesis of the GGN was optimized using response surface methodology and central composite design (CCD). The effect of two independent variables including KOH-to-raw rice ash (KOH/RRA) ratio and temperature on the specific surface area of the GGN was determined. To have better removal of Cr (VI), GGN was modified using the grafting amine group method. In the Cr (VI) removal process, the effects of four independent variables including initial Cr (VI) concentration, adsorbent dosage, contact time, and initial solution pH were studied., Results: The results of this study showed that the optimum values of the KOH/RRA ratio and temperature for the preparation of GGN were 10.85 and 749.61 °C, respectively. The maximum amount of SSA obtained at optimum conditions for GGN was 551.14 ± 3.83 m 2 /g. The optimum conditions for Cr (VI) removal were 48.35 mg/L, 1.46 g/L, 44.30 min, and 6.87 for Cr (VI) concentration, adsorbent dosage, contact time, and pH, respectively. Based on variance analysis, the adsorbent dose was the most sensitive factor for Cr (VI) removal. Langmuir isotherm (R2 = 0.991) and Pseudo-second-order kinetic models (R2 = 0.999) were the best fit for the study results and the Q max was 138.89 mg/g., Conclusions: It can be concluded that the predicted conditions from the GGN synthesis model and the optimum conditions from the Cr (VI) removal model both agreed with the experimental findings., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Springer Nature Switzerland AG 2020.)

We provide the initial demonstration of a general thin film deposition technique that leverages the unique solubility properties of supercritical fluids. The technique is the solution-phase analogue of physical vapor deposition and allows thin films of a semiconducting polymer to be grown without the need for in situ chemical reactions. Film growth is approximately linear with time, indicating that film thickness can be controlled in a straightforward manner by varying the time of deposition. To further demonstrate the flexibility of the technique, we demonstrate precise control over the location of material deposition using a combination of photolithography and resistive heating. The potential for scalable manufacturing is demonstrated by use of a master to control deposition onto a flexible polymer film. Finally, we demonstrate a unique deposition capability of this technique by depositing patterns onto the curved interior of a hemisphere made from a silicone elastomer. This capability is not possible with any printing or line-of-sight deposition technique. More generally, the ability to control the deposition of solution processed materials with high accuracy provides the long sought after bridge between top-down and bottom-up self-assembly.

Purpose: To investigate whether increased parental age is associated with an increased risk for de novo copy number variant (CNV) formation in offspring., Methods: CNV calls from 2323 individuals referred to Signature Genomic Laboratories for clinical microarray-based comparative genomic hybridization were investigated; 17% of the samples were prenatal and 83% were postnatal. The de novo CNV data were further split into de novo CNVs bound by low copy repeats (LCRs) and those not bound by LCRs., Results: No association was found between CNV occurrence and paternal age in both the prenatal (p = 0.6795) and postnatal (p = 0.1741) cohorts. Maternal age was significantly higher with de novo CNV occurrence in our postnatal cohort (p = 0.0126), an effect which may be driven by formation of de novo CNVs that are bound by LCRs (p = 0.0026). Furthermore, a significant positive correlation was observed between maternal age and de novo CNVs (Point-Biserial R 2  = 0.0503, p = 0.0152)., Conclusions: This large-scale study did not find any evidence for the influence of increased paternal age on de novo CNV formation, while increased maternal age appeared to increase risk for de novo, non-complex CNV occurrence in offspring with intellectual disability/developmental delay. Further studies and continued technological advances will help yield more information on the risk factors for de novo CNVs., Competing Interests: Declaration of competing interest The Department of Molecular and Human Genetics at Baylor College of Medicine receives revenue from clinical genetic testing conducted at Baylor Genetics., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Objectives: Bacteriophages are infectious replicating entities that are under consideration as antimicrobial bioagents to control bacterial infections. As an alternative or supplement to antibiotics, bacteriophages can be used to circumvent the resistance to existing antibiotics. The aim of this study was to assess the synergistic effect of a naturally isolated phage and ampicillin against Escherichia coli O157., Materials and Methods: In the present study, a natural phage against E. coli O157 was isolated, the morphology and molecular characteristics of the phage were identified, and the combination of bacteriophage and antibiotic to combat clinically isolated drug-resistant E. coli O157 was evaluated., Results: The results showed the synergistic action between a naturally isolated phage and ampicillin in solid (disk diffusion test) and liquid culture media. Addition of the isolated phage, gT0 E.co -MGY2, to the microbial lawn of bacteria in modified antibiotic disk diffusion test, altered susceptibility pattern of E. coli O157 from resistant to sensitive based on the inhibition zones. Combinations of bacteriophage and ampicillin significantly enhanced the killing of bacterial strains when compared to treatment with ampicillin or phage alone in liquid culture. Moreover, it lasted few hours for ampicillin to reverse the growth of E. coli O157, while the bacteriophage and combination treatment stopped the proliferation of bacteria from the beginning, and this can compensate the delayed onset of antibiotic action., Conclusion: The synergistic action of bacteriophages and antibiotics is an alternative that cannot only be effective against bacterial infections but also contribute to the reduction of antibiotic resistance.

Objectives: In this study, we aimed to assess the value of admission time CBC parameters in predicting post-primary PCI corrected TIMI frame count., Background: Recent years have witnessed a large series of studies evaluating different laboratory variables to predict no-reflow phenomenon following primary PCI (PPCI) in patients with STEMI. However, a general agreement about the most reliable predictor of the no-reflow phenomenon is challenging and also intriguing., Methods: The current study concluded 208 consecutive patients who underwent primary PCI for ST-Elevation Myocardial Infarction (STEMI) from January 2014 to February 2016. Blood samples were obtained after taking ECG. Complete blood samples were collected and analyzed within 5 minutes from sampling. Post-PCI corrected Thrombolysis in Myocardial Infarction (TIMI) frame count was determined by one interventional cardiologist blinded to patients' clinical data. The correlation between admission time blood parameters and post-primary PCI corrected TIMI frame count in patients with STEMI were assessed., Results: Corrected TIMI frame count was positively correlated with WBC count (R: 0.18, P-value: <0.01), neutrophil count (R: 0.34, P-value: <0.01), and platelet count (R: 0.23, P-value: <0.01) and negatively correlated with lymphocyte count (R: -0.2, P-value: <0.01). Multiple linear regression results demonstrated that corrected TIMI frame count was positively correlated with neutrophil count (P < 0·001) and platelet count (P < 0·001) and negatively correlated with lymphocyte count (p=0.004)., Conclusion: High counts of WBC, neutrophil, and platelet and low count of lymphocyte may be predictors of no-reflow in STEMI patients undergoing PPCI. The clinical significance of such predictive parameters becomes clear as we consider the treatment approach in STEMI patients. Appropriate risk stratification leads to better treatment planning and allocation of resources., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Over the past decades, the incidence of life-threatening fungal infections has increased dramatically in particular among patients with hampered immune function. Fungal infections cause around 1.5 million deaths annually, superior to malaria and tuberculosis. With respect to high toxicity, narrow spectrum of activity and drug resistance to current antifungals, there is an urgent need to discover novel leads from molecules of natural origin especially those derived from plants and microorganisms for antifungal drug discovery. Among antifungal drugs introduced into the clinic, those affecting ergosterol biosynthesis are still superior to other classes and the vital role of ergosterol in fungal growth and development. This review highlights current knowledge about available antifungal agents and further issues on antifungal drug discovery from compounds of natural origin which affect ergosterol biosynthesis. Special attention is made to the fungal sterol C24-methyltransferase (SMT), a crucial enzyme in ergosterol biosynthesis pathway as a novel target for rational drug design., (Copyright© 2019 Iranian Neuroscience Society.)

