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Abstract Objective This study was designed to evaluate the impact of VLCKD on cardiovascular risk factors in patients with T2DM. Methods Until March 2024, extensive searches were conducted on PubMed, Scopus, Web of Science, Embase, and other relevant databases. The purpose was to identify clinical trials examining the impact of VLCKD on glycemic control, lipid profile, and blood pressure. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) method was used to assess the evidence’s degree of certainty. Results Our initial search found a total of 2568 records and finally 29 trials were included in final analysis. Our results showed that adherence from VLCKD led to significant reduction in fasting blood sugar (WMD= -11.68 mg/dl; 95% CI: -18.79, -4.56; P = 0.001), HbA1c (WMD= -0.29; 95% CI: -0.44, -0.14; P

Abstract Background The growing elderly population worldwide is accompanied by an increased disrupting daily activities and self-care. Neglecting the multifaceted needs of the elderly can lead to detrimental effects such as loneliness or social isolation, threatening healthy aging. Self-care is a key strategy to enhance daily functioning and mitigate feelings of loneliness among the elderly. This study was conducted with the aim of investigating the feelings of loneliness and its relationship with self-care and Activities of Daily Living (ADL) among the older adults of Tabriz city. Methods In this observational cross-sectional study, we engaged 315 older adults using a simple random sampling. Participants were selected randomly from Iran’s Integrated Health System (IIHS) framework. Three questionnaires including de Jong Gierveld Loneliness Scale, Persian version of self-care scale, and ADL-Katz were used for data collection. The Partial Least Squares and Spearman’s correlation were used to investigate the relationships between demographic characteristics, loneliness, self-care, and ADL. Results The sample comprised 315 respondents 51.1% were female, 49.5% had a middle school literacy and 86% were married. A significant negative relationship was observed between loneliness and self-care (P

Abstract Diabetes mellitus (DM) is among the most widespread non-communicable diseases and poses a substantial global health challenge. The aim of this study was to examine the incidence of DM and its nutritional, anthropometric, laboratory, demographic, and behavioral determinants, as well as comorbidities, within a Kurdish population residing in western Iran. This research was conducted in the Ravansar Non-Communicable Disease (RaNCD) cohort study, followed 9170 participants aged 35–65 years, for an average ± SD of 7.11 ± 1.26 years, from 2015 until 2023. A hierarchical Cox regression model was used to estimates the adjusted hazard ratios (HRs). The incidence of DM was 4.45 (95% CI 3.96, 4.99) per 1000 person-years. We found several significant predictors for DM incidence, including prediabetes, comorbidity, urban residence, total antioxidant capacity (TAC), and the interaction between gender and body mass index (BMI). Prediabetes emerged as the strongest predictor of DM incidence, with a hazard ratio of 10.13 (CI 7.84, 13.09). Additionally, having two diseases (HR = 2.18; 95% CI 1.44, 3.29) or three and more diseases (HR = 3.17; 95% CI 2.06, 4.90) increased the risk of developing DM. Also, the hazard ratios for the effects of gender on DM incidence in the normal, overweight, and obese BMI groups were 0.24, 0.81, and 1.01, respectively. The presence of prediabetes and obesity serve as the crucial indicators for the onset of DM, emphasizing the pressing need for interventions to prevent DM in these circumstances. Furthermore, there are notable disparities between urban and rural populations in this study, warranting further investigations to ascertain the underlying causes of such variations.

Abstract Background Cardiovascular diseases (CVDs) are the primary cause of mortality globally. The prevalence of obesity is rising worldwide; there seems to be a significant positive association between obesity and CVDs. The distribution of fat in the abdominal area in the form of visceral (VAT) or subcutaneous adipose tissue (SAT) affects the risk of CVDs. The aim of the present study was to conduct a systematic review of the available literature regarding the association between the VAT-to-SAT ratio and CVDs. Methods A comprehensive search strategy was used to retrieve all human observational studies indexed in PubMed, Scopus and Google Scholar databases/search engines (from Jan 2000 up to Oct 2023). The VAT-to-SAT or SAT-to-VAT ratio was an independent variable and various cardiovascular diseases, including hypertension, atherosclerosis, coronary heart disease, cerebrovascular disease and heart failure, were considered as outcomes of interest. Results Out of 1173 initial studies, 910 papers were screened. Based on the inclusion criteria, 883 papers were excluded. Finally, 27 papers (18 cross-sectional and 9 cohort studies) published between 2010 and 2023 which met the inclusion criteria were reviewed. Conclusions The distribution of abdominal fat seems to be associated with the risk of CVDs; the majority of the evidence suggests that a higher abdominal VAT-to-SAT ratio is associated with the development of CVDs. Therefore, this ratio can be used as a prognostic indicator for CVDs. Trial registration Not applicable.

