Search

The aim of this study was to estimate suspended sediment by the ANN model, DT with CART algorithm and different types of SRC, in ten stations from the Lorestan Province of Iran. The results showed that the accuracy of ANN with Levenberg-Marquardt back propagation algorithm is more than the two other models, especially in high discharges. Comparison of different intervals in models showed that running models with monthly data,resulted in smaller error and better estimated results. Moreover, results showed that using Minimum Variance Unbiased Estimator (MVUE) bias correction factor modified the SRC results, especially in monthly time steps in almost all stations. Hence, it can be said that if because of advantages such as simplicity, SRC models are preferred, it is better that MSRC (modified sediment rating curve) is used in monthly period.

The surface stress effects on electro-thermo-mechanical linear vibration of triple-walled boron nitride nano tube embedded in an elastic medium conveying fluid flow using nonlocal Euler-Bernoulli beam theory for clamped-clamped boundary condition are investigated. The kinematic energy of fluid and nano tube, strain energy, the external work done due to the van der Waals forces, elastic medium, viscosity of fluid for nano tube, centripetal force of fluid for the inner layer of nano tube are obtained. Using energy method and applying Hamilton’s principle, the governing equations of motion for triple-walled boron nitride nano tube under surface stress effects are derived. To solve these equations, the differential quadrature method is used. Their research results show that the dimensionless natural frequency decreases with an increase in fluid velocity. Also the buckling phenomenon is occurred, when the dimensionless natural frequency is equal to zero, which the system loses its stability due to the divergence. It can be seen that the stability range increases with increasing the thickness and length to diameter due to surface stresses. This study may be useful to accurately measure the vibration characteristics of nanotubes conveying fluid flow and to design nanofluidic devices for detecting blood Glucose.

Biological and demographic parameters of the mealybug ladybird, Cryptolaemus montrouzieri (Mulsant) were evaluated on citrus mealybug, Planococcus citri (Risso) and obscure mealybug, Pseudococcus viburni (Signoret) under 24 ± 2 ºC, 80 ± 5% relative humidity and a photoperiod of 16:8 (L: D) h. The mealybugs had a significant effect on developmental time and reproductive and demographic parameters of the ladybird. Life span (egg to adult death) was obtained 220.85 ± 5.78 and 119.44 ± 2.1 days when fed on Pl. citri and Ps. viburni, respectively. However, mean number of eggs per female (fecundity) and mean percent of egg hatching were significantly higher on Ps. viburni than on Pl. citri. In addition, values of intrinsic rate of increase (rm), finite rate of increase (λ) andnet reproductive rate (R0) were significantly higher on Ps. viburni than on Pl. citri.The values of intrinsic rate of increase were estimated 0.081and 0.094 day-1 on Pl. citri and Ps. viburni, respectively. Results of this study suggested that the obscure mealybug is a more suitable prey than the citrus mealybug as the ladybird displayed shorter developmental time, and higher fecundity and growth rate when fed with obscure mealybug.

Purpose: The aim of this study was to assess the cost-effectiveness of confocal scan laser ophthalmoscopy (HRT II) and compare it with scanning laser polarimetry (GDx) for diagnosing glaucoma. Methods: A cost-effectiveness analysis was performed at two eye hospitals in Iran. The outcome was measured as the proportion of correctly diagnosed patients based on systematic review and Meta analysis. Costs were estimated at two hospitals that used the HRT II (Noor Hospital) and current diagnostic testing technology GDx (Farabi Hospital) from the perspective of the healthcare provider. The incremental cost-effectiveness ratio (ICER) was estimated on the base scenario. Results: Annual average costs were estimated as 12.70 USD and 13.59 USD per HRT II and GDx test in 2012, respectively. It was assumed that 80% of the maximum feasible annual tests in a work shift would be performed using HRT II and GDx and that the glaucoma-positive (Gl+) proportion would be 56% in the referred eyes; the estimated diagnostic accuracies were 0.753 and 0.737 for GDx and HRT II, respectively. The incremental cost-effectiveness ratio (ICER) was estimated at USD44.18 per additional test accuracy. In a base sensitivity sampling analysis, we considered different proportions of Gl+ patients (30%–85%), one or two work shifts, and efficiency rate (60%–100%), and found that the ICER ranged from USD29.45to USD480.26, the lower and upper values in all scenarios. Conclusion: Based on ICER, HRT II as newer diagnostic technology is cost-effective according to the World Health Organization threshold of

Background: One of the most common and important diagnostic methods for the detection of heart diseases is coronary angiography. The aim of this study was to determine the optimum angle of the bed by using vital signals to optimize the patient′s position after the angiography. Materials and Methods: This study was a randomized clinical trial (RCT) on participants after angiography who were divided into five groups. The first group was placed routinely in a supine position. In the other groups, all of the patients were placed in bed by angle 15°, 30°, 45°, and 60° upward. In each group, vital signals were measured that included blood pressure, percent of blood oxygen saturation, heart rate, respiratory rate, and temperature. All of measured data compared with the pain score has been achieved from numerical pain scale. The data were analyzed by descriptive statistics method, variance analysis, and post hoc tests in the Statistical Package for the Social Sciences (SPSS) software, version 16. Estimation of the relationship was done by MATLAB version 2011. The level of significance was considered to be 0.05. Results: In various groups, there was no significance difference in demographic variables such as gender, age, height, and weight. The mean of pain score, heart rate, systolic blood pressure, and respiratory rate changed significantly (P < 0.05) but the temperature variation, blood oxygen saturation, and diastolic blood pressure in subjects were not significant (P > 0.05). It showed linear changes between pain and systolic blood pressure, respiratory rate, and heart rate changes. A dramatic reduction was also seen in systolic blood pressure, respiratory rate, heart rate, and also pain at an angle of 45 ° . Conclusion: This study showed that, 45 ° was the best angle of the bed to optimize the patient′s position after the procedure, based on his/her vital signs and pain score. Thus, in order to relive pain, this change in bed angle is advised to be planned by postangiography nurses in patients after coronary angiography.

Background: Renal failure is a major public health problem in the world. These patients experience high levels of psychological tension, anxiety, and depression, which leads to their lowered quality of life, increased health care costs, and early mortality. Due to medication side effects in these patients, non-medicational methods are more in demand now. This study aimed to investigate the effect of hope therapy on depression, anxiety, and stress among the patients undergoing hemodialysis. Materials and Methods: This is a clinical trial. Fifty patients undergoing hemodialysis were selected. Patients were assigned to two groups of hope therapy and placebo. Intervention of hope therapy was administered for 60–90 min during dialysis sessions once a week for eight sessions. In the placebo group, non-specific intervention was administered with the same number of sessions. Depression, Anxiety, and Stress scale (DASS)-21 questionnaire was completed at the end of the last session and 4 weeks later. Data were analyzed by paired t-test, repeated measures analysis of variance (ANOVA), and least significant difference (LSD) post hoc test through SPSS 18. Results: There was a significant difference in mean scores of depression, anxiety, and stress in hope therapy group before, immediately after, and 1 month after intervention (P < 0.05), while there was no significant difference in mean scores of depression, anxiety, and stress before and immediately after intervention in the placebo group. Changes in mean scores of depression, anxiety, and stress were significantly higher in hope therapy group compared to placebo (P < 0.05). Conclusions: The obtained results showed that hope therapy is effective on reduction of depression, anxiety, and stress.

