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ObjectivesTo evaluate a modified ovariohysterectomy (OHE) technique performed by a single person and compare it with the conventional method based on time efficiency, trauma, and postoperative pain.MethodsIn a prospective, randomized, experimental study, 18 healthy, large, deep-chested, mixed-breed intact female dogs were randomly allocated to conventional (n = 9) and instrument shank-assisted (n = 9) groups. On the basis of video recordings, the various surgical step durations were analyzed: total surgery time (TST), pedicle intervention time (PIT), suspensory release time (SRT), shanking time (ShT), clamping time (ClpT), ligating time (LigT), and closure time (CT). The Glasgow composite pain scale short-form (GCMPS-SF), university of Melbourne pain scale (UMPS), and Visual Analogue Scales (VAS) were used to measure pain. C-reactive protein (CRP) fluctuation was also investigated. These evaluations were completed before and 6, 24, 48, and 72 h postoperatively.ResultsInstrument shank-assisted OHE was less time-consuming than conventional OHE (p = 0.005), improved PIT by 30.7% (6.44 min for both pedicles, p = 0.014), and correlated strongly with TST (ρ = 0.862, p = 0.003 and ρ = 0.955, p = 0.000, respectively). The two method’s surgical step durations were also TST = 47.40 ± 9.9 vs. 34.70 ± 6.7 min, PIT = 20.96 ± 5.78 vs. 14.52 ± 3.73 min, SRT = 78.97 ± 69.10 vs. ShT = 20.39 ± 8.18 s (p = 0.035), ClpT = 50.66 ± 45.04 vs. 63.55 ± 37.15 s (p = 0.662), LigT = 12.82 ± 3.37 vs. 8.02 ± 3.11 min (p = 0.005), and CT = 16.40 ± 4.5 vs. 11.60 ± 2.5 min (p = 0.013), respectively. While both techniques inflicted pain on the animals, the novel approach resulted in a reduction of pain at T6 (GCMPS-SF, p = 0.015 and VAS, p = 0.002), T24 (UMPS, p = 0.003), and T48 (GCMPS-SF, p = 0.015 and UMPS, p = 0.050). Both methods exhibited a peak in CRP level after 24 h, which subsequently returned to baseline after 48 h. However, the shank-assisted method demonstrated a significantly lower reduction in CRP level at the 48-h compared to the other group (p = 0.032).ConclusionInstrument shank-assisted technique permitted ovarian removal without an assistant, less damage to animals and reducing its time when compared to a conventional technique, and resulting in an alternative that causes less surgical stress and fatigue. Further research with a larger population size is required to determine the serum CRP levels as an alternative pain biomarker.

Abstract Background In recent years, cases of human visceral leishmaniasis (HVL) have been reported in some districts of Golestan Province, northeastern Iran, particularly in rural areas. Recent epidemiological evidence in Leishmania infantum endemic regions of in Iran indicates approximately 50%–80% of seropositive dogs are asymptomatic for Leishmania infection. Objectives The goal in this study was to determine Leishmania species infecting domestic dogs in Golestan Province, Iran. Methods Between 2015 and 2016, blood samples were obtained from 100 domestic dogs in rural regions of Golestan Province, northeastern Iran. All samples were tested for anti‐Leishmania antibodies using a direct agglutination test (DAT), and for Leishmania spp. kinetoplast DNA (kDNA) using PCR. Results Seven (7%) dogs were antibody positive and 25 dogs (25%) were Leishmania spp. DNA positives by PCR positive for leishmaniasis. Four of the seven (71%) antibody‐positive dogs and 19 of the 25 (76%) PCR‐positive dogs were asymptomatic. The rate of infection detected by PCR was significantly higher in male dogs (21/75, 28%) than that in female dogs (4/25, 16%). The ITS1 PCR‐RFLP assay identified the presence of L. infantum, L. tropica or Crithidia spp. in the 25 PCR‐positive samples. Conclusions The high proportion of asymptomatic dogs in the study areas represent they act as potential reservoirs in the transmission cycle of Leishmania spp. and also Crithidia fasciculata as an emerging agent for the first time. Moreover, our data showed that PCR is a more reliable assay than DAT for detecting Leishmania spp. infection among asymptomatic dogs.