Abstract Background Infertility in men causes problems in various aspects of their lives, including personal, family and social life. One of the most important of these problems is anxiety. Anxiety in infertile men can affect their health, quality of life, and response to treatment, highlighting the significance of anxiety in these men. Thus, this systematic review and meta-analysis was conducted to investigate the prevalence of anxiety symptoms in infertile men. Methods To conduct this review study, two researchers independently searched international databases such as PubMed, Cochrane Library, Web of sciences, Scopus, PsyINFO, and the Google scholar search engine in English without considering any time limit until January 2, 2024. Keywords such as "anxiety," "infertility," "prevalence," and "epidemiology" were used, taking into account the specific search method of each database. Using the Newcastle–Ottawa Scale (NOS), the quality of the articles was evaluated by two researchers independently. Results In the systematic part of the study, 27 studies were included, and given the variety of measurement tools (8 different tools) used to investigate anxiety symptoms in infertile men, 24 studies were analyzed in five subgroups of tools. The pooled prevalence of anxiety symptoms in infertile men was 21.37% (95% CI: 15.73–27.02). The lowest and highest prevalence of anxiety in infertile men were related to the Beck anxiety inventory (BAI) and Depression Anxiety Stress Scales (DASS), accounting for 7.08% (95% CI: 3.27–10.90) and 34.90% (95%CI: 28.90–40.90) values respectively. This prevalence was 19.80% (95%CI: 9.01–30.59) for the Hospital Anxiety and Depression Scale (HADS), 30.06% (95%CI: 18.59–41.52) for the Spielberger Trait Anxiety Inventory (STAI-T), and 18.52% (95%CI: 7.76–29.29) for the Self-Rating Anxiety Scale (SAS). Conclusion The results of this systematic review and meta-analysis indicated that the prevalence of anxiety symptoms in infertile men requires special attention to healthcare planning. The healthcare system of different countries should evaluate the symptoms of anxiety in infertile men and take appropriate measures to reduce them according to the culture of the countries. It is recommended that all infertile couples be assessed for anxiety symptoms using a standardized tool during their initial evaluation.

Introduction: Nowadays, Clinical courses are meticulously structured to give students essential opportunities to elevate their professional qualifications, so that the patients’ safety is protected and their conditions improve. Given the many challenges in the clinical environment of the operating room, this study was conducted to compare the impact of team-based and task-based learning methods in the clinical settings on the perceived competence of surgery and the quality of training from the operating room nursing students’ point of view∙Methods: This quasi-experimental study was conducted on fifty 5th semester operating room technology students at Hamadan University of Medical Sciences in 2023. In this study, studentswere selected using the convenience sampling method and placed in two educational groups (team-based and task-based) of 25 subjects using the matching method. After implementing thetraining process in the operating room setting, the data related to the study were collected using the valid questionnaires of perceived competence in surgery (Cronbach’s alpha=0.86) andquality of education (Cronbach’s alpha=0.94). Also, the data analysis was conducted at the descriptive and inferential (included independent t-test and analysis of covariance) statistics level using SPSS version 16 software. Results: Findings showed that the mean clinical training quality score was significantly higher in the team-based learning group than in the other group (P=0.014). Also, after the medianintervention, the perceived competence score of surgery was higher in the task-based learning group than in the team-based group, and the difference in the average change of the competence score between the two groups was statistically significant (P

Pistachio is one of the economic nut fruits in Iran. Water limitation is the most restrictive factor for its production. To overcome the water scarcity crisis, introducing drought-tolerant rootstocks is among the crucial breeding strategies. To investigate the drought tolerance of five Qazvin native pistachio genotypes, an experiment was carried out as a factorial experiment in a completely randomized design with four replications in the greenhouse conditions. The factors were pistachio genotypes (Madari, KalKhandan, Kalehbozi, Sefid, and Ghermez) and irrigation regime (normal conditions and drought stress). The highest relative water content under drought irrigation conditions belonged to the Sefid (59.99%), and Ghermez (59.09%) genotypes. The lowest value (54.68%) belonged to the Madari genotype. The highest electrolyte leakage under drought irrigation conditions belonged to the Madari genotype (55.75%). The lowest electrolyte leakage (42.44%) belonged to the Sefid genotype. Under drought stress, the highest amount of chlorophyll a (2.12 mg g-1 fresh weight), total chlorophyll (3.051 mg g-1 fresh weight), and carotenoid (2.38 mg g-1 fresh weight) was observed in Ghermez genotype. In contrast, the highest amount of chlorophyll b (1.34 mg g-1 fresh weight) was observed in the Sefid genotype. The lowest amounts of chlorophyll and carotenoid in the drought stress belonged to the Madari genotype. According to the results, the Ghermez and Sefid genotypes with lower electrolyte leakage and higher relative water content, chlorophyll, carotenoid, and biomass under water stress, were the more drought-tolerant genotypes. Madari and KalKhandan genotypes with higher electrolyte leakage and lower relative leaf water content, chlorophyll, and biomass were the most drought-sensitive genotypes.