The destructive growth and collapse of cavitation bubbles are used for therapeutic purposes in focused ultrasound procedures and can contribute to tissue damage in traumatic injuries. Histotripsy is a focused ultrasound procedure that relies on controlled cavitation to homogenize soft tissue. Experimental studies of histotripsy cavitation have shown that the extent of ablation in different tissues depends on tissue mechanical properties and waveform parameters. Variable tissue susceptibility to the large stresses, strains, and strain rates developed by cavitation bubbles has been suggested as a basis for localized liver tumor treatments that spare large vessels and bile ducts. However, field quantities developed within microns of cavitation bubbles are too localized and transient to measure in experiments. Previous numerical studies have attempted to circumvent this challenge but made limited use of realistic tissue property data. In this study, numerical simulations are used to calculate stress, strain, and strain rate fields produced by bubble oscillation under histotripsy forcing in a variety of tissues with literature-sourced viscoelastic and acoustic properties. Strain field calculations are then used to predict a theoretical damage radius using tissue ultimate strain data. Simulation results support the hypothesis that differential tissue responses could be used to design tissue-selective treatments. Results agree with studies correlating tissue ultimate fractional strain with resistance to histotripsy ablation and are also consistent with experiments demonstrating smaller lesion size under exposure to higher frequency waveforms. Methods presented in this study provide an approach for modeling tissue-selective cavitation damage in general.

Diabetes mellitus has been always one of the most prevalent chronic diseases in the last decades. There exist a wide range of pharmacological agents for controlling this disease. However, these agents fare differently in terms of efficacy and safety. Hence, the aim of this study was to compare dulaglutide and liraglutide, two glucagon-like peptide-1 receptor agonists, in terms of efficacy and safety, drawing on a systematic review and meta-analysis. A systematic review and meta-analysis were carried out in January 2018. The articles were evaluated by two independent investigators and their quality was evaluated using Jadad scale and the Cochrane Collaboration's tools. Finally, the eligible articles entered the study. HbA1c and FBS were considered as efficacy outcomes. Safety profile was evaluated based on several outcomes such as serious side effects and vital signs. Three articles met the inclusion and exclusion criteria. The results indicated that the mean difference (MD) of HbA1c reduction was -0.10% (95% CI, -0.20% to -0.01%, P=0.03) in the patients who received dulaglutide in comparison with the patients who received liraglutide. In addition, dulaglutide was safer than liraglutide in terms of gastrointestinal problems (RR=0.85, 95% CI, 0.73 to 0.99, P=0.04, I 2 =55%) and heart rate (RR=-1.14, 95% CI, -1.90 to -0.38, P=0.003, I 2 =0%). Once-weekly dulaglutide showed a further reduction in HbA1c compared to once-daily liraglutide. However, comparisons between these regimens indicated no significant difference between groups in either FBS reduction or safety profile. Similarly, no statistically significant difference was observed in treatment discontinuation, hypoglycemia events, and vital signs.

Evaluation of pharmaceutical systems performance is an essential prerequisite for promoting evidence-based policy-making and improvement in health system performance. This study attempts to evaluate the performance of Iran pharmaceutical system based on the world health organization (WHO)'s indicators, including access, quality, and rational use of medicines. In this cross-sectional descriptive study, inspired by the instructions proposed by WHO, public and private pharmaceutical service-providers were evaluated in three dimensions and 16 indicators. Accordingly, eleven separate checklists were developed and, in terms of translation, face and content validity were certified by pharmaceutical sector's experts. Sampling was randomly carried out in five cities. Depending on the type of indicators, retrospective or prospective approaches was determined for data collection. The data were collected from April to November 2018 and analyzed by SPSS 24. The availability of targeted key medicines in various cities as well as in public and private pharmacies was 97.5% with no significant difference. Although the medicines cost was higher in private sectors than in public ones, they were affordable in both sectors. In quality indicators, public sectors enjoyed a higher level than the private sectors did. The average number of medicines per prescription in public pharmacies was 3.2 and it was 3.4 in private ones. On average, in public sectors 33% and 32% of outpatients received antibiotics and injectable medicines, respectively. Finally, 77% of medicines were prescribed by using their generic names and 25% of prescriptions were in accordance with key medicines list. This study reveals that the availability and affordability of targeted key medicines in Iran are in good condition; however, in terms of rational use of medicines, Iran fails to meet the standard levels.

Background: In the past decades, economic sanctions imposed on Iran for its nuclear program. The embargo made difficulty in foreign trade and led to lack of timely access to medicines. As the internationally-led sanctions caused to the shortage of medicine there, healthcare systems need to applied the new policies for maintaining health service quality especially in pharmaceutical sector., Objectives: This paper is about policies applied in Iran health system during the crisis reached its peak in 2012 as a good experience for guarantying access to pharmaceutical products., Methods: Through interviewing experts and managers in pharmaceutical regulatory system, the implemented policies in targeted historical period were extracted, then quantitative data were analyzed to show the impact of the policies on the access and affordability of medicines before and after their implementation in Iran food and drug administration (IFDA). This paper tries to show strategies employed by to tackle the crisis caused by sanctions and to offer practical policies to make medicines more accessible at the time of crisis., Results: In order to reduce the harmful effects of this crisis, IFDA proposed some changes at different levels ranging from organizational procedures to parliament legislations. The main achievements of IFDA were making drugs easily available are as follows, significantly reducing prices, decreasing the share of market regarding the imported medicines, facilitating the manufacture of domestic medicines, encouraging foreign investment in manufacturing drugs domestically, controlling the shortage of drugs, and finally giving financial support to all patients in general and to those patients who had problem paying for drugs in particular., Conclusion: These experiences which made the Iran pharmaceutical sector survive during the international sanctions, can be considered as a good example of resilience strategies in similar situations. Graphical abstract IFDA policies to improve access to pharmaceutical products in sanction.