Abstract Objective To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle. Methods In this case‐control study, 15 adult patients with unilateral CAI and 15 healthy controls were studied. Both the unstable and uninjured ankles in patients with unilateral CAI (CAI group, n = 15) were compared with that of healthy individuals (control group, n = 15). Applying body photo‐reflective markers, the participant's motion during gait was measured. Biomechanical variables including overall ankle‐toe angle, linear velocity, linear acceleration, angular velocity, angular acceleration, range of motion (RoM) in dorsiplantar flexion, and inversion‐eversion at initial contact, loading response, mid‐stance, terminal stance, pre‐swing, and swing phase of the gait were measured. Results In patients with CAI, the injured and uninjured ankles were significantly different regarding angle‐toe angle, inversion‐eversion RoM, dorsiplantar flexion in mid‐stance, inversion‐eversion at initial contact and terminal stance as well as the pre‐swing and swing phases (p

Background: Sexual self-concept is an individual's perception of his/her sexual feelings and actions, which can be affected by chronic diseases, including diabetes. As a biological and psychological crisis, diabetes can cause mood changes. The present study was conducted to determine the effects of virtual emotion regulation training on the positive and negative sexual self-concept of diabetic married women. Methods: An interventional study was conducted on women with type 2 diabetes covered by the comprehensive health service centers of Gorgan (Iran) in 2019. Overall, 36 eligible diabetic women were enrolled via available sampling. The subjects were assigned to an intervention group (n=19) and a control group (n=17) through four-block allocation and random selection without placement. Virtual emotion regulation training was held during 4 sessions, once a week, for the intervention group. Both groups completed the Persian version of Beck’s Depression Inventory and Snell’s Multidimensional Sexual Self-Concept Questionnaire at baseline, immediately after the last virtual training session, and one month after the last training session. Data were analyzed using ANOVA and Bonferroni's post hoc test at a significance level of 0.05. Results: The mean score of positive sexual self-concept of patients after the last training session was 133.68 ± 18.91in the intervention and 131.17 ± 18.86 in the control group. The mean score of positive sexual self-concept of patients one month after the training was 10± 9.51in the intervention group and 15.17 ± 11.92in the control group. The mean score of negative sexual self-concept of patients after the last training session was 10.42± 10.04 in the intervention and 14.52± 14.39 in the control group. The interaction effects of time and group on the positive sexual self-concept did not differ significantly (P=0.316). The group effect was also not statistically significant (P=0.58). The interaction effects of time and group on the negative sexual self-concept were significant (P=0.023), and the group effect was not statistically significant (P₌0.47). Conclusion: The significant interaction of time and group on negative sexual self-concept indicates that the negative sexual self-concept in diabetic women has been affected by the intervention. Given the significant effects of virtual emotion regulation training on the management of negative emotions, this type of intervention can be beneficial for improving the health of diabetic women.

Background and Objectives: Most patients experience anxiety during the Extracorporeal Shock Wave Lithotripsy (ESWL). One of the on-pharmacological ways to control anxiety in patients with ESWL is acupressure. This study aims to determine the effect of acupressure on anxiety in older women candidates for ESWL Methods: This randomized controlled clinical trial was conducted on 66 eligible older women candidates for ESWL referred to Ordibehesht Surgical Center in Isfahan, Iran in 2021. They were selected by a continuous sampling method and assigned to the intervention and control groups by the block randomization method. The intervention group received acupressure for 20 minutes, while in the control group, the acupoints were only touched (without applying pressure). Data collection tools were the Spielberger State-Trait Anxiety Inventory and Visual Anxiety Scale, completed 60 minutes before and immediately after the intervention. T-test, chi-square test, and Mann-Whitney U test were used to analyze the data. Results: The two groups were similar in terms of demographic variables. Before the intervention, there was no statistically significant difference between the two groups in anxiety (P> 0.05). After the intervention, the mean severity of anxiety was 3.70±0.77 in the experimental group and 7.36±0.55 in the control group. The mean post-test quality of anxiety was 35.48±5.97 in the intervention group and 61.39±2.42 in the control group. These differences between the two groups were statistically significant (P