Background: Formoterol and salmeterol are two long-acting β2-agonists given by inhalation, with bronchodilating effects lasting for at least 12 h after a single administration. Formoterol has a faster onset of action compared with salmeterol. The aim of this study was to perform a systematic review and meta-analysis on the data published from previous review in order to calculate pooled estimates of effectiveness and safety assessment of formoterol and salmeterol in treatment of patients with asthma. Materials and Methods: In this study, we conducted an electronic search for medical citation databases including Cochrane, PubMed, Scopus, PsycInfo, and IranMedex. Besides manual search of the databases that record randomized clinical trials, conference proceedings, and journals related to asthma were included. Studies were evaluated by two independent people based on inclusion and exclusion criteria, and the common outcomes of studies were entered into the RevMan 5.0.1 software, after evaluation of studies and extraction of data from them; and in cases where there were homogeneous studies, meta-analysis was performed, and for heterogeneous studies, the results were reported qualitatively. Results: Of the 1539 studies initially found, 13 were included in the study. According to the meta-analysis conducted, no significant difference was found between the inhalation of formoterol 12 μg and salmeterol 50 μg in the two outcomes of mean forced expiratory volume 1 s (FEV1), 12 h after inhalation of medication and Borg score (A frequently used scale for quantifying breathlessness) after inhalation of medication. In addition, salmeterol was more effective than formoterol in the two outcomes of percent decrease in FEV1 after inhalation of methacholine and the number of days without an attack. Since the two outcomes of FEV1 30-60 min after inhalation of medication and morning peak expiratory flow after inhalation of medication were heterogeneous, they had no meta-analysis capabilities, and its results were reported qualitatively. Conclusion: The data from included studies shows that, more efficacy has been achieved with Salmeterol, especially in some outcomes such as the percent decrease in FEV1 after inhalation of Methacholine, and the number of days without an attack; and therefore, the administration of Salmeterol seems to be beneficial for patients, compared with Formoterol.

Andalus faced during the era of the emirate during the reign of 'Abd al-Rahman AIdakhl (138-172 AH / 756-788 AD) ,a number of risks and external challenges that targeted the security and civilization and therefore the Islamic presence which represents the most serious by: : The king Charlemagne crackdown on Al-Andalus years(157-162 AH/774-778 AD ), carried out at the request of the local rebel leaders Abdul Rahman inside, they had asked for help the king Charlemagne against prince Abdul Rahman without realizing the result of this action if it led to success, In addition to that most of these revolutions it was supported by the Abbasid caliphate but the campaign ended in dismal failure, and led the campaign for the results were negative for the king Charlemagne positive but it is positive for the prince of Al-Andalus Abdul Rahman.

Aim: To estimate factors associated with having ever had a Sexually Transmitted Disease (STDs) in Canada and explore provincial variation. Methods: The 2009-2010 Canadian Community Health Survey (CCHS) was used to examine demographic and behavioral factors associated with having ever had an STD. Univariate and multivariate analyses were conducted. Also, probit models were employed to estimate the probability of having ever had an STD in Canada. Results: People living in the Territories had the highest probability of having ever been diagnosed with an STD (OR = 2.11, 95% CI (1.76, 2.52)) and residents from Maritime Provinces were least likely to have been diagnosed with an STD (OR = .64, 95 % CI (.55, .74)). Women were more likely to have ever had an STD with an odds ratio of 2.06 (95% CI (1.90, 2.24)). In our study, income, marriage, and education were found to be protective factors. Behavioral factors such as smoking and binge drinking had significant harmful effects on sexual health. Daily smokers were 1.56 times (95% CI (1.43, 1.71)) more likely to have been diagnosed with an STD compared with non-smokers. Similarly, individuals with binge drinking frequency of more than once per week had 2.57 (95% CI (2.15, 3.07)) higher odds of having ever had an STD. Conclusion: Both demographic and behavioral factors influence the likelihood of having ever been diagnosed with an STD in Canada. Women, people with lower income, lower education, or unmarried are more likely to have ever had an STD. Smoking and binge drinking are significantly associated with an increase in the likelihood of ever having an STD in Canada. Appropriate policy interventions could address some of these factors leading to reductions in STD incidence and prevalence in Canada.

Sexual dysfunction has been demonstrated to be related to a poor quality of life. These dysfunctions are especially prevalent among men. This cross-sectional study aimed to investigate the psychometric properties of the Persian translation of the Sexual Quality of Life–Male (SQOL-M), translated and adapted to measure sexual quality of life among Iranian men. Forward–backward procedures were applied in translating the original SQOL-M into Persian, and then the psychometric properties of the Persian translation of the SQOL-M were studied. A total of 181 participants (23-60 years old) were included in the study. Validity was assessed by construct validity using confirmatory factor analysis, convergent validity, and content validity. The international index of erectile function (IIEF) and the work ability index were used to study the convergent validity. Reliability was evaluated through internal consistency and test–retest reliability analyses. The results from confirmatory factor analysis confirmed a one-factor solution for the Persian version of the SQOL-M. Content validity of the translated measure was endorsed by 10 specialists. Pearson correlations indicated that work ability index score, dimensions of the IIEF, and the IIEF total score were positively correlated with the Persian version of the SQOL-M ( p < .001). Reliability evaluation indicated a high internal consistency and test–retest reliability. The Cronbach’s alpha coefficient and intraclass correlation coefficients were .96 and .95, respectively. Results indicated that the Persian version of the SQOL-M has good to excellent psychometric properties and can be used to assess the sexual quality of life among Iranian men.

In the current work, the effect of extrinsic Rashba spin-orbit coupling (RSOC) on the electronic band structure (BS) and magnetic susceptibility (MS) of ferromagnetic silicene is investigated in the presence of external perpendicular electric field. The Kane-Mele Hamiltonian and Dirac cone approximation besides the Green’s functions approach have been used to study the MS of the spin-up and spin-down bands. By changing the electric field, energy of the inter-band transitions and MS are tuned. Our findings show that MS could be easily controlled by an external electric field and RSOC. The system shows three phases: Topological insulator (TI), valley-spin polarized metal (VSPM) and band insulator (BI) for various RSOC and electric field strengths. The maximum and minimum value of MS appears in the VSPM and BI regimes, respectively. RSOC leads to the distortion of BS and reduction of the effective mass which in combination with SOC provides some changes like phase transition of VSPM from antiferromagnetic to the paramagnetic phase. Strong RSOC results to the drastic reduction of MS and double peak of the spin-up or spin-down curves at low temperatures.