Objective: The aim of the study was to investigate the overall estimates of cross-sectional areas of the median nerve measured by ultrasonography in accordance with the electrodiagnostic classification of carpal tunnel syndrome severity., Design: MEDLINE (PubMed), Embase (Ovid), and Web of Science were searched for studies reporting the median nerve cross-sectional area measured by ultrasonography for mild, moderate, and severe carpal tunnel syndrome based on electrodiagnostic study. Cross-sectional area values measured at the carpal tunnel inlet were included in the analyses., Results: Overall, 866 citations were retrieved and checked for eligibility. Finally, 16 articles were included for meta-analysis. These studies included a total sample of 2292 wrists including 776 mild, 823 moderate, and 693 severe carpal tunnel syndrome. The pooled analysis revealed a mean cross-sectional area of 11.64 mm (95% confidence interval = 11.23-12.05 mm, P < 0.001) for mild carpal tunnel syndrome, a mean cross-sectional area of 13.74 mm (95% confidence interval = 12.59-14.89 mm, P < 0.001) for moderate carpal tunnel syndrome, and a mean cross-sectional area of 16.80 mm (95% confidence interval = 14.50-19.1 mm, P < 0.001) for severe carpal tunnel syndrome., Conclusions: This is the first meta-analysis that provides the pooled median nerve cross-sectional area values in accordance with the electrodiagnostic classification of carpal tunnel syndrome severity. The values obtained in this study have clinical utility in ultrasonographic assessment of patients with carpal tunnel syndrome.

Water treatment technologies based on graphene oxide (GO) sponges show promise due to their high surface area and versatile chemistry, yielding an excellent adsorption affinity for different contaminants. However, the bacteria removal capacity and the intrinsic antimicrobial properties of GO sponges are not well understood. While GO has been successfully functionalized with antibiotics or metal biocides, these antimicrobials present cytotoxicity concerns. Natural antimicrobial agents such as antimicrobial enzymes, peptides, and polymers hold promise in this respect due to their relatively low cost, biocompatibility, and ability to readily functionalize GO by covalent bond formation with oxygen-containing functional groups. In this work, the antimicrobial enzyme lysozyme, antimicrobial peptide nisin, and antimicrobial polyamide ε-poly-l-lysine were used to covalently functionalize the surface of a hierarchically porous GO sponge. The antimicrobial activity of the functionalized material was demonstrated against two model organisms: the Gram-positive B. subtilis and Gram-negative E. coli . The performance of the porous material in a simulated filtration context was evaluated using packed column experiments, and an improved bacterial retention of both strains by the functionalized sponge was demonstrated. Furthermore, samples of spent sponge after filtration were evaluated with a membrane integrity assay demonstrating antimicrobial activity in a continuous flow mode.

Soluble amyloid beta (Aβ) oligomers are the most common forms of Aβ in the early stage of Alzheimer's disease (AD). They are highly toxic to the neurons but their capability to activate microglia remains controversial. Microglia develop two distinct phenotypes, classic (M1) and alternative (M2). Tuning of microglia to the alternative (anti-inflammatory) state is of major interest in treatment of neuroinflammatory disease. This study aimed to assess tuning the microglia to produce interferon beta (IFN-β) as an anti-inflammatory cytokine through TLR4 pathway in a rat model of AD. Microglial BV-2 cells were treated with 1 μg/ml lipopolysaccharides (LPS), Monophosphoryl lipid A (MPL), or vehicles for 24 h, and then incubated with Aβ oligomer. After 24 h, cell pellets were harvested and TIR-domain-containing adapter-inducing interferon-β (TRIF), interferon regulatory factor 3 (IRF3), and IFN-β levels were measured. The ligands/vehicle were microinjected into the right ventricle of male Wistar rats every 3 days. Two weeks later, an osmotic pump filled with oligomeric Aβ/vehicle was implanted in the left ventricle. After 2 weeks, TRIF, IRF3, and IFN-β levels were measured in the hippocampal tissue. TNF-α and IFN-β levels were assessed in the hippocampus using immunohistochemistry. The oligomeric Aβ did not change TRIF, IRF3, and IFN-β levels in both cell culture and hippocampal tissue. However, pretreatment with LPS or MPL increased the level of these proteins. BV-2 cells morphologically express M1 state in presence of higher dose of Aβ oligomer (10 μM). Pretreatment with LPS or MPL decreased the TNF-α and increased the number of IFN-β positive cells in the hippocampus of Aβ-treated rats. In conclusion, pretreatment with low dose TLR4 agonists could induce microglia to produce neuroprotective cytokines including IFN-β which may be considered as a potential strategy to combat neuronal degeneration in AD.

Three-dimensional macrostructures (3DMs) of graphene and graphene oxide are being developed for fast and efficient removal of contaminants from water and air. The large specific surface area, versatile surface chemistry and exceptional mechanical properties of graphene-based nanosheets enable the formation of robust and high-performance 3DMs such as sponges, membranes, beads and fibres. However, little is known about the relationship between the materials properties of graphene-based 3DMs and their environmental performance. In this Review, we summarize the self-assembly and environmental applications of graphene-based 3DMs in removing contaminants from water and air. We also develop the critical link between the materials properties of 3DMs and their environmental performance, and identify the key parameters that influence their capacities for contaminant removal.