The purpose of this study is to determine the status of knowledge management in the titles of specialized doctoral courses in the humanities of higher education. The present study is a type of mixed exploratory research project. Hence, a combination of qualitative and quantitative methods has been used. First, the components of knowledge management were extracted by content analysis method with an inductive approach and based on that, a questionnaire in the form of 9 main components and 44 questions was prepared and provided to the experts. In addition, the checklist was prepared in the form of 442 sub-items. In the content analysis of 2250 specialized courses in 11 humanities disciplines in the doctoral program, 3260 identifiers were extracted. This study showed that knowledge sharing 25.46%, knowledge application 17.48%, knowledge change 12.73%, knowledge creation 11.75%, knowledge identification 9.97%, knowledge organization 7.73%, knowledge development 6.23% knowledge presentation, 4.97%, and knowledge protection obtained 3.68% of the data. In order to prepare graduates as capable future leaders, higher education needs to play a pivotal and effective role in teaching knowledge management to students. Utilizing knowledge management-based curricula facilitates the skills needed to apply and rely on knowledge. Applying standard methods in education and research prepares future managers to present and share knowledge in organizations. Knowledge management promotes a comprehensive approach to identifying, capturing, retrieving, sharing, and evaluating the knowledge capital of organizations.

Oral health problems in patients with chronic renal failure can endanger their systemic health. The aim of this study was to assess the correlation of Decayed, Missing, Filled, Teeth(DMFT) and Glomerular Filtration Rate (GFR).Materials & Methods:In this descriptive-analytical study, using the Shahidieh project conducted on 9000 people from the city of Yazd in 2017 for data collection. The serum creatininelevel, and age, gender and weight of patients were extracted from the questionnaire designed for the Yazd Shahedieh Project after receiving permission. The GFR of each individual was calculated using the Cockcroft Gault formula. For assessment of oral health status, the DMF index of permanent teeth of adults was calculated. The Data analyzed using t-test, ANOVA, Pearson’s correlation coefficient, and regression analysis.Results:Weight was not related to the number of carious teeth but was directly related to the number of filled teeth. Weight was also inversely related to the number of missing teeth and DMFT. Serum creatinine was not related to the number of decayed teeth but was directly related to the number of missing teeth and DMFT. Serum creatinine was inversely related to the number of filled teeth. Age was inversely related to the number of decayed and filled teeth, but was directly related to the number of missing teeth and DMFT. GFR is directly related to the number of decayed and filled teeth, but is inversely related to the number of missing teeth and DMFT. GFR and DMFT index had a significant and inverse relationship.Conclusion:According to the present study the lower GFR index and the higher the serum creatinineand the higher the stage of kidney disease, a direct correlation of a high DMFT index was observed.

Objectives: This research aims to design a structural model of cultural development in public libraries from specialists, librarians, and managers of public libraries' viewpoints in the country.Methods: The current research is exploratory-applied research, which was conductedfield. The research method in terms of data collection method is using the mixedresearch method, which was carried out in a qualitative-quantitative manner. The statistical population in the qualitative part includes specialists in the field of knowledge and information science, philology, and sociology, as well as managers and experts in the field of public libraries, and in the quantitative part, it includes managers and librarians of public librariesin the centers of the province who have sufficient experience and expertise in the domainof public libraries. The research tool included semi-structured interviews and a researcher-made questionnaire, which was designed according to the research objectives and methods. Qualitative interviews and theoretical foundations in the field of research were used to prepare a questionnaire. After distributing the questionnaires, 319 questionnaires were collected and the entire process of research data analysis was done in SPSS statistical software and PLS structural equations.Results: The findings in the qualitative part of the research were categorized through interviews including 10 main categories: access to education, continuing education, cultural identity, literacy of cultural-artistic education, per capita study, cultural health, cultural capital, social capital and national independence, and 19 sub-categories as their subsets. The findings also showed that public libraries have a positive effect on cultural development indicators, i.e. the activities and services of public libraries can lead to an increase in cultural development among the population.Conclusions: The findings in the qualitative part through interviews include 10 main categories: access to education, continuing education, cultural identity, literacy of cultural-artistic education, per capita study, cultural health, cultural capital, social capital, and national independence, and 19 subcategories were classified as their subcategories. Also, the findings showed that public libraries have a positive effect on cultural development indicators, that is, the activities and services of public libraries can lead to an increase in cultural development in society.