مقدمه: عفونت روتاویروسی عامل بسیاری از گاستروانتریت‌های حاد در بین کودکان زیر 5 سال در کشورهایی است که برنامه‌ی معمول واکسیناسیون روتاویروس را اجرا نکردند. هدف این مطالعه، مرور سیستماتیک شواهد موجود در زمینه‌ی کارایی و ایمنی دو واکسن روتاتک و روتاریکس می‌باشد. روش‌ها: یک مرور نظام‌مند بین کارآزمایی‌های بالینی تصادفی شده و مطالعات تجربی بر روی کودکان زیر 5 سال جمعیت عمومی انجام شده است. پایگاه‌های اطلاعاتی پزشکی Medline، Ovid، Cochranel proquest، Scopus، DARE، HTA و NH SEED جستجو گردیدند. هتروژنیسیتی مطالعات با انجام متاآنالیز ارزیابی شد. به منظور برآورد تجمیعی کارایی واکسن روتاویروس (روتاریکس ®و روتاتک ®) از مدل تصادفی استفاده شده است و سوگرایی انتشار نیز با آزمون‌های Egger و Begg ارزیابی شد. یافته‌ها: 12 مطالعه مطابق با معیارهای ورود جهت تحلیل نهایی به دست آمد. برآورد ترکیبی کارایی برای تمام پیامدها برای روتاتک و روتاریکس به ترتیب 70/0 (85/0-65/0 :CI 95 درصد)، 80/0 (87/0-68/0 :CI 95 درصد) محاسبه گردید. نسبت خطر محاسبه شده‌ی عوارض در گروه مورد نسبت به گروه شاهد بین 20/1-83/0 قرار داشت. نتیجه‌گیری: واکسیناسیون روتاویروس سبب پیشگیری قابل توجهی از موارد حاد و غیر حاد اسهال روتاویروسی در کودکان می‌شود و می‌تواند بار قابل انتساب به بیماری را کاهش دهد. انجام مطالعات هزینه- اثربخشی برای اجرای برنامه‌ی معمول واکسیناسیون روتاویروس در ایران ضروری به نظر می‌رسد.

Objective: To determine the epidemiological characteristics of fatal traumatic accidents in patients referred to a hospital in Babol, Northern Iran.Methods: Thiswas a cross-sectionalstudy being performed during a 1-year period including all the dead trauma patients referred to ShahidBeheshtiHospital of Babol. We included all those patients who were transferred to our center to trauma and injuries and passed away during the hospital stay. Those who dieddue toelectrical shock, drowningandsuffocationcaused byhangingsandpoisoningwereexcluded from the study.Demographic information such as age, sex, marital status, education, employment, the type, location, and time of injury, injured parts of body and treatment methods, the cause, location and time of death were recorded.Results: From the 92 dead patients, 76were men(82.6%) and16were women (17.4%). The cause of deathin 53 cases (57.6%) washead injury. Regarding the location,30patients (32.6%) diedat thesceneof the accident,62(67.4%) diedin the hospital. The maximum rateof trauma occurredin the afternoon shiftbetween the hours of13:30 to 19:30.The headand facewere themost damaged organs.Road traffic accidents were the most common cause of injury related mortality recordedin 81 patients (88.0%). Most of the accidentsoccurredinintercity roads in 27 people (33.3%) and the others inrural-urbanroads. Pedestrianswere the most common victims of road traffic accidents mortality being reported in 29 people (35.8%).Conclusion: Road traffic accidents are among the most common cause of injury related mortality in our region. Increasing the public knowledge and improve the traffic law enforcement measures should be considered for decreasing the morbidity and mortality.

این مطالعه به بررسی توالی رسوبات کرتاسه زیرین شامل سازندهای سرچشمه و سنگانه در خاور منطقه کپه داغ ( برش چینه‏شناسی باغک) از نقطه نظر پالینولوژیکی می‏پردازد. بر اساس مطالعات انجام شده ، 25 جنس و 31 گونه داینوفلاژله شناسایی گردید. با توجه به داینوفلاژله‏های شناسایی شده و با استفاده از مطالعه فرامینیفرهای موجود در این برش سن بارمین پسین-آپتین پیشین برای سازند سرچشمه و سن آپتین میانی- آلبین میانی برای سازند سنگانه در برش چینه‏شناسی باغک تعیین گردید. تجمع داینوفلاژله‏های شناسایی شده در برش مورد مطالعه با بخشی از بیوزون Odontochitina operculata zone انطباق دارند. بررسی سه گروه اصلی از عناصر پالینولوژیکی (فیتوکلاست‏ها، پالینومورف‏های دریایی و مواد آلی فاقد ساختمان) و نتایج حاصل از مطالعه آماری فاکتورهای مؤثر بر درجه حفظ شدگی مواد ارگانیکی مانند فاکتور حفاظت از مواد ارگانیکی (Lability) و نسبت پالینومورف های دریایی به AOM و همینطور نسبت AOM شفاف به AOM تیره نشان می دهد نرخ رسوب‌گذاری و میزان اکسیژن محیط متغیر بوده و از سمت سازند سرچشمه به سمت سازند سنگانه عمق محیط افزایش یافته و شرایط کم انرژی تر و آرام تر و با میزان کمتری از اکسیژن بر محیط رسوبی غالب گشته است. داینوفلاژله های شاخص محیط رسوبی نیز نشان می دهند که سازندهای سرچشمه و سنگانه در محیط نرتیک داخلی تا نرتیک خارجی نهشته شده اند.

We consider the problem of distributing two conducting materials in a ball with fixed proportion in order to minimize the first eigenvalue of a Dirichlet operator. It was conjectured that the optimal distribution consists of putting the material with the highest conductivity in a ball around the center. In this paper, we show that the conjecture is false for all dimensions greater than or equal to two.

Background and Objectives : The risk of coronary artery disease increases with increasing of blood pressureboth in hypertensive and normotensive persons on the other hand nutritional factors have asignificant effect on blood pressure. The purpose of this study was to assess theeffect of caffeine on blood pressure in sedentary healthy male during resistance exercise. Methods: In single-blind crossover study , twenty healthy and non-athlete male in the University of Mohaghegh Ardabili randomly selected and stratified according to age and BMI into twogroups: caffeine and placebo. The subjects performed repetitions to exhaustion at 60% of 1RM for any motion of chest press, leg press, squat and lat pulldown, 1 hour after taking caffeine (6 mg/kg body weight) or Placebo (similar dosage of starch). Blood pressure (BP) was measured before and 1 hour after taking caffeine and also immediately after any exercise. Data analysis was conducted using independent and paired t-test. Results : Results indicated that systolic and diastolic BP and mean arterial pressure significantly elevated following caffeine intake at rest, but no significant differences were observed after exercise. Conclusion: These findings indicate that caffeine at this dosage level alters cardiovascular dynamics by augmenting arterial blood pressure in moderately non-athletes male at rest. However, it seems that taking caffeine before resistance exercise does not cause abnormal elevations in blood pressure in sedentary healthy male.

This paper presents a new meta-heuristic solution to find the efficient frontier using the mean-variance approach. Portfolio optimization problem is a quadratic programming model and, changes to NP-hard if the number of assets and constraints has increased, and it cannot be solved using common mathematical methods in a reasonable time. Therefore, a heuristic or meta-heuristic algorithm should be used that is the appropriate solution. This paper optimizes portfolio using a new meta-heuristic algorithm called hunting search algorithm. To determine the strengths and precision of proposed algorithm, a case study is designed using Iran stock market data from 1/3/1389 to 1/3/1390 for big thirty companies. The proposed algorithm finds the efficient frontier precisely and in timely manner. To determine abilities of the algorithm, two verified examples, Hang Sang 31 and Dax100 are also solved with it. Results show that hunting search algorithm has a high speed and high accuracy in order to solve portfolio optimization problems, and it can be used to find the efficient frontiers in various portfolio optimization problems.