Background: Alemtuzumab and natalizumab are approved as second-line therapies for relapsing-remitting multiple sclerosis (RRMS) patients in Iran who have shown an inadequate response to other disease-modifying therapy (DMT). In the absence of head-to-head trials, evaluations based on decision analytic modeling may be a suitable alternative to compare alemtuzumab and natalizumab in RRMS., Purpose: To evaluate the cost-effectiveness of alemtuzumab compared with natalizumab in RRMS in Iran, based on an indirect comparison of clinical trial data., Methods: A cost-utility analysis was conducted using a cohort-based Markov model to analyze cost-utility in a cohort of 1,000 RRMS patients treated with alemtuzumab or natalizumab who had failed at least one previous DMT. Costs were measured in 2018 US Dollars, and were estimated from both the societal and National Healthcare Service (NHS) perspective over a 20-year time horizon in Iran. One-way deterministic sensitivity analyses were carried out to investigate the impact of individual variables on model results., Results: Alemtuzumab dominated natalizumab in both NHS and societal perspective analyses. From the NHS perspective, the total discounted costs per patient were estimated at $147,417 and $150,579 for alemtuzumab and natalizumab, respectively, over 20 years. The discounted quality-adjusted life years were estimated to be 7.07 and 6.05, respectively. Results were similar for the societal perspective analysis. Results were most sensitive to acquisition costs and the time horizon, while no sensitivity was observed for Expanded Disability Status Scale (EDSS) health-states utility, relapse relative risk, adverse event or EDSS-related costs, and laboratory/monitoring costs., Conclusion: Alemtuzumab was dominant in the treatment of RRMS compared with natalizumab due to lower total cost, greater efficacy and slowing of disease progression, and lower rate of relapses over a 20-year time horizon in Iran. Comparative head-to-head trials and long-term follow-up are needed to confirm these results.

Synaptic function and memory performance are disrupted by soluble form of β-amyloid (Aβ). In the previous study, we found that early activation of microglia by toll-like receptor 2 (TLR2) attenuated Alzheimer's disease-associated cognitive deficit. This study was designed to investigate whether pretreatment with the TLR2 receptor ligand can regulate microglia to produce interferon β (INFβ) in a rat model of Alzheimer's disease. For this purpose, the BV-2 cell line was cultured in a 24-well plate, treated with Pam3Cys (1 μg/ml), and then incubated with oligomeric Aβ for 24 h. The expression of TRIF, IRF3, and INFβ was measured by western blot technique. For in-vivo study, bilateral guide cannulas were streotaxically implanted in the right and left lateral ventricles. Pam3Cys/vehicle was microinjected into the right ventricle every 3 days. Two weeks later, an osmotic pump was inserted into the left ventricle to microinfuse oligomeric Aβ/placebo over 14 days. In the meanwhile, treatment with Pam3Cys was continued every 3 days. Then, expression of TRIF, IRF3, and INFβ was measured in the hippocampus. The results showed that although oligomeric Aβ could not alter the expression of these proteins at the cell and tissue level, treatment with Pam3Cys resulted in enhanced expression of them at both cell culture and hippocampal tissue following treatment with oligomeric Aβ. It is concluded that stimulation of microglia through TLR2 pathway induces INFβ expression, which may in part mediate neuroprotection against oligomeric Aβ.

Purpose: The purpose of this study was to investigate the ultrasonographic reference values for diameters and cross-sectional area (CSA) of the median nerve between the two heads of the pronator teres muscle in healthy population as well as to correlate the findings with height, weight, sex and age., Methods: Fifty-five healthy Caucasian volunteers (110 median nerves) were included in this study. The reference range (mean ± 2 standard deviations; 2.5th-97.5th quintiles) and the upper limit of side-to-side difference of the median nerve between the two heads of the pronator teres muscle were investigated using high-frequency ultrasound. The effects of age, sex, height, handedness, and body mass index (BMI) were examined., Results: The mean age was 39.4 ± 10.6 years (range 18-75 years). The mean ± 2SD of the median CSA was 4.9-12.9 mm 2 . The upper limit of normal side-to-side difference was 3.0 mm 2 . The differences between genders and between the dominant and non-dominant hands were not significant. The mean antero-posterior and transverse diameters were 7.2 ± 1.5 and 10.7 ± 2.4 mm, respectively. Significant correlations were observed between the dominant-side CSA and BMI (r = 0.33; p = 0.01) and age (r = 0.31; p = 0.02). The correlation between the CSA and height (r = 0.19; p = 0.16) was not significant., Conclusions: The measurements obtained in this study are of importance for examining median nerve entrapments in the forearm using high-frequency ultrasound. Age and BMI showed to be correlated with median nerve CSA; while gender and height were not.

Oxidative cleavage of cycloalkenylalkylphosphonates 1 followed by treatment with base gives rise to homologated cycloalkenones 2 in good to excellent yields. Subjecting cycloalk-2-enylphosphonates 3 to identical conditions provides the one-carbon ring-contracted compounds 4 in excellent yields. Oxidative cleavage of γ,δ-unsaturated ketophosphonates 6 followed by treatment with base affords 2-cyclopenten-1-ones 7 in good overall yields. This method may offer a practical alternative to existing methods for effecting one-carbon ring expansion, ring contraction, and annulation reactions.

Self-assembly of graphene oxide (GO) nanosheets into porous 3D sponges is a promising approach to exploit their capacity to adsorb contaminants while facilitating the recovery of the nanosheets from treated water. Yet, forming mechanically robust sponges with suitable adsorption properties presents a significant challenge. Ultra-strong and highly porous 3D sponges are formed using GO, vitamin C (VC), and cellulose nanocrystals (CNCs) - natural nanorods isolated from wood pulp. CNCs provide a robust scaffold for the partially reduced GO (rGO) nanosheets resulting in an exceptionally stiff nanohybrid. The concentration of VC as a reducing agent plays a critical role in tailoring the pore architecture of the sponges. By using excess amounts of VC, a unique hierarchical pore structure is achieved, where VC grains act as soft templates for forming millimeter-sized pores, the walls of which are also porous and comprised of micron-sized pores. The unique hierarchical pore structure ensures the interconnectivity of pores even at the core of large sponges as evidenced by micro and nano X-ray computed tomography. The unique pore architecture translates into an exceptional specific surface area for adsorption of a wide range of contaminants, such as dyes, heavy metals, pharmaceuticals and cyanotoxin from water.

The aim of this study was to investigate membrane synthesis by interfacial polymerization methods, the application of synthesized nano-composite membrane for natural organic matters (NOMs) removal from water, evaluation of fouling mechanism and antifouling properties. Polysulfone (PSf) was selected as a porous ultrafiltration membrane support and interfacial polymerization was done using tannic acid (TA) and Trimesoyl chloride (TMC) with central composite design (CCD). The effects of TA and TMC monomer concentrations, reaction time and post treatment temperature was evaluated. The synthesized membrane was characterized by field emission scanning electron microscope (FESEM), atomic force microscopy (AFM), attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) and water contact angle. Based on the results, the optimum conditions for synthesizing nano-composite were: TA concentration of 0.27 g/L, TMC concentration of 0.22 g/L, reaction time of 68.29 min and temperature of 25.23 °C. The predicted optimum operational conditions were a NOM concentration of 6.429 mg/L; time of 10.931 min and applied pressure of 1.039 bar. The potential applications of the synthesized nano-composite membranes with interfacial polymerization can enhance water treatment.