Family businesses and their internationalization have attracted increasing attention. Over the years, scholars have attempted to shed light on different characteristics of family firms that support their successful internationalization. In this research, we focus on familiness and investigate how familiness plays a role in the process of internationalization. Familiness refers to competencies and capabilities that are created in family firms because of the interaction between family and business. To answer this question, we have employed a qualitative research method and semi-structured interviews to collect data from seven family businesses from an emerging economy that were operating internationally. Built upon the social capital theory, our findings shed light on how the nature of family relationships in terms of different aspects of cognitive, relational, and structural dimensions facilitate the internationalization of family firms.

Behavioral studies using personal digital devices typically produce rich longitudinal datasets of mixed data types. These data provide information about the behavior of users of these devices in real-time and in the users’ natural environments. Analyzing the data requires multidisciplinary expertise and dedicated software. Currently, no generalizable, device-agnostic, freely-available software exists within Python scientific computing ecosystem to preprocess and analyze such data. This paper introduces a Python package, Niimpy, for analyzing digital behavioral data. The Niimpy toolbox is a user-friendly open-source package that can quickly be expanded and adapted to specific research requirements. The toolbox facilitates the analysis phase by offering tools for preprocessing, extracting features, and exploring the data. It also aims to educate the user on behavioral data analysis and promotes open science practices. Over time, Niimpy will expand with new data analysis features developed by the core group, new users, and developers. Niimpy can help the fast-growing number of researchers with diverse backgrounds who collect data from personal and consumer digital devices to systematically and efficiently analyze the data and extract useful information. This novel information is vital for answering research questions in various fields, from medicine to psychology, sociology, and others.

Abstract Objectives Complete cleaning of temporary cement before permanent cementation of cement‐retained implant‐supported prosthesis (CISP) when recementing the crown is critical. This study evaluated the effect of different cleaning methods for removing traces of temporary cement on the final tensile bond force (TBF) of CISP recemented with resin cement. Materials and Methods Seventy computer‐aided design/computer‐aided manufacturing metal implant‐supported copings were prepared and distributed into seven groups (N = 10). Copings of six groups (60 samples) were cemented with temporary cement with eugenol and subjected to 5000 thermocycling. After debonding by a universal testing machine, the internal surfaces of the copings were cleaned using one of the six following methods: 1‐an ultrasonic water bath (UW), 2‐sandblasting, then washing with water (SW), 3‐sandblasting and an ultrasonic water bath (SUW), 4‐an ultrasonic isopropyl alcohol bath (UA), 5‐sandblasting, then washing with isopropyl alcohol (SA) or 6‐sandblasting and an ultrasonic isopropyl alcohol bath (SUA). Then the subjects were subsequently cemented by dual‐cure self‐adhesive resin cement. In the seventh group (control, N = 10), the copings were cemented by dual‐cure self‐adhesive resin cement without the temporization phase. The TBF was tested using a universal testing machine with a cross‐head speed of 1 mm/min. Two‐way analysis of variance (ANOVA) and post‐hoc Tamhane tests were used for statistical analysis at a significance level of α = .05. Results The maximum mean of TBF value was observed in SUA group (845 ± 203 N), and the minimum was observed in the temporary cement group (49 ± 20 N). All groups which were cleaned with isopropyl alcohol showed significantly higher TBF values compared with those cleaned with water. Conclusions Cleaning of the inner surface of metal copings after debonding with sandblasting and isopropyl alcohol results in the highest value of TBF by eliminating the effect of remaining eugenol and removing traces of temporary cements.