Introduction: The influenza vaccine is one of the controversial challenges in today's societies. Considering the importance of using the flu vaccine in preventing the spread of influenza virus, the Twitter network, as a rich source of data, provides suitable conditions for research in this field to examine the attitudes of different people about this vaccine. The results in one hand will help health authorities to make more comprehensive decisions on long-term health plans for people with an awareness of the attitude of individuals towards the flu vaccine; on the other hand, it is concerned with data miners. Method: In this review study, approximately 1.220.539 tweets have been gathered from the Twitter social network during a one month period and have been clustered by using Mallet software. Categorizing users and separating tweets have done with an appropriate approximation. The content and sentiments of the selected tweets were analyzed and the locations of the users were checked. Results: In sentiments analysis, 76.28% of the tweets had a positive weight, 1.87% was neutral, and 19.68% had negative weight, indicating a positive attitude about the influenza vaccine. The location of users showed the highest rate of sending tweets from Canada, Britain and the United States, and Asian countries, and in particular, Iran, had a very small percentage of it. Conclusion: The highest rate of positive tweets were respectively sent by ‘individual’, ‘health’, and ‘organization’ groups indicating the global acceptance of the influenza vaccine and the success of the global health organizations on vaccination.

Background: The recent studies show that Rotavirus is important cause of the acute gastroenteritis. The aim of this review is to estimate the number of Rotavirus infection among Iranian children by performing a systematic review and estimating a pooled data. Methods: We performed a systematic literature review in relevant databases including PUBMED, MEDLINE, OVID, SID, MAGIRAN, and IRANMEDEX. Search in databases was done in October 10, 2013. Meta-analysis was performed using the STATA statistical package version 11. We assessed heterogeneity by Q-test and used random model for pooling measures of proportion of Rotavirus infection among Iranian children with diarrhea (and 95% confidence intervals [CI]). Sub group analysis between in-patient and outpatient group were done and publication bias was assessed by Egger and Begg tests. Results: A total of 154 records were identified in our searching. There were 36 studies including a total of 15,368 children with diarrhea. Out of 15,368 children, 6,338 were positive for Rotavirus gastroenteritis. Overall pooled estimate of infection with Rotavirus among cases of gastroenteritis was 0.35 (95% CI, 0.28-0.41). Pooled estimates for hospitalized children and outpatient subgroups were 0.39 (95% CI, 0.30-0.48), and 0.31 (95% CI, 0.23-0.38), respectively. Conclusions: This study supports the importance of Rotavirus in the Iranian population such as common cause of diarrhea among children. Therefore, decision to adopt immunization programs to prevent Rotavirus infection might be helpful in Iran.

In this paper we study the optical conductivity and density of states (DOS) of doped gapped graphene beyond the Dirac cone approximation in the presence of electron-phonon (e-ph) interaction under strain, i.e., within the framework of a full π-band Holstein model, by using the Kubo linear response formalism that is established upon the retarded self-energy. A new peak in the optical conductivity for a large enough e-ph interaction strength is found which is associated to transitions between the midgap states and the Van Hove singularities of the main π-band. Optical conductivity decreases with strain and at large strains, the system has a zero optical conductivity at low energies due to optically inter-band excitations through the limit of zero doping. As a result, the Drude weight changes with e-ph interaction, temperature and strain. Consequently, DOS and optical conductivity remains stable with temperature at low e-ph coupling strengths.

To study the protein subunits and fractions of almond meal in comparison to soybean meal and cottonseed meal, two methods including SDS-Page electrophoresis and CNCPS were used in this research. The results of protein fractions according to CNCPS shows a significant difference (p

Following publication of the original article [1], these errors were flagged:

BACKGROUND: Today, the scope of dental activities is a broad range from the needs assessment for epidemiological studies to the implementation of comprehensive programs for the prevention of oral diseases at various levels of the society. This study aimed to identify and prioritize the need researches in the field of oral and dental health in a dental hospital in Tehran, Iran. METHODS: This applied research was a mixed methods study carried out in Tehran, Iran, in 2018. The data gathering tool included a data collection form used for reviewing the documents, a semi-structured interview, and an open questionnaire. MAXQDA 10.0, Expert Choice 11.0, and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) software were used for analyzing the collected data. RESULTS: After analyzing the results of the qualitative phase, 171 research topics in 6 areas were obtained, including 44 topics in “dental clinical care and treatment,” 37 topics in “health and prevention,” 19 topics in “education and health promotion,” 37 topics in “management of dental care delivery,” 16 topics in “policy and its requirements,” and 18 topics in “dentistry materials, equipment and technologies.” CONCLUSION: According to the results, it can be recommended that the research resources should be allocated based on the priorities identified by the present study so that the studied hospital has the highest dynamic performance in achieving its goals and objectives.

Aims: Organophosphates are well-known as an important group of poisons. The aim of the current study is to investigate acetylcholinesterase enzyme (ACHE) level in workers' blood of a poison-producing industry and its relationship with annual poison production and the use of personal protective equipment (PPE). Materials and Methods: This cross-sectional study was conducted during 2012–2015 on 84 workers from different units of a poisons-producing industry and a 20-person control group. The PPE used during the years of study includes Asphalt gloves, rubber gloves, and mask felt. The AChE level was detected based on the modified Ellman method. Results: The maximum AChE level was observed in the control group. In addition, the minimum was found in the workers in 2015. The mean AChE level in the control group was significantly higher than that in the worker (P < 0.05). The mean AChE level in the workers based on the study years was significantly different, but this was not significant between the blood samples taken in the years of 2014 and 2015. Furthermore, it was found that both poisons-producing amount and PPE distribution were enhanced more during the past year of the study, while the poison amount entering to the body decreased. Conclusion: It was deduced that the AChE level in workers' blood was lowered with increasing at the exposure years due to irreversible effects. It is also observed that growth at the PPE application acted as an important parameter to decline exposure to poisons and subsequently various health complications.

"n "n Objective: "n We aimed to describe psychiatrists' attributions on non-compliance related issues resulting in re-hospitalizations of psychiatric patients. "nMethod: In a cross sectional study, we included 500 randomly selected psychiatric readmitted patients and registered their demographic data (including age, sex, job, marital status, and educational level), and psychiatric clinical data including diagnosis, medications, and presence of psychiatric disorders in family members). Possible noncompliance issues by means of type and causes were asked through a structured interview by a psychiatrist. "nResults: Non-compliance was reported as a possible cause of admission in 441 88.2) of the re-hospitalized cases. No insight to disease (n=295; 59%), and feeling of cure (n=138; 27.6%) were the 2 most prevalent causes for noncompliance of the patients . "nConclusion: It seems that non-compliance, as a prevalent factor, possibly causes readmission in psychiatric wards. Providing a better insight to disease and to instruct patients to take their medications even if they have some feeling of cure is important to decrease such problems.