Background: Unfavorable associations between air pollution and myocardial infarction are broadly investigated in recent studies and some of them revealed considerable associations; however, controversies exists between these investigations with regard to culprit components of air pollution and significance of correlation between myocardial infarction risk and air pollution., Methods: The association between exposure to PM 10 , PM 2.5 , ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide concentration of background air that residents of Tehran, the capital city of Iran, which is ranked as the most air polluted city of Iran and the relative risk of developing ST-elevation myocardial infarction (STEMI) were investigated by a case-crossover design. Our study included 208 patients admitted with a diagnosis of STEMI and undergone primary percutaneous intervention. Air pollutant concentration was averaged in 24-h windows preceding the time of onset of myocardial infarction for the case period. Besides, the mean level of each element of air pollution of the corresponding time in one week, two weeks and three weeks before onset of myocardial infarction, was averaged separately for each day as one control periods. Thus, 624 control periods were included in our investigation such that. Each patient is matched and compared with him/herself., Results: The mean level of PM 10 in case periods (61.47µg/m 3 ) was significantly higher than its level in control periods (57.86µg/m 3 ) (P-value = 0.019, 95% CI: 1.002-1.018, RR = 1.010). Also, the mean level of PM 2.5 in case periods (95.40µg/m 3 ) was significantly higher than that in control days (90.88µg/m 3 ) (P-value = 0.044, 95% CI: 1.001-1.011, RR = 1.006). The level of other components including NO 2 , SO 2 , CO and O 3 showed no significant differences between case and control periods. A 10µg/m 3 increase in PM 10 and PM 2.5 would result in 10.10% and 10.06% increase in STEMI event, respectively. Furthermore, the results of sub-group analysis showed that older patients (equal or more than 60 year-old), diabetic patients, non-hypertensive ones and patients with more than one diseased vessel may be more vulnerable to the harmful effect of particular matters including PM 10 and PM 2.5 on development of STEMI., Conclusion: Air pollution is a worldwide pandemic with great potential to cause terrible events especially cardiovascular ones. PM 2.5 and PM 10 are amongst ambient air pollutant with a high risk of developing STEMI. Thus, more restrictive legislations should be applied to define a safe level of indoor and outdoor air pollutant production., (Copyright © 2017 Elsevier Inc. All rights reserved.)

In the present study, feasibility of low-fat hamburger production by partial replacement with quince seed gum (QSG) was investigated. The effects of different QSG levels (1.2, 2.4, 3.6, and 4.8 wt%) on cooking loss, water holding capacity, lipid oxidation, antioxidant activity, and hardness of hamburger were investigated during a period of 9 days. The optimization was carried out based on minimum cooking loss, lipid oxidation, and maximum water holding capacity, antioxidant activity, and tissue hardness. Optimum conditions were achieved as 3.26% oil, 4.73% QSG, and 8.25th day of storagability. According to the optimum conditions, values for cooking loss, water holding capacity, lipid oxidation, free radical scavenging, raw hamburger hardness, and fried hamburger hardness were as 13.80%, 55.61%, 0.59 mg MDA/Kg, 48.12%, 2.99 N, and 8.66 N, respectively. Overall acceptability of optimized hamburgers was better and more acceptable than control ones.

Overuse of injections is a common problem in many low-income and middle income countries. While cultural factors and attitudes of both physicians and patients are important factors, physicians› financial intensives may play an important role in overprescribing of injections. This study was designed to assess the effects of providing injection- services in physicians› ambulatory offices on prescribing injectable medicines. This cross-sectional study was conducted in Tehran in 2012 -2013and included a random sample of general physicians, pediatricians and infectious disease specialists. We collected data on the provision of injection services in or in proximity of physician offices, and obtained data from physicians› prescriptions in the previous three-month period. We analyzed the data using ANOVA, Student›s t-test and linear regression methods. We obtained complete data from 465 of 600 sampled physicians. Overall 41.9% of prescriptions contained injectable medicines. 75% of physicians offered injection services in their offices. Male physicians and general physicians were more likely to offer the services, and more likely to prescribe injectables. We observed a clear linear relationship between the injection service working hours and the proportion of prescriptions containing injectables (p-value<0.001). Providing injection service in the office was directly linked with the proportion of prescriptions containing injectables. While provision of injection services may provide a direct financial benefit to physicians, it is unlikely to be able to substantially reduce injectable medicines› prescription without addressing the issue.

Application of surgical stents for implant placement via guided flapless surgery is increasing. However, high cost, need for some professional machines, and not taking into account the soft-tissue parameters have limited their application. We sought to design and introduce a technique named in-office guided implant placement (iGIP) to decrease the cost by using available devices in office and enhance the applicability of surgical stents. A customized surgical stent was fabricated based on prosthetic, soft- and hard-tissue parameters by taking into account the amount of available bone (using the computed tomographic [CT] data), soft-tissue thickness and contour (using a composite-covered radiographic stent), and position of the final crown (by diagnostic cast wax up and marking the final crown position with composite). The efficacy of iGIP, in terms of the accuracy of the three-dimensional position of the implant placed in the study cast and in patient's mouth, was confirmed by direct observation and postoperative CT. The iGIP can enhance implant placement in the prosthetically desired position in various types of edentulism. Using this technique minimizes the risk of unwanted consequences, as the soft-tissue thickness and contour are taken into account when fabricating a surgical stent.

Premise of the Study: Populations with phenotypic polymorphism in discrete characters may be good models for investigating genome evolution and speciation. Sphagnum magellanicum Brid. is found throughout the northern hemisphere, and despite considerable variation in morphological characters, it is considered one of the least taxonomically controversial peatmoss species. We have observed two main morphs of the species associated with different microhabitats. Here we investigated the genomic and environmental basis of this intraspecific morphological variation., Methods: We conducted transplant and common garden experiments to test whether the two morphs are genetically differentiated. We then used RAD-sequencing to quantify the genomic divergence between the morphs and approximate Bayesian computation (ABC) to infer the most likely demographic scenario explaining the genome-wide differentiation of the two morphs., Key Results: We found that genomic differentiation between the two morphs is unexpectedly high and that several of the differentiated morphological characters have a genetic basis. Using simulation approaches, we found support for a scenario of ancient divergence followed by recent secondary contact., Conclusions: We show that the two morphs represent the two main genetic clusters previously found worldwide. Our results demonstrate that relatively minor morphological differentiation in a presumed phenotypically plastic peatmoss may be associated with massive divergence across the genome., (© 2017 Botanical Society of America.)