Background and Aim: Cutaneous leishmaniasis (CL) is an important health problem in Iran and one of the world ̛s neglected diseases which is caused by Leishmania spp. The aim of this study was to investigate the epidemiology of cutaneous leishmaniasis and its associated risk factors in an endemic center in Golestan Province. Materials and Methods: This descriptive cross-sectional study included patients with suspected CL who had been referring to the health centers of Gonbad–e Qabus town, between 2018 and 2020. Demographic and epidemiological data of CL patients were recorded and diagnosis of Leishmania spp. was made by Giemsa staining of direct smear. PCR was also used to determine and confirm the parasite species. Results: From 1979 suspected CL lesions, 1704(87.4%) had positive smears. 898 (52.7%) patients were male and 806 (47.3%) were female. The highest incidence rate was observed in the patients of less than 5 (25.93%) and those between 25 and 45 years of age (25.41%). In all samples in this study, Leishmania major was the only Leishmania spp detected by ITS-PCR. Also, Critidia fasciulata was identified in three patients. Conclusion: The study provided valuable data concerning the epidemiologic aspects of the CL in an old endemic focus in north of Iran, which can be used as the basis for planning future control strategies.

Refineries are amongst the most energy-intensive and polluting industries in the world. Biotechnology may serve as an alternative low-cost and environmental-friendly tool to the current costly, toxic and hazardous refining processes. In this study, the compositional redistribution of a heavy hydrocarbon cut is investigated under biological conversion using native microbial consortia. The native consortia were obtained by batch enrichment method applied on oil-polluted soil samples from oil refineries of Iran. The bioconversion experiments were conducted with 20% and 40% (v/v) of the heavy cut as the sole carbon source and 10% (v/v) of the consortia broth in 250 ml flasks containing a mineral medium. The samples kept at 30°C stirring at 120 rpm for one week. The biotreated hydrocarbons were then separated and analyzed for determination of saturate, aromatic and resin fractions using column chromatography and gravimetric measurements. The results showed that the amounts of saturates increased by 6% to 92% while the resins decreased by 10% to 70% in most cases, compared to the blank. The GC-Mass analysis of the saturate fractions also revealed an increase in the cyclic and branched alkanes and a decrease in the S-containing and N-containing compounds.

Background: Adolescents with congenital heart disease (CHD) need lifelong health care. Empowerment in these patients can lead to greater participation in care and self-management skills. The current research is a psychometric study on the empowerment of the adolescents with congenital heart diseases.Methods: This psychometric study was performed on 200 patients with congenital heart disease referred to medical centers and hospitals of Isfahan University of Medical Sciences. The initial 15-item tool of this study was translated into Persian after obtaining permission from the original author. Then the psychometric process of the scale, including the examination of content validity index, content validity ratio with the judgment of 30 experts; and the validity of its structure was performed using heuristic factor analysis. The internal homogeneity of the instrument was determined by Cronbach's alpha coefficient and the reliability test of the instrument was evaluated by the open test method.Findings: The content validity index (CVI) was above 0.8 for each item. According to the results of exploratory factor analysis, none of the shared values was less than 0.5. The results of Pearson correlation test showed a significant positive relationship between the two stages of distributing the questionnaires (P = 0.001). Based on Cronbach's alpha coefficient, the total internal consistency of the scale was obtained 0.725, and 0.73-0.99 for its components.Conclusion: The adolescent empowerment scale for congenital diseases was approved with 15 items. Meanwhile, its reliability and validity were approved, too. So, this scale can be used as a reliable tool for caring for and examining the empowerment of adolescents with congenital diseases.

This paper presents an analytical method for determining the bending stresses and deformations in prismatic, noncircular profile shafts with trochoidal cross sections. The so-called higher trochoids can be used as form-fit shaft-hub connections. Hybrid (mixed) higher trochoids (M-profiles) were developed for the special application as a profile contour for the form-fit shaft and hub connections in an earlier work by the author. M-profiles combine the advantages of the two standardised polygonal and spline contours, which are used as shaft-hub connections for the transmission of high torques. In this study, the geometric and mechanical properties of the higher hybrid trochoids were investigated using complex functions to simplify the calculations. The pure bending stress and shaft deflection were determined for M-profiles using bending theory based on the theory of mathematical elasticity. The loading cases consisted of static and rotating bends. Analytical, numerical, and experimental results agreed well. The calculation formulas developed in this work enable reliable and low-cost dimensioning with regard to the stresses and elastic deformations of profile shafts subjected to bending loads.