1-Introduction The Kopeh-Dagh as an inverted basin (Allen et al. 2003) is extended from the east of the Caspian Sea to NE Iran, north Afghanistan and Turkmenistan. Following the closure of palaeo-Tethys in the Middle Triassic and the opening of Neo-Tethys during the early to middle Jurassic, the Kopeh-Dagh basin formed during the early to middle Jurasic. Sedimentation took place continuously from the Jurassic through the Neogene time in the Kopeh-Dagh basin (Afshar-Harb 1979). The first geological study on these strata was done by Amiranian oil company from 1937 to 1938. Many biological and stratigraphical studies had been carried on later on this basin. Kalantari (1969), Seyed-Emami (1980), Seyed-Emami and Aryai (1981), Seyed-Emami et al. (1984, 1994, 1996), Immel et al (1997), Raisossadat and Mousavi-Harami (2000), Raisossadat (2004, 2006) and Mahanipour et al. (2011) are among those who studied the biostratigraphy and sedimentology of the Cretaceous strata of this basin. In this paper we report on palynological and paleoecological data from two mid-Cretaceous formations (Sarcheshmeh and Sanganeh) in Baghak section situated in eastern part of Kopeh-Dagh basin. 2-Materials and Methods Fifteen samples from the Sarcheshmeh and thirty five samples from Sanganeh formation were processed palynologically. The preparation method of Traverse, 2007 was used. Cold hydrochloric (20%) and hydrofluoric (50%) acids were used to dissolve carbonates and silicates. The residue was neutralized and centrifuged in ZnCl2 (specific gravity 1.9), then sieved at 15 um using a nylon mesh, and mounted on microscope slides using liquid Canada balsam. Three slides were made from each sample. The microscope slides were examined under a light microscope and the index dinocysts were photographed and presented in two plates. In order to study palynofacies, in each slide numbers of organic materials including phytoclasts, marine palynomorphs and non-structural organic materials were calculated in five purview and then the percent of each palynological elements were acquired. 3- Discussion, Results and Conclusion All of the 50 rock samples prepared have yielded dinofalgellate cysts. The assemblages recorded include such taxa as: Acomosphaera sp., Achomosphaera neptunii, Batioladinium sp., Bourkidinium granulatum, Cauca parva, Circulodinium sp., Circulodinium brevispinosum, Circulodinium distinctum, Cometodinium sp., Coronifera oceanica, Cribroperidinium sp., Cribroperidinium orthoceras, Florentinia sp., Florentinia cooksoniae, Florentinia mantelii, Glaphyrocysta sp., Gonyaulacysta sp., Gonyaulacysta polythyris, Hystrichosphaeridium sp., Kiokansium sp., Kiokansium polypes, Klithrosphaeridium sp., Muderongia sp., Muderongia tabulate, Odontochitina operculata, Oligosphaeridium complex, Oligosphaeridium poculum, Oligosphaeridium porosum, Oligosphaeridium totum, Paleoperidinium cretaceum, Prolixosphaeridium sp., Prolixosphaeridium parvispinium, Pseudoceratium sp., Pseudoceratium retusum, Pterodinium sp., Spiniferites sp., Spiniferites ramosus, Subtilisphaera sp., Systematophora sp., Tanyosphaeridium sp. (Plate 1-2). Based on the presence of the index dinoflagellate cyst, Odontochitina operculata throughout the entire section, it can be concluded that the first appearance of this species is before the first sample of the Sarcheshmeh Formation (sample 398) and therefore the identified dinoflagellate cysts are a part of the Odontochitina operculata Zone. This palynozone originally erected by Wilson (1984) for Aptian strata in New Zealand and Morgan (1980) suggest the age of Aptian for Odontochitina operculata Zone. The presence of species Gonyaulacysta polythyris, Circulodinium brevispinosum and Florentinia mantelii which are recorded from early Aptian strata in different part of the world such as Australia (Backhouse, 1988), France (Stover, 1996), south of Alpine Italia (Torricelli,2000) and south of Tanzania (Schrank & Mahmoud, 2002) in lower formation reveal the age of Late Barremian to early Aptian for the Sarcheshmeh Formation. The Upper formation contains species Cauca parva with middle Aptian-Lower Albian age (Stover, 1996) and Frorentinia cooksonia with middle Albian age (Williams 1993) found in different regions such as Libya (Uwins & Batten, 1988), United States (Hedlund & Norris, 1986) and west of Australia (Cookson & Eisenack, 1962). This species suggest the age of middle Aptian- middle Albian for the Sanganeh Formation. Statistical analyses of the three main groups of palynological elements (Phytoclasts, Marine palynomorphs and non-structural organic materials) lead to the recognition of five palynofacies in studied section. Studying the recognized palynofacies indicate that the sedimentation rate and oxygen level of the basin were variable but decreasing from Sarcheshmeh to Sanganeh Formation. Based on index dinoflagellates it can be concluded that depositional environment of the Sarcheshmeh and Sanganeh formations ranged from inner to outer neritic environment.

Background: Varicella zoster virus is the etiologic agent of primary varicella (chickenpox) during childhood, and varicella vaccination has not been introduced in Iran. The aim of this study is to estimate cost-effectiveness of one- and two-dose Varicella Vaccination Program in Iran. Methods: A decision-tree model was conducted to evaluate the cost-effectiveness of the Varicella Vaccination Program in a cohort of 12 months children in Iran. Epidemiologic parameters of varicella were extracted from local and international sources, and cost of disease was estimated based on societal prospective in 2015 US$. Incremental cost per disability-adjusted life years (DALY) averted calculated as final outcome. Sensitivity analysis was also performed for lower and upper estimate of incidence, DALY, and vaccine efficacy. Results: Considering the vaccine efficacy of 95%, for the two-dose and 85% for the one-dose vaccination, incremental cost-effectiveness ratio (ICER) per DALYs averted were US$41,531 and US$17,280, respectively. ICER has changed between (US$ 6,177–US$167,047) in lower and upper base estimate of epidemiological burden parameters in sensitivity analysis. Conclusions: Varicella vaccination is not cost-effective in Iran in one-dose and two-dose scenario under the assumptions of this study in base case scenario according to the threshold of incremental cost per DALY averted less than three time of GDP per capita in Iran = US$ 14,292. One-dose vaccination program might be cost-effective in upper scenario of epidemiological burden of varicella in sensitivity analysis.

• Introduction: Increasing volume of information in various sciences, such as medicine, has led to the use of various strategies to effectively provide students, researchers, and teachers with medical and paramedical information. The Iranian Ministry of Health and Medical Education has developed an online digital library, called Iranian National Medical Digital Library (INMDL), which provides access to databases of medical fields. However, it is believed that most researchers in Isfahan University of Medical Sciences still tend to use printed resources due to their insufficient familiarity with electronic databases. The aim of this study was to describe the knowledge of physicians about and their use of INMDL in teaching hospitals in Isfahan, Iran. • Methods: This applied descriptive survey was carried out on physicians from 9 educational hospitals in Isfahan. The number of participants was determined based on the Morgan's sample size table. From the 500 physicians working in 9 hospitals, 217 individuals were randomly determined. Data collection tool was a questionnaire whose validity was confirmed by professionals. The reliability of the questionnaire was verified after a pilot study (α = 0.87). Finally, 127 questionnaires were completed and data was analyzed in SPSS18. • Results: Most physicians had little knowledge about the e-journals and book databases available on INMDL. Moreover, the majority of physicians made very little use of INMDL. Among the existing resources, most use was made of e-journals while databases and e-books stood next. Education level was significantly correlated with the knowledge of physicians and their use of INMDL. 81 percent of physicians had little awareness to INMDL's e-books and 85.2 percent of physicians had very little use of INMDL's e-books. A strong correlation was also detected between the knowledge of physicians about INMDL and their use of it. Among the electronic journal databases and e-book databases, Science Direct and MD Consult were most frequently used. • Conclusion: Medical librarians need to have an active role in informing and educating physicians about methods of searching for information in INMDL resources. In addition, as lack of time is a problem for physicians, educating them to use Alert and RSS services is necessary. Moreover, face to face training can be possible by appropriate medical librarians. • Keywords: Awareness; Physicians; Iranian National Medical Digital Library; Hospitals, Teaching.