Background: In recent years the generation rate of construction and demolition waste (C&D) has significantly augmented. The aim of this study was to assessed the quality and quantity of construction and demolition waste in Tehran (capital of Iran)., Methods: Questionnaire methods were used for estimating the amount of generated C&D wastes national statistical data and typical waste generation data. In order to defining the composition of C&D waste, trucks were randomly selected and their wastes were separated and weighted., Results: According to obtained results, about 82,646,051 m 3 of C&D waste (average 16,529,210 m 3 per year) were generated during 2011 to 2016 which only about 26% of them has been recycled. Mixing sand and cement, concrete, broken bricks and soil have the highest amount of the composition of C&D waste in Tehran that was 30, 19, 18 and 11%, respectively. Based on the results, about 2,784,158 t of the waste will generate in 2025 and this is approximately 122% higher than wastes generate in 2016. Based on MAPSA's data, 360 teams of personnel cruise and control the illegal disposals, but due to the expansion of Tehran this number of teams is inadequate and can't be effective in controlling the situation., Conclusion: In general, the overall condition of C&D waste management in Tehran seems undesirable and needs to be updated based on the experience of successful countries in this field.

In today's competitive world, there are several strategies to deal with the fast changing environment, among which New product development (NPD) is a common strategy. However, almost half of the resources that companies devote to NPD are spent on products that may fail. This issue is particularly highlighted in the pharmaceutical industry mainly because of a long development-time, low success rate, high capital requirement, and market uncertainty. This study identifies critical success factors of NPD based on the relevant literatures and expert opinions in Iranian pharmaceutical industry, then prioritizes them using the methodology of multiple criteria decision making (MCDM) through analyzing 50 filled questionnaires structured based on the AHP (Analytical Hierarchy Process) approach. Although the NPD success factors seem the same in both generic and bio-generic pharmaceutical industries, the underlying factors and related sub-factors show the different importance in these two industries. However, this study reveal that, the company capabilities is the most important factor affecting new product development success in both pharmaceutical generic and bio-generic industry. The results of this study contribute to create baseline information for pharmaceutical industry especially Iranian pharmaceutical companies to be more effective in budget allocation on improving NPD success factors so that they can boost the success rate of NPD more effectively.

In the present study, a novel Cr 6+ -imprinted Pebax/chitosan/GO/APTES nanofibrous adsorbent (Cr 6+ -PCGA) was prepared and its performance was compared with PCGA nanofibers for selective sorption of Cr(VI) ions from aqueous solutions. The prepared nanofibers were characterized using FTIR, SEM and EDAX analysis. The influence of batch sorption experiments including GO/APTES content, pH, contact time, Cr(VI) initial concentration and temperature on the Cr(VI) sorption efficiency using synthesized nanofibers was investigated. The Cr(VI) sorption data were well described using pseudo-second-order kinetic and Redlich-Peterson isotherm models. The maximum sorption capacities of Cr 6+ -PCGA and PCGA nanofibers for Cr(VI) ions sorption were found to be 204.5 and 550.5mgg -1 , respectively. Thermodynamic studies indicated an endothermic and spontaneous nature of Cr(VI) ions sorption using both Cr 6+ -PCGA and PCGA nanofibers. The selectivity coefficient values of Cr(VI)/Pb(II), Cr(VI)/Cu(II) and Cr(VI)/Ni(II) indicated the higher selectivity of Cr 6+ -PCGA nanofibrous adsorbent for Cr(VI) ions separation compared to PCGA nanofibers. The good stability and reusability of Cr 6+ -PCGA nanofibrous adsorbent for five sorption/desorption cycles promised a higher potential of ion-imprinted nanofibers for separation of metal ions from aqueous systems in a large scale., (Copyright © 2016 Elsevier B.V. All rights reserved.)

There is increasing interest in using quartz crystal microbalance with dissipation monitoring (QCM-D) to investigate the interaction of nanoparticles (NPs) with model surfaces. The high sensitivity, ease of use and the ability to monitor interactions in real-time has made it a popular technique for colloid chemists, biologists, bioengineers, and biophysicists. QCM-D has been recently used to probe the interaction of NPs with supported lipid bilayers (SLBs) as model cell membranes. The interaction of NPs with SLBs is highly influenced by the quality of the lipid bilayers. Unlike many surface sensitive techniques, by using QCM-D, the quality of SLBs can be assessed in real-time, hence QCM-D studies on SLB-NP interactions are less prone to the artifacts arising from bilayers that are not well formed. The ease of use and commercial availability of a wide range of sensor surfaces also have made QCM-D a versatile tool for studying NP interactions with lipid bilayers. In this review, we summarize the state-of-the-art on QCM-D based techniques for probing the interactions of NPs with lipid bilayers.

Identifying the mechanisms of nanoparticle (NP) interactions with cell membranes is key to understanding potential NP cytotoxicity and applications as nanocarriers for targeted drug delivery. To elucidate these mechanisms of interaction, supported phospholipid bilayers (SPBs) are commonly used as models of cell membranes. However, SPBs are soft thin films, and, as such, their properties can be significantly affected by the underlying substrate. Free-floating cell membranes would be best modeled by weakly adhered SPBs; thus, we propose a method for tailoring the interfacial interaction of an electrically charged SPB-substrate system based on modulations in the solution chemistry. Using the dissipation signal of the quartz crystal microbalance with dissipation monitoring (QCM-D), we show that the method can be used to tailor SPB-substrate interactions without the loss of its structural integrity. To demonstrate the application of the method, SPBs are exposed to cationic and anionic polystyrene latex NPs. These studies reveal that the bilayer response to the modulations in the interfacial interaction with its underlying substrate can be used as a sensitive tool to probe the integrity of SPBs upon exposure to NPs. As expected, anionic NPs tend to impart no significant damage to the anionic bilayers, whereas cationic NPs can be detrimental to bilayer integrity. This is the first report of a QCM-D based method to probe bilayer integrity following exposure to NPs. Importantly, the degree of SPB interaction with its underlying substrate is shown to be a critical factor in the kinetics of bilayer disruption by cationic NPs, whereby weakly adhered bilayers are prone to significantly faster breakup. Since free-floating cell membranes are better represented by a weakly adhered SPB, the results of this work critically influence paradigms in experimental studies involving SPBs as models for cell membranes.