In this research, reliability indicators of water distribution networks were evaluated under pipe failure conditions. The case studies included two benchmark networks and one real-life water distribution network in Iran with more hydraulic constraints. Some important reliability indicators were presented, such as resilience index, network resilience, modified resilience index, and minimum surplus head index. GANetXL was used to do the one-objective and two-objective optimization of the previously mentioned water distribution networks in order to not only minimize the cost but also maximize the reliability indicators. Moreover, the results of a statistical analysis for each pipe were used to determine the sensitive pipes that were of the most failure probability. GANetXL is an optimization tool in the Microsoft Excel environment and works based on a genetic algorithm. GANetXL has the capability of being linked to EPANET (hydraulic simulation software). The results obtained clearly showed that network resilience index was poor performance when compared with the other indexes under pipe failure conditions, especially in real-life networks that include small pipe diameters. It was also showed that if a water distribution network was optimized only in terms of cost, then there would be an unacceptable pressure drop at some nodes in case of pipe failure.

Abstract Background Coronavirus disease 2019 is an infectious disease with many presentations, and many of its effects on the human body are still unknown. Pheochromocytoma is a neuroendocrine tumor that may occur sporadically or be a manifestation of a hereditary disease line multiple endocrine neoplasia type 2. Case presentation In this study, we report a case of an Iranian patient infected with coronavirus disease 2019, causing unusual presentations of pheochromocytoma, including myocarditis and cerebrovascular involvement. Conclusions We discovered a case of pheochromocytoma as an unusual presentation of COVID-19. In further investigations we also discovered thyroid medullary carcinoma and at the end MEN 2 syndrome was diagnosed. After proper treatment many symptoms were eliminated.

Achieving the rate and the amount of mass transfer is of paramount importance in selecting optimum conditions for drying and affects the development of the quality of drying. Note that, to obtain the amount of mass transfer, the conditions of mass transfer such as temperature, pressure, geometry, and diffusion coefficient should be completely determined. In this research, an experiment is conducted in atmospheric conditions and then the amount of mass flow in a spherical body is measured. Utilizing the Newman equation and the experimental results, the diffusion coefficient is found to be in the range of 10-11 m2/s. Additionally, the experimental data reveal the linear and exponential variation of diffusion coefficient with a constant coefficient of 1306.8 and exponent of 2.0883 which is against size and time. Results show that findings are in considerably high agreement with the experimental data.

Wastewater treatment unit in an oil refinery is one of the main emission sources of volatile organic compounds and exposure to these pollutants has major negative impacts on refinery staff and residents of adjacent areas. The purpose of this study is to investigate the concentration of volatile organic compounds in refinery effluents and to estimate the emission of these compounds into the air. Concentration and pollution load of volatile organic compounds in operating units and basins of treatment unit wastewater were analyzed using gas chromatography and emission estimation of them was done using the Rank 2 and Rank 3 of the US Environmental Protection Agency. The pollution received by wastewater plant was 1095 ton/y of five components: benzene, toluene, xylene, ethyl benzene and hexane, while 5379 ton/y for the eleven pollutants including previous five components plus pentane, heptane, methyl cyclohexane, 1-2-4 tri-methylbenzene, 1-3-5 tri-methylbenzene and dodecane. Based on refinery feed, for each ton of crude oil processed, 187 g of the total 5 compounds and 692 g of 11 compounds are produced from operational units; but only 78% of the 11 compounds and 60% of the 5 compounds could reach the treatment unit, which indicates the emission of pollutants in the transfer path. Overall, for each ton of processed crude oil, 48.5 g of 5 compounds and 241.6 g of 11 compounds from effluent treatment ponds are emitted to the atmosphere. Identifying the sources of volatile organic compounds production is one of the ways to reduce the pollution load entering the treatment unit and thus reduces the emission from the refinery. Based on these results, refineries could apply proper strategies for emission decrease. This research has been done for a refinery with ten megatons capacity per year and medium complexity, which could be used by any analogous refinery in the world.