Objective: This study aimed to describe attributors of family stressors which cause rehospitalizations in patients with psychotic disorders. Materials and methods: In a cross sectional study (during 2006-7) 203 randomly selected psychiatric readmitted patients with psychotic diagnosis and registered demographic and psychiatric clinical data were included. Family stressors as the possible cause of readmission were asked through a structured interview by the psychiatrist. Results: Family factors were reported as a cause in 132 (60.6%) cases. Poor family support (n=88; 43.3%) and family conflict (n=58; 28.6%) were the two most prevalent family stressors, respectively. Bivariate analysis showed that admission due to family issues was different among men and women (79.1% vs. 38.7%, respectively p

Abstract In this study a newly developed thin-walled structure with the combination of circular and square sections is investigated in term of crashworthiness. The results of the experimental tests are utilized to validate the Abaqus/ExplicitTM finite element simulations and analysis of the crush phenomenon. Three polynomial meta-models based on the evolved group method of data handling (GMDH) neural networks are employed to simply represent the specific energy absorption (SEA), the initial peak crushing load (P1) and the secondary peak crushing load (P2) with respect to the geometrical variables. The training and testing data are extracted from the finite element analysis. The modified genetic algorithm NSGA-II, is used in multi-objective optimisation of the specific energy absorption, primary and secondary peak crushing load according to the geometrical variables. Finally, in each optimisation process, the optimal section energy absorptions are compared with the results of the finite element analysis. The nearest to ideal point and TOPSIS optimisation methods are applied to choose the optimal points.

Epilepsy is a common neurological disease that is treated with medications; however, patients with drug-resistant epilepsy, commonly intractable temporal lobe epilepsy, tend to have better control with surgical treatment. While the mainstay of surgical treatment is anterior temporal lobectomy, it carries risk of potential adverse effects hence minimally invasive techniques are now being used as an alternative to open surgery. This systematic review and meta-analysis compare the efficacy and safety of three of the most used techniques: laser interstitial thermal therapy (LITT), radiofrequency ablation (RFA) and stereotactic radiosurgery (SRS). Multiple databases were searched and PRISMA guidelines were followed to make an indirect meta-analysis using the currently available studies for the three techniques in terms of seizure freedom, risk of major complications and reoperations. Further subgroup analyses were carried out for LITT in terms of follow up periods and seizure freedom in patients with or without hippocampal sclerosis. A total of 42 papers were included in this study with a total of 1675 patients (1303 treated by LITT, 188 treated by RFA and 184 treated by SRS). LITT had the highest rate of seizure freedom (55.0%, CI 51.5 - 58.5%, P = 0.148), and the lowest rates of major complications (2.3%, CI 1.2 - 3.5%, P = 0.070), and reoperations (14.3%, CI 10.4 - 18.3%, P = 0.042) compared to RFA and SRS which had seizure freedom of 46.3% (CI 18.8 - 73.7%, P = 0.000) and 53.8% (CI 44.4 - 63.3%; I^2 = 40.4%, P = 0.098), major complication rate of 3.9% (CI 0.7 - 7.0%; I^2 = 0%, P = 0.458) and 14.3% (CI 3.1 - 25.5%, P = 0.000) and reoperation rate of 28.6% (CI -4.3 - 61.5%, P = 0.000) and 15.4% (CI 6.1 - 24.8%; I^2 = 0%, P = 0.392) respectively. In conclusion, LITT showed the highest rate of seizure freedom and the lowest rate of major complications and reoperations compared to RFA and SRS in single-arm studies of intractable mesial temporal lobe epilepsy. However, the lack of direct comparisons between treatment modalities limits definitive conclusions. Despite this, LITT appears to offer a favorable safety profile, warranting further prospective, comparative studies to validate these findings., Competing Interests: Declarations. Ethical approval: Ethical approval is not applicable to our study design. Prospero registery number: CRD42024594624. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background and Purpose: Atrial fibrillation (AF), a common arrhythmia, is linked with atrial electrical and structural changes, notably low voltage areas (LVAs) which are associated with poor ablation outcomes and increased thromboembolic risk. This study aims to evaluate the efficacy of a deep learning model applied to 12‑lead ECGs for non-invasively predicting the presence of LVAs, potentially guiding pre-ablation strategies and improving patient outcomes., Methods: A retrospective analysis was conducted on 204 AF patients, who underwent catheter ablation. Pre-procedural sinus rhythm ECGs and electroanatomical maps (EAM) were utilized alongside demographic data to train a deep learning model combining Long Short-Term Memory networks and Convolutional Neural Networks with a cross-attention layer. Model performance was evaluated using a 5-fold cross-validation strategy., Results: The model effectively identified the presence of LVA on the examined atrial walls, achieving accuracies of 78 % for both the anterior and posterior walls, and 82 % for the LA roof. Moreover, it accurately predicted the global left atrial (LA) average voltage <0.7 mV, with an accuracy of 88 %., Conclusion: The study showcases the potential of deep learning applied to 12‑lead ECGs to effectively predict regional LVAs and global LA voltage in AF patients non-invasively. This model offers a promising tool for the pre-ablation assessment of atrial substrate, facilitating personalized therapeutic strategies and potentially enhancing ablation success rates., Competing Interests: Declaration of competing Interest The authors have no relevant disclosures., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Low voltage areas (LVA) are pivotal in atrial fibrillation (AF) pathogenesis, influencing local left atrial LA excitation and perpetuating AF occurrences. While pulmonary vein isolation (PVI) with cryo-balloon (CB) ablation is effective for AF, it doesn't provide insights into the LA substrate or detect LVA, which affects ablation success rates. This study examines whether LA voltage and LVAs can be anticipated by analyzing the voltage signal amplitude at the coronary sinus (CS) catheter, which is standard in CB and radiofrequency ablation procedures., Methods: A retrospective analysis of 284 patients with recurrent AF undergoing RF catheter ablation was conducted at a high-volume EP center in Germany. The correlation between LA voltage and LVA with the CS signal was explored., Results: The signal amplitude in the CS significantly correlated with voltage in LA walls, particularly in the proximal CS (correlation coefficient ρ = 0.81, p < 0.001). A CS signal cut-off of 1.155 mV effectively predicted severe atrial LVAs (>40%) with a sensitivity of 90.7% and a specificity of 100%. While a threshold of 1.945 mV identified patients with no significant atrial LVAs (<5%) with a sensitivity of 88% and a specificity of 50% (AUC: 0.81, 95% CI: 0.71-0.89, p < 0.001)., Conclusion: The CS signal amplitude is associated with the LA voltage. Due to its potential as a diagnostic tool for atrial LVAs, the signal amplitude in the CS could provide valuable information about the LA substrate, especially when 3D mapping is not feasible., (© 2024 The Author(s). Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.)