Activated sludge process is a biological process that is widely used in the domestic and industrial wastewater treatment in over the world. The foam formation is often reported in wastewater treatment plants which are related to this process. Some operational problems can be created by foaming, such as effluent quality deteriorates, the creation of malodorous, increased time requirements in order to plant maintenance, and in extreme cases, hazardous working conditions resulting from foam spilling out of the aeration basin and as well as increased in operational costs. There are different ways to overcome this problem, such as reduce air flows into the aeration basin, reduction in the grease and oil content of the wastewater, surface and return activated sludge (RAS) chlorination, anoxic and anaerobic selectors, solid retention time (SRT) control and antifoams and organic polymer addition. On the other hand, rapid and accurate identification of the foam causes is in the first step to control bulking and foaming. Foam problem is often created by filamentous bacteria, such as Nocardia and Gordonia species. This bacterium has a role important in activated sludge.

Spore-producing organisms have small dispersal units enabling them to become widespread across continents. However, barriers to gene flow and cryptic speciation may exist. The common, haploid peatmoss Sphagnum magellanicum occurs in both the Northern and Southern hemisphere, and is commonly used as a model in studies of peatland ecology and peatmoss physiology. Even though it will likely act as a rich source in functional genomics studies in years to come, surprisingly little is known about levels of genetic variability and structuring in this species. Here, we assess for the first time how genetic variation in S. magellanicum is spatially structured across its full distribution range (Northern Hemisphere and South America). The morphologically similar species S. alaskense was included for comparison. In total, 195 plants were genotyped at 15 microsatellite loci. Sequences from two plastid loci (trnG and trnL) were obtained from 30 samples. Our results show that S. alaskense and almost all plants of S. magellanicum in the northern Pacific area are diploids and share the same gene pool. Haploid plants occur in South America, Europe, eastern North America, western North America, and southern Asia, and five genetically differentiated groups with different distribution ranges were found. Our results indicate that S. magellanicum consists of several distinct genetic groups, seemingly with little or no gene flow among them. Noteworthy, the geographical separation of diploids and haploids is strikingly similar to patterns found within other haploid Sphagnum species spanning the Northern Hemisphere. Our results confirm a genetic division between the Beringian and the Atlantic that seems to be a general pattern in Sphagnum taxa. The pattern of strong genetic population structuring throughout the distribution range of morphologically similar plants need to be considered in future functional genomic studies of S. magellanicum.

Background: Postoperative nausea and vomiting (PONV) and postoperative pain are among the most common side-effects of surgery. Many factors, such as a change in the level of sex hormones, are reported to affect these complications. This study aimed to evaluate the probable effects of the menopause on PONV and postoperative pain., Methods: Prospective study, in which a total number of 144 female patients undergoing cystocele or rectocele repair surgery under standardized spinal anesthesia were included. Patients were divided into two equally sized sample groups of pre- and postmenopausal women (n = 72). The occurrence of PONV, the severity of pain as assessed by visual analog scale (VAS) pain score, and the quantity of morphine and metoclopramide required were recorded at 2, 4, 6, 12, 18 and 24 h after surgery., Results: The mean VAS pain score and the mean quantity of morphine required was higher among premenopausal women (P = 0.006). Moreover, these patients required more morphine for their pain management during the first 24 h after surgery compared to postmenopausal women (P < 0.0001). No difference was observed between the two groups regarding the incidence of PONV (P = 0.09 and P = 1.00 for nausea and vomiting, respectively) and the mean amount of metoclopramide required (P = 0.38)., Conclusions: Premenopausal women are more likely to suffer from postoperative pain after cystocele and rectocele repair surgery. Further studies regarding the measurement of hormonal changes among surgical patients in both pre- and postmenopausal women are recommended to evaluate the effects on PONV and postoperative pain.

Introduction: Speech intelligibility, the ability to be understood verbally by listeners, is the gold standard for assessing the effectiveness of cochlear implantation. Thus, the goal of this study was to compare the speech intelligibility between normal-hearing and cochlear-implanted children using the Persian intelligibility test., Materials and Methods: Twenty-six cochlear-implanted children aged 48-95 months, who had been exposed to 95-100 speech therapy sessions, were compared with 40 normal-hearing children aged 48-84 months. The average post-implanted time was 14.53 months. Speech intelligibility was assessed using the Persian sentence speech intelligibility test., Results: The mean score of the speech intelligibility test among cochlear-implanted children was 63.71% (standard deviation [SD], 1.06) compared with 100% intelligible among all normal-hearing children (P<0.000). No effects of age or gender on speech intelligibility were observed in these two groups at this range of ages (P>0.05)., Conclusion: Speech intelligibility in the Persian language was poorer in cochlear-implanted children in comparison with normal-hearing children. The differences in speech intelligibility between cochlear-implanted and normal-hearing children can be shown through the Persian sentence speech intelligibility test.

Managing the supply chain plays an important role in creating competitive advantages for companies. Adequate information flow in supply chain is one of the most important issues in SCM. Therefore, using certain Information Systems can have a significant role in managing and integrating data and information within the supply chain. Pharmaceutical supply chain is more complex than many other supply chains, in the sense that it can affect social and political perspectives. On the other hand, managing the pharmaceutical supply chain is difficult because of its complexity and also government regulations in this field. Although, Iran has progressed a lot in pharmaceutical manufacturing, still there are many unsolved issues in managing the information flow in the pharmaceutical supply chain. In this study, we reviewed the benefits of using different levels of an integrated information system in the supply chain and the possible challenges ahead.

Objectives: The aim of this study was to evaluate the psychometric features of the Persian version of the Autism Behavior Checklist (ABC)., Method: The International Quality of Life Assessment (IQOLA) approach was used to translate the English ABC into Persian. A total sample of 184 parents of children including 114 children with autism disorder (mean age =7.21, SD =1.65) and 70 typically developing children (mean age = 6.82, SD =1.75) completed the ABC. Internal consistency, test-retest reliability, concurrent and discriminant validity, and cut-off score were assessed., Results: The results of this study revealed that the Persian version of the ABC has an acceptable degree of internal consistency (.73). Test-retest comparisons using interclass correlation confirmed the instrument's time stability (.83). The instrument's concurrent validity with Gilliam Autism Rating Scale (GARS) was verified; the correlation between total scores was .94. In the discriminant validity, the autism group had significantly higher scores compared to the normal group. Receiver Operating Characteristic (ROC) analysis revealed that individuals with total scores below 25 are less likely to be in the autism group., Conclusion: The Persian version of the ABC can be used as an initial screening tool in clinical contexts.