Abstract Background Superficial temporal artery aneurysm is a rare vascular abnormality without specific clinical symptoms. In this case report, we present the case of a patient with superficial temporal artery aneurysm who was diagnosed with migraine headache at first. Case presentation A 60-year-old Iranian man with a previous history of headaches, who did not respond properly to the treatments following the initial diagnosis of migraine, presented with a painless lump in the left temporal region, and he was diagnosed with superficial temporal artery aneurysm via Doppler ultrasound. Finally, surgical removal of the left superficial temporal artery aneurysm was performed. Conclusions This case shows the importance of vascular causes in the approach to headache etiologies, especially when the headache is prolonged without proper responses to treatment. Computed tomography angiography and magnetic resonance angiography are appropriate diagnostic methods for aneurysm detection that should be considered in future studies.

With increased length of the crest in a certain width range, the labyrinth weirs increase the discharge capacity. In this study, a laboratory flume was used with a length of 8 m and a width and height of 0.6 m, in which the hydraulic loss of linear/non-linear, labyrinth, triangular, and trapezoidal weirs were investigated. Dimensional analysis using the Buckingham methodology showed that the discharge coefficient (Cd) is a function of parameters such as hydraulic head ratio (Ht/P), weir shape factor (Sf), and hydraulic loss ratio (Hf/P). The results showed that the ATRL weir has a lower discharge coefficient than the ALR by 44% and ATPL a lower discharge coefficient than ALR by 50%. The ATRL weir has a higher hydraulic loss than ALR by 2300% and a higher hydraulic loss than ATPL by 2000%. The TRL weir has a higher hydraulic loss than LR by 4900% and a higher hydraulic loss than TPL by 5700%. The TRL weir has a lower discharge coefficient than LR by 41% and TPL by 43%. The best correlation with the Cubic statistical model was obtained in the TPL weir in terms of discharge coefficient and in the ALR weir in terms of hydraulic loss.

Endovascular stenting of the pulmonary artery treats arterial stenosis from pulmonary hypertension, congenital heart defects, or post-transplant stricture. Patients with malignant extrinsic pulmonary arterial compression, secondary to large mediastinal or pulmonary masses, often present with dyspnea, hypoxemia, and right ventricular failure. Conventional therapies like surgery, chemotherapy, and radiation are often slow and fail to promptly resolve acute symptoms.Balloon angioplasty and stenting have been explored as a rapid treatment to alleviate symptoms of external pulmonary artery compression. Despite its potential, the adoption of this procedure is limited due to risks like stent misplacement, migration, cardiac arrhythmias, and arterial rupture.This paper presents 3 cases of pulmonary angiography and stenting performed for malignant extrinsic pulmonary artery compression. These cases aim to demonstrate the feasibility of pulmonary artery stenting, encouraging its consideration as a palliative option for symptomatic patients with this condition.

Background and Objective: Restrictions imposed during the coronavirus disease 2019 (COVID-19) pandemic led to a decrease in physical activity levels across various age groups, particularly among students. This study aimed to determine the effect of eight weeks of corrective exercises on musculoskeletal pain levels in 13-15-year-old students. Methods: This clinical trial was conducted on 101 students (44 girls and 57 boys) aged 13 to 15 experiencing musculoskeletal pain in various body parts in Bandar Mahshahr, Khuzestan Province, during the second half of the academic year 2021-2022. Participants were selected based on the Adolescent Nordic Musculoskeletal Questionnaire (NMQ), considering only the first question regarding the presence or absence of pain in each of the nine body regions (neck, shoulder, elbow, hand, upper back, lower back, pelvis, knee, and ankle) in the past seven days. A score of 1 was assigned to the presence of pain and 0 to the absence of pain. Participants were randomly assigned to two groups of 60: A control group and an intervention group. The intervention group performed corrective exercises at home for eight weeks, with three sessions per week, each lasting 40 minutes. No intervention was provided to the control group. Musculoskeletal pain levels in the neck, shoulder, upper back, elbow-arm, wrist, lower back, knee, and ankle were then compared in the pre-test, post-test, and follow-up. Results: The mean and standard deviation of the total pain scores for the intervention and control groups were 1.32±0.41 and 1.33±0.46 in the pre-test, 1.01±0.08 and 1.34±0.46 at the post-test, and 1.17±0.36 and 1.11±0.31 at follow-up, respectively. Results revealed that eight weeks of corrective exercises significantly reduced musculoskeletal pain levels in the students’ neck, shoulder, upper and lower back, elbow, knee, wrist, ankle, pelvis, and thigh (P