Background: In atrial fibrillation (AF) management, understanding left atrial (LA) substrate is crucial. While both electroanatomic mapping (EAM) and late gadolinium enhancement magnetic resonance imaging (LGE-MRI) are accepted methods for assessing the atrial substrate and are associated with ablation outcome, recent findings have highlighted discrepancies between low-voltage areas (LVAs) in EAM and LGE areas., Objective: The purpose of this study was to explore the relationship between LGE regions and unipolar and bipolar LVAs using multipolar high-density mapping., Methods: Twenty patients scheduled for AF ablation underwent preablation LGE-MRI. LA segmentation was conducted using a deep learning approach, which subsequently generated a 3-dimensional mesh integrating the LGE data. High-density EAM was performed in sinus rhythm for each patient. The electroanatomic map and LGE-MRI mesh were coregistered. LVAs were defined using cutoffs of 0.5 mV for bipolar voltage and 2.5 mV for unipolar voltage. The correspondence between LGE areas and LVAs in the LA was analyzed using confusion matrices and performance metrics., Results: A considerable 87.3% of LGE regions overlapped with unipolar LVAs, compared with only 16.2% overlap observed with bipolar LVAs. Across all performance metrics, unipolar LVAs outperformed bipolar LVAs in identifying LGE areas (precision: 78.6% vs 61.1%; sensitivity: 87.3% vs 16.2%; F 1 score: 81.3% vs 26.0%; accuracy: 74.0% vs 35.3%)., Conclusion: Our findings demonstrate that unipolar LVAs strongly correlate with LGE regions. These findings support the integration of unipolar mapping alongside bipolar mapping into clinical practice. This would offer a nuanced approach to diagnose and manage AF by revealing critical insights into the complex architecture of the atrial substrate., Competing Interests: Disclosures The authors have no conflicts of interest to disclose., (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Factor Xa inhibitors (FXaI) are increasingly used for anticoagulation therapy, yet their association with intracranial hemorrhage poses a significant challenge. Although andexanet alfa (AA) and four-factor prothrombin complex concentrate (4F-PCC) have shown promise in reversing FXaI effects, their comparative efficacy and safety remain uncertain. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a literature search on electronic databases to obtain the relevant studies until May 16, 2024. Our primary outcomes were successful anticoagulation reversal, overall mortality (including 30-day and in-hospital mortality), and thromboembolic events. Secondary outcomes were length of hospital and intensive care unit stay and hematoma volume expansion. Data were pooled using a random-effects model. We included 16 eligible studies with a total of 2,977 patients. A statistically significant improvement in hemostatic efficacy rates was in favor of the AA group (risk ratio [RR] 1.10, 95% confidence interval [CI] 1.01-1.20, P = 0.02). Lower overall mortality rates were found in the AA group (RR 0.67, 95% CI 0.51-0.88, P = 0.004). However, no difference was found in 30-day mortality rates (RR 0.82, 95% CI 0.58-1.16, P = 0.26). In terms of thromboembolic events, more events were found in the AA group (RR 1.47, 95% CI 1.01-2.15, P = 0.046). AA was associated with a longer duration of hospital stay compared to 4F-PCC (mean difference [MD] 0.64, 95% CI 0.07-1.22, P = 0.03). Neither a significant difference in length of intensive care unit stay (MD 0.25, 95% CI - 0.36 to 0.86, P = 0.41) nor a significant difference in hematoma volume expansion was reported (MD - 0.89, 95% CI - 3.11 to 1.34, P = 0.435). Our results suggest that AA is superior to 4F-PCC in enhancing the hemostatic efficacy and reducing the overall and in-hospital mortality rates. More thromboembolic events are thought to be associated with the use of AA. However, more studies are required to validate whether the better results of AA in improving hemostatic efficacy are enough to make up for their higher cost and their possible risk of thromboembolic events., (© 2024. The Author(s).)

Background: Atrial fibrillation (AF) triggers atrial remodeling, impacting atrial function and ablation efficacy. This remodeling leads to atrial cardiomyopathy and dilatation, linked to mitral regurgitation, forming atrial functional mitral regurgitation (aFMR). Our study explores the relationship between early-stage-aFMR and the atrial electrical architecture, focusing on left atrial bipolar voltage and low-voltage areas (LVAs) in AF patients., Methods: We enrolled 282 patients undergoing redo-PVI after AF recurrence post-PVI. Echocardiography was performed prior to ablation, and only patients with no, mild, or mild-to-moderate aFMR were included. Ablation used radiofrequency and a 3D mapping system, with atrial voltage documented on each atrial wall. LVAs were calculated using high-density maps, and patients were followed for 15 months., Results: Significant differences in left atrial voltage and LVA extent were observed based on aFMR severity. Patients with aFMR 1 + had significantly lower atrial voltage compared to no-aFMR, but no significant increase in LVAs. Patients with aFMR 2 + showed lower voltage amplitudes in all atrial regions and larger LVAs compared to no-aFMR patients. AF recurrence was significantly higher in the aFMR group (62.9% vs. 48.3%, p  = 0.027) within 1 year. aFMR was associated with AF recurrence after adjusting for sex, age, and AF types (HR: 1.517, 95% CI: 1.057-2.184, p  = 0.025)., Conclusion: aFMR in AF patients may indicate progressive atrial remodeling and left atrial cardiomyopathy, characterized by reduced atrial voltage and increased LVAs. aFMR is linked to PVI outcomes, suggesting its consideration in AF therapy decision-making., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Mohsen, Rottländer, Großmann, Lewandowski, Horlitz and Stöckigt.)

Background: Fibrotic atrial cardiomyopathy plays an important role in determining the outcome of ablation in patients with atrial fibrillation (AF). Two main methods are being used for the evaluation of fibrosis: voltage-based high-density (HD) electroanatomical mapping (EAM) and late gadolinium enhancement MRI (LGE-MRI). The comparability between both methods in detecting fibrosis has not been systematically investigated., Methods: LGE-MRIs of the left atrium (LA) were performed in 21 patients. LA-fibrosis was evaluated using a custom-designed software generating a 3D-model of the LA. HD-electroanatomical maps were recorded in each patient. After processing the maps and the MRI models by excluding the mitral valve, pulmonary veins, and the left atrial appendage, the LGE areas were measured and compared to the low voltage areas (LVA) in the HD maps using three different cutoff values of 0.5 mV, 0.7 mV, and 1.0 mV., Results: The analysis revealed significant differences between EAM and LGE-MRI in assessing LA-fibrosis at 0.5-mV (for anterior and posterior walls) and 1.0-mV cutoffs (for anterior and posterior wall and septum). However, no significant differences were found between EAM and LGE-MRI when using a 0.7-mV cutoff for all the investigated areas., Conclusions: A voltage cutoff of 0.7 mV provided the best correlation between EAM and LGE MRI for detecting left atrial fibrosis. It supports the idea that a 0.5-mV cutoff may underestimate fibrosis, as areas with local signal voltages between 0.6 and 0.8 mV could also show LGE on MRI. Further research is needed to determine the ideal voltage cutoff for detecting left atrial fibrosis., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The seminal vesicles are frequently overlooked when reviewing abdominal and pelvic imaging studies, and normal variants and pathologic conditions are often missed or misinterpreted. This is largely due to lack of familiarity with the organ, its anatomic variants, congenital abnormalities and disease conditions. This pictorial review aims to familiarize the reader with the range of normal appearances, congenital anomalies and disease entities that involve the seminal vesicles to avoid overtreatment and misdiagnoses., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aim of the Study: Cholangiocarcinoma (CCA) comprises a diverse group of malignancies that occur anywhere along the biliary tree. Gene polymorphisms are risk factors for CCA development. Expression levels of epidermal growth factor (EGF) are correlated with progressive tumor growth and metastasis by increasing tumor cell proliferation and migration. The EGF rs4444903 (G) allele seems to enhance carcinogenesis in several types of cancer. The aim was to study the association between epidermal growth factor EGF (rs4444903) gene polymorphism and risk of CCA in Egyptian patients., Material and Methods: This case-control study included 100 subjects, 50 CCA patients and 50 healthy individuals as controls. The EGF (rs4444903) genotyping was performed by real-time polymerase chain reaction (PCR)., Results: The risk of CCA increased more in subjects with GG and AG genotypes than in those with AA genotype compared to the control group ( p = 0.009, 0.037, OR = 4.20, 2.83, 95% CI: 1.40-12.60, 1.05-7.60 respectively). The variant G allele showed a highly significant association with CCA risk in the dominant model ( p = 0.009). However, in the recessive model the G allele showed a nonsignificant association with the risk of CCA ( p = 0.075). There were no significant differences between the EGF rs4444903 SNP genotypes in terms of the size of foci and presence of chronic hepatitis C virus (HCV) infection in the CCA group ( p = 0.220, 0.645, respectively)., Conclusions: EGF rs4444903 polymorphism may have a role in the pathogenesis of CCA and the minor G allele may predispose to CCA, but it has no effect on severity of the disease., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Clinical and Experimental Hepatology.)