Background: The growth of pharmaceutical expenditure and patients' out of pocket has motivated policy makers to encourage patients to substitution of brands medicines with their generic alternatives called generic substitution., Objectives: As the patients are final decision makers to accept generic substitution, the aim of this study is to evaluate the patient perception about generic medicines and underlying factors which can promote the generic acceptance., Setting: The study was done in community pharmacies in Tehran, the capital city of Iran., Method: A cross-sectional descriptive study inviting people purchasing their drug at community pharmacies were per-formed using a self-administrated anonymous questionnaire (N=1309)., Main Outcomes Measures: Besides the demographic section, 16 items of developed questionnaire were categorized to five main factors including: patients' perception about efficiency, safety and cost of generic medicines, patient trust on physicians and pharmacists' advice., Results: Findings of completed questionnaires showed among the aforementioned factors the physician has the first priority to encourage patients to use of generics medicines which followed respectively by pharmacist's role, cost of medicines, efficacy, and safety concerns., Conclusion: In conclusion, the trust of Iranian's society on the physicians and pharmacists advice would create a credible opportunity to reduce pharmaceutical expenditures as well as patients' out of pocket by promotion of generic substitution.

The present study aimed to evaluate pharmacy practice regarding dietary supplements in Tehran (I.R. Iran). So, the factors affecting on pharmacists' practice including their knowledge, attitude, and some underlying factors were evaluated. This is an observational knowledge; attitude and practice (KAP) study. The unit of analysis include pharmacies practice located in Tehran. The data was collected in 2013 via an anonymous, self-administered; postal questionnaire consisted of demographic information, knowledge (subjective and objective questions), attitude, and practice evaluation part. Descriptive and inferential statistics were performed using SPSS. This study showed that although the knowledge has a significant effect on attitude and practice, the attention should be paid on other underlying factors such as experience, pharmacy ownership situation and academic degree which might have positive impact on pharmacists' practice. According to this study, although many underlying factors such as experience, university and pharmacy ownership have impact on pharmacy practice regarding dietary supplements, the most attention should paid to knowledge as the main factor and more attention should be paid to training on dietary supplement could be recommended.

Chondroid syringoma (CS) is an uncommon benign adnexal tumor of the skin with eccrine and apocrine origin, which usually involves the head and neck region. The presentation of CS in other areas of the body is rare. A 45-year-old male patient presented to the dermatology clinic with a chief complaint of a painless, slow-growing mass on his left forearm, which gradually developed over the course of 2 years. A solitary, firm, purple, mobile, non-tender nodule was located in the distal part of left dorsal forearm, which was 1.8 cm in diameter. The tumor was surgically excised and sent for the histopathological evaluation. Results of biopsy and hematoxylin and eosin staining confirmed the diagnosis of CS and showed no evidence of malignancy. Although CS is an uncommon tumor in uppr limb region, it should be considered as one of the differential diagnoses, when dealing with tumors of this area.

Nanocomposites that contain reinforcements with preferred orientation have attracted significant attention because of their promising applications in a wide range of multifunctional fields. Many efforts have recently been focused on developing facile methods for preparing aligned graphene sheets in solvents and polymers because of their fascinating properties including liquid crystallinity and highly anisotropic characteristics. Self-aligned in situ reduced graphene oxide (rGO)/polymer nanocomposites are prepared using an all aqueous casting method. A remarkably low percolation threshold of 0.12 vol% is achieved in the rGO/epoxy system owing to the uniformly dispersed, monolayer graphene sheets with extremely high aspect ratios (>30000). The self-alignment into a layered structure at above a critical filler content induces a unique anisotropy in electrical and mechanical properties due to the preferential formation of conductive and reinforcing networks along the alignment direction. Accompanied by the anisotropic electrical conductivities are exceptionally high dielectric constants of over 14000 with 3 wt% of rGO at 1 kHz due to the charge accumulation at the highly-aligned conductive filler/insulating polymer interface according to the Maxwell-Wagner-Sillars polarization principle. The highly dielectric rGO/epoxy nanocomposites with the engineered structure and properties present high performance electromagnetic interference shielding with a remarkable shilding efficiency of 38 dB., (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Objective: To compare the effectiveness of rational, behavioral and emotive therapy (REBT) and person-centered therapy (PCT) on self-differentiation and intimacy among divorce clients., Methods: In quasi-experimental study, 42 divorce clients (both males and females) who presented to the Counsling Center of Sanandaj, Iran were sampled. They were categorized into three groups of PCT, REBT, and control group (each group contained 14 subjects). The recovery indices (dependent variables) employed were the subject of self-differentiation and intimacy, which were measured twice before and after intervention of Differentiation of Self Inventory-2 (DSI-2) and intimacy. The therapy involved 8 one-hour sessions. It was held twice a week and therapeutic effects were traced after 8 months., Results: The results showed that REBT and PCT were effective on self-differentiation scale and intimacy. Also they were influential in recovery self-differentiation scale and intimacy follow up stage., Conclusion: REBT and PCT were effective on self-differentiation and its subscales (Emotional reactivity, "I" position, Emotional cut off and Fusion with other) and general intimacy., Declaration of Interest: None.

Background: Medications, a main strategic commodity in any country, are strictly related to community health and sustainable development. Self-medication and irregular use of medications can increase their adverse effects. This study investigated the factors related to irregular and arbitrary use of medications in pregnant women admitted to health centers and clinics of Yazd, Iran, and their practice in this context., Methods: This was a descriptive- analytic cross-sectional study conducted among 180 pregnant women. Participants were selected by cluster sampling. We chose six health centers and clinics from all medical centers in Yazd by a simple random method. A questionnaire was completed by the pregnant women who were consecutively admitted to each center. Data were analyzed by ANOVA, t-test, Chi-square, and Pearson tests with SPSS-15 software., Results: More than 35% of the women self-medicated during pregnancy. Women with academic degrees scored higher in the knowledge section; however, this difference was not significant.  The mean attitude scores for academic and nonacademic graduates were 34.92 (from 60) and 29.87, respectively while the mean practice scores were 15 (from 20) and 14.25 for academic and non-academic graduates, respectively., Conclusion: The results of this study showed an increased prevalence of self-medication among pregnant women. Because of potential fetomaternal hazards related to medications, it is necessary to conduct educational programs to prevent this harmful habit and attitude in pregnant women.