The pathogenic anaerobic bacteria Yersinia pestis ( Y. pestis ), which is well known as the plague causative agent, has the ability to escape or inhibit innate immune system responses, which can result in host death even before the activation of adaptive responses. Bites from infected fleas in nature transmit Y. pestis between mammalian hosts causing bubonic plague. It was recognized that a host's ability to retain iron is essential in fighting invading pathogens. To proliferate during infection, Y. pestis , like most bacteria, has various iron transporters that enable it to acquire iron from its hosts. The siderophore-dependent iron transport system was found to be crucial for the pathogenesis of this bacterium. Siderophores are low-molecular-weight metabolites with a high affinity for Fe 3+ . These compounds are produced in the surrounding environment to chelate iron. The siderophore secreted by Y. pestis is yersiniabactin (Ybt). Another metallophore produced by this bacterium, yersinopine, is of the opine type and shows similarities with both staphylopine and pseudopaline produced by Staphylococcus aureus and Pseudomonas aeruginosa , respectively. This paper sheds light on the most important aspects of the two Y. pestis metallophores as well as aerobactin a siderophore no longer secreted by this bacterium due to frameshift mutation in its genome.

Antibiotic resistance, and, in a broader perspective, antimicrobial resistance (AMR), continues to evolve and spread beyond all boundaries. As a result, infectious diseases have become more challenging or even impossible to treat, leading to an increase in morbidity and mortality. Despite the failure of conventional, traditional antimicrobial therapy, in the past two decades, no novel class of antibiotics has been introduced. Consequently, several novel alternative strategies to combat these (multi-) drug-resistant infectious microorganisms have been identified. The purpose of this review is to gather and consider the strategies that are being applied or proposed as potential alternatives to traditional antibiotics. These strategies include combination therapy, techniques that target the enzymes or proteins responsible for antimicrobial resistance, resistant bacteria, drug delivery systems, physicochemical methods, and unconventional techniques, including the CRISPR-Cas system. These alternative strategies may have the potential to change the treatment of multi-drug-resistant pathogens in human clinical settings.

Intestinal obstruction caused by a remnant fallopian tube from previous hysterectomy is a rare entity that has been reported once in the literature. We report the case of a 61-year-old woman who presented with both small and large bowel obstructions caused by a strangulating remnant fallopian tube. She had an ovarian sparing hysterectomy 16 years ago and was diagnosed with antiphospholipid syndrome. Our case report will discuss the clinical presentation, imaging and outcome of the patient. It will also briefly tackle other rare causes of bowel obstruction., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: The constant need for rapid financial gain drives the international illegal drug industry, which encourages healthy individuals to smuggle drugs through internal concealment. The aim of this study was to evaluate our practice of the management of body packers using a hospital-based protocol in order to validate it., Methods: Electronic hospital data were retrospectively reviewed between 2000 and 2013 of all patients that were admitted to Hillingdon Hospital with a history of internal drug concealment. Demographic as well as clinical data including investigations and management were collected., Results: One hundred and twenty patients were admitted over the study period to our surgical unit. This included 86 male and 34 female patients with a mean age of 38 (range 19-64) years. Three per cent (n = 4) underwent surgery for either cocaine toxicity or obstruction. The rest of the patients were managed conservatively with bowel cleansing preparations to encourage the natural passage of drug packages., Conclusion: Conservative treatment is safe and effective for drug body packers. We therefore recommend conservative management to be the mainstay for body packers with surgery only being indicated on clinical grounds., (© 2015 Royal Australasian College of Surgeons.)

Antibiotic-resistant bacteria has become a global phenomenon, mainly due to the inappropriate use of antibiotics. There are no studies in Lebanon to assess the public's knowledge, attitudes and practices (KAP) of antibiotic usage. A cross-sectional study was carried out using a self-administered questionnaire completed by a random convenience sample of 500 people. Nearly half of the respondents (46.1%) demonstrated moderate knowledge levels, while 40.6% demonstrated moderate attitudes. Although 80.2% knew that antibiotics are anti-bacterial, 73.5% did not know that antibiotics are not anti-viral. Moreover, 68.3% of respondents reported consuming antibiotics 1-3 times per year, while 22.4% consumed antibiotics on their own accord. Approximately 66.7% realized that abusing antibiotics could lead to resistance. Participant knowledge and attitudes were significantly associated with monthly family income, educational level, place of residency, having medical insurance, working in the health sector or having a relative working in the health sector. Nation-wide awareness campaigns targeting susceptible demographics should be initiated., (Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.)

Introduction: Fistulas are a relatively common occurrence in Crohn's disease (CD), and often present early in the disease process. Additionally, patients suffering from either CD or ulcerative colitis are shown to have an increased risk of colorectal malignancies compared with the general population., Presentation of Case: We present a case of adenocarcinoma in an ano-vaginal fistula in a patient with longstanding CD., Discussion: Various pathogenic mechanisms for the development of carcinoma in fistulas have been suggested, but there is no consensus and indeed this risk may be cumulative. In this case report, we also discuss the pathogenesis of mucinous adenocarcinoma in fistulas secondary to CD., Conclusion: Better detection of adenocarcinoma in patients presenting with persistent non-resolving fistulas in the presence of CD should be undertaken with regular biopsies following examinations under anaesthetic of the anorectum., (Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.)

The medical records of 31,808 patients with gastric cancer registered with the West-Midlands Cancer Registry between 1957-1981 were reviewed to determine the influence of age on presentation, stage assessment, management, survival and mortality rates. When analysed by stage, and excluding post-operative deaths, survival was similar in all age groups. This study confirms stage of disease to be the single most important prognostic factor. The inverse relationship between laparotomy and age implies inadequate assessment of stage in the elderly. The poor prognosis in unresected cases suggests that increased precise staging by laparotomy or laparoscopy will have minimal adverse effects. On the other hand this may result in increased resections and survival.